WorldWideScience

Sample records for winnipeg regional health

  1. Regional tree growth and inferred summer climate in the Winnipeg River basin, Canada, since AD 1783

    Science.gov (United States)

    St. George, Scott; Meko, David M.; Evans, Michael N.

    2008-09-01

    A network of 54 ring-width chronologies is used to estimate changes in summer climate within the Winnipeg River basin, Canada, since AD 1783. The basin drains parts of northwestern Ontario, northern Minnesota and southeastern Manitoba, and is a key area for hydroelectric power production. Most chronologies were developed from Pinus resinosa and P. strobus, with a limited number of Thuja occidentalis, Picea glauca and Pinus banksiana. The dominant pattern of regional tree growth can be recovered using only the nine longest chronologies, and is not affected by the method used to remove variability related to age or stand dynamics from individual trees. Tree growth is significantly, but weakly, correlated with both temperature (negatively) and precipitation (positively) during summer. Simulated ring-width chronologies produced by a process model of tree-ring growth exhibit similar relationships with summer climate. High and low growth across the region is associated with cool/wet and warm/dry summers, respectively; this relationship is supported by comparisons with archival records from early 19th century fur-trading posts. The tree-ring record indicates that summer droughts were more persistent in the 19th and late 18th century, but there is no evidence that drought was more extreme prior to the onset of direct monitoring.

  2. Choking Lake Winnipeg

    Science.gov (United States)

    Byrne, J. M.; Little, L. J.; Dodgson, K. A.; MacDonald, R. J.; Graham, J.

    2009-12-01

    The problems of waterway eutrophication and coastal zone hypoxia are reaching epidemic proportions. Fresh water and coastal marine environments around the world are suffering unprecedented pollution loadings. We are developing an education program to address the dramatic need for public, community and K-12 education about the harsh impacts of elevated nutrient loads on fresh and marine water environments. The Lake Winnipeg watershed is adopted as the poster child of fresh water eutrophication in western North America. The watershed, one of the largest on the continent, is in rapid decline due to pollution, population pressures and water diversion. A concerted education program is needed to change personal and society actions that negatively impact the Winnipeg watershed; and the confluence of the watershed - Lake Winnipeg. But the education program goes beyond Lake Winnipeg. Negative impacts of nutrient loads are adversely affecting environments right to the oceans. Major dead zones that are expanding on our continental shelves due to nutrient overloading threaten to coalesce into extensive regions of marine life die-off. This presentation outlines the documentary education production process under development. We are building a series of Public Service Announcements (PSAs) for national television networks. The PSAs will direct educators, stakeholders and citizens to an associated website with educational video clips detailing the issues of eutrophication and hypoxia. The video clips or webisodes, present interviews with leading scientists. The discussions address the causes of the problems, and presents workable solutions to nutrient overloads from a variety of sources. The webisodes are accompanied by notes and advice to teachers on ways and means to use the webisodes in classrooms. The project is fully funed by a group of Canadian Community Foundations, with the understanding the work wil be available free to educators anywhere in the world. Our education

  3. Personality differences between users of wine, beer and spirits in a community sample: the Winnipeg Health and Drinking Survey.

    Science.gov (United States)

    McGregor, Darcy; Murray, Robert P; Barnes, Gordon E

    2003-09-01

    To date there are many studies describing the protective and risk factors associated with alcohol consumption and cardiovascular health (the U- or J-shaped curve). These studies have only accounted for part of the effects. One hypothesis is that personality differences may account for some of the unexplained variance. It is also unclear if wine, beer and distilled spirits have equivalent effects on health. The purpose of this study is to describe the differences in personality among users of wine, beer and spirits. Data were from a community sample of 1,257 men and women in Winnipeg, Manitoba, Canada, that was first enrolled in 1989-90. We examined and compared the demographic and personality characteristics of wine, beer and spirits drinkers in this sample. The groups differed significantly on the dimensions of extraversion, psychoticism and reducer-augmenter in univariate tests. In multivariate models, for the total sample and for females, predominant drinking of wine was associated with low scores on the Vando scale (augmenters). Higher consumption of beer among males was associated with higher levels of neuroticism. In these instances, personality does contribute to the characterization of groups.

  4. Organic coolant in Winnipeg riverbed sediments

    International Nuclear Information System (INIS)

    Guthrie, J.E.; Acres, O.E.

    1979-03-01

    Between January and May 1977 a prolonged leak of organic coolant occurred from the Whiteshell Nuclear Research Establishment's nuclear reactor, and a minimum of 1450 kg of coolant entered the Winnipeg River and was deposited on the riverbed. The level of radioactivity associated with this coolant was low, contributing less than 0.2 μGy (0.02 mrad) a year to the natural background gamma radiation field from the riverbed. The concentration of coolant in the water samples never exceeded 0.02 mg/L, the lower limit of detection. The mortality of crayfish, held in cages where the riverbed was covered with the largest deposits of coolant, was not significantly different from that in the control cages upstream of the outfall. No evidence of fish kill was found. (author)

  5. Therapeutic landscapes of home: Exploring Indigenous peoples' experiences of a Housing First intervention in Winnipeg.

    Science.gov (United States)

    Alaazi, Dominic A; Masuda, Jeffrey R; Evans, Joshua; Distasio, Jino

    2015-12-01

    In this paper, we explore Indigenous perspectives of culture, place, and health among participants in a landmark Canadian Housing First initiative: At Home/Chez Soi (AHCS) project. Implemented from 2009 to 2013 in Winnipeg and four other Canadian cities, AHCS was a multi-city randomized control trial that sought to test the effectiveness of Housing First as a model for addressing chronic homelessness among people living with mental illnesses. As Winnipeg's homeless population is over 70% Indigenous, significant efforts were made to accommodate the culturally specific health, spiritual, and lifestyle preferences of the project's Indigenous participants. While a daunting challenge from an intervention perspective, Winnipeg's experience also provides a unique opportunity to examine how Indigenous participants' experiences can inform improved housing and mental health policy in Canada. In our study, conducted independently from, but with endorsement of the AHCS project, we utilized a case study approach to explore the experiences of the project's Indigenous participants. Data were collected by means of in-depth qualitative interviews with Indigenous participants (N = 14) and key informant project staff and investigators (N = 6). Our exploratory work demonstrates that despite relative satisfaction with the AHCS intervention, Indigenous peoples' sense of place in the city remains largely disconnected from their housing experiences. We found that structural factors, particularly the shortage of affordable housing and systemic erasure of Indigeneity from the urban sociocultural and political landscape, have adversely impacted Indigenous peoples' sense of place and home. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Influenza 1918 : disease, death, and struggle in Winnipeg

    National Research Council Canada - National Science Library

    Jones, Esylt W

    2007-01-01

    ... communities within the city, including its role in the eruption of the largest labour confrontation in Canadian history, the Winnipeg General Strike of 1919. Arguing that labour historians have largely ignored the impact of infectious disease upon the working class, Jones draws on a wide range of primary sources including mothers' allowance and orphanage case fi...

  7. Influenza 1918: disease, death and struggle in Winnipeg

    National Research Council Canada - National Science Library

    Jones, Esyllt Wynne

    2007-01-01

    ... communities within the city, including its role in the eruption of the largest labour confrontation in Canadian history, the Winnipeg General Strike of 1919. Arguing that labour historians have largely ignored the impact of infectious disease upon the working class, Jones draws on a wide range of primary sources including mothers' allowance and orphanage case fi...

  8. 6th Krakow-Winnipeg Conference on Advanced Bioimaging Technologies

    International Nuclear Information System (INIS)

    2011-09-01

    Starting from 1997 researchers have been meet in Krakow, Poland for the Krakow-Winnipeg conference on MRI. The scope of the conference includes the latest technical advances in biomedical imaging including molecular imaging and nanotechnology. Other topics for presentation include recent developments in whole body MRI, multi-transmit technology and gradient-free MRI. Book of Abstracts from the 6 th Conference contains 29 abstracts of Oral Presentations and 11 abstracts of Posters.

  9. Food deserts in Winnipeg, Canada: a novel method for measuring a complex and contested construct

    Directory of Open Access Journals (Sweden)

    Joyce Slater

    2017-10-01

    Full Text Available Introduction: "Food deserts" have emerged over the past 20 years as spaces of concern for communities, public health authorities and researchers because of their potential negative impact on dietary quality and subsequent health outcomes. Food deserts are residential geographic spaces, typically in urban settings, where low-income residents have limited or no access to retail food establishments with sufficient variety at affordable cost. Research on food deserts presents methodological challenges including retail food store identification and classification, identification of low-income populations, and transportation and proximity metrics. Furthermore, the complex methods often used in food desert research can be difficult to reproduce and communicate to key stakeholders. To address these challenges, this study sought to demonstrate the feasibility of implementing a simple and reproducible method of identifying food deserts using data easily available in the Canadian context. Methods: This study was conducted in Winnipeg, Canada in 2014. Food retail establishments were identified from Yellow Pages and verified by public health dietitians. We calculated two scenarios of food deserts based on location of the lowest-income quintile population: (a living ≥ 500 m from a national chain grocery store, or (b living ≥ 500 m from a national chain grocery store or a full-service grocery store. Results: The number of low-income residents living in a food desert ranged from 64 574 to 104 335, depending on the scenario used. Conclusion: This study shows that food deserts affect a significant proportion of the Winnipeg population, and while concentrated in the urban core, exist in suburban neighbourhoods also. The methods utilized represent an accessible and transparent, reproducible process for identifying food deserts. These methods can be used for costeffective, periodic surveillance and meaningful engagement with communities, retailers and policy

  10. Barriers, motivators and facilitators related to prenatal care utilization among inner-city women in Winnipeg, Canada: a case–control study

    OpenAIRE

    Heaman, Maureen I; Moffatt, Michael; Elliott, Lawrence; Sword, Wendy; Helewa, Michael E; Morris, Heather; Gregory, Patricia; Tjaden, Lynda; Cook, Catherine

    2014-01-01

    Background The reasons why women do not obtain prenatal care even when it is available and accessible are complex. Despite Canada’s universally funded health care system, use of prenatal care varies widely across neighborhoods in Winnipeg, Manitoba, with the highest rates of inadequate prenatal care found in eight inner-city neighborhoods. The purpose of this study was to identify barriers, motivators and facilitators related to use of prenatal care among women living in these inner-city neig...

  11. Immigrant families in historical perspective: the experiences of Polish pioneers in Winnipeg, 1896-1919

    OpenAIRE

    ŁUKASZ ALBAŃSKI

    2017-01-01

    This paper focuses on an early Polish family life in Winnipeg. The family often served as a mechanism to reduce a sense of dislocation and to facilitate immigrants' adaptation. The family was also the primary economic unit. The family relations were affected by gender. Both immigrant men and women found themselves reconsidering traditional roles. Somehow immigration tested their family roles in newways.

  12. The French Regions and Their Social Health

    Science.gov (United States)

    Jany-Catrice, Florence

    2009-01-01

    In this article, a new indicator designed to capture the multidimensionality of the social health of the French regions is put to the test. Drawing on regional data for 2004, this indicator of social health (ISH) sheds new light on the social performance of the French regions. The worst performers are the highly urbanised regions, whereas others,…

  13. 'I'm more aware of my HIV risk than anything else': syndemics of syphilis and HIV among gay men in Winnipeg.

    Science.gov (United States)

    Yu, Dorothy; Hatala, Andrew R; Reimer, Joss; Lorway, Rob

    2017-12-22

    Despite decreased rates of HIV infection in Winnipeg, syphilis incidence continues to rise. Communities of men who have sex with men shoulder much of this burden of illness. This qualitative study aimed to better understand the co-evolution of HIV and syphilis in Winnipeg through a series of interviews with gay men. Eighteen individuals were recruited through advertising in sexual health centres and through subsequent snowball sampling. Thematic interpretive analysis and inductive reasoning were used to find individual and shared group meanings. We found that HIV formed the contextual ground on which sexual decision-making was made, with three main themes emerging during interviews: 1) bacterial STI transience being contrasted against HIV permanence; 2) syphilis being 'dirty' versus HIV carrying significant stigma, though being spared the label of uncleanliness; and 3) the role of pleasure and intimacy in sexual health decision-making. Based on these findings, we recommend further exploration to develop more effective strategies around syphilis prevention, in particular with regards to the longer-term illness ramifications and its relationship to HIV transmission.

  14. Immigrant families in historical perspective: the experiences of Polish pioneers in Winnipeg, 1896-1919

    Directory of Open Access Journals (Sweden)

    ŁUKASZ ALBAŃSKI

    2017-10-01

    Full Text Available This paper focuses on an early Polish family life in Winnipeg. The family often served as a mechanism to reduce a sense of dislocation and to facilitate immigrants' adaptation. The family was also the primary economic unit. The family relations were affected by gender. Both immigrant men and women found themselves reconsidering traditional roles. Somehow immigration tested their family roles in newways.

  15. 6{sup th} Krakow-Winnipeg Conference on Advanced Bioimaging Technologies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-09-15

    Starting from 1997 researchers have been meet in Krakow, Poland for the Krakow-Winnipeg conference on MRI. The scope of the conference includes the latest technical advances in biomedical imaging including molecular imaging and nanotechnology. Other topics for presentation include recent developments in whole body MRI, multi-transmit technology and gradient-free MRI. Book of Abstracts from the 6{sup th} Conference contains 29 abstracts of Oral Presentations and 11 abstracts of Posters.

  16. Regional governance: strategies and disputes in health region management

    Directory of Open Access Journals (Sweden)

    Adriano Maia dos Santos

    2014-08-01

    Full Text Available OBJECTIVE To analyze the regional governance of the health systemin relation to management strategies and disputes. METHODOLOGICAL PROCEDURES A qualitative study with health managers from 19 municipalities in the health region of Bahia, Northeastern Brazil. Data were drawn from 17 semi-structured interviews of state, regional, and municipal health policymakers and managers; a focus group; observations of the regional interagency committee; and documents in 2012. The political-institutional and the organizational components were analyzed in the light of dialectical hermeneutics. RESULTS The regional interagency committee is the chief regional governance strategy/component and functions as a strategic tool for strengthening governance. It brings together a diversity of members responsible for decision making in the healthcare territories, who need to negotiate the allocation of funding and the distribution of facilities for common use in the region. The high turnover of health secretaries, their lack of autonomy from the local executive decisions, inadequate technical training to exercise their function, and the influence of party politics on decision making stand as obstacles to the regional interagency committee’s permeability to social demands. Funding is insufficient to enable the fulfillment of the officially integrated agreed-upon program or to boost public supply by the system, requiring that public managers procure services from the private market at values higher than the national health service price schedule (Brazilian Unified Health System Table. The study determined that “facilitators” under contract to health departments accelerated access to specialized (diagnostic, therapeutic and/or surgical services in other municipalities by direct payment to physicians for procedure costs already covered by the Brazilian Unified Health System. CONCLUSIONS The characteristics identified a regionalized system with a conflictive pattern of

  17. Determinants of health disparities between Italian regions

    Directory of Open Access Journals (Sweden)

    Giannoni Margherita

    2010-06-01

    Full Text Available Abstract Background Among European countries, Italy is one of the countries where regional health disparities contribute substantially to socioeconomic health disparities. In this paper, we report on regional differences in self-reported poor health and explore possible determinants at the individual and regional levels in Italy. Methods We use data from the "Indagine Multiscopo sulle Famiglie", a survey of aspects of everyday life in the Italian population, to estimate multilevel logistic regressions that model poor self-reported health as a function of individual and regional socioeconomic factors. Next we use the causal step approach to test if living conditions, healthcare characteristics, social isolation, and health behaviors at the regional level mediate the relationship between regional socioeconomic factors and self-rated health. Results We find that residents living in regions with more poverty, more unemployment, and more income inequality are more likely to report poor health and that poor living conditions and private share of healthcare expenditures at the regional level mediate socioeconomic disparities in self-rated health among Italian regions. Conclusion The implications are that regional contexts matter and that regional policies in Italy have the potential to reduce health disparities by implementing interventions aimed at improving living conditions and access to quality healthcare.

  18. Evaluation of a medication order writing standards policy in a regional health authority

    Science.gov (United States)

    Raymond, Colette B.; Coates, Jan; Woloschuk, Donna M. M.

    2013-01-01

    Background: The Winnipeg Regional Health Authority (WRHA) implemented a medication order writing standards (MOWS) policy (including banned abbreviations) to improve patient safety. Widespread educational campaigns and direct prescriber feedback were implemented. Methods: We audited orders within the WRHA from 2005 to 2009 and surveyed all WRHA staff in 2011 about the policy and suggestions for improving education and compliance. Results: Overall, orders containing banned abbreviations, acronyms or symbols numbered 2261/8565 (26.4%) preimplementation. After WRHA-wide didactic education, the proportion declined to 1358/5461 (24.9%) (p = 0.043) and then, with targeted prescriber feedback, to 1186/6198 (19.1%) (p < 0.0001). A survey of 723 employees showed frequent violations of the MOWS, despite widespread knowledge of the policy. Respondents supported ongoing efforts to enforce the policy within the WRHA. Nonprescribers were significantly more likely than prescribers to agree with statements regarding enhancing compliance by defining prescriber/transcriber responsibilities and placing sanctions on noncompliant prescribers. Discussion: Education, raising general awareness and targeted feedback to prescribers alone are insufficient to ensure compliance with MOWS policies. WRHA staff supported ongoing communication, improved tools such as compliant preprinted orders and reporting and feedback about medication incidents. A surprising number of respondents supported placing sanctions on noncompliant prescribers. Conclusion: Serial audits and targeted interventions such as direct prescriber feedback improve prescription quality in inpatient hospital settings. Education plus direct prescriber feedback had a greater impact than education alone on improving compliance with a MOWS policy. Future efforts at the WRHA to improve compliance will require an expanded focus on incentives, resources and development of action plans that involve all affected staff, not just prescribers

  19. Health Concerns in the Amazon Region

    Centers for Disease Control (CDC) Podcasts

    Residents of the Amazon region of South America contend with a number of health threats - from mosquito-borne diseases to difficulty accessing doctors and healthcare facilities in such a vast area. This podcast helps explore some of the health issues in the region and what's being done to address them.

  20. Mercosur's regional health agenda: architecture and themes

    Directory of Open Access Journals (Sweden)

    Luisa Guimaraes Queiroz

    Full Text Available This article describes the shaping of institutional health spaces in the Mercosur, with analysis of themes and results and considerations on the construction of the regional agenda and on the effects of regional economic integration processes on health policies and systems. We discuss the organization, operation, focus topics, and results achieved in specific health forums (Meeting of Ministers of Health and Sub-Working Group 11, seeking to analyze the architecture and issues addressed by the regional agenda and drawing parallels with the European experience. The aim of this reflection is to identify how the work done by Mercosur structures contributes to building a regional agenda, with the expectation that the integration can contribute to reducing inequalities in access to health care in the region.

  1. Veneto Region, Italy. Health system review.

    Science.gov (United States)

    Toniolo, Franco; Mantoan, Domenico; Maresso, Anna

    2012-01-01

    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. This HiT is one of the first to be written on a subnational level of government and focuses on the Veneto Region of northern Italy. 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 Veneto Region is one of Italy's richest regions and the health of its resident population compares favourably with other regions in Italy. Life expectancy for both men and women, now at 79.1 and 85.2 years, respectively, is slightly higher than the national average, while mortality rates are comparable to national ones. The major causes of death are tumours and cardiovascular diseases. Under Italy's National Health Service, the organization and provision of health care is a regional responsibility and regions must provide a nationally defined (with regional input) basic health benefit package to all of their citizens; extra services may be provided if budgets allow. Health care is mainly financed by earmarked central and regional taxes, with regions receiving their allocated share of resources from the National Health Fund. Historically, health budget deficits have been a major problem in most Italian regions, but since the early 2000s the introduction of efficiency measures and tighter procedures on financial management have contributed to a significant decrease in the Veneto Regions health budget deficit.The health system is governed by the Veneto Region government (Giunta) via the Departments of Health and Social Services, which receive technical support from a single General Management Secretariat. Health care is

  2. THE 'FROZEN' HEART OF THE CONTINENT: PLACE-BRANDING WINNIPEG IN CANADIAN CRIME FILMS

    Directory of Open Access Journals (Sweden)

    James Gacek

    2016-08-01

    Full Text Available Brands play an imperative role when representing places, as culture and the people who live and create it are at the core of the brand. Aside from promoting experiences and destinations, place brands enhance culture and identity, and orchestrate space and atmosphere to create a particular ambiance in which societies are immersed. Over the past century, the representation of Canada in fictional film has generally emphasized its northerly location, its imagined wilderness landscape, and inevitably, its harsh winter climate. For films that focus on crime, justice is frequently imagined along the lines of the cinematic western, with frontier lawmen bringing order and the reach of the state to remote frontier outposts. For much of the twentieth century, this cultural depiction of Winnipeg justice remained frozen and unchallenged. However, beginning in the latter decades of the twentieth century, a growing number of independent Canadian crime films have taken up these familiar Hollywood tropes in ways that reflect, refract, and sometimes challenge the dominant construction of crime and justice. I examine how these films construct crime and the places that foster crime by emphasizing aspects of racialized identity, class, and the branding dynamics of the city of Winnipeg. Far from the rugged northwest of mid-century Hollywood cinema, crime is relocated to the contemporary city, and while still shaped by the endless Canadian winter, justice is frequently fraught, and the power of law and order distant and unable to extend the civilizing effects of the state to these new urban frontiers.

  3. Health regionalization in Amazonas: progress and challenges.

    Science.gov (United States)

    Garnelo, Luiza; Sousa, Amandia Braga Lima; Silva, Clayton de Oliveira da

    2017-04-01

    This paper analyses the health services regionalization process in the State of Amazonas through a case study covering the health sub-region Manaus Surroundings. This is a qualitative, descriptive and analytical research, which data were collected using interviews, documents and Internet reviews, oriented by the guiding concept of health regionalization. Study findings revealed a social setting dominated by asymmetry, verticality, competitiveness and fragile multilateral relations among municipalities, associated to a bureaucratic profile of local institutions operating in the region under study. The political agents have limited acknowledgement of the sociopolitical and institutional conditions in which they operate. They usually impute healthcare networks' management and operational issues to the natural and geographical characteristics of the Amazon region, but their financing, governance and technical capacity are insufficient to overcome them.

  4. Health Concerns in the Amazon Region

    Centers for Disease Control (CDC) Podcasts

    2009-04-09

    Residents of the Amazon region of South America contend with a number of health threats - from mosquito-borne diseases to difficulty accessing doctors and healthcare facilities in such a vast area. This podcast helps explore some of the health issues in the region and what's being done to address them.  Created: 4/9/2009 by Emerging Infectious Diseases.   Date Released: 4/9/2009.

  5. Newborns health in the Danube Region

    DEFF Research Database (Denmark)

    Andersen, Zorana J; Sram, Radim J; Ščasný, Milan

    2016-01-01

    risks, and knowledge gaps in the Danube Region, based on publicly available databases, registers, and literature, as a rationale and incentive for a new integrated project. The review also proposes the concept for the project aiming to characterize in utero exposures to multiple environmental factors....... Estimating the burden of environmental exposures on early-life health is a growing research area in Europe which has major public health implications, but the data from the Danube Region are largely missing. AIM: This review presents an inventory of current environmental challenges, related early-life health...... and estimate their effect on early-life health, evaluate economic impact, as well as identify interventions with a potential to harness social norms to reduce emissions, exposures and health risks in the Danube Region. METHODS: Experts in environmental epidemiology, human biomonitoring and social science...

  6. Riel Converter Station, Winnipeg: Site selection and environmental assessment status report

    International Nuclear Information System (INIS)

    1991-01-01

    As part of its expansion plans, Manitoba Hydro is planning to construct a converter station east of Winnipeg to receive power from a 850-km dc transmission line which will be constructed to bring power from a new generating station in the north of the province. Work performed to date on site selection and preliminary environmental assessment of the converter station is reviewed. The role of the converter station is described and the potential impacts are summarized in such areas as employment opportunities, pollution and noise during construction, electric and magnetic field effects, and land use impacts. Site selection criteria are outlined and potential sites are identified and evaluated. The Deacon site has been chosen as the preferred site since it has a number of inherent advantages including existing ownership by Manitoba Hydro, proximity to existing transmission rights-of-way, and low visual and land-use impact. 12 figs

  7. 13th North American Caribou Workshop, 25-28 October 2010, Winnipeg, Manitoba, Canada.

    Directory of Open Access Journals (Sweden)

    Rolf Egil Haugerud (editor in chief

    2012-03-01

    Full Text Available The 13th North American Caribou Workshop which was held in Winnipeg, Manitoba, was a great success with more than 400 participants: people from Canada, the United States, Norway and Greenland, representatives from co-management and resource management boards across North America, First Nations, Inuit and Inuvialuit, governmental and non-governmental organisations, private companies, researchers, students and youth. The theme of the Workshop was Sustaining Caribou and their Landscapes – Knowledge to Action and the intent of the organizers was twofold: first, to provide participants with the opportunity to share scientific and traditional knowledge on different subspecies and ecotypes of Rangifer across the circumpolar North, the particularities of the different landscapes and land use management issues; second, to explore innovative ways to transfer knowledge to action, ensuring the long-term persistence of Rangifer throughout its range through the development of better governance structures, sound policies and effective communication.

  8. Physicians’ circularity in health regions in Brazil

    Directory of Open Access Journals (Sweden)

    Paulo Henrique Seixas

    Full Text Available Abstract Objectives: to characterize the medical circularity in Brazil and to discuss the case in the North and South Barretos regions, São Paulo. Methods: a cross-sectional study using secondary data from the national registrations and a case study of physician’s sample in the North-Barretos and South-Barretos regions. Results: in the health regions in Brazil, on an average, 45% of the physicians in activities circulate in more than one region. The Capitals of the States have more stable physicians while more than 50% of the medical workforce work in other regions. The professionals with the greatest tendency to move from one work place to another are those who work in surgical specialties in services to uphold the diagnostic and therapy. Conclusions: there is a high circulation of physicians among the regions, with distinct characteristics between geographical and health regions. In case of Barretos area, the professionals move from one workplace to another according to their professional association and specialized practice.

  9. Rodzina imigrancka z perspektywy historycznej: doświadczenia polskich pionierów w Winnipeg, 1896-1919

    OpenAIRE

    ALBAŃSKI, ŁUKASZ

    2011-01-01

    This paper focuses on an early Polish family life in Winnipeg. The family often served as a mechanism to reduce a sense of dislocation and to facilitate immigrants' adaptation. The family was also the primary economic unit. The family relations were affected by gender. Both immigrant men and women found themselves reconsidering traditional roles. Somehow immigration tested their family roles in newways. Ewa Jurczyk-Romanowska

  10. A 1000-year record of dry conditions in the eastern Canadian prairies reconstructed from oxygen and carbon isotope measurements on Lake Winnipeg sediment organics

    Science.gov (United States)

    Buhay, W.M.; Simpson, S.; Thorleifson, H.; Lewis, M.; King, J.; Telka, A.; Wilkinson, Philip M.; Babb, J.; Timsic, S.; Bailey, D.

    2009-01-01

    A short sediment core (162 cm), covering the period AD 920-1999, was sampled from the south basin of Lake Winnipeg for a suite of multi-proxy analyses leading towards a detailed characterisation of the recent millennial lake environment and hydroclimate of southern Manitoba, Canada. Information on the frequency and duration of major dry periods in southern Manitoba, in light of the changes that are likely to occur as a result of an increasingly warming atmosphere, is of specific interest in this study. Intervals of relatively enriched lake sediment cellulose oxygen isotope values (??18Ocellulose) were found to occur from AD 1180 to 1230 (error range: AD 1104-1231 to 1160-1280), 1610-1640 (error range: AD 1571-1634 to 1603-1662), 1670-1720 (error range: AD 1643-1697 to 1692-1738) and 1750-1780 (error range: AD 1724-1766 to 1756-1794). Regional water balance, inferred from calculated Lake Winnipeg water oxygen isotope values (??18Oinf-lw), suggest that the ratio of lake evaporation to catchment input may have been 25-40% higher during these isotopically distinct periods. Associated with the enriched d??18Ocellulose intervals are some depleted carbon isotope values associated with more abundantly preserved sediment organic matter (d??13COM). These suggest reduced microbial oxidation of terrestrially derived organic matter and/or subdued lake productivity during periods of minimised input of nutrients from the catchment area. With reference to other corroborating evidence, it is suggested that the AD 1180-1230, 1610-1640, 1670-1720 and 1750-1780 intervals represent four distinctly drier periods (droughts) in southern Manitoba, Canada. Additionally, lower-magnitude and duration dry periods may have also occurred from 1320 to 1340 (error range: AD 1257-1363), 1530-1540 (error range: AD 1490-1565 to 1498-1572) and 1570-1580 (error range: AD 1531-1599 to 1539-1606). ?? 2009 John Wiley & Sons, Ltd.

  11. Theoretical reflections on governance in health regions.

    Science.gov (United States)

    Bretas, Nilo; Shimizu, Helena Eri

    2017-04-01

    This article analyzes governance in health regions, through the contributions of two studies: one on a governance model and the other on duties in the management of public policies networks. The former conducted a meta-analysis of 137 case studies in the literature on collaborative governance aimed at preparing an explanatory and analytical model. Authors identified critical variables that will influence the results: a previous history of conflict or cooperation, incentives for participation, power imbalances, leadership and institutional design. They also identified key factors: face-to-face dialogue, trust building and development of commitment and shared vision. The latter study examined networks of public policies in the analytic tradition and the perspective of governance, incorporating concepts from the field of political science, economics and interorganizational relations, in order to support the management of public policies networks. The study identified network management as equivalent to a strategic game involving functions: network activation, framework of relations, intermediation, facilitation and consensus building and mediation and arbitration. The combination of the two reflections provides a conceptual reference for better understanding of governance in health regions.

  12. Nutrient delivery to Lake Winnipeg from the Red-Assiniboine River Basin – A binational application of the SPARROW model

    Science.gov (United States)

    Benoy, Glenn A; Jenkinson, R. Wayne; Robertson, Dale M.; Saad, David A.

    2016-01-01

    Excessive phosphorus (TP) and nitrogen (TN) inputs from the Red–Assiniboine River Basin (RARB) have been linked to eutrophication of Lake Winnipeg; therefore, it is important for the management of water resources to understand where and from what sources these nutrients originate. The RARB straddles the Canada–United States border and includes portions of two provinces and three states. This study represents the first binationally focused application of SPAtially Referenced Regressions on Watershed attributes (SPARROW) models to estimate loads and sources of TP and TN by jurisdiction and basin at multiple spatial scales. Major hurdles overcome to develop these models included: (1) harmonization of geospatial data sets, particularly construction of a contiguous stream network; and (2) use of novel calibration steps to accommodate limitations in spatial variability across the model extent and in the number of calibration sites. Using nutrient inputs for a 2002 base year, a RARB TP SPARROW model was calibrated that included inputs from agriculture, forests and wetlands, wastewater treatment plants (WWTPs) and stream channels, and a TN model was calibrated that included inputs from agriculture, WWTPs and atmospheric deposition. At the RARB outlet, downstream from Winnipeg, Manitoba, the majority of the delivered TP and TN came from the Red River Basin (90%), followed by the Upper Assiniboine River and Souris River basins. Agriculture was the single most important TP and TN source for each major basin, province and state. In general, stream channels (historically deposited nutrients and from bank erosion) were the second most important source of TP. Performance metrics for the RARB SPARROW model are similarly robust compared to other, larger US SPARROW models making it a potentially useful tool to address questions of where nutrients originate and their relative contributions to loads delivered to Lake Winnipeg.

  13. Inequalities in health: approaches by health authorities in an English health region.

    Science.gov (United States)

    McCarron, P; Yates, B

    2000-06-01

    In 1995 the Department of Health published Variations in health: what can the Department of Health do? This recommended that health authorities should have a comprehensive plan for identifying and tackling variations in health. We investigated how health authorities in the South and West Region were taking forward this work. Semi-structured interviews and reviews of documentation were conducted in all health authorities in the South and West Region of England. All health authorities viewed tackling inequalities in health as important; however, explicit strategies did not exist and Health of the Nation targets were a vehicle for determining priorities of inequalities. Explicit corporate commitment was often weak. Analyses were being conducted to determine the magnitude of local health inequalities and to assist in designing appropriate interventions. The importance of alliance working was highlighted; much work was being done although success was variable. Efforts are being made throughout the South and West region to tackle inequalities in health. Although strategic vision at the corporate level was often lacking, there was evidence of commitment to taking the inequalities agenda forward within public health directorates. Strengthening of primary care and alliance working roles is essential. Recent national strategy documents, forthcoming legislation, and a review of health inequalities recognize the health effects of inequalities and require health authorities to collaborate with local partners to tackle these, and will offer opportunities to improve corporate commitment and alliance working. Uptake and success of these opportunities will have a major influence on progress in tackling health inequalities.

  14. Assessment of whether upstream passage for Lake Sturgeon is needed at the Pointe du Bois Generating Station (Winnipeg River)

    International Nuclear Information System (INIS)

    Pratt, T.

    2010-01-01

    This document reviewed Manitoba Hydro's proposal to modernize the Pointe du Bois Generating Station (GS) on the Winnipeg River, with particular reference to the potential impacts on Lake Sturgeon in Management Unit 5 (MU5) where large numbers of the fish spawn at the base of the falls. The modernization will involve replacing the spillway, dam segments and replacing or repairing the powerhouse. The pros and cons of providing upstream fish passage for Lake Sturgeon and the generating station were outlined. The only spawning area in the MU5 area may be altered considerably due to changes in water flow, depending on the design chosen for modernization. A potential benefit of providing upstream fish passage for Lake Sturgeon would be to increase genetic diversity within the Winnipeg River. Another potential benefit would be to allow Lake Sturgeon, from the relatively dense population below the GS, to move upstream into MU4 where unfilled habitat may be available and Lake Sturgeon abundance is lower. A potential disadvantage of providing fish passage would be the loss of individual Lake Sturgeon from the healthy population in MU5 with no accompanying benefit to MU4. There would be no net gain to MU4 or MU5 if migrating Lake Sturgeon returned to MU5 rather than proceeding upstream. It was concluded that these current gaps in knowledge must be filled in order to fully assess the environmental impacts. 2 figs.

  15. Health region development from the perspective of system theory - an empirical cross-regional case study.

    Science.gov (United States)

    Volgger, Michael; Mainil, Tomas; Pechlaner, Harald; Mitas, Ondrej

    2015-01-01

    Governments are increasingly establishing health regions to deal with current challenges of public health service. These regions are seen as instruments to balance public and private stakeholders, and offer health care to regional citizens as well as to medical/health tourists. However, it is still unclear how the development of such health regions as well as their governance may be conceptualized. We apply Luhmann's system theory approach in the context of a cross-regional case study that compares health region developments in the Autonomous Province of Bolzano-South Tyrol (Italy) with particular regard to the Eastern Dolomites and in the province of Zeeland (the Netherlands). We suggest that Luhmann's system theory provides a useful set of criteria to evaluate and judge health region development. Fully developed health regions can be understood as auto-poietic systems. By emphasizing programs, personnel, and communication channels, these case studies illustrate the suitability of the system theory toolset to analyze the governance and spatial embeddedness of health regions. Additionally, the study contributes to literature by indicating that health regions are closely related to identity issues and to decision making in regions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Regionalization and political dynamics of Brazilian health federalism.

    Science.gov (United States)

    Dourado, Daniel de Araujo; Elias, Paulo Eduardo Mangeon

    2011-02-01

    The implications from the Brazilian federal structure on the regionalization of health actions and services in the National Unified Health System (SUS) were analyzed, considering that the regional health planning in Brazil takes place within the context of intergovernmental relations as an expression of cooperative federalism in health. The analysis was based on a historical approach to Brazilian health federalism, recognizing two development periods, decentralization and regionalization. Regional health planning of SUS was explored in light of the theoretical framework of federalism. It is concluded that relative centralization of the process is needed in intergovernmental committees to actualize federal coordination and that it is essential to consider formalizing opportunities for dissent, both in regional management boards and in the intergovernmental committees, so that the consensus decision-making can be accomplished in healthcare regionalization.

  17. Perceptions of barriers, facilitators and motivators related to use of prenatal care: A qualitative descriptive study of inner-city women in Winnipeg, Canada.

    Science.gov (United States)

    Heaman, Maureen I; Sword, Wendy; Elliott, Lawrence; Moffatt, Michael; Helewa, Michael E; Morris, Heather; Tjaden, Lynda; Gregory, Patricia; Cook, Catherine

    2015-01-01

    The objective of this qualitative descriptive study was to explore the perceptions of women living in inner-city Winnipeg, Canada, about barriers, facilitators, and motivators related to their use of prenatal care. Individual, semi-structured interviews were conducted in person with 26 pregnant or postpartum women living in inner-city neighborhoods with high rates of inadequate prenatal care. Interviews averaged 67 min in length. Recruitment of participants continued until data saturation was achieved. Inductive content analysis was used to identify themes and subthemes under four broad topics of interest (barriers, facilitators, motivators, and suggestions). Sword's socio-ecological model of health services use provided the theoretical framework for the research. This model conceptualizes service use as a product of two interacting systems: the personal and situational attributes of potential users and the characteristics of health services. Half of the women in our sample were single and half self-identified as Aboriginal. Participants discussed several personal and system-related barriers affecting use of prenatal care, such as problems with transportation and child care, lack of prenatal care providers, and inaccessible services. Facilitating factors included transportation assistance, convenient location of services, positive care provider qualities, and tangible rewards. Women were motivated to attend prenatal care to gain knowledge and skills and to have a healthy baby. Consistent with the theoretical framework, women's utilization of prenatal care was a product of two interacting systems, with several barriers related to personal and situational factors affecting women's lives, while other barriers were related to problems with service delivery and the broader healthcare system. Overcoming barriers to prenatal care and capitalizing on factors that motivate women to seek prenatal care despite difficult living circumstances may help improve use of prenatal

  18. Primary health care in the Southern Mediterranean region.

    NARCIS (Netherlands)

    Weide, M.G.; Fakiri, F. el; Kulu Glasgow, I.; Grielen, S.J.; Zee, J. van der

    1998-01-01

    This book gives an overview of primary health care in the Southern Mediterranean region. For twelve countries detailed information is provided on the structure and financing of health care, the organisation of primary care (including mother and child health care and immunisation programmes), health

  19. Income-related health inequalities across regions in Korea

    Directory of Open Access Journals (Sweden)

    Ahn Byung

    2011-10-01

    Full Text Available Abstract Introduction In addition to economic inequalities, there has been growing concern over socioeconomic inequalities in health across income levels and/or regions. This study measures income-related health inequalities within and between regions and assesses the possibility of convergence of socioeconomic inequalities in health as regional incomes converge. Methods We considered a total of 45,233 subjects (≥ 19 years drawn from the four waves of the Korean National Health and Nutrition Examination Survey (KNHANES. We considered true health as a latent variable following a lognormal distribution. We obtained ill-health scores by matching self-rated health (SRH to its distribution and used the Gini Coefficient (GC and an income-related ill-health Concentration Index (CI to examine inequalities in income and health, respectively. Results The GC estimates were 0.3763 and 0.0657 for overall and spatial inequalities, respectively. The overall CI was -0.1309, and the spatial CI was -0.0473. The spatial GC and CI estimates were smaller than their counterparts, indicating substantial inequalities in income (from 0.3199 in Daejeon to 0.4233 Chungnam and income-related health inequalities (from -0.1596 in Jeju and -0.0844 in Ulsan within regions. The results indicate a positive relationship between the GC and the average ill-health and a negative relationship between the CI and the average ill-health. Those regions with a low level of health tended to show an unequal distribution of income and health. In addition, there was a negative relationship between the GC and the CI, that is, the larger the income inequalities, the larger the health inequalities were. The GC was negatively related to the average regional income, indicating that an increase in a region's average income reduced income inequalities in the region. On the other hand, the CI showed a positive relationship, indicating that an increase in a region's average income reduced health

  20. Regional health governance: A suggested agenda for Southern African health diplomacy.

    Science.gov (United States)

    Penfold, Erica Dale; Fourie, Pieter

    2015-12-01

    Regional organisations can effectively promote regional health diplomacy and governance through engagement with regional social policy. Regional bodies make decisions about health challenges in the region, for example, the Union of South American Nations (UNASUR) and the World Health Organisation South East Asia Regional Office (WHO-SEARO). The Southern African Development Community (SADC) has a limited health presence as a regional organisation and diplomatic partner in health governance. This article identifies how SADC facilitates and coordinates health policy, arguing that SADC has the potential to promote regional health diplomacy and governance through engagement with regional social policy. The article identifies the role of global health diplomacy and niche diplomacy in health governance. The role of SADC as a regional organisation and the way it functions is then explained, focusing on how SADC engages with health issues in the region. Recommendations are made as to how SADC can play a more decisive role as a regional organisation to implement South-South management of the regional social policy, health governance and health diplomacy agenda.

  1. Regional Interrelationships: A Leadership Opportunity for Health Care.

    Science.gov (United States)

    Rotarius, Timothy; Liberman, Aaron

    Given the impact that the health care industry has on the national economy, health care executives need to move beyond simply providing health care treatments and instead focus on strategically leading their regions, including the other key industry contributors in their specific regions. Geographic and economic regions can be viewed as concentric circles of influence, with each circle recognizing the resources and contributions that are specific to a region. An acknowledgement by health care executives of the regional interrelationships that exist in a specific region is necessary for health care managers to strategically lead regional interrelationships. A template for implementation of this process is included. To understand the various factors that exist within circles of influence, several distinct yet interrelated vertical bases of knowledge will be discussed. The 5 bases of knowledge examined here include the following: Health Care, Tourism, Defense and Technology, Education, and Retail. It is important to note that the resources identified in the Tourism, Defense and Technology, Education, and Retail knowledge bases all have a direct influential relationship upon the health care resources of the region. For description purposes, the Central Florida geographic and economic region will be examined for interrelationships between the 5 knowledge bases.

  2. [Social inequalities in health, missions of a regional healthcare agency].

    Science.gov (United States)

    Ginot, Luc

    The presence of social inequalities in health requires a multi-faceted intervention, focusing on the social determinants as well as the provision of care and prevention strategies. Regional health agencies have important levers at their disposal, as illustrated by the example of the Île-de-France region. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. Embedding health literacy into health systems: a case study of a regional health service.

    Science.gov (United States)

    Vellar, Lucia; Mastroianni, Fiorina; Lambert, Kelly

    2017-12-01

    Objective The aim of the present study was to describe how one regional health service the Illawarra Shoalhaven Local Health District embedded health literacy principles into health systems over a 3-year period. Methods Using a case study approach, this article describes the development of key programs and the manner in which clinical incidents were used to create a health environment that allows consumers the right to equitably access quality health services and to participate in their own health care. Results The key outcomes demonstrating successful embedding of health literacy into health systems in this regional health service include the creation of a governance structure and web-based platform for developing and testing plain English consumer health information, a clearly defined process to engage with consumers, development of the health literacy ambassador training program and integrating health literacy into clinical quality improvement processes via a formal program with consumers to guide processes such as improvements to access and navigation around hospital sites. Conclusions The Illawarra Shoalhaven Local Health District has developed an evidence-based health literacy framework, guided by the core principles of universal precaution and organisational responsibility. Health literacy was also viewed as both an outcome and a process. The approach taken by the Illawarra Shoalhaven Local Health District to address poor health literacy in a coordinated way has been recognised by the Australian Commission on Safety and Quality in Health Care as an exemplar of a coordinated approach to embed health literacy into health systems. What is known about the topic? Poor health literacy is a significant national concern in Australia. The leadership, governance and consumer partnership culture of a health organisation can have considerable effects on an individual's ability to access, understand and apply the health-related information and services available to them

  4. Health conditions and role limitation in three European Regions: a public-health perspective

    Directory of Open Access Journals (Sweden)

    Gabriela Barbaglia

    2017-01-01

    Conclusion: The contribution of health conditions to role limitation in the three European regions studied is high. Mental disorders are associated with the largest impact in most of the regions. There is a need for mainstreaming disability in the public health agenda to reduce the role limitation associated with health conditions. The cross-regional differences found require further investigation.

  5. Perinatal health in the Danube region

    DEFF Research Database (Denmark)

    Knudsen, Lisbeth E.; Andersen, Zorana J.; Sram, Radim J.

    2017-01-01

    In 2013-2015, a consortium of European scientists - NEWDANUBE - was established to prepare a birth cohort in the Danube region, including most of the countries with the highest air pollution in Europe, the area being one-fifth of the European Union's (EU's) territory, including 14 countries (nine...

  6. WHO global and regional strategies for health and environment

    International Nuclear Information System (INIS)

    Hisashi Ogawa

    1996-01-01

    This paper describes the WHO global and regional strategies for health and environment and discusses research needs on environmental health to support the implementation of the strategies. Particular emphasis on applied researches which generate information, for decision making, on health effects of development and environmental changes in specific locations

  7. Health Service Utilization in Amhara Region of Ethiopia | Fantahun ...

    African Journals Online (AJOL)

    Background: Information on health service utilization is crucial for planning, organizing and evaluation of health services. Objective: Assess perceived morbidity and examine the factors associated with utilization of health services by a sample of the population of the Amhara Region. Methods: Questionnaire was ...

  8. Perinatal health in the Danube region - new birth cohort justified.

    Czech Academy of Sciences Publication Activity Database

    Knudsen, L. E.; Andersen, Z.J.; Šrám, Radim; Braun Kohlová, M.; Gurzau, E.S.; Fucic, A.; Gribaldo, L.; Rössner ml., Pavel; Rössnerová, Andrea; Máca, V.; Zvěřinová, I.; Gajdošová, D.; Moshammer, H.; Rudnai, P.; Ščasný, M.

    2017-01-01

    Roč. 32, 1-2 (2017), s. 9-14 ISSN 2191-0308 Institutional support: RVO:68378041 Keywords : birth cohort * child health * Danube region * environmental exposures Subject RIV: DN - Health Impact of the Environment Quality OBOR OECD: Public and environmental health

  9. WHO global and regional strategies for health and environment

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, Hisashi [World Health Organization, Manila (Philippines). Regional Office for the Western Pacific

    1997-12-31

    This paper describes the WHO global and regional strategies for health and environment and discusses research needs on environmental health to support the implementation of the strategies. Particular emphasis on applied researches which generate information, for decision making, on health effects of development and environmental changes in specific locations.

  10. 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.

  11. [The contributions of local authorities to regional public health policy].

    Science.gov (United States)

    de Maria, Florence; Grémy, Isabelle

    2009-01-01

    Local authorities in France are key players in shaping public health policy by their action on the determinants of health and through their actions aimed at specific population groups. Since the public health act of 9 August 2004 establishing the first regional public health plans, their level of involvement and role continues to grow as coordinators, funders and project managers within the greater Paris metropolitan region. Their active participation in regional policy to improve population health and reduce inequalities in health has led to a better organization of the public health programs implemented (in terms of visibility, dialogue, coordination, transparency, and better awareness of context and integration of local issues). Their participation is also a source of innovation resulting in the proposal and use of new approaches (such as the development of health surveillance and observation for advising the local decision-making process). Within the current context of the "Hospitals, patients, health and territories" bill, which entrusts the governance of regional health policy to a specific agency, the role given to local authorities in this new organizational structure must be clearly defined to take into account all of their existing and potential contributions to public health policy.

  12. [Health-Promoting Schools Regional Initiative of the Americas].

    Science.gov (United States)

    Ippolito-Shepherd, Josefa; Cerqueira, Maria Teresa; Ortega, Diana Patricia

    2005-01-01

    In Latin America, comprehensive health promotion programmes and activities are being implemented in the school setting, which take into account the conceptual framework of the Health-Promoting Schools Regional Initiative of the Pan American Health Organization, Regional office of the World Health Organization (PAHO/WHO). These programmes help to strengthen the working relationships between the health and education sectors. The Health-Promoting Schools Regional Initiative, officially launched by PAHO/WHO in 1995, aims to form future generations to have the knowledge, abilities, and skills necessary for promoting and caring for their health and that of their family and community, as well as to create and maintain healthy environments and communities. The Initiative focuses on three main components: comprehensive health education, the creation and maintenance of healthy physical and psychosocial environments, and the access to health and nutrition services, mental health, and active life. In 2001, PAHO conducted a survey in 19 Latin American countries to assess the status and trends of Health-Promoting Schools in the Region, for the appropriate regional, subregional, and national planning of pertinent health promotion and health education programmes and activities. The results of this survey provided information about policies and national plans, multisectoral coordination mechanisms for the support of health promotion in the school settings, the formation and participation in national and international networks of Health-Promoting Schools and about the level of dissemination of the strategy. For the successful development of Health-Promoting Schools is essential to involve the society as a whole, in order to mobilise human resources and materials necessary for implementing health promotion in the school settings. Thus, the constitution and consolidation of networks has been a facilitating mechanism for the exchange of ideas, resources and experiences to strengthen

  13. Locating regional health policy: Institutions, politics, and practices

    Science.gov (United States)

    Riggirozzi, Pia; Yeates, Nicola

    2015-01-01

    Poverty reduction and health became central in the agendas of Southern regional organisations in the last two decades. Yet, little is known about how these organisations address poverty, inclusion and social inequality, and how Southern regional formations are engaging in power constellations, institutions, processes, interests and ideological positions within different spheres of governance. This article reviews academic literatures spanning global social policy, regional studies and diplomacy studies, and the state of knowledge and understanding of the ‘place’ of regional actors in health governance as a global political practice therein. It identifies theoretical and thematic points of connection between disparate literatures and how these can be bridged through research focusing on the social policies of regional organisations and regional integration processes. This framework hence locates the contributions of each of the research articles of this Special Issue of Global Social Policy on the regional dimension of health policy and diplomacy in relation to Southern Africa and South America. It also highlights the ways in which the articles bring new evidence about how social relations of welfare are being (re)made over larger scales and how regional actors may initiate new norms to improve health rights in international arenas engaging in new forms of ‘regional’ diplomacy. PMID:26635495

  14. Thoughts on the development of active regional public health systems.

    Science.gov (United States)

    Reis, Ademar Arthur Chioro Dos; Sóter, Ana Paula Menezes; Furtado, Lumena Almeida Castro; Pereira, Silvana Souza da Silva

    2017-04-01

    Decentralization and regionalization are strategic themes for reforms in the health system. This paper analyzes the complex process of health regionalization being developed in Brazil. This paper identifies that the normative framework from the Brazilian National Health System, SUS has made advances with respect to its institutionalization and overcoming the initial centrality involved in municipalization. This has strengthened the development of regionalization and the intergovernmental agreement on health but the evidence points to the need to promote a revision. Based on document analysis, literature review and the views given by the authors involved in management in SUS as well as generating radically different views, the challenges for the construction of a regionalization that is active, is debated. We also discuss: its relations with planning and the dimensioning of service networks, the production of active care networks and shared management spaces, the inter-federative agreements and regional regulations, the capacity to coordinate regional systems and financing and the impact of the political dimension and electoral cycles. Regionalization (and SUS itself) is an open book, therefore ways and possibilities on how to maintain an active form of regionalization can be recommended.

  15. Health status and health systems financing in the MENA region: roadmap to universal health coverage.

    Science.gov (United States)

    Asbu, Eyob Zere; Masri, Maysoun Dimachkie; Kaissi, Amer

    2017-01-01

    Since the declaration of the Millennium Development Goals (MDGs) in 1990, many countries of the Middle East and North Africa (MENA) region made some improvements in maternal and child health and in tackling communicable diseases. The transition to the global agenda of Sustainable Development Goals brings new opportunities for countries to move forward toward achieving progress for better health, well-being, and universal health coverage. This study provides a profile of health status and health financing approaches in the MENA region and their implications on universal health coverage. Time-series data on socioeconomics, health expenditures, and health outcomes were extracted from databases and reports of the World Health Organization, the World Bank and the United Nations Development Program and analyzed using Stata 12 statistical software. Countries were grouped according to the World Bank income categories. Descriptive statistics, tables and charts were used to analyze temporal changes and compare the key variables with global averages. Non-communicable diseases (NCDs) and injuries account for more than three quarters of the disability-adjusted life years in all but two lower middle-income countries (Sudan and Yemen). Prevalence of risk factors (raised blood glucose, raised blood pressure, obesity and smoking) is higher than global averages and counterparts by income group. Total health expenditure (THE) per capita in most of the countries falls short of global averages for countries under similar income category. Furthermore, growth rate of THE per capita has not kept pace with the growth rate of GDP per capita. Out-of-pocket spending (OOPS) in all but the high-income countries in the group exceeds the threshold for catastrophic spending implying that there is a high risk of households getting poorer as a result of paying for health care. The alarmingly high prevalence of NCDs and injuries and associated risk factors, health spending falling short of the GDP

  16. Sports participation, physical activity, and health in the European regions.

    Science.gov (United States)

    Lera-López, Fernando; Marco, Rocio

    2018-08-01

    In a context of stagnation of the level of health-enhancing physical activity in Europe, this study examines the geographical stratification of sports participation and physical activity (PA) at the regional level in 28 European countries. While previous research has focused on the national approach, this study considers the regional level across 208 European regions. Individual survey data from the Eurobarometer 80.2 is combined with a regional-level approach to the 208 regions to quantify sports participation and PA at the regional level. The results show important differences and a geographical stratification of sports participation and PA among the European regions, albeit following different patterns. In particular, a north-south gap is identified in terms of PA rates and an east-west gap is detected in terms of sports participation levels. Applying the cluster technique, a taxonomy of four different European regions is developed considering both types of indicators. Finally, the existence of sports spatial spillovers among regions is verified, obtaining a positive autocorrelation among neighbouring regions for being involved in PA and sporting activities. The results may have significant implications in terms of policy measures to improve health through PA and sports participation at the regional level in Europe.

  17. Barriers, motivators and facilitators related to prenatal care utilization among inner-city women in Winnipeg, Canada: a case-control study.

    Science.gov (United States)

    Heaman, Maureen I; Moffatt, Michael; Elliott, Lawrence; Sword, Wendy; Helewa, Michael E; Morris, Heather; Gregory, Patricia; Tjaden, Lynda; Cook, Catherine

    2014-07-15

    The reasons why women do not obtain prenatal care even when it is available and accessible are complex. Despite Canada's universally funded health care system, use of prenatal care varies widely across neighborhoods in Winnipeg, Manitoba, with the highest rates of inadequate prenatal care found in eight inner-city neighborhoods. The purpose of this study was to identify barriers, motivators and facilitators related to use of prenatal care among women living in these inner-city neighborhoods. We conducted a case-control study with 202 cases (inadequate prenatal care) and 406 controls (adequate prenatal care), frequency matched 1:2 by neighborhood. Women were recruited during their postpartum hospital stay, and were interviewed using a structured questionnaire. Stratified analyses of barriers and motivators associated with inadequate prenatal care were conducted, and the Mantel-Haenszel common odds ratio (OR) was reported when the results were homogeneous across neighborhoods. Chi square analysis was used to test for differences in proportions of cases and controls reporting facilitators that would have helped them get more prenatal care. Of the 39 barriers assessed, 35 significantly increased the odds of inadequate prenatal care for inner-city women. Psychosocial issues that increased the likelihood of inadequate prenatal care included being under stress, having family problems, feeling depressed, "not thinking straight", and being worried that the baby would be apprehended by the child welfare agency. Structural barriers included not knowing where to get prenatal care, having a long wait to get an appointment, and having problems with child care or transportation. Attitudinal barriers included not planning or knowing about the pregnancy, thinking of having an abortion, and believing they did not need prenatal care. Of the 10 motivators assessed, four had a protective effect, such as the desire to learn how to protect one's health. Receiving incentives and getting

  18. Barriers, motivators and facilitators related to prenatal care utilization among inner-city women in Winnipeg, Canada: a case–control study

    Science.gov (United States)

    2014-01-01

    Background The reasons why women do not obtain prenatal care even when it is available and accessible are complex. Despite Canada’s universally funded health care system, use of prenatal care varies widely across neighborhoods in Winnipeg, Manitoba, with the highest rates of inadequate prenatal care found in eight inner-city neighborhoods. The purpose of this study was to identify barriers, motivators and facilitators related to use of prenatal care among women living in these inner-city neighborhoods. Methods We conducted a case–control study with 202 cases (inadequate prenatal care) and 406 controls (adequate prenatal care), frequency matched 1:2 by neighborhood. Women were recruited during their postpartum hospital stay, and were interviewed using a structured questionnaire. Stratified analyses of barriers and motivators associated with inadequate prenatal care were conducted, and the Mantel-Haenszel common odds ratio (OR) was reported when the results were homogeneous across neighborhoods. Chi square analysis was used to test for differences in proportions of cases and controls reporting facilitators that would have helped them get more prenatal care. Results Of the 39 barriers assessed, 35 significantly increased the odds of inadequate prenatal care for inner-city women. Psychosocial issues that increased the likelihood of inadequate prenatal care included being under stress, having family problems, feeling depressed, “not thinking straight”, and being worried that the baby would be apprehended by the child welfare agency. Structural barriers included not knowing where to get prenatal care, having a long wait to get an appointment, and having problems with child care or transportation. Attitudinal barriers included not planning or knowing about the pregnancy, thinking of having an abortion, and believing they did not need prenatal care. Of the 10 motivators assessed, four had a protective effect, such as the desire to learn how to protect one

  19. [Multidisciplinary health houses and regional development: a necessarily shared dyanamics.].

    Science.gov (United States)

    Autès, Michel; Dufay, Marie-Guite

    2009-03-29

    Many regional authorities (Conseils Régionaux) have taken up the issue of health houses by underlining their competence in dealing with regional development issues. This initiative is part of a broader process designed to ensure the continuity of healthcare at the different levels of provision as well as equal, universal access according to the specific needs of patients, from prevention to the most specialized forms of medical treatment. Health houses are one of the chief access points in this process, and are situated at the cross-roads of health and healthcare. The territorial health project must provide the fondations of the new health house model. According to the Health Committee of the Association of French Regions (Commission Santé de l'Association des Régions de France), there are three prerequisites: 1. a multidisciplinary offer of access to front-line healthcare services; 2. public healthcare activities: prevention, promotion of health...; 3. a network mode of organization with the local and regional hospital system to ensure optimum healthcare provision for patients. Yet a number of obstacles need to be overcome, particularly the risk of concentrating healthcare provision within a single center, thus depriving the surrounding area, but also the ill-adapted current framework of remuneration for independent medical practitioners. The purpose of regional authorities (i.e. Conseils Régionaux) is not to ensure the expansion of health houses, but rather to enable innovation by accompanying the different actors involved within the sector. Heeding the specific requirements of the local area and its needs, as well as the will of elected representatives and healthcare professionals, their aim is to develop a policy of exemplarity with all the actors involved in the sector and to uphold their legitimacy as agents of regional development. The ?Hospital, patients, health and territories' law (loi "Hôpital, patients, santé et territoires") may yet throw the

  20. Developing regional workplace health and hazard surveillance in the Americas

    Directory of Open Access Journals (Sweden)

    Choi Bernard C. K.

    2001-01-01

    Full Text Available An objective of the Workers' Health Program at the Pan American Health Organization (PAHO is to strengthen surveillance in workers' health in the Region of the Americas in order to implement prevention and control strategies. To date, four phases of projects have been organized to develop multinational workplace health and hazard surveillance in the Region. Phase 1 was a workshop held in 1999 in Washington, D.C., for the purpose of developing a methodology for identifying and prioritizing the top three occupational sentinel health events to be incorporated into the surveillance systems in the Region. Three surveillance protocols were developed, one each for fatal occupational injuries, pesticide poisoning,4 and low back pain, which were identified in the workshop as the most important occupational health problems. Phase 2 comprised projects to disseminate the findings and recommendations of the Washington Workshop, including publications, pilot projects, software development, electronic communication, and meetings. Phase 3 was a sub-regional meeting in 2000 in Rosario, Argentina, to follow up on the progress in carrying out the recommendations of the Washington workshop and to create a Virtual Regional Center for Latin America that could coordinate the efforts of member countries. Currently phase 4 includes a number of projects to achieve the objectives of this Center, such as pilot projects, capacity building, editing a compact disk, analyzing legal systems and intervention strategies, software training, and developing an internet course on surveillance. By documenting the joint efforts made to initiate and develop Regional multinational surveillance of occupational injuries and diseases in the Americas, this paper aims to provide experience and guidance for others wishing to initiate and develop regional multinational surveillance for other diseases or in other regions.

  1. [Regional health and autonomy conferences (CRSAs): the implications for medical democracy at a regional level].

    Science.gov (United States)

    Devictor, Bernadette

    2010-01-01

    The HPST law seeks to reorganize the governance of healthcare at a regional level and to maintain the existence of regional health conferences, now known as regional health and autonomy conferences (CRSAs). The purpose of this article is to examine the new duties attributed to the CRSAs and to consider the various issues raised by their practice. The article also provides an analysis of the preconditions required for the successful implementation of medical democracy at a regional level, ie.: the involvement of the CRSAs in the assessment of regional healthcare policies, the mobilization of funds, the composition of the CRSAs (including the full range of healthcare areas), the importance of providing adequate support for territorial conferences, and the elaboration of a communicative space for fostering exchanges between CRSAs.

  2. Regional Climate Change and Development of Public Health Decision Aids

    Science.gov (United States)

    Hegedus, A. M.; Darmenova, K.; Grant, F.; Kiley, H.; Higgins, G. J.; Apling, D.

    2011-12-01

    According to the World Heath Organization (WHO) climate change is a significant and emerging threat to public health, and changes the way we must look at protecting vulnerable populations. Worldwide, the occurrence of some diseases and other threats to human health depend predominantly on local climate patterns. Rising average temperatures, in combination with changing rainfall patterns and humidity levels, alter the lifecycle and regional distribution of certain disease-carrying vectors, such as mosquitoes, ticks and rodents. In addition, higher surface temperatures will bring heat waves and heat stress to urban regions worldwide and will likely increase heat-related health risks. A growing body of scientific evidence also suggests an increase in extreme weather events such as floods, droughts and hurricanes that can be destructive to human health and well-being. Therefore, climate adaptation and health decision aids are urgently needed by city planners and health officials to determine high risk areas, evaluate vulnerable populations and develop public health infrastructure and surveillance systems. To address current deficiencies in local planning and decision making with respect to regional climate change and its effect on human health, our research is focused on performing a dynamical downscaling with the Weather Research and Forecasting (WRF) model to develop decision aids that translate the regional climate data into actionable information for users. WRF model is initialized with the Max Planck Institute European Center/Hamburg Model version 5 (ECHAM5) General Circulation Model simulations forced with the Special Report on Emissions (SRES) A1B emissions scenario. Our methodology involves development of climatological indices of extreme weather, quantifying the risk of occurrence of water/rodent/vector-borne diseases as well as developing various heat stress related decision aids. Our results indicate that the downscale simulations provide the necessary

  3. Sustainability Strategies for Regional Health Information Organization Startups

    DEFF Research Database (Denmark)

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

    2016-01-01

    the population health of an underserved urban population, and an HIE capability to enable the transition to a healthcare landscape that rewards care coordination across suburban hospitals and physician practices. Conclusions: We propose two models of technology and sustainability strategies for developing bottom...... initiatives by states and regional health information organizations (HIOs). Given the high failure rates of regional U.S. HIOs in the past, our primary objective is to identify the key characteristics of HIO startups that became operational and demonstrated sustainability with non-renewable SHIECAP funding...

  4. Building a regional health equity movement: the grantmaking model of a local health department.

    Science.gov (United States)

    Baril, Nashira; Patterson, Meghan; Boen, Courtney; Gowler, Rebekah; Norman, Nancy

    2011-01-01

    The Boston Public Health Commission's Center for Health Equity and Social Justice provides grant funding, training, and technical assistance to 15 organizations and coalitions across New England to develop, implement, and evaluate community-based policy and systems change strategies that address social determinants of health and reduce racial and ethnic health inequities. This article describes Boston Public Health Commission's health equity framework, theory of change regarding the elimination of racial and ethnic health inequities, and current grantmaking model. To conclude, the authors evaluate the grant model and offer lessons learned from providing multiyear regional grants to promote health equity.

  5. An economic assessment of population health risk in region

    Directory of Open Access Journals (Sweden)

    Nina Vladimirovna Zaytseva

    2012-06-01

    Full Text Available This paper proposes a method of economic assessment of population health risk as a tool of life qualitymanagement and qualityof labor resources in the region (as factors of a region’s economic security. The technique is based on the cost of reducing the period of disability in the implementation of population health risk and takes into account the effects of risk prevention on levels of the budgetary system of the Russian Federation. The method intends to support making decisions on planning measures to reduce population health risk at the level of regions, territories and separate objects to assess their cost-performance, optimization of investment and operating costs to reduce the population health risk and sustainable development of the territory

  6. Nurse training in health in different regions in Brazil

    Directory of Open Access Journals (Sweden)

    Carinne Magnago

    Full Text Available Abstract Objectives: to identify on the one hand whether there has been any changes in the nurse training in Brazil and on the other if regionalizing health incurred interference in this process. Methods: an exploratory research of a multiple case study in a qualitative approach developed between November 2015 and March 2017, in seven regions in Brazil. The data were collected by in-depth interviews with 16 administrators of the undergraduate courses in nursing and by documentary analysis of the Projetos Políticos Pedagógicos (Political Pedagogical Projects. Content analysis was undertaken by having the theoretical references of the Diretrizes Curriculares Nacionais (National Curriculum Guidelines. Results: varied profiles of undergraduates were observed with higher tendency for the basic level in health practice or for hospital level with competencies in health care that is still fragmented and not interdisciplinary. The curricular structure of the courses focuses on isolated disciplines with little or no interdisciplinary integration and the pedagogical model is based on traditional teaching-learning strategies and additional evaluation process. There were no differences in health among the regions. Conclusions: it is necessary in concomitance with the changes that are required in the field of training to undertake efforts in the development of health units and training institutions, which has already proven to be a factor of professional retention and regional development.

  7. [Satisfaction with health services in the North Bohemia Region].

    Science.gov (United States)

    Masopust, V; Rajman, K

    1989-04-01

    In May 1988 in the North Bohemian region an anonymous survey was made in which 3,767 respondents participated, i.e. 0.42% of the population living in the region. The survey was focused on the satisfaction with and attitudes of patients to the health services. 73.64% of the respondents evaluated the provided services positively, 24.39% had an ambivalent attitude and 1.97% evaluated them negatively. Material shortcomings in the health services were criticized by 54.05% of the respondents, 37.75% criticized long waiting periods and 23.17% shortage of health personnel. The greatest advantage of our health services is that they are free of charge (49.91% respondents); availability (48.23%) and good interpersonal relations (21.56%). The satisfaction with the health services was expressed by 85.72% respondents verbally, 5.57% by criticism, 1.57% by a bribe and 1.43% by complaints. The most pretentious group are young patients working in industry. A positive attitude to the health services correlates with a positive evaluation of health workers. Thus the necessity arises to guard the ethical and professional standard of the health workers.

  8. Expanded BPA residential weatherization program: summary of regional health effects

    International Nuclear Information System (INIS)

    Sandusky, W.F.; Thor, P.W.; Alton, C.C.; Mellinger, P.J.; Cross, F.T.

    1984-11-01

    The Final Environmental Impact Statement (FEIS) for the Bonneville Power Administration (BPA) Expanded Residential Weatherization Program has been completed, printed, and distributed. This document incorporates numerous revisions based on both oral and written comments received during the public comment of the Draft Environmental Impact Statement (DEIS). The estimates of regional health effects were revised to incorporate results of the second Pacific Northwest Residential Energy Survey (PNWRES). The FEIS now expresses the estimated regional health effects in terms of incidence of cancers per 100,000 people exposed, which allows comparison to be made to the annual average risk of fatality by other causes. The estimates of regional health effects are also compared to health effects resulting from supplying and operating a conventional coal plant at a power level equal to the amount of energy saved from installation of additional tightening measures. Numerical results for the estimated health effects described above are provided. A summary of the comments received on the DEIS is also provided, along with estimated health effects associated with the Environmentally Preferred and BPA Preferred Alternatives to the Proposed Action. 8 refs., 3 figs., 5 tabs

  9. Regional Disparities in Romania. Contribution of the Regional Operational Program to Health Infrastructure

    Directory of Open Access Journals (Sweden)

    VICTOR PLATON

    2013-01-01

    Full Text Available Health infrastructure is one of the weaknesses of socio-economic development in Romania and in other European states. In order to get a better picture of the Romanian health system issues, this paper analyzes a number of statistical indicators considered representative for the national and European health infrastructure for a 20 years period, between 1990 and 2010. Our paper has three main objectives: (a to identify the main trends for health infrastructure in some of the European Union countries; (b to describe the evolution of the health system in Romania, the comparative situation at the European level as well as regional level indicators dynamics; (c to overview the Regional Operational Program in Romania, how much does it help the regional health infrastructure in our country. At the European level, there is a constant decrease in the number of hospital beds. For this indicator, Romania has slightly higher values than the European average. We must mention that the hospital beds indicator offers limited information on health infrastructure which also includes medical equipment and specific devices and practices. The number of hospitals in Romania increased with 18.9% during the last 20 years (1990-2010. During the observed timeline, the number of hospitals in Romania had a constant positive evolution at regional level. The number of doctors in hospitals has an increasing trend at the local as well as at the international level. Romania has a number of doctors twice lower than the European average (3.6 doctors for one thousand inhabitants. The Regional Operational Program (ROP has a limited influence in achieving the objectives stated in Applicants Guide for Priority Axis 3. Major Intervention Area 3.1. This happens because supporting infrastructure improvements will not create institutional modernization. The financial contribution through ROP will result in the modernization of 11% of the existing hospitals in Romania.

  10. Research culture in a regional allied health setting.

    Science.gov (United States)

    Borkowski, Donna; McKinstry, Carol; Cotchett, Matthew

    2017-07-01

    Research evidence is required to guide best practice, inform policy and improve the health of communities. Current indicators consider allied health research culture to be low. This study aimed to measure the allied health research culture and capacity in a Victorian regional health service. The Research Capacity and Culture tool was used to evaluate research capacity and culture across individual, team and organisation domains. One-way ANOVA was used to determine differences between allied health professions, whereas responses to open-ended questions were themed using open coding. One hundred thirty-six allied health professionals completed the survey. There were statistically significant differences in the organisation domain between social work, physiotherapy and occupational therapy professions; in the team domain, between social work and all other professions. Motivators for conducting research included providing a high-quality service, developing skills and increasing job satisfaction. Barriers included other work roles taking priority, a lack of time and limited research skills. Multi-layered strategies including establishing conjoint research positions are recommended to increase allied health research culture in this regional area.

  11. Regional South Australia Health (RESONATE) survey: study protocol

    Science.gov (United States)

    Jones, Martin; Gillam, Marianne; May, Esther

    2018-01-01

    Introduction Access to quality healthcare services is considered a moral right. However, for people living in regional locations, timely access to the services that they need may not always be possible because of structural and attitudinal barriers. This suggests that people living in regional areas may have unmet healthcare needs. The aim of this research will be to examine the healthcare needs, expectations and experiences of regional South Australians. Methods and analysis The Regional South Australia Health (RESONATE) survey is a cross-sectional study of adult health consumers living in any private or non-private dwelling, in any regional, rural, remote or very remote area of South Australia and with an understanding of written English. Data will be collected using a 45-item, multidimensional, self-administered instrument, designed to measure healthcare need, barriers to healthcare access and health service utilisation, attitudes, experiences and satisfaction. The instrument has demonstrated acceptable psychometric properties, including good content validity and internal reliability, good test–retest reliability and a high level of acceptability. The survey will be administered online and in hard-copy, with at least 1832 survey participants to be recruited over a 12-month period, using a comprehensive, multimodal recruitment campaign. Ethics and dissemination The study has been reviewed and approved by the Human Research Ethics Committee of the University of South Australia. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media, broadcast media, print media, the internet and various community/stakeholder engagement activities. PMID:29654014

  12. [Health and globalization in the San Diego-Tijuana region].

    Science.gov (United States)

    Villa-Caballero, Leonel; Caballero-Solano, Víctor Manuel; Andrade-Barreto, Olga Alicia

    2008-01-01

    The international process of trading goods and services with significant reduction in barriers known as globalization is clearly observed at the San Diego-Tijuana region. This essay addresses issues arising at this unique geographical area associated with the globalization process and its public health consequences. Social, cultural and political aspects have very important implications on the health status of the U.S-Mexican population and in the health care systems on both sides of the border. One of the most powerful world economies borders a developing country resulting in a dramatic comparison that has negative outcomes such as health disparities, high prevalence of chronic diseases and new epidemiological risks. Poverty and migration are a few of the contributing factors triggering this asymmetrical relationship. Challenges in border health require a comprehensive binational participation and the solutions are yet to be determined.

  13. Trade in health services in the ASEAN region.

    Science.gov (United States)

    Arunanondchai, Jutamas; Fink, Carsten

    2006-12-01

    Promoting quality health services to large population segments is a key ingredient to human and economic development. At its core, healthcare policymaking involves complex trade-offs between promoting equitable and affordable access to a basic set of health services, creating incentives for efficiencies in the healthcare system and managing constraints in government budgets. International trade in health services influences these trade-offs. It presents opportunities for cost savings and access to better quality care, but it also raises challenges in promoting equitable and affordable access. This paper offers a discussion of trade policy in health services for the ASEAN region. It reviews the existing patterns of trade and identifies policy measures that could further harness the benefits from trade in health services and address potential pitfalls that deeper integration may bring about.

  14. Health for all: a fundamental goal of public health in our region.

    Science.gov (United States)

    Binns, Colin; Lee, Mi Kyung

    2015-01-01

    Since its foundation 30 years ago, the mission of the Asia-Pacific Academic Consortium for Public Health has been promoting "health for all" through public health. "Health for all" became the theme of Walter Patrick's public health career and inspired his contribution to APACPH. However, the universality of health care is now under threat, more from economists and politicians than public health workers. Health for all remains a continuing challenge for all public health workers in our region. Progress is being made toward this goal as life expectancy in the Western Pacific has increased from 64 to 78 in the past 3 decades. Prof Walter Patrick was strong public health advocate, and this review was written as a tribute to good friend and inspiring colleague who believed in, and worked for "health for all." © 2014 APJPH.

  15. Regional Geographic Information Systems of Health and Environmental Monitoring

    Directory of Open Access Journals (Sweden)

    Kurolap Semen A.

    2016-12-01

    Full Text Available The article describes a new scientific and methodological approach to designing geographic information systems of health and environmental monitoring for urban areas. Geographic information systems (GIS are analytical tools of the regional health and environmental monitoring; they are used for an integrated assessment of the environmental status of a large industrial centre or a part of it. The authors analyse the environmental situation in Voronezh, a major industrial city, located in the Central Black Earth Region with a population of more than 1 million people. The proposed research methodology is based on modern approaches to the assessment of health risks caused by adverse environmental conditions. The research work was implemented using a GIS and multicriteria probabilistic and statistical evaluation to identify cause-and-effect links, a combination of action and reaction, in the dichotomy ‘environmental factors — public health’. The analysis of the obtained statistical data confirmed an increase in childhood diseases in some areas of the city. Environmentally induced diseases include congenital malformations, tumors, endocrine and urogenital pathologies. The main factors having an adverse impact on health are emissions of carcinogens into the atmosphere and the negative impact of transport on the environment. The authors identify and characterize environmentally vulnerable parts of the city and developed principles of creating an automated system of health monitoring and control of environmental risks. The article offers a number of measures aimed at the reduction of environmental risks, better protection of public health and a more efficient environmental monitoring.

  16. The Pan American Health Organization and the mainstreaming of human rights in regional health governance.

    Science.gov (United States)

    Meier, Benjamin Mason; Ayala, Ana S

    2014-01-01

    In the absence of centralized human rights leadership in an increasingly fragmented global health policy landscape, regional health offices have stepped forward to advance the rights-based approach to health. Reviewing the efforts of the Pan American Health Organization (PAHO), this article explores the evolution of human rights in PAHO policy, assesses efforts to mainstream human rights in the Pan American Sanitary Bureau (PASB), and analyzes the future of the rights-based approach through regional health governance, providing lessons for other regional health offices and global health institutions. This article explores PAHO's 15-year effort to mainstream human rights through PASB technical units, national capacity-building, the Inter-American human rights system, and the PAHO Directing Council. Through documentary analysis of PAHO policies and semi-structured interviews with key PASB stakeholders, the authors analyze the understandings and actions of policymakers and technical officers in implementing human rights through PAHO governance. Analyzing the themes arising from this narrative, the authors examine the structural role of secretariat leadership, state support, legal expertise, and technical unit commitment in facilitating a rights-based approach to the health in the Americas. Human rights are increasingly framing PAHO efforts, and this analysis of the structures underlying PAHO's approach provides an understanding of the institutional determinants of the rights-based approach to health, highlighting generalizable themes for the mainstreaming of human rights through regional health governance. With this regional-level understanding of health governance, future national-level research can begin to understand the causal forces linking regional human rights work with national policy reforms and public health outcomes. © 2014 American Society of Law, Medicine & Ethics, Inc.

  17. [Regional differences in the health care of basal cell carcinoma].

    Science.gov (United States)

    Augustin, J; Schäfer, I; Thiess, P; Reusch, M; Augustin, M

    2016-10-01

    Basal cell carcinoma (BCC) is the most common type of skin cancer in Germany. So far, it is unclear whether regional variations exist in the health care of the BCC. Analysis of regional variations in health care (e. g., skin cancer screening) and their causes using the example of BCC. Qualitative and quantitative analysis of the regional health care situation of BCC based on three studies was undertaken. These studies include the analysis of n = 7015 histopathological indications whose average tumor thickness is regarded as a characteristic of the quality of care, and a secondary data analysis of GK insured (n = 6.1 million DAK-insured persons), and a nationwide survey (FORSA) of n = 1004 participants focusing on the use of skin cancer screening. Analysis of the histopathological examination showed regional variations in average tumor depth of penetration. These are associated with the rural/urban characteristics of the region and individual sociodemographic indicators (e. g., employment sector or education). The results for age- and gender-specific use (DAK data) showed higher participation rates regarding skin cancer screening in western than in eastern federal states (Bundesländer). Moreover, it was revealed that the trend for using skin cancer screening was higher in urban than in rural areas. The results of population-related surveys confirm this trend. Although it is not possible to compare the studies directly, all three showed an association between city/state and the use of skin cancer screenings. In addition, sociodemographic characteristics that are related to the quality of health care were identified.

  18. Implementation and integration of regional health care data networks in the Hellenic National Health Service.

    Science.gov (United States)

    Lampsas, Petros; Vidalis, Ioannis; Papanikolaou, Christos; Vagelatos, Aristides

    2002-12-01

    Modern health care is provided with close cooperation among many different institutions and professionals, using their specialized expertise in a common effort to deliver best-quality and, at the same time, cost-effective services. Within this context of the growing need for information exchange, the demand for realization of data networks interconnecting various health care institutions at a regional level, as well as a national level, has become a practical necessity. To present the technical solution that is under consideration for implementing and interconnecting regional health care data networks in the Hellenic National Health System. The most critical requirements for deploying such a regional health care data network were identified as: fast implementation, security, quality of service, availability, performance, and technical support. The solution proposed is the use of proper virtual private network technologies for implementing functionally-interconnected regional health care data networks. The regional health care data network is considered to be a critical infrastructure for further development and penetration of information and communication technologies in the Hellenic National Health System. Therefore, a technical approach was planned, in order to have a fast cost-effective implementation, conforming to certain specifications.

  19. Robustness in practice--the regional planning of health services.

    Science.gov (United States)

    Best, G; Parston, G; Rosenhead, J

    1986-05-01

    Earlier work has criticized the dominant tendencies in operational research contributions to health services planning as characterized by optimization, implausible demands for data, depoliticization, hierarchy and inflexibility. This paper describes an effort which avoids at least some of these pitfalls. The project was to construct a planning system for a regional health council in Ontario, Canada, which would take account of the possible alternative future states of the health-care system's environment and would aim to keep options for future development open. The planning system devised is described in the paper. It is based on robustness analysis, which evaluates alternative initial action sets in terms of the useful flexibility they preserve. Other features include the explicit incorporation of pressures for change generated outside the health-care system, and a satisficing approach to the identification of both initial action sets and alternative future configurations of the health-care system. It was found possible to borrow and radically 're-use' techniques or formulations from the mainstream of O.R. contributions. Thus the 'reference projection' method was used to identify inadequacies in performance which future health-care system configurations must repair. And Delphi analysis, normally a method for generating consensus, was used in conjunction with cluster analysis of responses to generate meaningfully different alternative futures.

  20. Ministry of Health and regional health agency measures for medical imaging

    International Nuclear Information System (INIS)

    Podeur, Annie

    2011-01-01

    The issues in imaging are the appropriate use of equipment and optimising the organisation of imaging facilities, through a pooling of medical resources. The Ministry responsible for health has confirmed its desire to increase the number of MRI devices in order to better address patient needs in compliance with best practices, especially in dealing with strokes and cancers. The primary need is to reinforce radiation protection, essentially with regard to children. The steps taken are designed to speed up the replacement of irradiating techniques. According to the SROS-PRS (regional health care organisation scheme - regional health care project), the ARS (regional health agencies) are required to mobilize all resources in order to meet the national objectives for improving access to imaging and reducing disparities in access and efficiency. It is up to the ARS to define the territorial distribution of supply, with appropriate gradation of imaging facilities, in particular to ensure a permanent supply of care. (author)

  1. A regional-scale Ocean Health Index for Brazil.

    Science.gov (United States)

    Elfes, Cristiane T; Longo, Catherine; Halpern, Benjamin S; Hardy, Darren; Scarborough, Courtney; Best, Benjamin D; Pinheiro, Tiago; Dutra, Guilherme F

    2014-01-01

    Brazil has one of the largest and fastest growing economies and one of the largest coastlines in the world, making human use and enjoyment of coastal and marine resources of fundamental importance to the country. Integrated assessments of ocean health are needed to understand the condition of a range of benefits that humans derive from marine systems and to evaluate where attention should be focused to improve the health of these systems. Here we describe the first such assessment for Brazil at both national and state levels. We applied the Ocean Health Index framework, which evaluates ten public goals for healthy oceans. Despite refinements of input data and model formulations, the national score of 60 (out of 100) was highly congruent with the previous global assessment for Brazil of 62. Variability in scores among coastal states was most striking for goals related to mariculture, protected areas, tourism, and clean waters. Extractive goals, including Food Provision, received low scores relative to habitat-related goals, such as Biodiversity. This study demonstrates the applicability of the Ocean Health Index at a regional scale, and its usefulness in highlighting existing data and knowledge gaps and identifying key policy and management recommendations. To improve Brazil's ocean health, this study suggests that future actions should focus on: enhancing fisheries management, expanding marine protected areas, and monitoring coastal habitats.

  2. [Organizational wellbeing in the health sector: the Piemonte Region experience].

    Science.gov (United States)

    Converso, Daniela; Baratti, Alberto

    2010-01-01

    In 2007, the Health Councillorship of the Piedmont region announced, in convention with the Psychology Department of the University of Turin, of the creation of "Workgroup for Safeguard of Organizational Wellbeing" composed by psychologists, occupational doctors, and superintendents for Prevention and Protection services. This group is aimed at promoting pilot experiences in the Health Units in order to prevent and combat psychosocial discomfort and to sustain workers' wellbeing. A complex intervention started in January 2009 and involved the personnel from Services for the Organization and Development of Human Resources, Personnel Services, Services for Occupational Medicine, Services of Communication, Quality Services, belonging to all of the Health Units from Piedmont, and of some structures operating within the national health service, for a total of 23 work groups. Based on the results produced and/or from the shared reflections in the classroom between the 23 groups, four main themes were singled out, corresponding to different levels and fields of interventions, in order to favour the contrast of psychosocial distress and to promote a culture of wellbeing, were adopted taking into account needs and cultural specificity of different Units' realities. The activities embarked on, inside every main theme represent, in the expectations of all the participants, good practices that could be spread to the different Local Health Units.

  3. Transnational health care: from a global terminology towards transnational health region development.

    Science.gov (United States)

    Mainil, Tomas; Van Loon, Francis; Dinnie, Keith; Botterill, David; Platenkamp, Vincent; Meulemans, Herman

    2012-11-01

    Within European cross-border health care, recent studies have identified several types of international patients. Within the Anglo-Saxon setting, the specific terminology of medical tourism is used. The analytical purpose of the paper is to resolve this semantic difference by suggesting an alternative terminology, 'transnational health care' that is understood as a 'context-controlled and coordinated network of health services'. For demand-driven trans-border access seekers and cross-border access searchers, there is a need to opt for regional health-policy strategies. For supply-driven sending context actors and receiving context actors, there would be organizational benefits to these strategies. Applying the terminology of trans-border access seekers, cross-border access searchers, sending context and receiving context actors results in a transnational patient mobility typology of twelve types of international patients, based on the criteria of geographical distance, cultural distance and searching efforts, public/private/no cover and private/public provision of health services. Finally, the normative purpose of the paper is to encourage the use of this terminology to promote a policy route for transnational health regions. It is suggested that the development of transnational health regions, each with their own medical and supportive service characteristics, could enhance governmental context-controlled decision power in applying sustainable health destination management. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  4. Public health and health promotion capacity at national and regional level: a review of conceptual frameworks

    Directory of Open Access Journals (Sweden)

    Christoph Aluttis

    2014-04-01

    Full Text Available The concept of capacity building for public health has gained much attention during the last decade. National as well as international organizations increasingly focus their efforts on capacity building to improve performance in the health sector. During the past two decades, a variety of conceptual frameworks have been developed which describe relevant dimensions for public health capacity. Notably, these frameworks differ in design and conceptualization. This paper therefore reviews the existing conceptual frameworks and integrates them into one framework, which contains the most relevant dimensions for public health capacity at the country or regional level. A comprehensive literature search was performed to identify frameworks addressing public health capacity building at the national or regional level. We content-analysed these frameworks to identify the core dimensions of public health capacity. The dimensions were subsequently synthesized into a set of thematic areas to construct a conceptual framework which describes the most relevant dimensions for capacities at the national or regional level. The systematic review resulted in the identification of seven core domains for public health capacity: resources, organizational structures, workforce, partnerships, leadership and governance, knowledge development and country specific context. Accordingly, these dimensions were used to construct a framework, which describes these core domains more in detail. Our research shows that although there is no generally agreed upon model of public health capacity, a number of key domains for public health and health promotion capacity are consistently recurring in existing frameworks, regardless of their geographical location or thematic area. As only little work on the core concepts of public health capacities has yet taken place, this study adds value to the discourse by identifying these consistencies across existing frameworks and by synthesising

  5. Regionalizing Immigration, Health and Inequality: Iraqi Refugees in Australia

    Directory of Open Access Journals (Sweden)

    Lenore Manderson

    2012-01-01

    Full Text Available Humanitarian immigrants and refugees face multiple adjustment tasks and post-settlement support services concentrated in metropolitan areas play an important role. As part of an ongoing commitment, the Australian Government has increasingly supported resettlement in rural and regional areas of the country. Drawing on the experience of Iraqi migrants in Victoria, Australia, we examine some of the conditions that characterize regional resettlement and raise key questions for public health policy. Structural vulnerabilities and discriminations impact upon physical, mental and social wellbeing, leading to further exclusion, with negative long-term implications. The discussion throws light on the issues that migrants and refugees may encounter in other parts within Australia, but are also germane in many countries and highlight the resulting complexity for policy-making.

  6. Integration services to enable regional shared electronic health records.

    Science.gov (United States)

    Oliveira, Ilídio C; Cunha, João P S

    2011-01-01

    eHealth is expected to integrate a comprehensive set of patient data sources into a coherent continuum, but implementations vary and Portugal is still lacking on electronic patient data sharing. In this work, we present a clinical information hub to aggregate multi-institution patient data and bridge the information silos. This integration platform enables a coherent object model, services-oriented applications development and a trust framework. It has been instantiated in the Rede Telemática de Saúde (www.RTSaude.org) to support a regional Electronic Health Record approach, fed dynamically from production systems at eight partner institutions, providing access to more than 11,000,000 care episodes, relating to over 350,000 citizens. The network has obtained the necessary clearance from the Portuguese data protection agency.

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

    Science.gov (United States)

    Bowen, Kathryn J; Ebi, Kristie L

    2017-09-01

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

  8. Health conditions and role limitation in three European Regions: a public-health perspective.

    Science.gov (United States)

    Barbaglia, Gabriela; Adroher, Núria D; Vilagut, Gemma; Bruffaerts, Ronny; Bunting, Brentan; Caldas de Almeida, José Miguel; Florescu, Silvia; de Girolamo, Giovanni; de Graaf, Ron; Haro, Josep Maria; Hinkov, Hristo; Kovess-Masfety, Vivianne; Matschinger, Herbert; Alonso, Jordi

    To describe the distribution of role limitation in the European population aged 18-64 years and to examine the contribution of health conditions to role limitation using a public-health approach. Representative samples of the adult general population (n=13,666) aged 18-64 years from 10 European countries of the World Mental Health (WMH) Surveys Initiative, grouped into three regions: Central-Western, Southern and Central-Eastern. The Composite International Diagnostic Interview (CIDI 3.0) was used to assess six mental disorders and standard checklists for seven physical conditions. Days with full and with partial role limitation in the month previous to the interview were reported (WMH-WHODAS). Population Attributable Fraction (PAFs) of full and partial role limitation were estimated. Health conditions explained a large proportion of full role limitation (PAF=62.6%) and somewhat less of partial role limitation (46.6%). Chronic pain was the single condition that consistently contributed to explain both disability measures in all European Regions. Mental disorders were the most important contributors to full and partial role limitation in Central-Western and Southern Europe. In Central-Eastern Europe, where mental disorders were less prevalent, physical conditions, especially cardiovascular diseases, were the highest contributors to disability. The contribution of health conditions to role limitation in the three European regions studied is high. Mental disorders are associated with the largest impact in most of the regions. There is a need for mainstreaming disability in the public health agenda to reduce the role limitation associated with health conditions. The cross-regional differences found require further investigation. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Rating the Efficiency of Regional Health Systems and Compulsory Health Insurance

    Directory of Open Access Journals (Sweden)

    Tatyana Nikolayevna Russkikh

    2015-12-01

    Full Text Available In the face of increasing of the regional differentiation of the health systems and compulsory health insurance, the comparative analysis and efficiency assessment of their performance in the context of the subjects of the Russian Federation becomes particularly relevant. Therefore, the research is focused on the regional health systems and compulsory health insurance (CHI, and the subject matter of the study is the analysis of the system performance. In the article, the comparative analysis of the authors’ approaches to the formation of efficiency criteria of the performance of regional health systems and CHI, as well as to the development of a typology of the constituent entities of the Russian Federation based on these criteria is conducted. The authors propose a system of indicators to measure the economic, medical and social efficiency of the systems under consideration. Moreover, a set of indicators of economic efficiency forms two groups of indicators. The first group of indicators reflects the financial performance, and the second — the structural efficiency. A methodological approach to the formation of the rating for subjects of the Russian Federation according to the levels of efficiency, based on the procedures of cluster analysis and fuzzy mathematics are developed. A feature of the proposed approach to the construction of a typology of the subjects in terms of efficiency is the introduction of a reference subject with the national average performance indicators system that allows to qualitatively assess the effectiveness of regional health systems and CHI by comparing them with the «reference subject». The results of the empirical research have indicated a high differentiation of the subjects of the Russian Federation in terms of economic efficiency, have allowed to identify the subjects-outsiders. The theoretical and practical results can be used for the rational choice of priorities of the state policy in the field of the

  10. The use of a policy dialogue to facilitate evidence-informed policy development for improved access to care: the case of the Winnipeg Central Intake Service (WCIS).

    Science.gov (United States)

    Damani, Zaheed; MacKean, Gail; Bohm, Eric; DeMone, Brie; Wright, Brock; Noseworthy, Tom; Holroyd-Leduc, Jayna; Marshall, Deborah A

    2016-10-18

    Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba. Using guiding principles of public participation processes, we hosted a policy roundtable meeting to engage stakeholders and use their input to refine the policy directions. Here, we report on the use and input of a policy roundtable meeting and its role in contributing to the development of evidence-informed policy. Our evidence-informed policy directions focused on formal measurement/monitoring of quality, central intake as a preferred model for service delivery, provincial scope, transparent processes/performance indicators, and patient choice of provider. We held a policy roundtable meeting and used outcomes of facilitated discussions to refine these directions. Individuals from our team and six stakeholder groups across Manitoba participated (n = 44), including patients, family physicians, orthopaedic surgeons, surgical office assistants, Winnipeg Central Intake team, and administrators/managers. We developed evaluation forms to assess the meeting process, and collected decision-maker partners' perspectives on the value of the policy roundtable meeting and use of policy directions to improve access to scheduled clinical services after the meeting, and again 15 months later. We analyzed roundtable and evaluation data using thematic analysis to identify key themes. Four key findings emerged. First, participants supported all policy directions, with revisions and key implementation considerations identified. Second, participants felt the policy roundtable

  11. Health-care users, key community informants and primary health care workers' views on health, health promotion, health assets and deficits: qualitative study in seven Spanish regions.

    Science.gov (United States)

    Pons-Vigués, Mariona; Berenguera, Anna; Coma-Auli, Núria; Pombo-Ramos, Haizea; March, Sebastià; Asensio-Martínez, Angela; Moreno-Peral, Patricia; Mora-Simón, Sara; Martínez-Andrés, Maria; Pujol-Ribera, Enriqueta

    2017-06-13

    Although some articles have analysed the definitions of health and health promotion from the perspective of health-care users and health care professionals, no published studies include the simultaneous participation of health-care users, primary health care professionals and key community informants. Understanding the perception of health and health promotion amongst these different stakeholders is crucial for the design and implementation of successful, equitable and sustainable measures that improve the health and wellbeing of populations. Furthermore, the identification of different health assets and deficits by the different informants will generate new evidence to promote healthy behaviours, improve community health and wellbeing and reduce preventable inequalities. The objective of this study is to explore the concept of health and health promotion and to compare health assets and deficits as identified by health-care users, key community informants and primary health care workers with the ultimate purpose to collect the necessary data for the design and implementation of a successful health promotion intervention. A descriptive-interpretive qualitative research was conducted with 276 participants from 14 primary care centres of 7 Spanish regions. Theoretical sampling was used for selection. We organized 11 discussion groups and 2 triangular groups with health-care users; 30 semi-structured interviews with key community informants; and 14 discussion groups with primary health care workers. A thematic content analysis was carried out. Health-care users and key community informants agree that health is a complex, broad, multifactorial concept that encompasses several interrelated dimensions (physical, psychological-emotional, social, occupational, intellectual, spiritual and environmental). The three participants' profiles consider health promotion indispensable despite defining it as complex and vague. In fact, most health-care users admit to having

  12. Population health and status of epidemiology: WHO European Region I.

    Science.gov (United States)

    Rahu, Mati; Vlassov, Vasiliy V; Pega, Frank; Andreeva, Tatiana; Ay, Pinar; Baburin, Aleksei; Bencko, Vladimír; Csépe, Péter; Gebska-Kuczerowska, Anita; Ondrusová, Martina; Ribak, Joseph

    2013-06-01

    This article of the International Epidemiological Association commissioned paper series stocktakes the population health and status of epidemiology in 21 of the 53 countries of the WHO European Region. By United Nations geographical classification, these countries belong to Eastern Europe, Western Asia and South-Central Asia. Published data were used to describe population health indicators and risk factors. Epidemiological training and research was assessed based on author knowledge, information searches and E-mail survey of experts. Bibliometric analyses determined epidemiological publication outputs. Between-country differences in life expectancy, amount and profile of disease burden and prevalence of risk factors are marked. Epidemiological training is affected by ongoing structural reforms of educational systems. Training is advanced in Israel and several Eastern European countries. Epidemiological research is mainly university-based in most countries, but predominantly conducted by governmental research institutes in several countries of the former Soviet Union. Funding is generally external and limited, partially due to competition from and prioritization of biomedical research. Multiple relevant professional societies exist, especially in Poland, the Czech Republic and Hungary. Few of the region's 39 epidemiological academic journals have international currency. The number of epidemiological publications per population is highest for Israel and lowest for South-Central Asian countries. Epidemiological capacity will continue to be heterogeneous across the region and depend more on countries' individual historical, social, political and economic conditions and contexts than their epidemiologists' successive efforts. National and international research funding, and within- and between-country collaborations should be enhanced, especially for South-Central Asian countries.

  13. Moving towards South-South International Health: debts and challenges in the regional health agenda.

    Science.gov (United States)

    Herrero, María Belén

    2017-07-01

    The aim of this paper is twofold. First, it aims to investigate the increased interest in health as an important dimension of the foreign policy and diplomatic concerns together with the emergence of a new framework for regional health integration and regional health diplomacy. Second, it seeks to understand the role and practices of new regional blocs in the field of health and whether they are conducting to the emergence of new strategies for addressing health regional policies in South America. The regional policy process relates to health as a right. Thus, some practices and processes in social policy are setting new standards for political and social cohesion in the construction of new regionalism. Health crosses national, regional, and global agendas in a multi-directional fashion, rather than via one-way, top-down policy transfer. A special feature of Unasur is upholding regional health sovereignty despite the unique fact that member countries retain national autonomy. Unasur has projected foreign policy that promotes social values in ways that seem innovative. Experience as Unasur shows that regional organisms can become a game changer in global diplomacy and an influential actor in the international agenda. Resumen El objetivo de este artículo es doble. En primer lugar,investigar el creciente interés en la salud como una dimensión importante de la política exterior, en sintonía con el surgimiento de un nuevo marcopara la integración regional y la diplomacia en salud. En segundo lugar, comprender el papel y las prácticas de los nuevos bloques regionales en el campo de la salud y si estasconducena la emergencia de nuevas estrategias para abordar las políticas sanitarias regionales en América del Sur. Los nuevos procesos de integración regional se refieren a la salud como un derecho. Así, algunas prácticas y procesos de la política regional están estableciendo nuevos patrones de cohesión política y social en el avancede un nuevo regionalismo

  14. Integración regional andina en salud Health in Andean regional integration

    Directory of Open Access Journals (Sweden)

    Carlos A. Agudelo

    2007-01-01

    Full Text Available A pesar su historia compartida, los países de la Región Andina presentan una diversidad social y política que genera realidades sanitarias heterogéneas y procesos de integración complejos. Se han dado por décadas procesos generales, como la Asociación Latinoamericana de Libre Comercio y la Asociación Latinoamericana de Integración, o de alcance regional como la Comunidad Andina de Naciones, la Comunidad del Caribe y el Mercado Común Centroamericano. En el campo específico de la salud se cuenta con un instrumento en la Región Andina, el Convenio Hipólito Unánue, creado en 1971. Estos procesos de integración se han concentrado en los aspectos económicos, con base en acuerdos de preferencias arancelarias, los cuales han generado, en el largo plazo, un intercambio comercial apreciable. En el campo de la salud se ha avanzado menos, en términos de procesos que ponen en común experiencias nacionales, conocimientos y capacidades. El análisis de las experiencias de integración en salud muestra que esta depende de las fortalezas de cada país y, en gran parte, de los procesos políticos nacionales.Despite their shared history, the Andean countries are socially and politically diverse, with heterogeneous health realities and complex integration processes. General developments such as the Latin American Free Trade Association and Latin American Integration Association have existed for decades, along with others of a regional scope, like the Andean Community of Nations, Caribbean Community, and Central American Common Market. The health field has a specific instrument in the Andean Region called the Hipólito Unánue Agreement, created in 1971. Integration processes have concentrated on economic aspects, based on preferential customs agreements that have led to an important long-term increase in trade. Less progress has been made in the field of health in terms of sharing national experiences, knowledge, and capabilities. Analysis of

  15. eHealth for Remote Regions: Findings from Central Asia Health Systems Strengthening Project.

    Science.gov (United States)

    Sajwani, Afroz; Qureshi, Kiran; Shaikh, Tehniat; Sayani, Saleem

    2015-01-01

    Isolated communities in remote regions of Afghanistan, Kyrgyz Republic, Pakistan and Tajikistan lack access to high-quality, low-cost health care services, forcing them to travel to distant parts of the country, bearing an unnecessary financial burden. The eHealth Programme under Central Asia Health Systems Strengthening (CAHSS) Project, a joint initiative between the Aga Khan Foundation, Canada and the Government of Canada, was initiated in 2013 with the aim to utilize Information and Communication Technologies to link health care institutions and providers with rural communities to provide comprehensive and coordinated care, helping minimize the barriers of distance and time. Under the CAHSS Project, access to low-cost, quality health care is provided through a regional hub and spoke teleconsultation network of government and non-government health facilities. In addition, capacity building initiatives are offered to health professionals. By 2017, the network is expected to connect seven Tier 1 tertiary care facilities with 14 Tier 2 secondary care facilities for teleconsultation and eLearning. From April 2013 to September 2014, 6140 teleconsultations have been provided across the project sites. Additionally, 52 new eLearning sessions have been developed and 2020 staff members have benefitted from eLearning sessions. Ethics and patient rights are respected during project implementation.

  16. For two regional health foundations, returns from the Kentucky Health Issues Poll are worth the investments.

    Science.gov (United States)

    Walsh, Sarah E; Myers, Gail; Chubinski, Jennifer; Zepeda, Susan G

    2014-09-01

    With finite resources to advance their missions, regional health foundations should critically evaluate the investments they make. This article reviews the costs and associated benefits of large-scale public opinion polling--specifically, the annual Kentucky Health Issues Poll, which is sponsored by the Foundation for a Healthy Kentucky and Interact for Health, formerly the Health Foundation of Greater Cincinnati. In addition to the information generated by the poll, the sponsoring foundations have benefited from increased name recognition and credibility with key stakeholders, including state policy makers and the media. Furthermore, jointly funding the poll has strengthened the relationship between the sponsoring foundations and has fostered other key collaborations. We find that the benefits from this poll more than justify its modest costs ($120,000 per year) and hope that this assessment may prove informative for other funders considering similar investments. Project HOPE—The People-to-People Health Foundation, Inc.

  17. Examination of health status of population from Uranium contaminated regions

    International Nuclear Information System (INIS)

    Milacic, S.; Jovicic, D.; Pantelic, G.; Kovacevic, R.; Pavlovic, M.; Tanaskovic, I.

    2002-01-01

    malignant diseases and congenital malformations, and they develop after 5-20 years. Health surveillance of potentially exposed population from the contaminated regions, based on the Health program for occupationally exposed individuals and monitoring of biological parameters indicative of internal radioactive contamination, the disease may be anticipated and treated in time. Therefore, we proposed surveillance program targeted at population of contaminated regions of our country and the initial results of the research are presented in this paper

  18. MANAGEMENT OF INNOVATION IN HEALTH CARE AT THE REGIONAL LEVEL

    Directory of Open Access Journals (Sweden)

    Ye. G. Totskaya

    2014-01-01

    Full Text Available The paper reviews topical issues of organization and management of innovative activity in the regional health care system.Objective. Development and scientific substantiation of a conceptual model of managing innovation in the regional health care system, introduction of institutional mechanisms for its implementation, and evaluation of their efficacy in using diagnosis and treatment technologies. Objectives of the study included reviewing the organization status and problems hampering the development, identification of prospects, and justification for appropriate changes in innovation in healthcare system and medical science at the regional level.Material and methods. To conduct a comprehensive assessment of the status and meet challenges of innovation promotion, a methodology for social-hygienic research was worked out including bibliographic and analytical methods, situational analysis, sociological and economic methods, expert assessment, methods for quality management system audit in accordance with ISO 19011:2002, IDEFO function modeling (RD IDEF0-2000, and organizational modeling. The study was based on the analysis of foreign and domestic literature, statistics, methods for managerial modeling, as well as management experience (including innovative methodological approaches gained by Novosibirsk Research Institute of Traumatology and Orthopedics named after Ya.L. Tsivyan which meets the requirements for a platform for research and innovative product reproduction, including research, clinical, organizational, and managerial aspects. Other facilities were considered in conjunction with the leading innovative platform.Results. The paper presents a scientifically based model of innovative medical environment with its elements as subjects, each with a set of functions. Conceptual model for management includes structuring (resource, processes, and quality management; application of international standards and strategic management mechanisms

  19. Information support for health information management in regional Sri Lanka: health managers' perspectives.

    Science.gov (United States)

    Ranasinghe, Kaduruwane Indika; Chan, Taizan; Yaralagadda, Prasad

    Good management, supported by accurate, timely and reliable health information, is vital for increasing the effectiveness of Health Information Systems (HIS). When it comes to managing the under-resourced health systems of developing countries, information-based decision making is particularly important. This paper reports findings of a self-report survey that investigated perceptions of local health managers (HMs) of their own regional HIS in Sri Lanka. Data were collected through a validated, pre-tested postal questionnaire, and distributed among a selected group of HMs to elicit their perceptions of the current HIS in relation to information generation, acquisition and use, required reforms to the information system and application of information and communication technology (ICT). Results based on descriptive statistics indicated that the regional HIS was poorly organised and in need of reform; that management support for the system was unsatisfactory in terms of relevance, accuracy, timeliness and accessibility; that political pressure and community and donor requests took precedence over vital health information when management decisions were made; and use of ICT was unsatisfactory. HIS strengths included user-friendly paper formats, a centralised planning system and an efficient disease notification system; weaknesses were lack of comprehensiveness, inaccuracy, and lack of a feedback system. Responses of participants indicated that HIS would be improved by adopting an internationally accepted framework and introducing ICT applications. Perceived barriers to such improvements were high initial cost of educating staff to improve computer literacy, introduction of ICTs, and HIS restructure. We concluded that the regional HIS of Central Province, Sri Lanka had failed to provide much-needed information support to HMs. These findings are consistent with similar research in other developing countries and reinforce the need for further research to verify causes of

  20. Regional and inter-regional economic rules and the enforcement of the right to health: The case of Colombia.

    Science.gov (United States)

    Rodríguez, Liliana Lizarazo; De Lombaerde, Philippe

    2015-12-01

    The regional policy level is often seen as a (potential) source of progressive policy-making in health (and in social policy more widely), complementing or substituting national policy levels, which are perceived as underperforming. While it can certainly be argued that there are important opportunities to adopt regional approaches to tackle border-crossing health issues, this article draws the attention to the fact that the linkage between (inter-)regional and national policy levels is not uni-directional. While in some instances the regional level may indeed take the lead in the promotion of (the right to) health, in other instances it may well be the other way round. This article focuses on the case of Colombia, where international economic rules have deeply permeated public policies in the health sector. On one hand, Colombia has been opening markets through the conclusion of regional integration arrangements (e.g. Andean Community and the Pacific Alliance) and the new generation of Free Trade Agreements. On the other hand, Colombia has been one of the most active emerging countries in promoting the right to health as a justiciable fundamental right, in line with the International Covenant on Economic, Social, and Cultural Rights of the United Nations mainly due to the judicial activism of the Colombian Constitutional Court with interesting implications for regional social governance. The article shows that national courts can play an important role in the protection of the right to health in a context of economic integration and the absence of regional balancing policies.

  1. Forecasting drug utilization and expenditure in a metropolitan health region

    Directory of Open Access Journals (Sweden)

    Korkmaz Seher

    2010-05-01

    Full Text Available Abstract Background New pharmacological therapies are challenging the healthcare systems, and there is an increasing need to assess their therapeutic value in relation to existing alternatives as well as their potential budget impact. Consequently, new models to introduce drugs in healthcare are urgently needed. In the metropolitan health region of Stockholm, Sweden, a model has been developed including early warning (horizon scanning, forecasting of drug utilization and expenditure, critical drug evaluation as well as structured programs for the introduction and follow-up of new drugs. The aim of this paper is to present the forecasting model and the predicted growth in all therapeutic areas in 2010 and 2011. Methods Linear regression analysis was applied to aggregate sales data on hospital sales and dispensed drugs in ambulatory care, including both reimbursed expenditure and patient co-payment. The linear regression was applied on each pharmacological group based on four observations 2006-2009, and the crude predictions estimated for the coming two years 2010-2011. The crude predictions were then adjusted for factors likely to increase or decrease future utilization and expenditure, such as patent expiries, new drugs to be launched or new guidelines from national bodies or the regional Drug and Therapeutics Committee. The assessment included a close collaboration with clinical, clinical pharmacological and pharmaceutical experts from the regional Drug and Therapeutics Committee. Results The annual increase in total expenditure for prescription and hospital drugs was predicted to be 2.0% in 2010 and 4.0% in 2011. Expenditures will increase in most therapeutic areas, but most predominantly for antineoplastic and immune modulating agents as well as drugs for the nervous system, infectious diseases, and blood and blood-forming organs. Conclusions The utilisation and expenditure of drugs is difficult to forecast due to uncertainties about the rate

  2. Analysis of judicial demands in health at the Regional Health Department XII

    Directory of Open Access Journals (Sweden)

    Leticia Florido Povinske Domingues

    2017-08-01

    Full Text Available The management of lawsuits in health represents a challenge for most Brazilian municipalities. Many papers described in the literature characterized properly the problem as well as discussed the repercussions on the Unified Health System.In this context, the objective of this study was to analyze the situation of health judicial processes at the twelfth Regional Department in Registro, São Paulo´s state, evaluating the profile of the users who claim in court the couverage of treatment´s costs as well as examination, procedure or medication. For this, we analyzed data on lawsuits in the health field at the twelfth Regional Department in Registro (SP from january 2009 to october 2015.The variables studied were gender, age, municipality of origin of the lawsuit, the mentioned disease, the medical prescription origin, specialty of the prescriber, type of lawsuit triggered, year of the lawsuit, entity judicially triggered and requested items. It was analyzed thirty-eight lawsuits against the twelfth Regional Department, it was observed the prevalence of the female gender, age group above 51 years and originating from the municipality of Registro (SP.The most of the judicial actions are for care given at the Unified Health System, by prescribers of specialty in Clinical Medicine and diagnosed with Diabetes Mellitus. The processes were characterized in the majority by judicial actions called Ordinary Rite, against the State. On the analyzed cases, 92% requested only medications and of these 11% supplements like vitamins and enteral diets.The number of patients who have been served through legal actions in the last three years reached 47% of the total cases registered during the period of the seven years analyzed and the approximate cost was R$ 1,340,000.00.This study contributes to the diagnosis of the processes related to the health judicialization in the region studied. The results showed a predominance of processes which comes from of patients

  3. Regional and inter-regional economic rules and the enforcement of the right to health: The case of Colombia

    Science.gov (United States)

    Rodríguez, Liliana Lizarazo; De Lombaerde, Philippe

    2015-01-01

    The regional policy level is often seen as a (potential) source of progressive policy-making in health (and in social policy more widely), complementing or substituting national policy levels, which are perceived as underperforming. While it can certainly be argued that there are important opportunities to adopt regional approaches to tackle border-crossing health issues, this article draws the attention to the fact that the linkage between (inter-)regional and national policy levels is not uni-directional. While in some instances the regional level may indeed take the lead in the promotion of (the right to) health, in other instances it may well be the other way round. This article focuses on the case of Colombia, where international economic rules have deeply permeated public policies in the health sector. On one hand, Colombia has been opening markets through the conclusion of regional integration arrangements (e.g. Andean Community and the Pacific Alliance) and the new generation of Free Trade Agreements. On the other hand, Colombia has been one of the most active emerging countries in promoting the right to health as a justiciable fundamental right, in line with the International Covenant on Economic, Social, and Cultural Rights of the United Nations mainly due to the judicial activism of the Colombian Constitutional Court with interesting implications for regional social governance. The article shows that national courts can play an important role in the protection of the right to health in a context of economic integration and the absence of regional balancing policies. PMID:26635499

  4. Health care and patients' migration across Spanish regions.

    Science.gov (United States)

    Cantarero, David

    2006-06-01

    This paper analyses patient mobility across Spanish regions. A model of patient migration is specified and estimated using panel observations covering mobility and other main regional quality indicators over the period 1996-1999. Empirical results show that in Spain income and supply variables determines the quality of the service offered,, and that there is quality-driven mobility.

  5. Regionalizing the Recruitment of Health Personnel in Burkina Faso ...

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

    Human resources are essential to attaining the objectives of the Millennium development goals with respect to national health systems. In low-income countries, human health resources are characterized by a deficit of qualified personnel and an unequal distribution of existing personnel. To address these problems, the ...

  6. Correlates of maternal health care utilization in Rohilkhand region ...

    African Journals Online (AJOL)

    Maternal health care service utilization from health personnel was significantly associated with age at marriage ≥18 years, family size ≤3, birth order ≤2, nuclear family and higher socio‑economic status. Most of the pregnancy related complications were found among women aged >30 years, with birth order ≥3, having ...

  7. [Duration of work absence attributable to non work-related diseases by health regions in catalonia].

    Science.gov (United States)

    Torá Rocamora, Isabel; Martínez Martínez, José Miguel; Delclos Clanchet, Jordi; Jardí Lliberia, Josefina; Alberti Casas, Constança; Serra Pujadas, Consol; Manzanera López, Rafael; Benavides, Fernando G

    2010-01-01

    This study analyze the duration of episodes of work absence due to non work-related diseases in Catalonia by health regions, assuming a homogeneous distribution of durations between health regions. A retrospective cohort study of 811.790 episodes in 2005 and followed to episode closure through July 2007 provided by the Institut Català d'Avaluacions Mèdiques, describing their median duration (MD) in days for each of the seven health regions of Catalonia. The probability of returning to work was plotted according to Wang_Chang survival curves and median durations were then compared using the Barcelona health region as the referent group. Results were extended through stratification by sex. The Camp de Tarragona health region had the shortest MD (5 days), while the episodes in the Alt Pirineu i Aran region had the longest (MD, 13 days). The Barcelona health region had a MD of 7 days as was the case for Cataluña Central. MD in Girona was 8 days, and in Lleida and Terres de l'Ebre it was 9 days. This latter region also had the highest median duration 13 days. The are significant differences in the duration of work absence between the health regions of Catalonia. These differences persisted after adjusting for age, management of episodes and social security system status, in both men and women.

  8. Exploring Ecosystems and Health by Shifting to a Regional Focus: Perspectives from the Oceania EcoHealth Chapter

    Directory of Open Access Journals (Sweden)

    Jonathan Kingsley

    2015-10-01

    Full Text Available This article highlights contributions that can be made to the public health field by incorporating “ecosystem approaches to health” to tackle future environmental and health challenges at a regional level. This qualitative research reviews attitudes and understandings of the relationship between public health and the environment and the priorities, aspirations and challenges of a newly established group (the Oceania EcoHealth Chapter who are attempting to promote these principles. Ten semi-structured interviews with Oceania EcoHealth Chapter members highlighted the important role such groups can play in informing organisations working in the Oceania region to improve both public health and environmental outcomes simultaneously. Participants of this study emphasise the need to elevate Indigenous knowledge in Oceania and the role regional groups play in this regard. They also emphasis that regional advocacy and ecosystem approaches to health could bypass silos in knowledge and disciplinary divides, with groups like the Oceania EcoHealth Chapter acting as a mechanism for knowledge exchange, engagement, and action at a regional level with its ability to bridge the gap between environmental stewardship and public health.

  9. Exploring Ecosystems and Health by Shifting to a Regional Focus: Perspectives from the Oceania EcoHealth Chapter

    Science.gov (United States)

    Kingsley, Jonathan; Patrick, Rebecca; Horwitz, Pierre; Parkes, Margot; Jenkins, Aaron; Massy, Charles; Henderson-Wilson, Claire; Arabena, Kerry

    2015-01-01

    This article highlights contributions that can be made to the public health field by incorporating “ecosystem approaches to health” to tackle future environmental and health challenges at a regional level. This qualitative research reviews attitudes and understandings of the relationship between public health and the environment and the priorities, aspirations and challenges of a newly established group (the Oceania EcoHealth Chapter) who are attempting to promote these principles. Ten semi-structured interviews with Oceania EcoHealth Chapter members highlighted the important role such groups can play in informing organisations working in the Oceania region to improve both public health and environmental outcomes simultaneously. Participants of this study emphasise the need to elevate Indigenous knowledge in Oceania and the role regional groups play in this regard. They also emphasis that regional advocacy and ecosystem approaches to health could bypass silos in knowledge and disciplinary divides, with groups like the Oceania EcoHealth Chapter acting as a mechanism for knowledge exchange, engagement, and action at a regional level with its ability to bridge the gap between environmental stewardship and public health. PMID:26473903

  10. ORIGINAL ARTICLE Oral Health in the African Region: Progress ...

    African Journals Online (AJOL)

    Ogunbodede

    and to reinforce partnerships in order to mobilize and coordinate the human, financial, material and institutional resources needed .... strengthened their health facilities ... management information systems; ... professional associations, business and ... facilitating the implementation process as ... of Dentistry, University of the.

  11. Health effects in residents of regions with high background radiation

    International Nuclear Information System (INIS)

    Hanson, G.P.

    1984-01-01

    Possible health problems created by high natural levels of background radiation are hard to detect, partly because the health problems involved would exist to some degree irrespective of radiation exposure, partly because other factors affect the incidence of such problems, and partly because the differences between normal background radiation levels and radiation levels found in most high-radiation areas are not extreme. Nevertheless, the need to know about such health effects is evident, and so various studies conducted over the past 30 years have sought to determine whether those effects exist and what they are. Overall, however, the fragmentary and uncertain nature of many of these findings makes it hard to draw firm conclusions about the health risks involved or the desirability of countermeasures. So despite considerable efforts and some progress over the past three decades, the need for a clear quantitative assessment of the consequences is as great as ever

  12. Correlates of Maternal Health Care Utilization in Rohilkhand Region ...

    African Journals Online (AJOL)

    Bareilly district, Uttar Pradesh to cover maximum number of women. All currently ... inequalities in the utilization of maternal health care services have been ..... With regard to work status, one study made in four Indian states supports our ...

  13. Towards quality criteria for regional public health reporting: concept mapping with Dutch experts.

    Science.gov (United States)

    van Bon-Martens, Marja J H; Achterberg, Peter W; van de Goor, Ien A M; van Oers, Hans A M

    2012-06-01

    In the Netherlands, municipal health assessments are carried out by 28 Regional Health Services, serving 418 municipalities. In the absence of guidelines, regional public health reports were developed in two pilot regions on the basis of the model and experience of national health reporting. Though they were well received and positively evaluated, it was not clear which specific characteristics determined 'good public health reporting'. Therefore, this study was set up to develop a theoretical framework for the quality of regional public health reporting in The Netherlands. Using concept mapping as a standardized tool for conceptualization, 35 relevant reporting experts formulated short statements in two different brainstorming sessions, describing specific quality criteria of regional public health reports. After the removal of duplicates, the list was supplemented with international criteria, and the statements were sent to each participant for rating and sorting. The results were processed statistically and represented graphically. The output was discussed and interpreted, leading to the final concept map. The final concept map consisted of 97 criteria, grouped into 13 clusters, and plotted in two dimensions: a 'product' dimension, ranging from 'production' to 'content', and a 'context' dimension, ranging from 'science' to 'policy'. The three most important clusters were: (i) 'solution orientation', (ii) 'policy relevance' and (iii) 'policy impact'. This study provided a theoretical framework for the quality of regional public health reporting, indicating relevant domains and criteria. Further work should translate domains and criteria into operational indicators for evaluating regional public health reports.

  14. Regional differences in antihyperglycemic medication are not explained by individual socioeconomic status, regional deprivation, and regional health care services. Observational results from the German DIAB-CORE consortium.

    Directory of Open Access Journals (Sweden)

    Christina Bächle

    Full Text Available This population-based study sought to extend knowledge on factors explaining regional differences in type 2 diabetes mellitus medication patterns in Germany.Individual baseline and follow-up data from four regional population-based German cohort studies (SHIP [northeast], CARLA [east], HNR [west], KORA [south] conducted between 1997 and 2010 were pooled and merged with both data on regional deprivation and regional health care services. To analyze regional differences in any or newer anti-hyperglycemic medication, medication prevalence ratios (PRs were estimated using multivariable Poisson regression models with a robust error variance adjusted gradually for individual and regional variables.The study population consisted of 1,437 people aged 45 to 74 years at baseline, (corresponding to 49 to 83 years at follow-up with self-reported type 2 diabetes. The prevalence of receiving any anti-hyperglycemic medication was 16% higher in KORA (PR 1.16 [1.08-1.25], 10% higher in CARLA (1.10 [1.01-1.18], and 7% higher in SHIP (PR 1.07 [1.00-1.15] than in HNR. The prevalence of receiving newer anti-hyperglycemic medication was 49% higher in KORA (1.49 [1.09-2.05], 41% higher in CARLA (1.41 [1.02-1.96] and 1% higher in SHIP (1.01 [0.72-1.41] than in HNR, respectively. After gradual adjustment for individual variables, regional deprivation and health care services, the effects only changed slightly.Neither comprehensive individual factors including socioeconomic status nor regional deprivation or indicators of regional health care services were able to sufficiently explain regional differences in anti-hyperglycemic treatment in Germany. To understand the underlying causes, further research is needed.

  15. Regional variation in the predictive validity of self-rated health for mortality

    Directory of Open Access Journals (Sweden)

    Edward R. Berchick

    2017-12-01

    Full Text Available Self-rated health (SRH is a commonly used measure for assessing general health in surveys in the United States. However, individuals from different parts of the United States may vary in how they assess their health. Geographic differences in health care access and in the prevalence of illnesses may make it difficult to discern true regional differences in health when using SRH as a health measure. In this article, we use data from the 1986 and 1989–2006 National Health Interview Survey Linked Mortality Files and estimate Cox regression models to examine whether the relationship between SRH and five-year all-cause mortality differs by Census region. Contrary to hypotheses, there is no evidence of regional variation in the predictive validity of SRH for mortality. At all levels of SRH, and for both non-Hispanic white and non-Hispanic black respondents, SRH is equally and strongly associated with five-year mortality across regions. Our results suggest that differences in SRH across regions are not solely due to differences in how respondents assess their health across regions, but reflect true differences in health. Future research can, therefore, employ this common measure to investigate the geographic patterning of health in the United States.

  16. Child health in Peru: importance of regional variation and community effects on children's height and weight.

    Science.gov (United States)

    Shin, Heeju

    2007-12-01

    In developing countries, height and weight are good indicators of children's health and nutritional status. Maternal education has been accepted as one of the most important influences on child health. Using the 2000 Demographic and Health Survey of Peru, however, I find that the effect of maternal education varies as a function of region. In the most prosperous urban region, maternal education is less important for child health than in poor rural areas, and a higher level of education has a greater effect in rural areas. Multilevel analysis shows that a significant part of the observed correlation between maternal education and child health is moderated by regional differences and community characteristics. The finding suggests that Peruvian public policy should emphasize resource redistribution as well as women's education, and that investment in maternal education should be considered within regional contexts to enhance child health in rural areas.

  17. [Mobile Health Units: An Analysis of Concepts and Implementation Requirements in Rural Regions.

    Science.gov (United States)

    Hämel, K; Kutzner, J; Vorderwülbecke, J

    2017-12-01

    Access to health services in rural regions represents a challenge. The development of care models that respond to health service shortages and pay particular attention to the increasing health care needs of the elderly is an important concern. A model that has been implemented in other countries is that of mobile health units. But until now, there is no overview of their possible objectives, functions and implementation requirements. This paper is based on a literature analysis and an internet research on mobile health units in rural regions. Mobile health units aim to avoid regional undersupply and address particularly vulnerable population groups. In the literature, mobile health units are described with a focus on specific illnesses, as well as those that provide comprehensive, partly multi-professional primary care that is close to patients' homes. The implementation of mobile health units is demanding; the key challenges are (a) alignment to the needs of the regional population, (b) user-oriented access and promotion of awareness and acceptance of mobile health units by the local population, and (c) network building within existing care structures to ensure continuity of care for patients. To fulfill these requirements, a community-oriented program development and implementation is important. Mobile health units could represent an interesting model for the provision of health care in rural regions in Germany. International experiences are an important starting point and should be taken into account for the further development of models in Germany. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Opposite poles: A comparison between two Spanish regions in health-related quality of life, with implications for health policy

    Directory of Open Access Journals (Sweden)

    López-Valcárcel Beatriz G

    2010-09-01

    Full Text Available Abstract Background Although health is one of the main determinants of the welfare of societies, few studies have evaluated health related quality of life in representative samples of the population of a region or a country. Our aim is to describe the health-related quality of life of the inhabitants of two quite different Spanish regions (Canary Islands and Catalonia and to compare the prevalence of health problems between age-sex groups. Methods We use data obtained from the 2006 Health Survey of Catalonia and the 2004 Canary Islands Health Survey. With an ordinal composite variable measuring HRQOL we identify the association of characteristics of individuals with self-reported quality of life and test for differences between the regions. Results The prevalence of problems in the five EQ-5 D dimensions increases with age and is generally higher for women than for men. The dimension with the highest prevalence of problems is "anxiety/depression", and there is noteworthy the extent of discomfort and pain among Canary Island women. Education, especially among the elderly, has an important effect on health-related quality of life. Conclusions There are substantial structural and compositional differences between the two regions. Regional context is a significant factor, independent of the compositional differences, and the effects of context are manifest above all in women. The findings show the importance of disease prevention and the need for improving the educational level of the population in order to reduce health inequalities.

  19. Health effects in residents of high background radiation regions

    International Nuclear Information System (INIS)

    Hanson, G.P.

    1984-01-01

    Although the health effects of radiation doses in occupationally exposed persons had received attention, it was not until the 1950s, when the atmospheric atom bomb tests of the United States and the Soviet Union had raised the level of environmental radioactivity, that the long-term effects of low-level radiation dosage became a matter of popular concern throughout the world. The United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) was created, and the World Health Organization (WHO) appointed an expert committee to provide advice concerning radiation and human health. In its first report, the WHO expert committee identified several areas of high natural radiation where studies of the exposed population might possibly provide information concerning the effects of chromic low-level radiation dosage

  20. [Network Analyses in Regional Health Care Research: Example of Dermatological Care in the Metropolitan Region of Hamburg].

    Science.gov (United States)

    Augustin, J; Austermann, J; Erasmi, S

    2016-10-18

    Background: One of the overall objectives of the legislator is to ensure an overall "homogeneous", and easily accessible medical care for the population. The physician-patient ratio can be used to describe the regional health care situation. But this method does not provide information concerning the availability of, for instance, the nearest doctor. Therefore, further parameters such as accessibility must be taken into consideration. For this purpose, network analyses are an appropriate method. The objective of this study is to present methodological tools to evaluate the healthcare situation in the metropolitan region of Hamburg, primarily focusing on accessibility using dermatologists as an example. Methods: Analyzing data of 20 counties, the geographical distribution of N=357 dermatologists and the physician-patient ratio were calculated. In a second step, a network analysis regarding accessibility was performed. In order to calculate accessibility, address data (physicians) were transformed into coordinates, consisting of defined places (N=303) and restrictions (e. g. speed, turn restrictions) of the network. The calculation of population-based accessibility is based on grid cells for the population density. Results: Despite adequacy of the overall medical situation, differences in the availability of the nearest dermatologists in the metropolitan region are remarkable, particularly when use of public transport is taken into consideration. In some counties, over 60% of the population require at least one hour to get to the nearest dermatologist using public transportation. In rural regions within the metropolitan area are particularly affected. Conclusion: The network analysis has shown that the choice and availability of transportation in combination with the location (rural/urban) is essential for health care access. Especially elderly people in rural areas with restricted mobility are at a disadvantage. Therefore, modern health care approaches (e

  1. The Health Effects of Climate Change in the WHO European Region

    Directory of Open Access Journals (Sweden)

    Tanja Wolf

    2015-11-01

    Full Text Available The evidence of observed health effects as well as projections of future health risks from climate variability and climate change is growing. This article summarizes new knowledge on these health risks generated since the IPCC fourth assessment report (AR4 was published in 2007, with a specific focus on the 53 countries comprising the WHO European Region. Many studies on the effects of weather, climate variability, and climate change on health in the European Region have been published since 2007, increasing the level of certainty with regard to already known health threats. Exposures to temperature extremes, floods, storms, and wildfires have effects on cardiovascular and respiratory health. Climate- and weather-related health risks from worsening food and water safety and security, poor air quality, and ultraviolet radiation exposure as well as increasing allergic diseases, vector- and rodent-borne diseases, and other climate-sensitive health outcomes also warrant attention and policy action to protect human health.

  2. Empowering Health Care Decision-makers to Achieve Regional ...

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

    This project builds on earlier work on the development and validation of an economic model to estimate the social, economic, and health burden of tobacco, together with the expected impact of tax increases in Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, and Peru. Researchers will develop and evaluate the ...

  3. Space and place for WHO health development dialogues in the African Region.

    Science.gov (United States)

    Kirigia, Joses Muthuri; Nabyonga-Orem, Juliet; Dovlo, Delanyo Yao Tsidi

    2016-07-18

    Majority of the countries in the World Health Organization (WHO) African Region are not on track to achieve the health-related Millennium Development Goals, yet even more ambitious Sustainable Development Goals (SDGs), including SDG 3 on heath, have been adopted. This paper highlights the challenges - amplified by the recent Ebola virus disease (EVD) outbreak in West Africa - that require WHO and other partners' dialogue in support of the countries, and debate on how WHO can leverage the existing space and place to foster health development dialogues in the Region. To realise SDG 3 on ensuring healthy lives and promoting well-being for all at all ages, the African Region needs to tackle the persistent weaknesses in its health systems, systems that address the social determinants of health and national health research systems. The performance of the third item is crucial for the development and innovation of systems, products and tools for promoting, maintaining and restoring health in an equitable manner. Under its new leadership, the WHO Regional Office for Africa is transforming itself to galvanise existing partnerships, as well as forging new ones, with a view to accelerating the provision of timely and quality support to the countries in pursuit of SDG 3. WHO in the African Region engages in dialogues with various stakeholders in the process of health development. The EVD outbreak in West Africa accentuated the necessity for optimally exploiting currently available space and place for health development discourse. There is urgent need for the WHO Regional Office for Africa to fully leverage the space and place arenas of the World Health Assembly, WHO Regional Committee for Africa, African Union, Regional economic communities, Harmonization for Health in Africa, United Nations Economic Commission for Africa, African Development Bank, professional associations, and WHO African Health Forum, when it is created, for dialogues to mobilise the required resources to

  4. Déserts alimentaires à Winnipeg (Canada : une nouvelle méthodologie de mesure d'un concept complexe et controversé

    Directory of Open Access Journals (Sweden)

    Joyce Slater

    2017-01-01

    Full Text Available Introduction : Les « déserts alimentaires » ont vu le jour dans les 20 dernières années et forment des secteurs préoccupants pour les collectivités, les autorités en santé publique et les chercheurs en raison de leur effet négatif possible sur la qualité de l’alimentation et en raison de leurs conséquences sur la santé. Ce sont des espaces résidentiels, habituellement en milieu urbain, où les résidents à faible revenu n’ont que peu ou pas accès à des établissements de vente au détail d'aliments qui offrent suffisamment de variété à un prix abordable. La recherche sur les déserts alimentaires présente des défis méthodologiques, notamment la façon de repérer et de classer les magasins d’alimentation au détail, la définition de la population à faible revenu ainsi que les paramètres concernant le transport et la proximité. De plus, les méthodes complexes qui sont souvent employées dans la recherche sur les déserts alimentaires peuvent être difficiles à reproduire et à communiquer aux principaux intervenants. Pour surmonter ces difficultés, nous avons voulu montrer qu’on pouvait concevoir une méthode simple et reproductible pour repérer les déserts alimentaires, à l’aide de données facilement accessibles en contexte canadien. Méthodologie : Cette étude a été menée à Winnipeg (Canada en 2014. Les établissements de vente au détail des aliments ont été trouvés à l’aide des Pages Jaunes et vérifiés par des diététistes en santé publique. Nous avons créé deux scénarios sur les déserts alimentaires en fonction de l’emplacement de la population à quintile de revenu le plus faible : a celle qui habitait à 500 m ou plus d’une épicerie appartenant à une chaîne nationale et b celle qui habitait à 500 m ou plus d’une épicerie appartenant à une chaîne nationale ou d’une épicerie à service complet. Résultats : En fonction du scénario utilisé, 64 574 ou 104 335 r

  5. Health effects of the Chernobyl disaster: illness or illness behavior? A comparative general health survey in two former Soviet regions

    NARCIS (Netherlands)

    Havenaar, J.; Rumyantzeva, G.; Kasyanenko, A.; Kaasjager, K.; Westermann, Anneke; van den Brink, W.; van den Bout, J.; Savelkoul, J.

    1997-01-01

    Results are described of a general health survey (n = 3044) that was conducted 6.5 years after the Chernobyl accident in 1986 in a seriously contaminated region in Belarus and a socioeconomically comparable, but unaffected, region in the Russian Federation. The purpose of the study was to

  6. Status of national health research systems in ten countries of the WHO African Region

    Directory of Open Access Journals (Sweden)

    Kirigia Joses M

    2006-10-01

    Full Text Available Abstract Background The World Health Organization (WHO Regional Committee for Africa, in 1998, passed a resolution (AFR/RC48/R4 which urged its Member States in the Region to develop national research policies and strategies and to build national health research capacities, particularly through resource allocation, training of senior officials, strengthening of research institutions and establishment of coordination mechanisms. The purpose of this study was to take stock of some aspects of national resources for health research in the countries of the Region; identify current constraints facing national health research systems; and propose the way forward. Methods A questionnaire was prepared and sent by pouch to all the 46 Member States in the WHO African Region through the WHO Country Representatives for facilitation and follow up. The health research focal person in each of the countries Ministry of Health (in consultation with other relevant health research bodies in the country bore the responsibility for completing the questionnaire. The data were entered and analysed in Excel spreadsheet. Results The key findings were as follows: the response rate was 21.7% (10/46; three countries had a health research policy; one country reported that it had a law relating to health research; two countries had a strategic health research plan; three countries reported that they had a functional national health research system (NHRS; two countries confirmed the existence of a functional national health research management forum (NHRMF; six countries had a functional ethical review committee (ERC; five countries had a scientific review committee (SRC; five countries reported the existence of health institutions with institutional review committees (IRC; two countries had a health research programme; and three countries had a national health research institute (NHRI and a faculty of health sciences in the national university that conducted health research

  7. Eastern Health Board Regional Orthodontic Service: an initial audit.

    LENUS (Irish Health Repository)

    Dowling, P A

    1997-01-01

    This initial audit of 600 recently assessed Eastern Health Board orthodontic patients suggests that a large number of them (47 per cent) requires referral for routine restorative and preventive dental care. Closer links are needed with general dental practitioners and community dental surgeons to resolve these needs. The trend for a high referral of females and Class 11 Division 1 malocclusion type correlated well with studies in other countries.

  8. The health regionalization process from the perspective of the transation cost theory.

    Science.gov (United States)

    Sancho, Leyla Gomes; Geremia, Daniela Savi; Dain, Sulamis; Geremia, Fabiano; Leão, Cláudio José Silva

    2017-04-01

    This study analyzes the incidence of transaction costs in the regionalization process of health policies in the Brazilian federal system. In this work, regionalized health actions contracted and agreed between federal agencies have assumed a transactional nature. A conceptual theoretical essay of reflective nature was prepared with the purpose of questioning and proposing new approaches to improve the health regionalization process. The main considerations suggest that institutional management tools proposed by the standards and regulations of the Unified Health System have a low potential to reduce transaction costs, especially due to hardships in reconciling common goals among the entities, environment surrounded by uncertainty, asymmetries and incomplete information, bounded rationality and conflict of interest. However, regionalization can reduce the incidence of social and/or operational costs, through improved access to health and the construction of more efficient governance models.

  9. Regional health workforce planning through action research: lessons for commissioning health services from a case study in Far North Queensland.

    Science.gov (United States)

    Panzera, Annette June; Murray, Richard; Stewart, Ruth; Mills, Jane; Beaton, Neil; Larkins, Sarah

    2016-01-01

    Creating a stable and sustainable health workforce in regional, rural and remote Australia has long been a challenge to health workforce planners, policy makers and researchers alike. Traditional health workforce planning is often reactive and assumes continuation of current patterns of healthcare utilisation. This demonstration project in Far North Queensland exemplifies how participatory regional health workforce planning processes can accurately model current and projected local workforce requirements. The recent establishment of Primary Health Networks (PHNs) with the intent to commission health services tailored to individual healthcare needs underlines the relevance of such an approach. This study used action research methodology informed by World Health Organization (WHO) systems thinking. Four cyclical stages of health workforce planning were followed: needs assessment; health service model redesign; skills-set assessment and workforce redesign; and development of a workforce and training plan. This study demonstrated that needs-based loco-regional health workforce planning can be achieved successfully through participatory processes with stakeholders. Stronger health systems and workforce training solutions were delivered by facilitating linkages and planning processes based on community need involving healthcare professionals across all disciplines and sectors. By focusing upon extending competencies and skills sets, local health professionals form a stable and sustainable local workforce. Concrete examples of initiatives generated from this process include developing a chronic disease inter-professional teaching clinic in a rural town and renal dialysis being delivered locally to an Aboriginal community. The growing trend of policy makers decentralising health funding, planning and accountability and rising health system costs increase the future utility of this approach. This type of planning can also assist the new PHNs to commission health services

  10. [Primary and secondary data on dementia care as an example of regional health planning].

    Science.gov (United States)

    Ulrich, Lisa-R; Schatz, Tanja R; Lappe, Veronika; Ihle, Peter; Barthen, Linda; Gerlach, Ferdinand M; Erler, Antje

    2017-12-01

    Health service planning that takes into account as far as possible the regional needs and regional discrepancies is a controversial health issue in Germany. In a pilot scheme, we tested a planning process for regional healthcare services, based on the example of dementia care. The aim of this article is to present the strengths and limitations of this planning process. We developed an indicator set for dementia care based on routine regional data obtained from two German statutory health insurance companies. Additionally, primary data based on a questionnaire sent to all GPs in the area were evaluated. These data were expanded through the addition of official socio-demographic population data. Procedures and evaluation strategies, discussion of the results and the derivation of planning measures followed, in close agreement with a group of local experts. Few epidemiological data on regional variations in health care planning are publicly available. Secondary data from statutory health insurance companies can be assessed to support the estimation of regional health care needs, but interpretation is difficult. The use of surveys to collect primary data, and the assessment of results by the local health board may facilitate interpretation and may contribute towards more valid statements regarding regional health planning. Despite the limited availability of data and the considerable efforts involved in data analysis, the project demonstrates how needs-based health service planning can be carried out in a small region, taking into account the increasing demands of the local health care providers and the special local features.

  11. Modeling the Impacts of Global Climate and Regional Land Use Change on Regional Climate, Air Quality and Public Health in the New York Metropolitan Region

    Science.gov (United States)

    Rosenthal, J. E.; Knowlton, K. M.; Kinney, P. L.

    2002-12-01

    There is an imminent need to downscale the global climate models used by international consortiums like the IPCC (Intergovernmental Panel on Climate Change) to predict the future regional impacts of climate change. To meet this need, a "place-based" climate model that makes specific regional projections about future environmental conditions local inhabitants could face is being created by the Mailman School of Public Health at Columbia University, in collaboration with other researchers and universities, for New York City and the 31 surrounding counties. This presentation describes the design and initial results of this modeling study, aimed at simulating the effects of global climate change and regional land use change on climate and air quality over the northeastern United States in order to project the associated public health impacts in the region. Heat waves and elevated concentrations of ozone and fine particles are significant current public health stressors in the New York metropolitan area. The New York Climate and Health Project is linking human dimension and natural sciences models to assess the potential for future public health impacts from heat stress and air quality, and yield improved tools for assessing climate change impacts. The model will be applied to the NY metropolitan east coast region. The following questions will be addressed: 1. What changes in the frequency and severity of extreme heat events are likely to occur over the next 80 years due to a range of possible scenarios of land use and land cover (LU/LC) and climate change in the region? 2. How might the frequency and severity of episodic concentrations of ozone (O3) and airborne particulate matter smaller than 2.5 æm in diameter (PM2.5) change over the next 80 years due to a range of possible scenarios of land use and climate change in the metropolitan region? 3. What is the range of possible human health impacts of these changes in the region? 4. How might projected future human

  12. Towards an e-Health Cloud Solution for Remote Regions at Bahia-Brazil.

    Science.gov (United States)

    Sarinho, V T; Mota, A O; Silva, E P

    2017-12-19

    This paper presents CloudMedic, an e-Health Cloud solution that manages health care services in remote regions of Bahia-Brazil. For that, six main modules: Clinic, Hospital, Supply, Administrative, Billing and Health Business Intelligence, were developed to control the health flow among health actors at health institutions. They provided database model and procedures for health business rules, a standard gateway for data maintenance between web views and database layer, and a multi-front-end framework based on web views and web commands configurations. These resources were used by 2042 health actors in 261 health posts covering health demands from 118 municipalities at Bahia state. They also managed approximately 2.4 million health service 'orders and approximately 13.5 million health exams for more than 1.3 million registered patients. As a result, a collection of health functionalities available in a cloud infrastructure was successfully developed, deployed and validated in more than 28% of Bahia municipalities. A viable e-Health Cloud solution that, despite municipality limitations in remote regions, decentralized and improved the access to health care services at Bahia state.

  13. Mental health problems in a regional population of Australian adolescents: association with socio-demographic characteristics

    OpenAIRE

    Dray, Julia; Bowman, Jenny; Freund, Megan; Campbell, Elizabeth; Hodder, Rebecca K.; Lecathelinais, Christophe; Wiggers, John

    2016-01-01

    Background Population level data regarding the general mental health status, and the socio-demographic factors associated with the mental health status of adolescents in Australia aged 12?16?years is limited. This study assessed prevalence of mental health problems in a regional population of Australian students in Grades 7?10, and investigated associations between mental health problems and socio-demographic factors. Methods A web-based survey was conducted in 21 secondary schools located in...

  14. An Exponential Increase in Regional Health Information Exchange With Collaborative Policies and Technologies.

    Science.gov (United States)

    Downing, N Lance; Lane, Steven; Eisenberg, Mathew; Sharp, Christopher; Palma, Jonathan; Longhurst, Christopher

    2015-01-01

    In the United States, the ability to securely exchange health information between organization has been limited by technical interoperability, patient identity matching, and variable institutional policies. Here, we examine the regional experience in a national health information exchange network by examining clinical data sharing between eleven Northern California organizations using the same health information exchange (HIE) platform between 2013-2014. We identify key policies and technologies that have led to a dramatic increase in health information exchange.

  15. Health effects in residents of high background radiation regions

    International Nuclear Information System (INIS)

    Hanson, G.P.; Komarov, E.

    1983-01-01

    Studies carried out in various countries and by the World Health Organization on health effects of exposure of populations to high levels of natural background radiation result in observations of different significance. There are indications of changes in chromosome aberration rate; Down's syndrome has been observed to be possibly related to radiation exposure; malignant neoplasms in bone apparently correspond to high concentrations of 226 Ra in drinking water. Although various researchers have looked for them, effects have not been demonstrated regarding cancer mortality (other than malignant neoplasms involving bone), gross congenital abnormalities, fertility index, growth and development, hereditary disease (other than the possibility of Down's syndrome), infant mortality, longevity, multiple births, sex ratio, or spontaneous abortion rate. On the basis of reported data clear quantitative conception of the risk of low-level radiation from natural sources could not be developed and feasibility studies of further epidemiological programmes should be organized. The possibility of reducing the collective population dose from natural sources could be further explored and a basis for necessary legal action on establishment of standards for possible sources of natural radiation, such as building materials, fertilizers, natural gas and water, might be developed. (author)

  16. The crisis of health in a crisis ridden region.

    Science.gov (United States)

    Maziak, Wasim

    2009-01-01

    The overall picture of the Arab world today is dire; no Arab country is free from political strife, foreign intervention, or the threat of terrorism. Continuing instability and the failure of national governments to uphold the rule of law and deliver on development are tearing apart the fabric of Arab societies. Internally, Arab regimes' agendas are shaped by security and their makeup by kinship and loyalty, pushing people to seek refuge within their primordial loyalties. From the outside, foreign meddling in the name of "democracy" is deepening the Arab world's instability, therefore providing justification for opponents of change to discredit the values of human rights and power sharing. In such an environment, the voiceless majority becomes the main victims, with detrimental effects on their physical and mental wellbeing. A domino-like breakdown of the Arab region, with serious consequences for world's stability, is becoming an increasingly likely scenario.

  17. Defining fish community structure in Lake Winnipeg using stable isotopes (δ{sup 13}C, δ{sup 15}N, δ{sup 34}S): Implications for monitoring ecological responses and trophodynamics of mercury and other trace elements

    Energy Technology Data Exchange (ETDEWEB)

    Ofukany, Amy F.A. [Toxicology Centre, University of Saskatchewan, 44 Campus Drive, Saskatoon, Saskatchewan S7N 5B3 (Canada); Wassenaar, Leonard I. [Environment Canada, 11 Innovation Boulevard, Saskatoon, Saskatchewan S7N 3H5 (Canada); Bond, Alexander L., E-mail: alex.bond@rspb.org.uk [Environment Canada, 11 Innovation Boulevard, Saskatoon, Saskatchewan S7N 3H5 (Canada); Hobson, Keith A. [Environment Canada, 11 Innovation Boulevard, Saskatoon, Saskatchewan S7N 3H5 (Canada)

    2014-11-01

    The ecological integrity of freshwater lakes is influenced by atmospheric and riverine deposition of contaminants, shoreline development, eutrophication, and the introduction of non-native species. Changes to the trophic structure of Lake Winnipeg, Canada, and consequently, the concentrations of contaminants and trace elements measured in tissues of native fishes, are likely attributed to agricultural runoff from the 977,800 km{sup 2} watershed and the arrival of non-native zooplankters and fishes. We measured δ{sup 13}C, δ{sup 15}N, and δ{sup 34}S along with concentrations of 15 trace elements in 17 native fishes from the north and south basins of Lake Winnipeg in 2009 and 2010. After adjusting for differences in isotopic baseline values between the two basins, fishes in the south basin had consistently higher δ{sup 13}C and δ{sup 34}S, and lower δ{sup 15}N. We found little evidence of biomagnification of trace elements at the community level, but walleye (Sander vitreus) and freshwater drum (Aplodinotus grunniens) had higher mercury and selenium concentrations with increased trophic position, coincident with increased piscivory. There was evidence of growth dilution of cobalt, copper, manganese, molybdenum, thallium, and vanadium, and bioaccumulation of mercury, which could be explained by increases in algal (and consequently, lake and fish) productivity. We conclude that the north and south basins of Lake Winnipeg represent very different communities with different trophic structures and trace element concentrations. - Highlights: • Anthropogenic eutrophication and non-native species affect Lake Winnipeg’s ecosystem. • We measured stable isotopes and trace elements in 15 native fish species. • There was more evidence for growth dilution than biomagnification for most elements. • The trophic structures of the north and south basins were different. • These results will help determine the effects of recent arrival of zebra mussels.

  18. Defining fish community structure in Lake Winnipeg using stable isotopes (δ13C, δ15N, δ34S): Implications for monitoring ecological responses and trophodynamics of mercury and other trace elements

    International Nuclear Information System (INIS)

    Ofukany, Amy F.A.; Wassenaar, Leonard I.; Bond, Alexander L.; Hobson, Keith A.

    2014-01-01

    The ecological integrity of freshwater lakes is influenced by atmospheric and riverine deposition of contaminants, shoreline development, eutrophication, and the introduction of non-native species. Changes to the trophic structure of Lake Winnipeg, Canada, and consequently, the concentrations of contaminants and trace elements measured in tissues of native fishes, are likely attributed to agricultural runoff from the 977,800 km 2 watershed and the arrival of non-native zooplankters and fishes. We measured δ 13 C, δ 15 N, and δ 34 S along with concentrations of 15 trace elements in 17 native fishes from the north and south basins of Lake Winnipeg in 2009 and 2010. After adjusting for differences in isotopic baseline values between the two basins, fishes in the south basin had consistently higher δ 13 C and δ 34 S, and lower δ 15 N. We found little evidence of biomagnification of trace elements at the community level, but walleye (Sander vitreus) and freshwater drum (Aplodinotus grunniens) had higher mercury and selenium concentrations with increased trophic position, coincident with increased piscivory. There was evidence of growth dilution of cobalt, copper, manganese, molybdenum, thallium, and vanadium, and bioaccumulation of mercury, which could be explained by increases in algal (and consequently, lake and fish) productivity. We conclude that the north and south basins of Lake Winnipeg represent very different communities with different trophic structures and trace element concentrations. - Highlights: • Anthropogenic eutrophication and non-native species affect Lake Winnipeg’s ecosystem. • We measured stable isotopes and trace elements in 15 native fish species. • There was more evidence for growth dilution than biomagnification for most elements. • The trophic structures of the north and south basins were different. • These results will help determine the effects of recent arrival of zebra mussels

  19. The impact of regional and neighbourhood deprivation on physical health in Germany: a multilevel study

    Directory of Open Access Journals (Sweden)

    Razum Oliver

    2010-07-01

    Full Text Available Abstract Background There is increasing evidence that individual health is at least partly determined by neighbourhood and regional factors. Mechanisms, however, remain poorly understood, and evidence from Germany is scant. This study explores whether regional as well as neighbourhood deprivation are associated with physical health and to what extent this association can be explained by specific neighbourhood exposures. Methods Using 2004 data from the German Socio-Economic Panel Study (SOEP merged with regional and neighbourhood characteristics, we fitted multilevel linear regression models with subjective physical health, as measured by the SF-12, as the dependent variable. The models include regional and neighbourhood proxies of deprivation (i.e. regional unemployment quota, average purchasing power of the street section as well as specific neighbourhood exposures (i.e. perceived air pollution. Individual characteristics including socioeconomic status and health behaviour have been controlled for. Results This study finds a significant association between area deprivation and physical health which is independent of compositional factors and consistent across different spatial scales. Furthermore the association between neighbourhood deprivation and physical health can be partly explained by specific features of the neighbourhood environment. Among these perceived air pollution shows the strongest association with physical health (-2.4 points for very strong and -1.5 points for strong disturbance by air pollution, standard error (SE = 0.8 and 0.4, respectively. Beta coefficients for perceived air pollution, perceived noise and the perceived distance to recreational resources do not diminish when including individual health behaviour in the models. Conclusions This study highlights the difference regional and in particular neighbourhood deprivation make to the physical health of individuals in Germany. The results support the argument that

  20. Situational analysis: preliminary regional review of the Mental Health Atlas 2014.

    Science.gov (United States)

    Gater, R; Chew, Z; Saeed, K

    2015-09-28

    The WHO comprehensive Mental Health Action Plan 2013-2020 established goals and objectives that Member States have agreed to meet by 2020. To update the Atlas of Mental Health 2011, specific indicators from the Mental Health Action Plan and additional indicators on service coverage were incorporated into the questionnaire for the Atlas 2014. The data will help facilitate improvement in information gathering and focus efforts towards implementation of the Mental Health Action Plan. The questionnaire was completed by the national mental health focal point of each country. This preliminary review seeks to consolidate data from the initial response to the Atlas 2014 questionnaire by Member States in the Eastern Mediterranean Region. Data for this review were analysed for the whole Region, by health systems groupings and by individual countries. Where possible, data are compared with the Mental Health Atlas 2011 to give a longitudinal perspective.

  1. Pacific island health inequities forecast to grow unless profound changes are made to health systems in the region.

    Science.gov (United States)

    Matheson, Don; Park, Kunhee; Soakai, Taniela Sunia

    2017-10-01

    Objective Twenty years ago the Pacific's health ministers developed a 'Healthy Islands' vision to lead health development in the subregion. This paper reports on a review of health development over this period and discusses the implications for the attainment of the health related Sustainable Development Goals. Methods The review used qualitative and quantitative methods. The qualitative review included conducting semi-structured interviews with Pacific Island Government Ministers and officials, regional agencies, health workers and community members. A document review was also conducted. The quantitative review consisted of examining secondary data from regional and global data collections. Results The review found improvement in health indicators, but increasing health inequality between the Pacific and the rest of the world. Many of the larger island populations were unable to reach the health Millennium Development Goals. The 'Healthy Islands' vision remained an inspiration to health ministers and senior officials in the region. However, implementation of the 'Healthy Islands' approach was patchy, under-resourced and un-sustained. Communicable and Maternal and Child Health challenges persist alongside unprecedented levels of non-communicable diseases, inadequate levels of health finance and few skilled health workers as the major impediments to health development for many of the Pacific's countries. Conclusions The current trajectory for health in the Pacific will lead to increasing health inequity with the rest of the world. The challenges to health in the region include persisting communicable disease and maternal and child health threats, unprecedented levels of NCDs, climate change and instability, as well as low economic growth. In order to change the fortunes of this region in the age of the SDGs, a substantial investment in health is required, including in the health workforce, by countries and donors alike. That investment requires a nuanced response

  2. Family, money, and health: Regional differences in the determinants of life satisfaction over the life course

    Science.gov (United States)

    Margolis, Rachel; Myrskylä, Mikko

    2013-01-01

    We examine how family, money, and health explain variation in life satisfaction over the life cycle across seven global regions using data from the World Values Survey. With a life domain approach, we study whether the importance of the life domains varies by region and age groups and whether the variation explained by each factor is due to the magnitude or prevalence of each factor. Globally, family, money, and health explain a substantial fraction of life satisfaction, increasing from 12 percent in young adulthood to 15 percent in mature adulthood. Health is the most important factor, and its importance increases with age. Income is unimportant above age 50. Remarkably, the contribution of family is small across ages. Across regions health is most important in the wealthier, and income in the poorer regions of the world. Family explains a substantial fraction of life satisfaction only in Western Europe and Anglophone countries. Findings highlight that the population-level importance of family, money, and health in explaining variation in life satisfaction across regions is mainly attributable to the individual-level life satisfaction differences between people of different statuses rather than differences in the distribution of various states such as poor health across regions. PMID:24796263

  3. Audit of a diabetic health education program at a large Primary Health Care Center in Asir region.

    Science.gov (United States)

    Al-Khaldi, Y M; Khan, M Y

    2000-09-01

    To evaluate the health education program in a large Primary Health Care Center, to find out the problems faced by the staff and to suggest the practical and relevant solutions. This study was carried out at Wasat Abha Primary Health Care Center, Asir region during 1997. The files of diabetics who attended the center were evaluated for health education topics by using a checklist. The essential structure of diabetic health education program was assessed by using another check list designed by the investigators. Data entry and analysis was carried out through SPSS package. Chi-square test was applied wherever necessary. The total number of diabetics who attended Wasat Abha Primary Health Care Center was 198. The duration of diabetes mellitus was 7.7+5.8 years. Ninety percent of these were married, 50.5% were educated and 79% were employed. Compliance to appointment was good in 60% and poor in 30% of diabetics. About 73% of the diabetics received at least one health education topic while 27% did not receive any health education at all. Only 33% of diabetic patients had adequate health education. Ninety one percent were provided with diabetic identification cards, 80% were explained about diabetes and 77% were educated about the role of diet. Essential structure for diabetes education program was found to be unsatisfactory. Effective diabetic health education program needs the availability of all essential structures, community participation and integration of the government and private sectors. The deficiencies in the structures and the process of health education programs in our practice are almost universal to other Primary Health Care Centers in the Asir region. Providing the Primary Health Care Centers with all essential structures and annual auditing are complimentary to a successful diabetic health education program.

  4. Inequalities in healthy life expectancy by Brazilian geographic regions: findings from the National Health Survey, 2013.

    Science.gov (United States)

    Szwarcwald, Célia Landmann; Souza Júnior, Paulo Roberto Borges de; Marques, Aline Pinto; Almeida, Wanessa da Silva de; Montilla, Dalia Elena Romero

    2016-11-17

    The demographic shift and epidemiologic transition in Brazil have drawn attention to ways of measuring population health that complement studies of mortality. In this paper, we investigate regional differences in healthy life expectancy based on information from the National Health Survey (PNS), 2013. In the survey, a three-stage cluster sampling (census tracts, households and individuals) with stratification of the primary sampling units and random selection in all stages was used to select 60,202 Brazilian adults (18 years and over). Healthy life expectancies (HLE) were estimated by Sullivan's method according to sex, age and geographic region, using poor self-rated health for defining unhealthy status. Logistic regression models were used to investigate socioeconomic and regional inequalities in poor self-rated health, after controlling by sex and age. Wide disparities by geographic region were found with the worst indicators in the North and Northeast regions, whether considering educational attainment, material deprivation, or health care utilization. Life expectancy at birth for women and men living in the richest regions was 5 years longer than for those living in the less wealthy regions. Modeling the variation across regions for poor self-rated health, statistically significant effects (p < 0.001) were found for the North and Northeast when compared to the Southeast, even after controlling for age, sex, diagnosis of at least one non-communicable chronic disease, and schooling or socioeconomic class. Marked regional inequalities in HLE were found, with the loss of healthy life much higher among residents of the poorest regions, especially among the elderly. By combining data on self-rated health status and mortality in a single indicator, Healthy Life Expectancy, this study demonstrated the excess burden of poor health experienced by populations in the less wealthy regions of Brazil. To mitigate the effects of social exclusion, the development of strategies

  5. Health needs of regional Australian children in out-of-home care.

    Science.gov (United States)

    Arora, Nitin; Kaltner, Melissa; Williams, Judy

    2014-10-01

    This study aims to identify the health needs of children placed in out-of-home care in regional Queensland and to compare them with the needs of similar children in metropolitan Queensland. Retrospective chart review and subsequent analysis of data from the first assessments of the children placed in care from January 2005 to April 2011. Health needs based on assessment recommendations were then compared with needs and recommendations from a similar clinic in metropolitan Brisbane. Two hundred thirty-nine first assessments were reviewed. The average number of health referrals arising out of each assessment was 2. 72% children were between 2 and 12 years of age and accounted for 76% of the health referrals made. The 10-13% of the children needed referrals for medical and surgical specialties, audiology, speech pathology, dental, and ophthalmology/optometry, each. A percentage of 30 needed ongoing paediatric care. The 15% needed immunisation catch up, 35% counselling and behaviour management, and 15% formal mental health referrals. These were comparable to the health needs identified in out-of-home care children residing in metropolitan Queensland. Children in care who live in a regional setting have similar health-care needs compared with urban children. Given restricted health services in regional settings, there is difficulty in accessing services to meet these needs. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  6. [Model for the regional allocation of the National Health Care Fund].

    Science.gov (United States)

    Loreti, P; Muzzi, A; Bruni, G

    1989-01-01

    In 1978 a National Health Service (Servizio Sanitario Nazionale = SSN) was constituted in Italy which exercises jurisdiction in the sector of health care and is duty bound to assist all citizens. Basically speaking, the NHS is organized on three levels (national, regional and local) with the management of direct operations assigned to the (about 700) Local Health Boards (Unità Sanitaria Locale = USL) each of which covers a well determined territorial area. The Authors indicate that rarely discussed or evaluated are the procedures for the regional allocation of health care funding which is determined by Parliament within the ambit of the National Budget (The National Health Care Fund). The current allocation model distributes the available capital resources for each expense item (e.g. hospitalization, pharmaceutical assistance, etc.) on a per capita basis with respect to the regional populations modified in order to allow for differing degrees of health care requirements. The regional populations are subdivided into broad age groups (e.g. children, intermediary, the elderly) with specific weighting factors expressing the different level of health care requirements. The application of these weighting factors alters the regional populations (with no change in the total population of the country) in order to express them in equivalent units with respect to the health care need. Moreover, standardized death rates are introduced into the model as indicators of the different health risk, and their application leads to a further modification in the level of the regional populations so as to express them in equivalent units with respect to the health risk as well. Once the available financial resources have been subdivided in this "theoretical" way, the following corrective factors are applied: a) hospital mobility correction factor: the regions with a credit admissions balance are assigned an additional cost which is borne by the regions with a debit admissions balance; b

  7. Analysis of environment state in technogenic region and its threat to public health

    OpenAIRE

    Grishenko S.V.; Grishenko I.I.; Ohotnikova M.V.; Mustafina A.O.; Kudimov P.V.; Mustafin T.A.

    2014-01-01

    The purpose of the research is to give a complex hygienic evaluation of environment state in Donetsk region and to determine the degree of their potential danger to population health. It includes air pollution, water contamination, state of soil. Nearly 43000 samples of air, 32000 drinking water samples and 4500 soil samples were analyzed. Regions with the highest rate of environmental pollution were defined. It was found that the main sources of environment pollution in Donetsk region are fe...

  8. 77 FR 44107 - Information From Foreign Regions Applying for Recognition of Animal Health Status

    Science.gov (United States)

    2012-07-27

    ...We are amending the regulations that govern the importation of animals and animal products by consolidating the list of factors APHIS considers when evaluating the animal health status of a foreign region and by setting out new factors APHIS will consider when evaluating a region as historically free of a specific disease. These changes will make clearer the types of information APHIS needs from a requesting region in order to conduct an evaluation.

  9. Health spending, macroeconomics and fiscal space in countries of the World Health Organization South-East Asia Region.

    Science.gov (United States)

    Gupta, Indrani; Mondal, Swadhin

    2014-01-01

    The paper examines the issues around mobilization of resources for the 11 countries of the South-East Asia Region of the World Health Organization (WHO), by analysing their macroeconomic situation, health spending, fiscal space and other determinants of health. With the exception of a few, most of these countries have made fair progress on their own Millennium Development Goal (MDG) targets of maternal mortality ratio and mortality rate in children aged under 5 years. However, the achieved targets have been very modest - with the exception of Thailand and Sri Lanka - indicating the continued need for additional efforts to improve these indicators. The paper discusses the need for investment, by looking at evidence on economic growth, the availability of fiscal space, and improvements in "macroeconomic-plus" factors like poverty, female literacy, governance and efficiency of the health sector. The analysis indicates that, overall, the countries of the WHO South-East Asia Region are collectively in a position to make the transition from low public spending to moderate or even high health spending, which is required, in turn, for transition from lowcoverage-high out-of-pocket spending (OOPS) to highcoverage-low OOPS. However, explicit prioritization for health within the overall government budget for low spenders would require political will and champions who can argue the case of the health sector. Additional innovative avenues of raising resources, such as earmarked taxes or a health levy can be considered in countries with good macroeconomic fundamentals. With the exception of Thailand, this is applicable for all the countries of the region. However, countries with adverse macroeconomic-plus factors, as well as inefficient health systems, need to be alert to the possibility of overinvesting - and thereby wasting - resources for modest health gains, making the challenge of increasing health sector spending alongside competing demands for spending on other areas of

  10. Regional Standards for Rangeland Health and Guidelines for Livestock Grazing Management ... A Progress Report

    OpenAIRE

    1996-01-01

    In August 1995, new BLM regulations for rangeland administration went into effect. The new regulations require BLM to establish regional standards for rangeland health and guidelines for grazing management. This publication is a report on the alternatives being considered for the Montana/Dakotas Rangeland Health Standards and Guidelines process.

  11. World Health Organization Global Estimates and Regional Comparisons of the Burden of Foodborne Disease in 2010

    NARCIS (Netherlands)

    Havelaar, Arie H|info:eu-repo/dai/nl/072306122; Kirk, Martyn D; Torgerson, Paul R; Gibb, Herman J; Hald, Tine; Lake, Robin J; Praet, Nicolas; Bellinger, David C; de Silva, Nilanthi R; Gargouri, Neyla; Speybroeck, Niko; Cawthorne, Amy; Mathers, Colin; Stein, Claudia; Angulo, Frederick J; Devleesschauwer, Brecht

    2015-01-01

    Illness and death from diseases caused by contaminated food are a constant threat to public health and a significant impediment to socio-economic development worldwide. To measure the global and regional burden of foodborne disease (FBD), the World Health Organization (WHO) established the Foodborne

  12. The health status of population in the regions boarding to Semipalatinsk nuclear test site

    International Nuclear Information System (INIS)

    Balmukhanov, S.B.; Raisova, G.K.; Balmukhanov, T.S.; Voronin, A.M.; Sandybaev, M.N.

    2002-01-01

    It is performed the detailed investigation the health status of Semipalatinsk region population affected by constant radioactive irradiation during 40 years. The special attention attached to such pathologies as cancer, congenial defects of development and pathologies of cardio-vascular and nervous systems. It is also characterized the children health status. (author)

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

    Science.gov (United States)

    2011-01-01

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

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

    Science.gov (United States)

    Bell, Erica

    2011-05-01

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

  15. Oral Health Inequalities between Rural and Urban Populations of the African and Middle East Region.

    Science.gov (United States)

    Ogunbodede, E O; Kida, I A; Madjapa, H S; Amedari, M; Ehizele, A; Mutave, R; Sodipo, B; Temilola, S; Okoye, L

    2015-07-01

    Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations. © International & American Associations for Dental Research 2015.

  16. Annual report on activities of Regional Public Health Offices in the Slovak Republic in 2009

    International Nuclear Information System (INIS)

    2010-01-01

    A brief account of activities carried out by the Regional Public Health Offices in the Slovak Republic in 2009 is presented. These activities are reported under the headings: (1) Environment; (2) Preventive occupational medicine; (3) Hygiene, nutrition, food safety and cosmetic products; (4) Hygiene of children and youth; (5) Epidemiology; (6) Objectification of environmental factors and working environment; (7) Medical microbiology; (8) Health promotion; (9) Health protection against radiation; (10) Complaints and petitions; (11) Control of tobacco and alcohol.

  17. Annual report on activities of Regional Public Health Offices in the Slovak Republic in 2010

    International Nuclear Information System (INIS)

    2011-01-01

    A brief account of activities carried out by the Regional Public Health Offices in the Slovak Republic in 2010 is presented. These activities are reported under the headings: (1) Environment; (2) Preventive occupational medicine; (3) Hygiene, nutrition, food safety and cosmetic products; (4) Hygiene of children and youth; (5) Epidemiology; (6) Objectification of environmental factors and working environment; (7) Medical microbiology; (8) Health promotion; (9) Health protection against radiation; (10) Complaints and petitions; (11) Control of tobacco and alcohol.

  18. 76 FR 13209 - United States and State of Texas v. United Regional Health Care System; Proposed Final Judgment...

    Science.gov (United States)

    2011-03-10

    ... of Texas v. United Regional Health Care System, Civil Action No. 7:11-cv- 00030-O. On February 25..., ambulatory surgery center or radiology center in [a] 15 mile radius of United Regional Health Care System... 95% of billed charges for all inpatient and outpatient services at United Regional Health Care System...

  19. Regional variations in health care intensity and physician perceptions of quality of care.

    Science.gov (United States)

    Sirovich, Brenda E; Gottlieb, Daniel J; Welch, H Gilbert; Fisher, Elliott S

    2006-05-02

    Research has documented dramatic differences in health care utilization and spending across U.S. regions with similar levels of patient illness. Although patient outcomes and quality of care have been found to be no better in regions of high health care intensity, it is unknown whether physicians in these regions feel more capable of providing good patient care than those in low-intensity regions. To determine whether physicians in high-intensity regions feel better able to care for patients than physicians in low-intensity regions. Physician telephone survey. 51 metropolitan and 9 nonmetropolitan areas of the United States and a supplemental national sample. 10,577 physicians who provided care to adults in 1998 or 1999 were surveyed for the Community Tracking Study (response rate, 61%). The End-of-Life Expenditure Index, a measure of spending that reflects differences in the overall quantity of medical services provided rather than differences in illness or price, was used to determine health care intensity in the physicians' community. Outcomes included physicians' perceived availability of clinical services, ability to provide high-quality care to patients, and career satisfaction. Although the highest-intensity regions have substantially more hospital beds and specialists per capita, physicians in these regions reported more difficulty obtaining needed services for their patients. The proportion of physicians who felt able to obtain elective hospital admissions ranged from 50% in high-intensity regions to 64% in the lowest-intensity region (P market factors (for example, managed care penetration); the difference in perceived ability to provide high-quality care was no longer statistically significant (P = 0.099). The cross-sectional design prevented demonstration of a causal relationship between intensity and physician perceptions of quality. Despite more resources, physicians in regions of high health care intensity did not report greater ease in obtaining

  20. Farmers' perceptions of health in the Riverland region of South Australia: 'If it's broke, fix it'.

    Science.gov (United States)

    Rawolle, Tessa A; Sadauskas, David; van Kessel, Gisela; Dollman, James

    2016-10-01

    To explore perceptions of health among South Australian farmers. Descriptive qualitative study, using semi-structured interviews. Two rural towns in the Riverland region of South Australia. Fifteen adults involved in farming within the Riverland region of South Australia, from a variety of farming industries; age range 23-70 years old; 53% male, 47% female. Perceptions and definitions of health. Participants described an ecological understanding of health across individual, farm, and community domains. Participants perceived health as being able to function and complete farm work. Participants reported that farm work helped to maintain fitness, but the multiple stress and hazards associated with farming had a significant influence on health. Participants described how health was influenced by community activities and social support from friends and families. Women were reported to take a lead role in health. Health providers can frame interventions to resonate with the perceptions of health held by people, shaped and formed by the context of farming. Further research is needed to explore farmers' perceptions of health in different locations, from different industries and from a range of age groups. © 2016 National Rural Health Alliance Inc.

  1. A look at the ASEAN-NDI: building a regional health R&D innovation network.

    Science.gov (United States)

    Montoya, Jaime C; Rebulanan, Carina L; Parungao, Nico Angelo C; Ramirez, Bernadette

    2014-01-01

    Globally, there are growing efforts to address diseases through the advancement in health research and development (R&D), strengthening of regional cooperation in science and technology (particularly on product discovery and development), and implementation of the World Health Assembly Resolution 61.21 (WHA61.21) on the Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property (GSPA-PHI). As such, the Association of Southeast Asian Nations (ASEAN) is responding to this through the establishment of the ASEAN-Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines Innovation (ASEAN-NDI). This is important in the ASEAN considering that infectious tropical diseases remain prevalent, emerging, and reemerging in the region. This paper looks into the evolution of the ASEAN-NDI from its inception in 2009, to how it is at present, and its plans to mitigate public health problems regionally and even globally.

  2. Health policies and federative gaps in Brazil: an analysis of regional capacity of services delivery.

    Science.gov (United States)

    Ribeiro, José Mendes; Moreira, Marcelo Rasga; Ouverney, Assis Mafort; Silva, Cosme Marcelo Furtado Passos da

    2017-04-01

    This paper analyzes Brazilian health regions according to their service delivery capacity from the debate on the crisis of cooperative federalism in the SUS that resulted from decentralizing process established in the 1988 Constitution. Service delivery capacity tracer indicators were selected by regions and statistical analyses evidenced greater regional capacity in hospital care and large asymmetries with regard to the availability of physicians, high complexity equipment and private insurance coverage. In conclusion,we argue that further solutions are required to strengthen governmental capacity to reduce regional inequalities throughincreased central coordination.

  3. The utilization rate of the regional health information exchange: how it impacts on health care delivery outcomes.

    Science.gov (United States)

    Mäenpää, Tiina; Asikainen, Paula; Gissler, Mika; Siponen, Kimmo; Maass, Marianne; Saranto, Kaija; Suominen, Tarja

    2012-01-01

    Interest in improving quality and effectiveness is the primary driver for health information exchange efforts across a health care system to improve the provision of public health care services. The aim here was to describe and identify the impact of a regional health information exchange (HIE) using quantitative statistics for 2004-2008 in one hospital district in Finland. We conducted a comparative, longitudinal 5-year follow-up study to evaluate the utilization rates of HIE, and the impact on health care delivery outcomes. The selected outcomes were total laboratory tests, radiology examinations, appointments, emergency visits, and referrals. The HIE utilization rates increased annually in all 10 federations of municipalities, and the viewing of reference information increased steadily in each professional group over the 5-year study period. In these federations, a significant connection was found to the number of laboratory tests and radiology examinations, with a statistically significant increase in the number of viewed references and use of HIE. The higher the numbers of emergency visits and appointments, the higher the numbers of emergency referrals to specialized care, viewed references, and HIE usage among the groups of different health care professionals. There is increasing interest in HIE usage through regional health information system among health professionals to improve health care delivery regionally and bring information on the patient directly to care delivery. It will be important to study which changes in working methods in the service system are explained by RHIS. Also, the experiences of the change that has taken place should be studied among the different stakeholders, administrative representatives, and patients.

  4. Determinants of life expectancy in eastern mediterranean region: a health production function.

    Science.gov (United States)

    Bayati, Mohsen; Akbarian, Reza; Kavosi, Zahra

    2013-06-01

    Determinants of health or health production function in health economics literature constitute noticeable issues in health promotion. This study aimed at estimating a health production function for East Mediterranean Region (EMR) based on the Grossman theoretical model. This ecological study was performed using the econometric methods. The panel data model was used in order to determine the relationship between life expectancy and socioeconomic factors. The data for 21 EMR countries between 1995 and 2007 were used. Fixed-effect-model was employed to estimate the parameters based on Hausman test. In estimating the health production function, factors such as income per capita (β=0.05, Pdeterminants of health status, proxied by life expectancy at birth. A notable result was the elasticity of life expectancy with respect to the employment rate and its significance level was different between males (β=0.13, P0.001). In order to improve the health status in EMR countries, health policymakers should focus on the factors which lie outside the healthcare system. These factors are mainly associated with economic growth and development level. Thus, the economic stabilisation policies with the aim of increasing the productivity, economic growth, and reducing unemployment play significant roles in the health status of the people of the region.

  5. A 'mystery client' evaluation of adolescent sexual and reproductive health services in health facilities from two regions in Tanzania.

    Directory of Open Access Journals (Sweden)

    Zaina Mchome

    Full Text Available Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning. The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed.

  6. Health Extension Workers' and Mothers' Attitudes to Maternal Health Service Utilization and Acceptance in Adwa Woreda, Tigray Region, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Ruth Jackson

    Full Text Available The maternal health system in Ethiopia links health posts in rural communities (kebeles with district (woreda health centres, and health centres with primary hospitals. At each health post two Health Extension Workers (HEWs assist women with birth preparedness, complication readiness, and mobilize communities to facilitate timely referral to mid-level service providers. This study explored HEWs' and mother's attitudes to maternal health services in Adwa Woreda, Tigray Region.In this qualitative study, we trained 16 HEWs to interview 45 women to gain a better understanding of the social context of maternal health related behaviours. Themes included barriers to health services; women's social status and mobility; and women's perceptions of skilled birth attendant's care. All data were analyzed thematically.There have been substantial efforts to improve maternal health and reduce maternal mortality in Adwa Woreda. Women identified barriers to healthcare including distance and lack of transportation due to geographical factors; the absence of many husbands due to off-woreda farming; traditional factors such as zwar (some pregnant women are afraid of meeting other pregnant women, and discouragement from mothers and mothers-in-law who delivered their children at home. Some women experienced disrespectful care at the hospital. Facilitators to skilled birth attendance included: identification of pregnant women through Women's Development Groups (WDGs, and referral by ambulance to health facilities either before a woman's Expected Due Date (EDD or if labour started at home.With the support of WDGs, HEWs have increased the rate of skilled birth attendance by calling ambulances to transfer women to health centres either before their EDD or when labour starts at home. These findings add to the growing body of evidence that health workers at the community level can work with women's groups to improve maternal health, thus reducing the need for emergency

  7. Development of Community Mental Health Services: The Case of Emilia‐Romagna Italian Region

    Directory of Open Access Journals (Sweden)

    Angelo Fioritti

    2014-06-01

    Full Text Available Italian psychiatry has gained International attention after its radical reform of 1978, which established the progressive closure of mental hospitals and the establishment of community services throughout the country. However it is technically inappropriate to talk about Italian psychiatry as the devolution process has transferred to the regions all competences about policy, planning and evaluating health services. This explains the variety of “community psychiatries” that can be found along the peninsula and the reasons of interest that can arise from their comparison. The development of community psychiatry in Emilia‐Romagna, a region of 4 million inhabitants in Northern Italy, has proceeded through two partially overlapping phases of deinstitutionalization (1978‐1997 and development of integrated mental health departments (1990‐2008. The analysis of raw data about allocation of resources and professional capital development give way to tentative comparisons with the current Portuguese situation of implementation of a similar reform. In 2006 the regional Council launched a three year project aimed at rethinking the welfare system and the integration of social and health services, considering the dramatic social and demographic changes occurring in the region. This project has implied also a three year process of redrafting mental health policy finalised in the Emilia‐Romagna Mental Health Action Plan 2009‐2011 approved by the council in March 2009. It basically follows two strategies: integration of health and social services and further qualification of health services. The former is pursued through a reshaping of the planning and commissioning bodies of both health and social services, previously separated and now merging. They are taking responsibility on many issues related to mental health care, such as prevention, mental health promotion, supported employment, supported housing, subsidies, self‐help. The improvement of

  8. The Influence of Regional Social Inequality and Labour Market Characteristics on Health

    Directory of Open Access Journals (Sweden)

    Christiane Gross

    2013-09-01

    Full Text Available The influence of contextual factors on individual health status has been demonstrated by a number of studies even when controlling for the individual socio-economic situation (and other relevant factors. The article examines whether and to what extent variables of the place of residence have an effect on individual health status. We do not only refer to income levels and inequality, but also to effects of the educational level and inequality and the regional unemployment rate. As data basis for the individual level, we use the 2006 wave of the German Socio-Economic Panel Study (SOEP and add regional information on the aggregate level based on the regional units (Raumordnungsregionen of the Microcensus of 2005. These data will be analysed using multilevel models. The results reveal that regional educational inequality intensifies the individual educational effect, whereby members of less-educated groups in educationally disparate regions exhibit particularly low health chances. In addition, a high regional unemployment rate intensifies the negative effect of individual unemployment on men’s health.

  9. Annual report of the regional public health authorities in the Slovak Republic. Year 2012

    International Nuclear Information System (INIS)

    2013-02-01

    A brief account of activities carried out by the regional public health authorities of the Public Health Authority of the Slovak Republic (UVZ SR) in 2012 is presented. These activities are reported under the headings: (1) The environment; (2) Preventive occupational medicine; (3) Hygiene of nutrition, food safety and cosmetic products; (4) Hygiene of children and youth; (5) Epidemiology; (6) Objectivization of factors of living conditions; (7) Medical microbiology; (8) Health promotion; (9) Health protection against radiation; (10) Complaints and petitions; (11) Medical informatics and biostatistics; (12) Lectures and publications.

  10. Annual report of the regional public health authorities in the Slovak Republic. Year 2011

    International Nuclear Information System (INIS)

    2011-07-01

    A brief account of activities carried out by the regional public health authorities of the Public Health Authority of the Slovak Republic (UVZ SR) in 2011 is presented. These activities are reported under the headings: (1) The environment; (2) Preventive occupational medicine; (3)Hygiene of nutrition, food safety and cosmetic products; (4) Hygiene of children and youth; (5) Epidemiology; (6) Objectivization of factors of living conditions; (7) Medical microbiology; (8) Health promotion; (9) Health protection against radiation; (10) Complaints and petitions; (11) Medical informatics and biostatistics; (12) Lectures and publications.

  11. Annual report of the regional public health authorities in the Slovak Republic. Year 2010

    International Nuclear Information System (INIS)

    2011-04-01

    A brief account of activities carried out by the regional public health authorities of the Public Health Authority of the Slovak Republic (UVZ SR) in 2010 is presented. These activities are reported under the headings: (1) The environment; (2) Preventive occupational medicine; (3)Hygiene of nutrition, food safety and cosmetic products; (4) Hygiene of children and youth; (5) Epidemiology; (6) Objectivization of factors of living conditions; (7) Medical microbiology; (8) Health promotion; (9) Health protection against radiation; (10) Complaints and petitions; (11) Medical informatics and biostatistics.

  12. Therapeutic itineraries for patients with cerebrovascular accident: fragmentation of care in a regionalized health network

    Directory of Open Access Journals (Sweden)

    Márcia Cristina Rodrigues Fausto

    Full Text Available Abstract Objectives: to analyze the itineraries of patients with cerebrovascular accident (CVA in the Interstate health region in San Francisco Valley. Methods: this study uses the qualitative approach through the construction of Therapeutic Itineraries (IT. In the IT mapping the observation was prioritized on the different points and forms to access health service in search of care. Results: sixteen semi-structured interviews with healthcare users were conducted. There were diverse forms to access and provide services at the Rede Interestadual de Atenção à Saúde do Vale do Médio São Francisco-PEBA (Interstate Healthcare Network Region in the San Francisco Valley, which could be characterized by disorganized and uncoordinated care in the analyzed cases, despite the guarantee of hospital care. The Primary Health Care (APS teams are present at a care point with most of the patients' itineraries, however, little integration to the regionalized network and they were unable to perform their functions and coordinate the care. It is observed pilgrimage assistance, fragmented care and difficulties in receiving care after post hospitalization which is essential for the patients’ rehabilitation. Conclusions: traces of fragments of the regional health system are important warning signs that points out fragility in PEBA and demonstrate persistent gaps in the public health system to fulfil the responsibility and guarantee individuals’ right for health.

  13. Explaining regional variations in health care utilization between Swiss cantons using panel econometric models.

    Science.gov (United States)

    Camenzind, Paul A

    2012-03-13

    In spite of a detailed and nation-wide legislation frame, there exist large cantonal disparities in consumed quantities of health care services in Switzerland. In this study, the most important factors of influence causing these regional disparities are determined. The findings can also be productive for discussing the containment of health care consumption in other countries. Based on the literature, relevant factors that cause geographic disparities of quantities and costs in western health care systems are identified. Using a selected set of these factors, individual panel econometric models are calculated to explain the variation of the utilization in each of the six largest health care service groups (general practitioners, specialist doctors, hospital inpatient, hospital outpatient, medication, and nursing homes) in Swiss mandatory health insurance (MHI). The main data source is 'Datenpool santésuisse', a database of Swiss health insurers. For all six health care service groups, significant factors influencing the utilization frequency over time and across cantons are found. A greater supply of service providers tends to have strong interrelations with per capita consumption of MHI services. On the demand side, older populations and higher population densities represent the clearest driving factors. Strategies to contain consumption and costs in health care should include several elements. In the federalist Swiss system, the structure of regional health care supply seems to generate significant effects. However, the extent of driving factors on the demand side (e.g., social deprivation) or financing instruments (e.g., high deductibles) should also be considered.

  14. SALTRA: a regional program for workers' health and sustainable development in Central America.

    Science.gov (United States)

    Wesseling, Catharina; Aragón, Aurora; Elgstrand, Kaj; Flores, Reinaldo; Hogstedt, Christer; Partanen, Timo

    2011-01-01

    In 2003, the university-based Program on Work and Health in Central America, SALTRA, was launched to build national and regional capacities in occupational safety and health with the goal of preventing and reducing poverty in Central America. SALTRA has implemented 20 projects including action projects in priority sectors (e.g., construction, sugarcane, hospitals, migrant coffee workers); strengthening of surveillance (occupational health profiles, carcinogenic exposures, fatal injuries and pesticides); a participatory model for training and risk monitoring by workers; building occupational health capacity for professionals, employers, and workers, with collaborating networks between the countries; strengthening of universities in work, environment, and health; studies of serious occupational and environmental situations; communication channels; and continued efforts to raise political awareness. SALTRA has placed issues of workers' health on political, business, and academic agendas throughout the region and has laid the foundations for achieving substantial future improvements in health conditions of all workers in the region. External evaluators envisioned SALTRA as an innovative development model.

  15. Preparedness for Zika virus testing in the World Health Organization Western Pacific Region

    Directory of Open Access Journals (Sweden)

    Raynal C Squires

    2016-03-01

    Full Text Available On 1 February 2016, the World Health Organization (WHO declared that clusters of microcephaly cases and other neurological disorders occurring in Zika virus (ZIKV-affected areas constituted a public health emergency of international concern. Increased surveillance of the virus, including the requirement for laboratory confirmation of infection, was recommended. The WHO Regional Office for the Western Pacific therefore initiated a rapid survey among national-level public health laboratories in 19 countries and areas to determine regional capacity for ZIKV detection. The survey indicated that 16/19 (84% countries had capacity for molecular detection of ZIKV while others facilitated testing through referral. These results suggest that robust laboratory capacity is in place to support ZIKV surveillance in the Western Pacific Region.

  16. Preparedness for Zika virus testing in the World Health Organization Western Pacific Region.

    Science.gov (United States)

    Squires, Raynal C; Konings, Frank

    2016-01-01

    On 1 February 2016, the World Health Organization (WHO) declared that clusters of microcephaly cases and other neurological disorders occurring in Zika virus (ZIKV)-affected areas constituted a public health emergency of international concern. Increased surveillance of the virus, including the requirement for laboratory confirmation of infection, was recommended. The WHO Regional Office for the Western Pacific therefore initiated a rapid survey among national-level public health laboratories in 19 countries and areas to determine regional capacity for ZIKV detection. The survey indicated that 16/19 (84%) countries had capacity for molecular detection of ZIKV while others facilitated testing through referral. These results suggest that robust laboratory capacity is in place to support ZIKV surveillance in the Western Pacific Region.

  17. Respiratory health issues in the Asia-Pacific region: an overview.

    Science.gov (United States)

    Jamrozik, Euzebiusz; Musk, Arthur William

    2011-01-01

    The Asia-Pacific region is home to a large heterogeneous population whose respiratory health is influenced by diverse social, economic and environmental factors. Despite this variability, the most prevalent causes of respiratory morbidity and mortality are tobacco smoking, infection, and air pollution. This review aims to summarize current respiratory health issues in the region including smoking-related diseases especially COPD, lung cancer and infectious problems such as pandemic influenza, the severe acute respiratory syndrome coronavirus, bacterial pneumonia and tuberculosis, as well as the contribution of air pollution to respiratory disease. Published data on trends in the epidemiology and management of respiratory diseases and are summarized; finally, the limitations of available data and projections for the future of respiratory health in the region are discussed. © 2010 Commonwealth of Australia. Respirology © 2010 Asian Pacific Society of Respirology.

  18. [Importance of a regional observatory of malarial chemoresistance, an emerging public health problem in the Guyanas region].

    Science.gov (United States)

    Esterre, P; Volney, B; Meynard, J-B; Legrand, E

    2009-08-01

    A regular implementation of prophylactic and therapeutic decision trees was organized on a consensus basis in Cayenne, French Guiana in 1990, 1995 and 2002. The updated recommendations were based on the knowledge of the in vitro chemosensitivity profiles of the local isolates, mainly coming from big rivers (Maroni and Oyapock, frontiers with Suriname and Brazil, respectively; and more recently Approuague). Most of the patients infected by Plasmodium falciparum were followed by the medical staff of the main hospitals (Cayenne and Saint-Laurent) and of the peripheral health centers in remote areas. Consequently the epidemiological situation and evolution of chemoresistance have been widely observed on a long-term (since 1994) basis in the Maroni region. Yet, we have only partial information coming from the Oyapock valley, even though an important (most of the time) illegal immigration has been developing since the 90s' leading to a notable modification of the epidemiological status of malaria in this eastern region, including a regular increase of P. vivax infections. Presently very little P. vivax chloroquine (and mefloquine) resistance has been identified but this result could lead to a real public health problem in a near future. As such, the National Reference Center on Plasmodium Chemoresistance in the French West Indies and Guiana (CNRCP-AG in French) is a unique observatory of malaria chemoresistance in the Guyanese shield which works with research laboratories of the Institut Pasteur, Paris. This network strategy offers a very attractive perspective for applications of modern tools, including the validation of chemoresistance molecular markers, for malaria control at both medical and public health levels. Some examples related to chloroquine and artemether resistance are given.

  19. Level of infertility in regions according to Ministry of Public Health data.

    OpenAIRE

    Tymchenko, O. I.; Mykytenko, D. O.; Koba, O. P.; Lynchak, O. V.

    2014-01-01

    The aim of the research: estimation of morbidity and prevalence, risks of female and male infertility among the different regions of Ukraine. Materials and methods. The Morbidity and prevalence of female and male infertility were calculated according to Ministry of Public Health official statistics (2002-2012) per 1 000 of population of reproductive age (15-44). Relative risk including 95% confidence interval was calculated for each region in comparison with whole Ukraine. Results. In Ukrain...

  20. Home Monitoring and Personal Health Management Services in a Regional Health Telematics Network

    National Research Council Canada - National Science Library

    Traganitis, A

    2001-01-01

    ...), the R&D issues involved in the design, development and implementation of a modular and configurable Home Care Platform that supports different health and social care domains, and the results of the clinical...

  1. Health insurance subsidies and deductible choice: Evidence from regional variation in subsidy schemes.

    Science.gov (United States)

    Kaufmann, Cornel; Schmid, Christian; Boes, Stefan

    2017-09-01

    The extent to which premium subsidies can influence health insurance choices is an open question. In this paper, we explore the regional variation in subsidy schemes in Switzerland, designed as either in-kind or cash transfers, to study their impact on the choice of health insurance deductibles. Using health survey data and a difference-in-differences methodology, we find that in-kind transfers increase the likelihood of choosing a low deductible plan by approximately 4 percentage points (or 7%). Our results indicate that the response to in-kind transfers is strongest among women, middle-aged and unmarried individuals, which we explain by differences in risk-taking behavior, health status, financial constraints, health insurance and financial literacy. We discuss our results in the light of potential extra-marginal effects on the demand for health care services, which are however not supported by our data. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Regional health inequalities: changes observed in Brazil from 2000-2016.

    Science.gov (United States)

    Albuquerque, Mariana Vercesi de; Viana, Ana Luiza d'Ávila; Lima, Luciana Dias de; Ferreira, Maria Paula; Fusaro, Edgard Rodrigues; Iozzi, Fabíola Lana

    2017-04-01

    Advances in reducing poverty and inequalities in the 2000s had a paradoxical effect in Brazil. This article examines how socioeconomic transformations, and the complexity of health services, are expressed in the regions established for planning purposes and the inter-governmental management of the Brazilian Unified Health System. An effort was made to identify and explain differences in the compositions of the 438 existing health regions and their spatial distribution by comparing situations observed in 2016 with those in 2000. Factor analysis and grouping techniques were used to construct a typology in the two years of the series, which was based on a diverse set of secondary data sources. It was found that there was an evolution in terms of income levels and service provision within the health regions, with a significant improvement in the socioeconomic conditions of the population. These results suggest that there was a positive impact from the combination of strategies related to social, economic and regional policies for the promotion of development, which generated more widespread well-being within the affected areas. However, limitations remain regarding the policies implemented for the universalization of the health system.

  3. 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)

  4. [The eradication of the poliomyelitis in the European Region of the World Health Organization].

    Science.gov (United States)

    Limia Sánchez, Aurora

    2013-01-01

    Poliomyelitis was considered an important event for the public health since the end of XIX century when this disease became epidemic. As soon as vaccines were available member states of the World Health Organization (WHO) in the European Region started to implement vaccination programmes against polio with an important impact in the incidence in this disease. In May 1988, the World Health Assembly resolution for the global eradication of poliomyelitis was adopted and the mechanisms to oversee the progress in the different WHO Regions were established. This article briefly reviews the history of polio in the WHO European Region, the process for certification and maintenance, the strategies for eradication and the current situation in the European Region and globally. The European Region was certified polio-free in 2002. Nevertheless, there are still three endemic countries in the world, some others use live attenuated vaccines as well as countries in the Horn of Africa are recently suffering the reintroduction of wild poliovirus. Considering these circumstances, the risk of reintroduction of poliovirus and the generation of outbreaks in the European Region exists, therefore high vaccination coverage against polio and good quality surveillance systems are needed to be guaranteed in every member state.

  5. Highways and outposts: economic development and health threats in the central Brazilian Amazon region

    OpenAIRE

    Barcellos, Christovam; Feitosa, Patrícia; Damacena, Giseli N; Andreazzi, Marco A

    2010-01-01

    Abstract Background Economic development is often evoked as a driving force that has the capacity to improve the social and health conditions of remote areas. However, development projects produce uneven impacts on local communities, according to their different positions within society. This study examines the spatial distribution of three major health threats in the Brazilian Amazon region that may undergo changes through highway construction. Homicide mortality, AIDS incidence and malaria ...

  6. Training in reproductive health and sexuality: the case of a regional program in Latin America.

    Science.gov (United States)

    Ramos, S; Gogna, M

    1997-01-01

    Beginning in July 1993, a 5-year program has sought to provide social research, training, and technical assistance in reproductive health and sexuality in Argentina, Chile, Peru, and Colombia by 1) building research capacity and promoting an interdisciplinary approach to reproductive health and sexuality and 2) promoting a gender perspective to these issues. The target groups are women's nongovernmental organizations (NGOs); family planning, reproductive health, and women's health providers; and social scientists conducting health-related research. Training activities include regional workshops, a Regional Resident Fellowship Program to support graduate-level education, and provision of technical assistance. The first 3 years of the program have revealed that the basic training needs in these areas include 1) helping women's NGOs improve their record-keeping capacity, evaluation processes, theoretical and methodological background, and institutional-building ability; 2) sensitizing women's health providers to sociocultural dimension of health-illness issues and to a gender and human rights perspective; and 3) training social scientist researchers to apply their skills in applied research, develop their theoretical background, and improve research quality control procedures. The main challenges for training activities in the field of reproductive health and sexuality are posed by the complexity of the issues and their interdisciplinary nature.

  7. Inequities in visual health and health services use in a rural region in Spain.

    Science.gov (United States)

    Latorre-Arteaga, Sergio; Fernández-Sáez, José; Gil-González, Diana

    2017-06-06

    To analyse perceived visual health and health services use in a rural population in relation to socioeconomic characteristics and compared with the general population in Spain. Cross-sectional study in a rural population using a structured questionnaire including questions comparable to the Spanish National Health Survey (2012). A descriptive analysis was carried out through the calculation of frequencies and prevalence, the χ 2 test for independent variables, contrasts of proportions and logistic regression to obtain associations between the rural and general populations and socioeconomic variables. For the rural population studied, the prevalence of poor perceptions of visual health is 40.8% in men and 39.4% in women, and is strongly associated with age, employment situation, income and presence of chronic diseases (p ˂0.001). Compared with the general population, the rural population has a higher risk of presenting with serious difficulties related to farsightedness (OR: 2.56; 95% CI: 1.32-4.95) and make less use of optical correction (OR: 0.57; 95%CI: 0.44-0.74). The use of health services is not sufficient for adequate prevention, particularly in diabetics. For those affected by poor vision, the distance to travel to receive an eye exam, the belief that eyesight problems come with age and the cost of glasses are the principal reasons used to explain why eyesight problems are not resolved. The rural population presents worse visual health that is influenced by social and economic factors. Improving accessibility and reducing barriers is essential to tackle avoidable visual disability and reduce health inequities. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Job satisfaction and associated factors among health professionals working at Western Amhara Region, Ethiopia.

    Science.gov (United States)

    Temesgen, Kalkidan; Aycheh, Moges Wubie; Leshargie, Cheru Tesema

    2018-04-17

    In Ethiopia assuring the satisfaction of health care provider with their job is a major challenging problem. Job satisfaction is a worker's emotional response to different job related factors resulting in finding pleasure, comfort, confidence, rewards, personal growth and various positive opportunities, including upward mobility, recognition, and appraisal done on a merit pattern with monetary value as compensation. Professionals, whose needs and expectations are satisfied, tend to be more productive compared to their colleagues. Thus, study is aimed at assessing job satisfaction and associated factors among health professionals working at Western Amhara region, Ethiopia. An institution-based cross sectional study was conducted on March 2016 at Western Amhara region among 575 health professionals selected using simple random sampling. Logistic regression analysis was used to identify factors related to job satisfaction. Variables which have p-value less than or equal to 0.05 with corresponding AOR at 95 confidence interval was considered to declare the significance association. This study revealed that job satisfaction of health professional working at Western Amhara region was 31.7%. The mean age of respondent was 27.13 years. Majority of them, 79.3% and 95.3% were less than 30 years in age and orthodox Christian religion followers respectively. The presence of health professionals' reference manual/guide, alcohol drinking, workload, experience, educational status and profession types were identified as significant factors associated with health care professionals' job satisfaction level. Professional being laboratory technicians, pharmacists and Environmental health workers were 4.86 times more likely to satisfy themselves than nurses, midwives and Public health officers. Similarly, in their educational status, degree and above holders were 5.64 times more likely to satisfy themselves than below degree holders. Health professionals whose experience with > 3

  9. Iraqi health system in kurdistan region: medical professionals' perspectives on challenges and priorities for improvement.

    Science.gov (United States)

    Shabila, Nazar P; Al-Tawil, Namir G; Tahir, Rebaz; Shwani, Falah H; Saleh, Abubakir M; Al-Hadithi, Tariq S

    2010-11-30

    The views of medical professionals on efficiency of health system and needs for any changes are very critical and constitute a cornerstone for any health system improvement. This is particularly relevant to Iraqi Kurdistan case as the events of the last few decades have significantly devastated the national Iraqi health system while the necessity for adopting a new health care system is increasingly recognized since 2004. This study aims to examine the regional health system in Iraqi Kurdistan from medical professionals' perspectives and try to define its problems and priorities for improvement. A survey questionnaire was developed and administered to a convenience sample of 250 medical professionals in Erbil governorate. The questionnaire included four items; rating of the quality of services and availability of resources in the health institutions, view on different aspects of the health system, the perceived priority needs for health system improvement and gender and professional characteristics of the respondents. The response rate to the survey was 83.6%. A high proportion of respondents rated the different aspects of services and resources in the health institutions as weak or very weak including the availability of the required quantity and quality of medicines (68.7%), the availability of sufficient medical equipment and investigation tools (68.7%), and the quality of offered services (65.3%). Around 72% of respondents had a rather negative view on the overall health system. The weak role of medical research, the weak role of professional associations in controlling the system and the inefficient health education were identified as important problems in the current health system (87.9%, 87.1% and 84.9%, respectively). The priority needs of health system improvement included adoption of social insurance for medical care of the poor (82%), enhancing the role of family medicine (77.2%), adopting health insurance system (76.1%) and periodic scientific

  10. Annual report on activities of Regional Public Health Offices in the Slovak Republic in 2008

    International Nuclear Information System (INIS)

    2009-01-01

    A brief account of activities carried out by the Regional Public Health Offices in the Slovak Republic in 2008 is presented. These activities are reported under the headings: (1) Environment; (2) Preventive occupational medicine; (3) Hygiene, nutrition, food safety and cosmetic products; (4) Hygiene of children and youth; (5) Epidemiology; (6) Objectification of environmental factors and working environment; (7) Medical microbiology; (8) Health promotion; (9) Health protection against radiation; (10) Complaints and petitions; (11) Control of tobacco and alcohol; (12) Evaluation of punitive measures for 2008.

  11. A case study of population health improvement at a Midwest regional hospital employer.

    Science.gov (United States)

    Long, D Adam; Sheehan, Paula

    2010-06-01

    This article reviews the population health improvement initiative of a Midwest regional hospital employer. Services included health risk assessments, health education, and motivational health coaching conducted telephonically. Outcomes categories for this program evaluation comprised participation rates, participant satisfaction, health status and behavior change, productivity change, health care claims savings, and return on investment. Participation rates varied widely with incentive structure, although retention of participants in coaching programs averaged 89%. The participant satisfaction rate for the last 14 months of interventions was 96%. Four years of population health status and behavior trending showed significant improvements in smoking status, dietary fat and fiber intake, exercise, mental health (ie, stress, effects depressive symptoms in the past year, life satisfaction), readiness to change (ie, diet, exercise, stress, smoking, body weight), perceptions of overall health, an index of good health habits, sum of lifestyle health risks, and sum of risks and chronic conditions. Body mass index showed nonsignificant improvements during the years of greatest participation (years 2 to 4). Indicators of productivity demonstrated improvements as well. These gains were noted for employees across all health risk statuses, which suggests population health improvement strategies can influence productivity even for healthy employees. Program year 3 was evaluated for health care claims savings using a 2-stage multivariate regression approach. Stage 1 was a computation of propensity-to-participate scores. Stage 2 was an estimation of per member per month (PMPM) claims savings for participant cohorts using a propensity score-weighted linear regression analysis. Participants averaged $40.65 PMPM savings over the control population. Program return on investment, including incentive costs and vendor fees, was 2.87:1.

  12. Variations between world regions in individual health: a multilevel analysis of the role of socio-economic factors

    NARCIS (Netherlands)

    Witvliet, Margot I.; Kunst, Anton E.; Stronks, Karien; Arah, Onyebuchi A.

    2012-01-01

    Background: Living in a particular region might affect health. We aimed to assess variations between regions in individual health. The role of socio-economic factors in the associations was also investigated. Methods: World Health Survey data were analysed on 220 487 individuals. Main outcomes

  13. Productivity losses associated with tuberculosis deaths in the World Health Organization African region.

    Science.gov (United States)

    Kirigia, Joses Muthuri; Muthuri, Rosenabi Deborah Karimi

    2016-06-01

    In 2014, almost half of the global tuberculosis deaths occurred in the World Health Organization (WHO) African Region. Approximately 21.5 % of the 6 060 742 TB cases (new and relapse) reported to the WHO in 2014 were in the African Region. The specific objective of this study was to estimate future gross domestic product (GDP) losses associated with TB deaths in the African Region for use in advocating for better strategies to prevent and control tuberculosis. The cost-of-illness method was used to estimate non-health GDP losses associated with TB deaths. Future non-health GDP losses were discounted at 3 %. The analysis was conducted for three income groups of countries. One-way sensitivity analysis at 5 and 10 % discount rates was undertaken to assess the impact on the expected non-health GDP loss. The 0.753 million tuberculosis deaths that occurred in the African Region in 2014 would be expected to decrease the future non-health GDP by International Dollars (Int$) 50.4 billion. Nearly 40.8, 46.7 and 12.5 % of that loss would come from high and upper-middle- countries or lower-middle- and low-income countries, respectively. The average total non-health GDP loss would be Int$66 872 per tuberculosis death. The average non-health GDP loss per TB death was Int$167 592 for Group 1, Int$69 808 for Group 2 and Int$21 513 for Group 3. Tuberculosis exerts a sizeable economic burden on the economies of the WHO AFR countries. This implies the need to strongly advocate for better strategies to prevent and control tuberculosis and to help countries end the epidemic of tuberculosis by 2030, as envisioned in the United Nations General Assembly resolution on Sustainable Development Goals (SDGs).

  14. Increasing compliance with the World Health Organization Surgical Safety Checklist-A regional health system's experience.

    Science.gov (United States)

    Gitelis, Matthew E; Kaczynski, Adelaide; Shear, Torin; Deshur, Mark; Beig, Mohammad; Sefa, Meredith; Silverstein, Jonathan; Ujiki, Michael

    2017-07-01

    In 2009, NorthShore University HealthSystem adapted the World Health Organization Surgical Safety Checklist (SSC) at each of its 4 hospitals. Despite evidence that SSC reduces intraoperative mistakes and increase patient safety, compliance was found to be low with the paper form. In November 2013, NorthShore integrated the SSC into the electronic health record (EHR). The aim was to increase communication between operating room (OR) personnel and to encourage best practices during the natural workflow of surgeons, anesthesiologists, and nurses. The purpose of this study was to examine the impact of an electronic SSC on compliance and patient safety. An anonymous OR observer selected cases at random and evaluated the compliance rate before the rollout of the electronic SSC. In June 2014, an electronic audit was performed to assess the compliance rate. Random OR observations were also performed throughout the summer in 2014. Perioperative risk events, such as consent issues, incorrect counts, wrong site, and wrong procedure were compared before and after the electronic SSC rollout. A perception survey was also administered to NorthShore OR personnel. Compliance increased from 48% (n = 167) to 92% (n = 1,037; P World Health Organization SSC is a validated tool to increase patient safety and reduce intraoperative complications. The electronic SSC has demonstrated an increased compliance rate, a reduced number of risk events, and most OR personnel believe it will have a positive impact on patient safety. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Assessing needs and assets for building a regional network infrastructure to reduce cancer related health disparities.

    Science.gov (United States)

    Wells, Kristen J; Lima, Diana S; Meade, Cathy D; Muñoz-Antonia, Teresita; Scarinci, Isabel; McGuire, Allison; Gwede, Clement K; Pledger, W Jack; Partridge, Edward; Lipscomb, Joseph; Matthews, Roland; Matta, Jaime; Flores, Idhaliz; Weiner, Roy; Turner, Timothy; Miele, Lucio; Wiese, Thomas E; Fouad, Mona; Moreno, Carlos S; Lacey, Michelle; Christie, Debra W; Price-Haywood, Eboni G; Quinn, Gwendolyn P; Coppola, Domenico; Sodeke, Stephen O; Green, B Lee; Lichtveld, Maureen Y

    2014-06-01

    Significant cancer health disparities exist in the United States and Puerto Rico. While numerous initiatives have been implemented to reduce cancer disparities, regional coordination of these efforts between institutions is often limited. To address cancer health disparities nation-wide, a series of regional transdisciplinary networks through the Geographic Management Program (GMaP) and the Minority Biospecimen/Biobanking Geographic Management Program (BMaP) were established in six regions across the country. This paper describes the development of the Region 3 GMaP/BMaP network composed of over 100 investigators from nine institutions in five Southeastern states and Puerto Rico to develop a state-of-the-art network for cancer health disparities research and training. We describe a series of partnership activities that led to the formation of the infrastructure for this network, recount the participatory processes utilized to develop and implement a needs and assets assessment and implementation plan, and describe our approach to data collection. Completion, by all nine institutions, of the needs and assets assessment resulted in several beneficial outcomes for Region 3 GMaP/BMaP. This network entails ongoing commitment from the institutions and institutional leaders, continuous participatory and engagement activities, and effective coordination and communication centered on team science goals. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Assessing Needs and Assets for Building a Regional Network Infrastructure to Reduce Cancer Related Health Disparities

    Science.gov (United States)

    Wells, Kristen J.; Lima, Diana S.; Meade, Cathy D.; Muñoz-Antonia, Teresita; Scarinci, Isabel; McGuire, Allison; Gwede, Clement K.; Pledger, W. Jack; Partridge, Edward; Lipscomb, Joseph; Matthews, Roland; Matta, Jaime; Flores, Idhaliz; Weiner, Roy; Turner, Timothy; Miele, Lucio; Wiese, Thomas E.; Fouad, Mona; Moreno, Carlos S.; Lacey, Michelle; Christie, Debra W.; Price-Haywood, Eboni G.; Quinn, Gwendolyn P.; Coppola, Domenico; Sodeke, Stephen O.; Green, B. Lee; Lichtveld, Maureen Y.

    2015-01-01

    Significant cancer health disparities exist in the United States and Puerto Rico. While numerous initiatives have been implemented to reduce cancer disparities, regional coordination of these efforts between institutions is often limited. To address cancer health disparities nationwide, a series of regional transdisciplinary networks through the Geographic Management Program (GMaP) and the Minority Biospecimen/Biobanking Geographic Management Program (BMaP) were established in six regions across the country. This paper describes the development of the Region 3 GMaP/BMaP network composed of over 100 investigators from nine institutions in five Southeastern states and Puerto Rico to develop a state-of-the-art network for cancer health disparities research and training. We describe a series of partnership activities that led to the formation of the infrastructure for this network, recount the participatory processes utilized to develop and implement a needs and assets assessment and implementation plan, and describe our approach to data collection. Completion, by all nine institutions, of the needs and assets assessment resulted in several beneficial outcomes for Region 3 GMaP/BMaP. This network entails ongoing commitment from the institutions and institutional leaders, continuous participatory and engagement activities, and effective coordination and communication centered on team science goals. PMID:24486917

  17. Analysis of environment state in technogenic region and its threat to public health

    Directory of Open Access Journals (Sweden)

    Grishenko S.V.

    2014-03-01

    Full Text Available The purpose of the research is to give a complex hygienic evaluation of environment state in Donetsk region and to determine the degree of their potential danger to population health. It includes air pollution, water contamination, state of soil. Nearly 43000 samples of air, 32000 drinking water samples and 4500 soil samples were analyzed. Regions with the highest rate of environmental pollution were defined. It was found that the main sources of environment pollution in Donetsk region are ferrous and nonferrous metallurgy enterprises, power, coal, building industry and transport. All other sources ac¬count for only 5-10% of total emissions. Level of harmful technogenic pressing on population’s health was determined.

  18. World Health Organization Global Estimates and Regional Comparisons of the Burden of Foodborne Disease in 2010

    DEFF Research Database (Denmark)

    Havelaar, Arie H.; Kirk, Martyn D.; Torgerson, Paul R.

    2015-01-01

    parasitic helminths, were highly localised. Thus, the burden of FBD is borne particularly by children under five years old-although they represent only 9% of the global population-and people living in low-income regions of the world. These estimates are conservative, i.e., underestimates rather than......Illness and death from diseases caused by contaminated food are a constant threat to public health and a significant impediment to socio-economic development worldwide. To measure the global and regional burden of foodborne disease (FBD), the World Health Organization (WHO) established...... different burdens of FBD, with the greatest falling on the subregions in Africa, followed by the subregions in South-East Asia and the Eastern Mediterranean D subregion. Some hazards, such as non-typhoidal S. enterica, were important causes of FBD in all regions of the world, whereas others, such as certain...

  19. The tuberculosis program of Catalonia's Central Health Region (1986-1993).

    Science.gov (United States)

    Miret-Cuadras, P; Gonzalez-Fernandez, P; Lopez-Sanmartin, J L; Martin-Ramos, A; Pina Gutierrez, J M

    1997-04-01

    Catalonia's Central Health Region antituberculosis program, which began in 1985. To evaluate the cooperation of health staff and the program's effectiveness after 8 years. The following data from the nominal notifications and the expanded case reports were processed: epidemiological, clinical and treatment data, each patient's end results and the outcome of the contact investigation. The implementation of the program was evaluated by means of the number of notifications and contact investigations received, and its effectiveness was assessed by the percentage of sputum smear positive cases having completed treatment. There was an increase in the number of patients with an expanded case report (from 74% to 100%), with a final notification (from 61% to 99%) and with contact investigation (from 29% to 79%). The sputum smear positive cases who completed the treatment after 1990 exceeded 85%. The implementation of the program in the Region's health system is good and is improving in parallel with the control of the disease.

  20. Participatory evaluation of delivery of animal health care services by community animal health workers in Karamoja region of Uganda.

    Directory of Open Access Journals (Sweden)

    James Bugeza

    Full Text Available An evaluation exercise was carried out to assess the performance of Community Animal Health Workers (CAHWs in the delivery of animal health care services in Karamoja region, identify capacity gaps and recommend remedial measures.Participatory methods were used to design data collection tools. Questionnaires were administered to 204 CAHWs, 215 farmers and 7 District Veterinary Officers (DVOs to collect quantitative data. Seven DVOs and 1 Non Government Organization (NGO representative were interviewed as key informants and one focus group discussion was conducted with a farmer group in Nakapiripirit to collect qualitative data. Questionnaire data was analyzed using SPSS version 19. Key messages from interviews and the focus group discussion were recorded in a notebook and reported verbatim.70% of the farmers revealed that CAHWs are the most readily available animal health care service providers in their respective villages. CAHWs were instrumental in treatment of sick animals, disease surveillance, control of external parasites, animal production, vaccination, reporting, animal identification, and performing minor surgeries. Regarding their overall performance 88.8%(191/215 of the farmers said they were impressed. The main challenges faced by the CAHWs were inadequate facilitation, lack of tools and equipments, unwillingness of government to integrate them into the formal extension system, poor information flow, limited technical capacity to diagnose diseases, unwillingness of farmers to pay for services and sustainability issues.CAHWs remain the main source of animal health care services in Karamoja region and their services are largely satisfactory. The technical deficits identified require continuous capacity building programs, close supervision and technical backstopping. For sustainability of animal health care services in the region continuous training and strategic deployment of paraprofessionals that are formally recognised by the

  1. Participatory evaluation of delivery of animal health care services by community animal health workers in Karamoja region of Uganda.

    Science.gov (United States)

    Bugeza, James; Kankya, Clovice; Muleme, James; Akandinda, Ann; Sserugga, Joseph; Nantima, Noelina; Okori, Edward; Odoch, Terence

    2017-01-01

    An evaluation exercise was carried out to assess the performance of Community Animal Health Workers (CAHWs) in the delivery of animal health care services in Karamoja region, identify capacity gaps and recommend remedial measures. Participatory methods were used to design data collection tools. Questionnaires were administered to 204 CAHWs, 215 farmers and 7 District Veterinary Officers (DVOs) to collect quantitative data. Seven DVOs and 1 Non Government Organization (NGO) representative were interviewed as key informants and one focus group discussion was conducted with a farmer group in Nakapiripirit to collect qualitative data. Questionnaire data was analyzed using SPSS version 19. Key messages from interviews and the focus group discussion were recorded in a notebook and reported verbatim. 70% of the farmers revealed that CAHWs are the most readily available animal health care service providers in their respective villages. CAHWs were instrumental in treatment of sick animals, disease surveillance, control of external parasites, animal production, vaccination, reporting, animal identification, and performing minor surgeries. Regarding their overall performance 88.8%(191/215) of the farmers said they were impressed. The main challenges faced by the CAHWs were inadequate facilitation, lack of tools and equipments, unwillingness of government to integrate them into the formal extension system, poor information flow, limited technical capacity to diagnose diseases, unwillingness of farmers to pay for services and sustainability issues. CAHWs remain the main source of animal health care services in Karamoja region and their services are largely satisfactory. The technical deficits identified require continuous capacity building programs, close supervision and technical backstopping. For sustainability of animal health care services in the region continuous training and strategic deployment of paraprofessionals that are formally recognised by the traditional civil

  2. An online nursing leadership literature centre at the University of Manitoba Health Sciences Libraries.

    Science.gov (United States)

    Barrett, Patricia

    2009-09-01

    Decades of hospital restructuring in Canada resulted in significant reductions of nursing leadership positions and altered a nursing infrastructure important for guiding patient care. The importance of acquiring nursing leadership skills to address the negative effects of restructuring is advocated by Canadian nursing bodies. To describe a service innovation for a nursing community. The librarians of the University of Manitoba Health Sciences Libraries (UMHSL) created an online nursing leadership literature centre to support a leadership programme launched by the Nursing Leadership Council (NLC) of the Winnipeg Regional Health Authority. The article will contribute to the body of literature about health library services for nurses. The creation of the service is described. A literature search was undertaken to determine what services have been implemented by librarians for nursing leadership programmes, as well as to review the literature with regard to contributions made by librarians for nursing communities. The literature service, comprised of 19 webliographies based on the NLC's leadership topics, is available on the UMHSL website. A webliography, by definition, is a list of electronic works relating to a particular topic. The NLC created its own website that provides nurses with a means to identify, enhance and evaluate leadership competencies, and which is linked to the UMHSL website. The contributions of the UMHSL librarians to this project support the goals of instilling leadership skills in nurses, encouraging evidence-based nursing practice, and transforming a practice environment to meet the ultimate goal of effective patient care.

  3. Assessing the health equity impacts of regional land-use plan making: An equity focussed health impact assessment of alternative patterns of development of the Whitsunday Hinterland and Mackay Regional Plan, Australia (Short report)

    International Nuclear Information System (INIS)

    Gunning, Colleen; Harris, Patrick; Mallett, John

    2011-01-01

    Health service and partners completed an equity focussed health impact assessment to influence the consideration of health and equity within regional land-use planning in Queensland, Australia. This project demonstrated how an equity oriented assessment matrix can assist in testing regional planning scenarios. It is hoped that this HIA will contribute to the emerging interest in ensuring that potential differential health impacts continue to be considered as part of land-use planning processes.

  4. Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state

    Science.gov (United States)

    Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A

    2014-01-01

    Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version. PMID:23975626

  5. [Food and beverages available in automatic food dispensers in health care facilities of the Portugal North Health Region].

    Science.gov (United States)

    Rodrigues, Filipa Gomes; Ramos, Elisabete; Freitas, Mário; Neto, Maria

    2010-01-01

    Patients and health staff frequently need to stay in health care facilities for quite a long time. Therefore, it's necessary to create the conditions that allow the ingestion of food during those periods, namely through the existence of automatic food dispensers. However, the available food and beverages might not always be compatible with a healthy diet. The aim of this work was to evaluate if the food and beverages available in automatic food dispensers in public Ambulatory Care Facilities (ACF) and Hospitals of the Portugal North Health Region were contributing to a healthy diet, during the year of 2007. A questionnaire was elaborated and sent to the Coordinators of the Health Sub-Regions and to the Hospital Administrators. The questionnaire requested information about the existence of automatic food dispensers in the several departments of each health care facility, as well as which food and beverages were available and most sold. Afterwards, the pre-processing of the results involved the classification of the food and beverages in three categories: recommended, sometimes recommended and not recommended. The questionnaire reply ratio was 71% in ACF and 83% in Hospitals. Automatic food dispensers were available in all the Hospitals and 86.5% of ACF. It wasn't possible to acquire food in 37% of the health facility departments. These departments were all located in ACF. The more frequently available beverages in departments with automatic food dispensers were coffee, still water, tea, juices and nectars and soft drinks. Still water, coffee, yogurt, juices and nectars and soft drinks were reported as the most sold. The more frequently avaliable food items were chocolate, recommended cookies, not recommended cakes, recommended sandwiches and sometimes recommended croissants. The food items reported as being the most sold were recommended sandwiches, chocolate, recommended cookies, sometimes recommended croissants and not recommended cookies. The beverages in the

  6. Initial experiences and innovations in supervising community health workers for maternal, newborn, and child health in Morogoro region, Tanzania.

    Science.gov (United States)

    Roberton, Timothy; Applegate, Jennifer; Lefevre, Amnesty E; Mosha, Idda; Cooper, Chelsea M; Silverman, Marissa; Feldhaus, Isabelle; Chebet, Joy J; Mpembeni, Rose; Semu, Helen; Killewo, Japhet; Winch, Peter; Baqui, Abdullah H; George, Asha S

    2015-04-09

    Supervision is meant to improve the performance and motivation of community health workers (CHWs). However, most evidence on supervision relates to facility health workers. The Integrated Maternal, Newborn, and Child Health (MNCH) Program in Morogoro region, Tanzania, implemented a CHW pilot with a cascade supervision model where facility health workers were trained in supportive supervision for volunteer CHWs, supported by regional and district staff, and with village leaders to further support CHWs. We examine the initial experiences of CHWs, their supervisors, and village leaders to understand the strengths and challenges of such a supervision model for CHWs. Quantitative and qualitative data were collected concurrently from CHWs, supervisors, and village leaders. A survey was administered to 228 (96%) of the CHWs in the Integrated MNCH Program and semi-structured interviews were conducted with 15 CHWs, 8 supervisors, and 15 village leaders purposefully sampled to represent different actor perspectives from health centre catchment villages in Morogoro region. Descriptive statistics analysed the frequency and content of CHW supervision, while thematic content analysis explored CHW, supervisor, and village leader experiences with CHW supervision. CHWs meet with their facility-based supervisors an average of 1.2 times per month. CHWs value supervision and appreciate the sense of legitimacy that arises when supervisors visit them in their village. Village leaders and district staff are engaged and committed to supporting CHWs. Despite these successes, facility-based supervisors visit CHWs in their village an average of only once every 2.8 months, CHWs and supervisors still see supervision primarily as an opportunity to check reports, and meetings with district staff are infrequent and not well scheduled. Supervision of CHWs could be strengthened by streamlining supervision protocols to focus less on report checking and more on problem solving and skills development

  7. Evidence based practice in population health: a regional survey to inform workforce development and organisational change.

    Science.gov (United States)

    Adily, A; Ward, J

    2004-06-01

    To assess current capacity to implement evidence based practice (EBP) in population health. Postal survey of a regional population health workforce in Sydney, Australia. Division of Population Health, South Western Sydney Area Health Service. 104 population health staff (response rate: 73%). In the sample of regional population health practitioners, views about the current promotion of EBP were positive. Non-medical respondents with less that Masters degree were more likely to report "high self assessed need" to increase their capacity in EBP (p = 0.022). Confidence in understanding of EBP terminology was not associated with seniority but with highest level of education reached (pskills" or "need to increase their capacity in EBP" in their current position. The proportion of participants "strongly" supporting implementation of a colorectal cancer screening programme whose benefit was expressed as relative risk reduction was greater than that so supporting a programme whose benefit was expressed as number needed to screen (p = 0.008). Most respondents referred to their immediate managers when seeking support for EBP. The findings provide a quantitative baseline for capacity building through workplace programmes. Managerial commitment has been increased and performance development is now underway.

  8. Education and training of public health professionals in the European Region: variation and convergence.

    Science.gov (United States)

    Bjegovic-Mikanovic, Vesna; Vukovic, Dejana; Otok, Robert; Czabanowska, Katarzyna; Laaser, Ulrich

    2013-12-01

    To assess the exit competences of public health graduates across a diverse European landscape. The target population comprised 80 full institutional members of the Association of Schools of Public Health in the European Region with a participation rate 82.5 %. The web-based questionnaire covered institutional profiles and the ranking of exit competences for master of public health programmes, grouped according to WHO Essential Public Health Operations. European schools and departments usually are small units, funded from tax money. A total of 130 programmes have been indicated, together releasing 3,035 graduates in the last year before the survey. All competence groups showed high reliability and high internal consistency (α > 0.75, p teaching output has been assessed for health promotion, followed by disease prevention and identification of health hazards in the community, the least in emergency preparedness. Given the fragmentation of the institutional infrastructure, the harmonisation of programme content and thinking is impressive. However, the educational capacity in the European Region is far from being sufficient if compared to aspired US levels.

  9. Readiness of ethics review systems for a changing public health landscape in the WHO African Region.

    Science.gov (United States)

    Motari, Marion; Ota, Martin Okechukwu; Kirigia, Joses Muthuri

    2015-12-02

    The increasing emphasis on research, development and innovation for health in providing solutions to the high burden of diseases in the African Region has warranted a proliferation of studies including clinical trials. This changing public health landscape requires that countries develop adequate ethics review capacities to protect and minimize risks to study participants. Therefore, this study assessed the readiness of national ethics committees to respond to challenges posed by a globalized biomedical research system which is constantly challenged by new public health threats, rapid scientific and technological advancements affecting biomedical research and development, delivery and manufacture of vaccines and therapies, and health technology transfer. This is a descriptive study, which used a questionnaire structured to elicit information on the existence of relevant national legal frameworks, mechanisms for ethical review; as well as capacity requirements for national ethics committees. The questionnaire was available in English and French and was sent to 41 of the then 46 Member States of the WHO African Region, excluding the five Lusophone Member States. Information was gathered from senior officials in ministries of health, who by virtue of their offices were considered to have expert knowledge of research ethics review systems in their respective countries. Thirty three of the 41 countries (80.5 %) responded. Thirty (90.9 %) of respondent countries had a national ethics review committee (NEC); 79 % of which were established by law. Twenty-five (83.3 %) NECs had secretarial and administrative support. Over 50 % of countries with NECs indicated a need for capacity strengthening through periodic training on international guidelines for health research (including clinical trials) ethics; and allocation of funds for administrative and secretariat support. Despite the existing training initiatives, the Region still experiences a shortage of professionals

  10. Correlations of indoor second-hand smoking, household smoking rules, regional deprivation and children mental health: Scottish Health Survey, 2013.

    Science.gov (United States)

    Shiue, Ivy

    2015-07-01

    It has been known that second-hand smoking and deprivation could cluster together affecting child health. However, little is known on the role of household smoking rules. Therefore, it was aimed to study the relationships among indoor second-hand smoking, household smoking rules, deprivation level and children mental health in a country-wide and population-based setting. Data was retrieved from and analysed in Scottish Health Survey, 2013. Information on demographics, indoor second-hand smoking status, household smoking rules, deprivation level and child mental health by Strengths and Difficulties Questionnaire was obtained by household interview through parents. Statistical analysis included chi-square test and survey-weighted logistic regression modelling. Of 1019 children aged 4-12, 17.9% (n = 182) lived in the 15% most deprivation areas. Deprived areas tended to be where indoor smoking occurred (p Scottish children are greater Glasgow, Ayrshire & Arran and Forth Valley while the top three sub-regions of exposure to the indoor second-hand smoking are Fife, Forth Valley and Ayrshire & Arran. The top three sub-regions with indoor smoking allowed are greater Glasgow, Western Isles and Borders. Children emotional and behavioural problems were reduced when the strict household smoking rules (not allowed or outdoor areas) applied. One in six Scottish children lived in the 15% most deprivation areas and exposed to indoor second-hand smoking that could have led to emotional and behavioural problems. Public health programs promoting strict household smoking rules should be encouraged in order to optimise children mental health.

  11. Implementation of a guideline for local health policy making by regional health services : Exploring determinants of use by a web survey

    NARCIS (Netherlands)

    Kuunders, T.J.M.; Jacobs, M.A.M.; Paulussen, T.G.W.M.; van de Goor, L.A.M.; van Bon, M.J.H.; van Oers, J.A.M.

    Background Previous evaluation showed insufficient use of a national guideline for integrated local health policy by Regional Health Services (RHS) in the Netherlands. The guideline focuses on five health topics and includes five checklists to support integrated municipal health policies. This study

  12. Implementation of a guideline for local health policy making by regional health services: exploring determinants of use by a web survey

    NARCIS (Netherlands)

    Kuunders, T.J.M.; Jacobs, M.A.M.; Goor, I.A.M. van de; Bon-Martens, M.J.H. van; Oers, H.A.M. van; Paulussen, T.G.W.M.

    2017-01-01

    Background. Previous evaluation showed insufficient use of a national guideline for integrated local health policy by Regional Health Services (RHS) in the Netherlands. The guideline focuses on five health topics and includes five checklists to support integrated municipal health policies. This

  13. Soil health in the Mediterranean region: Development and consolidation of a multifactor index to characterize the health of agricultural lands

    Science.gov (United States)

    Gil, Eshel; Guy, Levy; Oshri, Rinot; Michael, Borisover; Uri, Yermiyahu; Leah, Tsror; Hanan, Eizenberg; Tal, Svoray; Alex, Furman; Yael, Mishael; Yosef, Steinberger

    2017-04-01

    The link among between soil health, soil conservation, and food security, resilience, and function under a wide range of agricultural uses and different environmental systems, is at the heart of many ecofriendly research studies worldwide. We consider the health of soil as a function of its ability to provide ecosystem services, including agricultural production (provisional services); regulating natural cycles (regulation services) and as a habitat for plants (support services). Soil health is affected by a wide range of soil properties (biotic and abiotic) that maintain complex interactions among themselves. The decline in soil health includes degradation in its physical properties (e.g., deterioration of soil structure, compaction and sealing, water-repellency, soil erosion by water and wind), chemical properties (e.g., salinization, depletion of nutrients and organic matter content, accumulation of pollutants and reduction of the soils' ion exchange capacity) and biological properties (e.g., vulnerable populations of microflora, microfauna, and mesofauna, leading to a breach of ecological balance and biodiversity and, as a result, destruction of beneficial populations and pathogen outbreaks). Numerous studies show that agricultural practices have a major impact on soil functioning. Substituting longstanding tillage with no-till cropping and the amalgamation of cover crops in crop rotations were found to improve soil properties. Such changes contributed to the enhancement of the agronomical performance of the soil. On the other hand, these practices may result in lessened effectiveness of controlling perennial weeds. The evaluation of soil-health status in the Mediterranean region is very limited. Moreover, existing approaches for evaluation that have been used (such as the Cornell and Hany tests) do not give sufficient weight to important agronomic processes, such as soil erosion, salinization, sodification, spread of weeds in the fields (in particular, weeds

  14. Stray animal populations and public health in the South Mediterranean and the Middle East regions

    Directory of Open Access Journals (Sweden)

    Aristarhos Seimenis

    2014-06-01

    Full Text Available Uncontrolled urban growth in South Mediterranean and the Middle East regions involves city dwellers and stray animals (mainly dogs and cats creating a dense and downgraded environment, in which irregular street garbage collection disposes sufficient food for survival and proliferation of stray animals. Under such conditions serious public health hazards are expected due to the increase of animal bites, the multiplication of insects and rodents vectors of different viral, bacterial, fungal and parasitic agents to which humans are exposed. Traditional national stray animal eradication programs and occasional small animals' humane elimination campaigns are insufficient to avert human and veterinary health risks when not coupled with modern technologies. In such environments, multiple foci of emerging and re‑emerging zoonoses easily spread, i.e. rabies, hydatidosis, leishmaniasis and toxoplasmosis. Upgrading urban and peri-urban situations requires integrated/coordinated management programmes, in which public and animal health services as well as municipalities have a crucial role. Control and upgrading programmes should be flexible and able to adapt to the specific conditions of the given country/region. In this context, intersectoral/interprofessional collaborations and community participation are crucial for any national and regional development strategies. In this respect, a global approach considering both public health and socio-economic problems shows to be extremely adequate and effective.

  15. Health transition in Brazil: regional variations and divergence/convergence in mortality.

    Science.gov (United States)

    Borges, Gabriel Mendes

    2017-08-21

    This study analyzes the main characteristics of the health transition in Brazil and its five major regions, using a framework that accounts for regional inequalities in mortality trends. The regional mortality divergence/convergence process is described and discussed by considering the specific contributions of age groups and causes of death in life expectancy variations. Results show that mortality change in Brazil has follow the epidemiologic transition theory to some extent during the period under analysis - for instance, the sharp decline in infant mortality in all regions (first from infectious and parasitic diseases and then from causes associated with the perinatal period) and the increase in the participation of chronic and degenerative diseases as the main cause of death. However, some features of Brazilian transition have not followed the linear and unidirectional pattern proposed by the epidemiologic transition theory, which helps to understand the periods of regional divergence in life expectancy, despite the long-term trends showing reducing regional inequalities. The emergence of HIV/AIDS, the persistence of relatively high levels of other infections and parasitic diseases, the regional differences in the unexpected mortality improvements from cardiovascular diseases, and the rapid and strong variations in mortality from external causes are some of the examples.

  16. Multidimensional poverty and catastrophic health spending in the mountainous regions of Myanmar, Nepal and India.

    Science.gov (United States)

    Mohanty, Sanjay K; Agrawal, Nand Kishor; Mahapatra, Bidhubhusan; Choudhury, Dhrupad; Tuladhar, Sabarnee; Holmgren, E Valdemar

    2017-01-18

    Economic burden to households due to out-of-pocket expenditure (OOPE) is large in many Asian countries. Though studies suggest increasing household poverty due to high OOPE in developing countries, studies on association of multidimensional poverty and household health spending is limited. This paper tests the hypothesis that the multidimensionally poor are more likely to incur catastrophic health spending cutting across countries. Data from the Poverty and Vulnerability Assessment (PVA) Survey carried out by the International Center for Integrated Mountain Development (ICIMOD) has been used in the analyses. The PVA survey was a comprehensive household survey that covered the mountainous regions of India, Nepal and Myanmar. A total of 2647 households from India, 2310 households in Nepal and 4290 households in Myanmar covered under the PVA survey. Poverty is measured in a multidimensional framework by including the dimensions of education, income and energy, water and sanitation using the Alkire and Foster method. Health shock is measured using the frequency of illness, family sickness and death of any family member in a reference period of one year. Catastrophic health expenditure is defined as 40% above the household's capacity to pay. Results suggest that about three-fifths of the population in Myanmar, two-fifths of the population in Nepal and one-third of the population in India are multidimensionally poor. About 47% of the multidimensionally poor in India had incurred catastrophic health spending compared to 35% of the multidimensionally non-poor and the pattern was similar in both Nepal and Myanmar. The odds of incurring catastrophic health spending was 56% more among the multidimensionally poor than among the multidimensionally non-poor [95% CI: 1.35-1.76]. While health shocks to households are consistently significant predictors of catastrophic health spending cutting across country of residence, the educational attainment of the head of the household is

  17. Polio eradication in the African Region on course despite public health emergencies.

    Science.gov (United States)

    Okeibunor, Joseph C; Ota, Martin C; Akanmori, Bartholomew D; Gumede, Nicksy; Shaba, Keith; Kouadio, Koffi I; Poy, Alain; Mihigo, Richard; Salla, Mbaye; Moeti, Matshidiso R

    2017-03-01

    The World Health Organization, African Region is heading toward eradication of the three types of wild polio virus, from the Region. Cases of wild poliovirus (WPV) types 2 and 3 (WPV2 and WPV3) were last reported in 1998 and 2012, respectively, and WPV1 reported in Nigeria since July 2014 has been the last in the entire Region. This scenario in Nigeria, the only endemic country, marks a remarkable progress. This significant progress is as a result of commitment of key partners in providing the much needed resources, better implementation of strategies, accountability, and innovative approaches. This is taking place in the face of public emergencies and challenges, which overburden health systems of countries and threaten sustainability of health programmes. Outbreak of Ebola and other diseases, insecurity, civil strife and political instability led to displacement of populations and severely affected health service delivery. The goal of eradication is now within reach more than ever before and countries of the region should not relent in their efforts on polio eradication. WHO and partners will redouble their efforts and introduce better approaches to sustain the current momentum and to complete the job. The carefully planned withdrawal of oral polio vaccine type II (OPV2) with an earlier introduction of one dose of inactivated poliovirus vaccine (IPV), in routine immunization, will boost immunity of populations and stop cVDPVs. Environmental surveillance for polio viruses will supplement surveillance for AFP and improve sensitivity of detection of polio viruses. Copyright © 2016 World Health Organization. Published by Elsevier Ltd. Published by Elsevier Ltd.. All rights reserved.

  18. Bibliometric analysis of public health research in Africa: The overall trend and regional comparisons

    Directory of Open Access Journals (Sweden)

    Yuh-Shan Ho

    2011-05-01

    Full Text Available Many diseases in Africa can be prevented with appropriate public health interventions. This study aimed to assess the bibliometric characteristics of public health related research articles published by researchers in African institutions from 1991 to 2005. Data used in this study were obtained from the online version of the ISI Web of Science: Science Citation Index Expanded (SCI-Expanded. Articles published between 1991 and 2005 that had the phrase ‘public health’ in the title, author keywords or abstract, and had at least one author whose contact address was in an African country, were selected for analysis. The annual number of public health related articles published by African researchers significantly increased from 28 articles in 1991 to 135 articles in 2005, a 382% increase. International collaboration also increased: from 45% of articles having international collaborators during 1991–1995, to 52% during1996–2000, and to 67% during 2001–2005. Collaborations were mostly with European and North American countries. Keywords, subject categories and collaboration patterns of articles varied across regions, reflecting differences in needs and collaboration networks. Public health related research output, as well as international collaborations, have been increasing in Africa. Regional variation observed in this study may assist policymakers to facilitate the advancement of public health research in different regions of Africa, and could be useful for international organisations in identifying needs and to allocate research funding. Future bibliometric analyses of articles published by African researchers, can consider conducting regional comparisons using standardised methods, as well as describing the overall patterns, in order to provide a more comprehensive view of their bibliometric characteristics.

  19. Architecture of a consent management suite and integration into IHE-based Regional Health Information Networks.

    Science.gov (United States)

    Heinze, Oliver; Birkle, Markus; Köster, Lennart; Bergh, Björn

    2011-10-04

    The University Hospital Heidelberg is implementing a Regional Health Information Network (RHIN) in the Rhine-Neckar-Region in order to establish a shared-care environment, which is based on established Health IT standards and in particular Integrating the Healthcare Enterprise (IHE). Similar to all other Electronic Health Record (EHR) and Personal Health Record (PHR) approaches the chosen Personal Electronic Health Record (PEHR) architecture relies on the patient's consent in order to share documents and medical data with other care delivery organizations, with the additional requirement that the German legislation explicitly demands a patients' opt-in and does not allow opt-out solutions. This creates two issues: firstly the current IHE consent profile does not address this approach properly and secondly none of the employed intra- and inter-institutional information systems, like almost all systems on the market, offers consent management solutions at all. Hence, the objective of our work is to develop and introduce an extensible architecture for creating, managing and querying patient consents in an IHE-based environment. Based on the features offered by the IHE profile Basic Patient Privacy Consent (BPPC) and literature, the functionalities and components to meet the requirements of a centralized opt-in consent management solution compliant with German legislation have been analyzed. Two services have been developed and integrated into the Heidelberg PEHR. The standard-based Consent Management Suite consists of two services. The Consent Management Service is able to receive and store consent documents. It can receive queries concerning a dedicated patient consent, process it and return an answer. It represents a centralized policy enforcement point. The Consent Creator Service allows patients to create their consents electronically. Interfaces to a Master Patient Index (MPI) and a provider index allow to dynamically generate XACML-based policies which are

  20. Sharing regulatory data as tools for strengthening health systems in the Region of the Americas

    Directory of Open Access Journals (Sweden)

    Varley Dias Sousa

    Full Text Available ABSTRACT Regulatory transparency is an imperative characteristic of a reliable National Regulatory Authority. In the region of the Americas, the process of building an open government is still fragile and fragmented across various Health Regulatory Agencies (HRAs and Regional Reference Authorities (RRAs. This study assessed the transparency status of RRAs, focusing on various medicine life-cycle documents (the Medicine Dossier, Clinical Trial Report, and Inspection Report as tools for strengthening health systems. Based on a narrative (nonsystematic review of RRA regulatory transparency, transparency status was classified as one of two types: public disclosure of information (intra-agency data and data- and work-sharing (inter-agency data. The risks/benefits of public disclosure of medicine-related information were assessed, taking into account 1 the involvement and roles of multiple stakeholders (health care professionals, regulators, industry, community, and academics and 2 the protection of commercial and personal confidential data. Inter-agency data- and work-sharing was evaluated in the context of harmonization and cooperation projects that focus on regulatory convergence. Technical and practical steps for establishing an openness directive for the pharmaceutical regulatory environment are proposed to improve and strengthen health systems in the Americas. Addressing these challenges requires leadership from entities such as the Pan American Health Organization to steer and support collaborative regional alliances that advance the development and establishment of a trustworthy regulatory environment and a sustainable public health system in the Americas, using international successful initiatives as reference and taking into account the domestic characteristics and experiences of each individual country.

  1. Sharing regulatory data as tools for strengthening health systems in the Region of the Americas.

    Science.gov (United States)

    Sousa, Varley Dias; Ramalho, Pedro I; Silveira, Dâmaris

    2016-05-01

    Regulatory transparency is an imperative characteristic of a reliable National Regulatory Authority. In the region of the Americas, the process of building an open government is still fragile and fragmented across various Health Regulatory Agencies (HRAs) and Regional Reference Authorities (RRAs). This study assessed the transparency status of RRAs, focusing on various medicine life-cycle documents (the Medicine Dossier, Clinical Trial Report, and Inspection Report) as tools for strengthening health systems. Based on a narrative (nonsystematic) review of RRA regulatory transparency, transparency status was classified as one of two types: public disclosure of information (intra-agency data) and data- and work-sharing (inter-agency data). The risks/benefits of public disclosure of medicine-related information were assessed, taking into account 1) the involvement and roles of multiple stakeholders (health care professionals, regulators, industry, community, and academics) and 2) the protection of commercial and personal confidential data. Inter-agency data- and work-sharing was evaluated in the context of harmonization and cooperation projects that focus on regulatory convergence. Technical and practical steps for establishing an openness directive for the pharmaceutical regulatory environment are proposed to improve and strengthen health systems in the Americas. Addressing these challenges requires leadership from entities such as the Pan American Health Organization to steer and support collaborative regional alliances that advance the development and establishment of a trustworthy regulatory environment and a sustainable public health system in the Americas, using international successful initiatives as reference and taking into account the domestic characteristics and experiences of each individual country.

  2. Regional differences in infection control conditions in a sample of primary health care services in Brazil

    Directory of Open Access Journals (Sweden)

    Mauro Henrique Nogueira Guimarães de Abreu

    2017-11-01

    Full Text Available International guidelines have pointed out the importance of the physical environment of health care facilities in preventing and controlling infection. We aimed to describe the physical environment of dental care facilities in Brazil in 2014, focusing on characteristics designed to control infections. Exactly 16,202 dental offices in the Brazilian Unified National Health System (SUS participated in this survey. Trained researchers extracted information about the infection control characteristics of health facilities by using a structured instrument. We used data from 12 dichotomous questions that evaluated the wall, floor, sink and tap conditions, and the presence and condition of sterilization equipment. We calculated a score by summing the number of characteristics handled appropriately for infection control, which could range from 0 to 12. Hierarchical cluster analyses were developed. None of the 12 criteria were met by all the oral health teams. Only 208 (1.3% dental offices correctly performed all 12-infection control practices. Two clusters, with different frequencies of structure for infection control in dental offices, were identified. South and Southeast regions had the highest frequencies for Cluster 1, with better structure of infection control in dental offices. Dental care facilities of oral health teams were not typically meeting the infection control guidelines regarding clinic design and equipment. Adherence to the guidelines varied among the Brazilian geographic regions.

  3. Health Sector Reform in the Kurdistan Region - Iraq: Financing Reform, Primary Care, and Patient Safety.

    Science.gov (United States)

    Anthony, C Ross; Moore, Melinda; Hilborne, Lee H; Mulcahy, Andrew W

    2014-12-30

    In 2010, the Kurdistan Regional Government asked the RAND Corporation to help guide reform of the health care system in the Kurdistan Region of Iraq. The overarching goal of reform was to help establish a health system that would provide high-quality services efficiently to everyone to prevent, treat, and manage physical and mental illnesses and injuries. This article summarizes the second phase of RAND's work, when researchers analyzed three distinct but intertwined health policy issue areas: development of financing policy, implementation of early primary care recommendations, and evaluation of quality and patient safety. For health financing, the researchers reviewed the relevant literature, explored the issue in discussions with key stakeholders, developed and assessed various policy options, and developed plans or approaches to overcome barriers and achieve stated policy objectives. In the area of primary care, they developed and helped to implement a new management information system. In the area of quality and patient safety, they reviewed relevant literature, discussed issues and options with health leaders, and recommended an approach toward incremental implementation.

  4. [The physical activity level of people working at a regional health office in Lima, Peru].

    Science.gov (United States)

    Sanabria-Rojas, Hernán; Tarqui-Mamani, Carolina; Portugal-Benavides, Walter; Pereyra-Zaldívar, Héctor; Mamani-Castillo, Lorenzo

    2014-01-01

    Determining the prevalence of physical activity for health workers from a regional health office in Lima; their nutritional status and history of non-communicable diseases is also described. The study was cross-sectional and observations were made between August and November 2012. The study population involved 172 health workers working at a regional health office in Lima (DIRESA) according to the inclusion criteria and their acceptance of the offer to participate. Workers were excluded who had some kind of physical limitation regarding physical exercise. Their physical activity level was determined by using the International Physical Activity Questionnaire (IPAQ) which measures physical activity domains: work, home, transport and leisure. SPSS-19 was used for processed the data and nutritional status was evaluated using the body mass index (BMI), according to WHO classification. 88.0 % of DIRESA workers had a low level of physical activity and 64.0 % were overweight. Among the most common non-communicable diseases, it was found that 4.7 % had diabetes, 15.6 % hypertension, 32.6 % dyslipidaemia and 15.0 % smoked. DIRESA workers had a high prevalence of physical inactivity and excess weight, so it is advisable to implement healthy policies helping to improve their health.

  5. [Core competencies in public health: a regional framework for the Americas].

    Science.gov (United States)

    Conejero, Juana Suárez; Godue, Charles; Gutiérrez, José Francisco García; Valladares, Laura Magaña; Rabionet, Silvia; Concha, José; Valdés, Manuel Vázquez; Gómez, Rubén Darío; Mujica, Oscar J; Cabezas, César; Lucano, Lindaura Liendo; Castellanos, Jorge

    2013-07-01

    The response is described to the 2010 call from the Pan American Health Organization to develop a Regional Framework on Core Competencies in Public Health, with a view to supporting the efforts of the countries in the Americas to build public health systems capacity as a strategy for optimal performance of the Essential Public Health Functions. The methodological process for the response was divided into four phases. In the first, a team of experts was convened who defined the methodology to be used during a workshop at the National Institute of Public Health of Mexico in 2010. The second phase involved formation of the working groups, using two criteria: experience and multidisciplinary membership, which resulted in a regional team with 225 members from 12 countries. This team prepared an initial proposal with 88 competencies. In the third phase, the competencies were cross-validated and their number reduced to 64. During the fourth phase, which included two workshops, in March 2011 (Medellín, Colombia) and June 2011 (Lima, Peru), discussions centered on analyzing the association between the results and the methodology.

  6. The importance of regional availability of health care for old age survival - Findings from German reunification

    DEFF Research Database (Denmark)

    Vogt, Tobias C.; Vaupel, James W

    2015-01-01

    BACKGROUND: This article investigates the importance of regional health care availability for old age survival. Using German reunification as a natural experiment, we show that spatial variation in health care in East Germany considerably influenced the convergence of East German life expectancy...... toward West German levels. METHOD: We apply cause-deleted life tables and continuous mortality decomposition for the years 1982-2007 to show how reductions in circulatory mortality among the elderly affected the East German catch-up in life expectancy. RESULTS: Improvements in remaining life expectancy...

  7. Health of primary teachers in Obalno-kraška region

    OpenAIRE

    Lavrič, Katja

    2013-01-01

    The purpose of the dissertation was to evaluate the health of elementary school teachers teaching in the southwestern part of Slovenia, in the so-called Obalno-kraška region. The main goals were to determine how often do these teachers engage in physical activity, how frequently are they absent from work due to health problems, how often do they feel tense, under stress or under severe pressure and how do they deal with it, how many of them smoke or live in a smoking environment, what is thei...

  8. Health policy and integrated mental health care in the SADC region: strategic clarification using the Rainbow Model.

    Science.gov (United States)

    van Rensburg, André Janse; Fourie, Pieter

    2016-01-01

    Mental illness is a well-known challenge to global development, particularly in low-to-middle income countries. A key health systems response to mental illness is different models of integrated health care, especially popular in the South African Development Community (SADC) region. This complex construct is often not well-defined in health policy, hampering implementation efforts. A key development in this vein has been the Rainbow Model of integrated care, a comprehensive framework and taxonomy of integrated care based on the integrative functions of primary care. The purpose of this study was to explore the nature and strategic forms of integrated mental health care in selected SADC countries, specifically how integrated care is outlined in state-driven policies. Health policies from five SADC countries were analysed using the Rainbow Model as framework. Electronic copies of policy documents were transferred into NVivo 10, which aided in the framework analysis on the different types of integrated mental health care promoted in the countries assessed. Several Rainbow Model components were emphasised. Clinical integration strategies (coordination of person-focused care) such as centrality of client needs, case management and continuity were central considerations, while others such as patient education and client satisfaction were largely lacking. Professional integration (inter-professional partnerships) was mentioned in terms of agreements on interdisciplinary collaboration and performance management, while organisational integration (inter-organisational relationships) emerged under the guise of inter-organisational governance, population needs and interest management. Among others, available resources, population management and stakeholder management fed into system integration strategies (horizontally and vertically integrated systems), while functional integration strategies (financial, management and information system functions) included human resource

  9. Evaluation of the efficiency of regional health-preserving educational space formation

    Directory of Open Access Journals (Sweden)

    Riza Akhmedzakievich Kasimov

    2014-11-01

    Full Text Available The article is devoted to the urgent problem of preserving children’s health. The author presents detailed characteristics of health-preserving educational space formation. It is regarded as a complex multilevel and multispectral system. The article defines the principles, methods, mechanisms of the health-preserving process on the municipal level. The subject of research includes the background, conditions and resources of health-preserving educational space formation. The participants of educational process (students, teachers, parents and representatives of local authorities are the object of the research. The study aims to evaluate the efficiency of health-preserving educational space formation within various conceptual and methodological approaches and the degree of involvement of the municipal authorities. In the course of the experiment the author tests the method of estimating the models of regional healthpreserving educational space formation and healthy lifestyle training, developed by the author. The article pays considerable attention to the justification of choosing the optimal strategy within the implementation of health preserving technologies on municipal level. It shows the crucial role of constructive inter-agency cooperation between the education system, health care and the authorities for effective and productive activities in this sphere

  10. Examining fiscal federalism, regionalization and community-based initiatives in Canada's health care delivery system.

    Science.gov (United States)

    Forest, Pierre-Gerlier; Palley, Howard A

    2008-01-01

    This study focuses on the ability of Canadian provinces to shape in different ways the development of various provincial health delivery systems within the constraints of the mandates of the federal Canada Health Act of 1984 and the fiscal revenues that the provinces receive if they comply with these mandates. In so doing, it will examine the operation of Canadian federalism with respect to various provincial health systems. This study applies a comparative analysis framework developed by Heisler and Peters to facilitate an understanding of the dimensionality of provincial health delivery systems as applied to the case of provincial regionalization and community-based initiatives. The three sets of relationships touched upon are: first, the levels of government and the nature of their involvement in public policy concerning the provincial health care delivery systems; and secondly, understanding of the factors influencing provincial governments' political dispositions to act in various directions. A third dimension that is taken are the factors influencing the "timing" of particular decisions. A fourth area noted by Heisler and Peters and other comparative analysts is the nature and characteristics of public and private sector activities in health care and other social policy areas. While the evolving nature of public and private sector health care delivery activities within Canada's provincial and territorial systems is a significant policy matter in the Canadian context, due to the space limitations of this article, they are not discussed herein.

  11. Location Allocation of Health Care Centers Using Geographical Information System: region 11 of Tehran

    OpenAIRE

    Mohsen Ahadnejad; Hosein Ghaderi; Mohammad Hadian; Payam Haghighatfard; Banafsheh Darvishi; Elham Haghighatfard; Bitasadat Zegordi; Arash Bordbar

    2015-01-01

     Background & Objective: Location allocation of healthcare centers facilitates the accessibility of health services and the lack of proper distribution of these centers leads to increasing problems of citizens' access to these centers. The main objective of this study was to evaluate the distribution of healthcare centers in the region of the study and to determine deprived areas from this services. Materials & Methods: This research is a case study that has b...

  12. Impact and management of dual relationships in metropolitan, regional and rural mental health practice.

    Science.gov (United States)

    Endacott, Ruth; Wood, Anita; Judd, Fiona; Hulbert, Carol; Thomas, Ben; Grigg, Margaret

    2006-01-01

    To explore the extent and impact of professional boundary crossings in metropolitan, regional and rural mental health practice in Victoria and identify strategies mental health clinicians use to manage dual relationships. Nine geographically located focus groups consisting of mental health clinicians: four focus groups in rural settings; three in a regional city and two in a metropolitan mental health service. A total of 52 participants were interviewed. Data revealed that professional boundaries were frequently breached in regional and rural settings and on occasions these breaches had a significantly negative impact. Factors influencing the impact were: longevity of the clinician's relationship with the community, expectations of the community, exposure to community 'gossip' and size of the community. Participants reported greater stress when the boundary crossing affected their partner and/or children. Clinicians used a range of proactive and reactive strategies, such as private telephone number, avoidance of social community activities, when faced with a potential boundary crossing. The feasibility of reactive strategies depended on the service configuration: availability of an alternative case manager, requirement for either patient or clinician to travel. The greater challenges faced by rural and regional clinicians were validated by metropolitan participants with rural experience and rural participants with metropolitan experience. No single strategy is used or appropriate for managing dual relationships in rural settings. Employers and professional bodies should provide clearer guidance for clinicians both in the management of dual relationships and the distinction between boundary crossings and boundary violation. Clinicians are clearly seeking to represent and protect the patients' interests; consideration should be given by consumer groups to steps that can be taken by patients to reciprocate.

  13. Impact of health legislation on the sale of anorectics in a city in the Amazon region

    OpenAIRE

    Castro,Luana Valéria da Silva; Farias Junior,Gilvo; Teixeira,Francisco Martins; Vieira,José Ricardo dos Santos; Maia,Cristiane do Socorro Ferraz

    2012-01-01

    OBJECTIVES: The International Narcotics Control Board released its 2005 annual report, highlighting the Brazil population as one of the largest consumers of anorectics. In Brazil, the National Health Surveillance Agency issued the resolution RDC 58/2007 in order to control the prescription and sale of such drugs. In Belém, the biggest city in the Brazilian Amazon region, this resolution came into force in 2008, leading to inspections of drugstores and magistral pharmacies. The aim of this wor...

  14. Integrating Oral Health with Non-Communicable Diseases as an Essential Component of General Health: WHO's Strategic Orientation for the African Region.

    Science.gov (United States)

    Varenne, Benoit

    2015-05-01

    In the context of the emerging recognition of non-communicable diseases (NCDs), it has never been more timely to explore the World Health Organization (WHO) strategic orientations on oral health in the WHO African region and to raise awareness of a turning point in the search for better oral health for everyone. The global initiative against NCDs provides a unique opportunity for the oral health community to develop innovative policies for better recognition of oral health, as well as to directly contribute to the fight against NCDs and their risk factors. The WHO African region has led the way in developing the first regional oral health strategy for the prevention and control of oral diseases integrated with NCDs. The support of the international oral health community in this endeavor is urgently needed for making a success story of this initiative of integrating oral health into NCDs.

  15. Quantifying regional consumption-based health impacts attributable to ambient air pollution in China.

    Science.gov (United States)

    Zhang, Yanxia; Qu, Shen; Zhao, Jing; Zhu, Ge; Zhang, Yanxu; Lu, Xi; Sabel, Clive E; Wang, Haikun

    2018-03-01

    Serious air pollution has caused about one million premature deaths per year in China recently. Besides cross-border atmospheric transport of air pollution, trade also relocates pollution and related health impacts across China as a result of the spatial separation between consumption and production. This study proposes an approach for calculating the health impacts of emissions due to a region's consumption based on a multidisciplinary methodology coupling economic, atmospheric, and epidemiological models. These analyses were performed for China's Beijing and Hebei provinces. It was found that these provinces' consumption-based premature deaths attributable to ambient PM 2.5 were respectively 22,500 and 49,700, which were 23% higher and 37% lower than the numbers solely within their boundaries in 2007. The difference between the effects of trade and trade-related emissions on premature deaths attributable to air pollution in a region has also been clarified. The results illustrate the large and broad impact of domestic trade on regional air quality and the need for comprehensive consideration of supply chains in designing policy to mitigate the negative health impacts of air pollution across China. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. A systematic review of the process of regionalization of Brazil's Unified Health System, SUS.

    Science.gov (United States)

    Mello, Guilherme Arantes; Pereira, Ana Paula Chancharulo de Morais; Uchimura, Liza Yurie Teruya; Iozzi, Fabíola Lana; Demarzo, Marcelo Marcos Piva; Viana, Ana Luiza d'Ávila

    2017-04-01

    This review focuses only on specific studies into the SUS regionalization process, which were based on empirical results and published since 2006, when the SUS was already under the aegis of the Pact for Health framework. It was found that the regionalization process is now underway in all spheres of government, subject to a set of challenges common to the different realities of the country. These include, primarily, that committee-structured entities are valued as spaces for innovation, yet also strive to overcome the bureaucratic and clientelist political culture. Regional governance is further hampered by the fragmentation of the system and, in particular, by the historical deficiency in planning, from the local level to the strategic policies for technology incorporation. The analyses enabled the identification of a culture of broad privilege for political negotiation, to the detriment of planning, as one of the main factors responsible for a vicious circle that sustains technical deficiency in management.

  17. Epidemiology of road traffic injuries in qassim region, saudi arabia: consistency of police and health data.

    Science.gov (United States)

    Barrimah, Issam; Midhet, Farid; Sharaf, Fawzi

    2012-01-01

    In Saudi Arabia, road traffic accidents (RTA) are becoming a serious public health problem. Police reports are designed for legal purposes with very little information on the health consequences. Also, health system data include detailed health information, but not related or linked to the data obtained police reports. Examining the consistency of these sources is vital to build an accurate surveillance system that can track the risk factors and the health consequences, as well as establishing and evaluating prevention interventions. This study is intended to: ▪ Examine the consistency of health -registration data with the data gathered by the traffic police department.▪ Elucidate the magnitude, risk factors and outcome of RTI in Qassim region of Saudi Arabia,▪ Compare the pattern of accidents in Qassim with those at different regions of the Kingdom. Health care information was collected on visits of victims of road traffic accidents to emergency and outpatients' departments of the major hospitals in Qassim region during the year 2010. The information included the patients' demographics, and clinical characteristics. Traffic Police Department information was also collected on all accidents that occurred in the study region. A Questionnaire was also developed and pilot tested to collect data from a random sample of population attending hospital outpatient and Primary Health Care clinics. Data included previous involvement in road traffic accident, and information about any injury; fatality or disability due to these RTI. During the study period, road traffic death rate based on death registration data was almost twice as high as the rate reported by the police (P police-reported data during the study period, as opposed to a non-significant increase of 8% according to health registration data during the same period. Population Survey Information showed the overall age-sex-adjusted rate for non-fatal RTI was 20.7 (95% CI, 20.0 - 21.3)/100 persons/year. The rate

  18. Data resources for assessing regional impacts of energy facilities on health and the environment

    International Nuclear Information System (INIS)

    Olson, R.J.

    1982-01-01

    Atmospheric emissions from fossil-fuel power plants and other sources continue to cause concern about impacts of these pollutants on human health and the environment. Assessing these impacts requires a regional-scale approach that integrates spatial and temporal patterns of emissions, environmental factors and human populations. Two examples of regional studies are presented, including a comparison of patterns of coal-fired power plants and selected diseases and identification of areas sensitive to acid rain which may transfer acid and toxic metals to aquatic systems and man. Energy, socio-economic, health and environmental data are often collected and summarized for counties in the USA. Counties are well-defined geopolitical units which can be used to integrate data, to aggregate data into larger regional units, and to display data as thematic maps. However, researchers are too frequently faced with the tedious task of assembling and reformatting files from several data-collection agencies prior to conducting regional studies. Systems such as UPGRADE, DIDS, SEEDIS and Geoecology have standardized many files into integrated data bases which utilize counties as the primary spatial unit. These systems are compared and data resources discussed. (author)

  19. Regional process redesign of lung cancer care: a learning health system pilot project.

    Science.gov (United States)

    Fung-Kee-Fung, M; Maziak, D E; Pantarotto, J R; Smylie, J; Taylor, L; Timlin, T; Cacciotti, T; Villeneuve, P J; Dennie, C; Bornais, C; Madore, S; Aquino, J; Wheatley-Price, P; Ozer, R S; Stewart, D J

    2018-02-01

    The Ottawa Hospital (toh) defined delay to timely lung cancer care as a system design problem. Recognizing the patient need for an integrated journey and the need for dynamic alignment of providers, toh used a learning health system (lhs) vision to redesign regional diagnostic processes. A lhs is driven by feedback utilizing operational and clinical information to drive system optimization and innovation. An essential component of a lhs is a collaborative platform that provides connectivity across silos, organizations, and professions. To operationalize a lhs, we developed the Ottawa Health Transformation Model (ohtm) as a consensus approach that addresses process barriers, resistance to change, and conflicting priorities. A regional Community of Practice (cop) was established to engage stakeholders, and a dedicated transformation team supported process improvements and implementation. The project operationalized the lung cancer diagnostic pathway and optimized patient flow from referral to initiation of treatment. Twelve major processes in referral, review, diagnostics, assessment, triage, and consult were redesigned. The Ottawa Hospital now provides a diagnosis to 80% of referrals within the provincial target of 28 days. The median patient journey from referral to initial treatment decreased by 48% from 92 to 47 days. The initiative optimized regional integration from referral to initial treatment. Use of a lhs lens enabled the creation of a system that is standardized to best practice and open to ongoing innovation. Continued transformation initiatives across the continuum of care are needed to incorporate best practice and optimize delivery systems for regional populations.

  20. Evidence for Policy Making: Health Services Access and Regional Disparities in Kerman

    Directory of Open Access Journals (Sweden)

    Mina Anjomshoa

    2013-12-01

    Full Text Available Background and purpose: Health indices, regarding to their role in the development of society, are one of the most important indices at national level. Success of national development programs is largely dependent on the establishment of appropriate goals at the health sector, among which access to healthcare facilities is an essential requirement. The aim of this study was to examine the disparities in health services access across the Kerman province. Materials and Methods: This was a cross-sectional study. Study sample included the cities of Kerman province, ranked based on 15 health indices. Data was collected from statistical yearbook. The indices were weighted using Shannon entropy, then using the TOPSIS technique and the result were classified into three categories in terms of the level of development across towns. Results: The findings showed distinct regional disparities in health services across Kerman province and the significant difference was observed between the cities in terms of development. Shannon entropy introduced the number of pharmacologist per 10 thousand people as the most important indicator and the number of rural active health center per 1000 people as the less important indicator. According to TOPSIS, Kerman town (0.719 and Fahraj (0.1151 ranked the first and last in terms of access to health services respectively. Conclusion: There are significant differences between cities of Kerman province in terms of access to health care facilities and services. Therefore, it is recommended that officials and policy-makers determine resource allocation priorities according to the degree of development for a balanced and equitable distribution of health care facilities.

  1. Improving Public Health and Environment through Plastic Waste Management in Mumbai Metropolitan Region

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    Sanjay RODE

    2015-12-01

    Full Text Available The Mumbai Metropolitan Region is growing in terms of population, industry, educational and commercial units. The daily requirements of commodities and services by all units have increased fast. Plastic is used extensively for packing, protection and service of various commodities. The use of plastic is much higher by industry and households in region. In Brihan Mumbai Municipal Corporation, the density of population is higher. The concentration of small and large industries is more. Therefore the plastic use is much higher for different purposes. It leads to more waste of plastic. In Ulhasnagar Municipal Corporation, the population and industrial units are less. Therefore plastic waste is less generated. Theaters are generating less plastic waste in metropolitan region. The Brihan Mumbai Municipal Corporation (BMC and municipal corporations in Thane district will continuously generate more plastic waste in future. The Tobit regression model shows that plastic waste is positively co-related and statistically significant with pollution and industry in region. Therefore the comprehensive policies are required to reduce plastic waste. This is because plastic waste is affecting on the health of human being. It also affects negatively on soil, air and water. The entire food supply chain gets affected due to plastic waste. The water logging is common due to plastic waste in region. It chock ups the drainage system and it becomes the ground for mosquitoes. It further leads to dengue, malaria and other diseases in region. Municipal corporations must collect plastic in separate bins and process it. The plastic and e-waste can be utilized for road construction in region. All the policies will certainly help to reduce the plastic waste and maintain the clean environment in region.

  2. Health care networks implementation and regional governance challenges in the Legal Amazon Region: an analysis of the QualiSUS-Rede Project.

    Science.gov (United States)

    Casanova, Angela Oliveira; Cruz, Marly Marques; Giovanella, Ligia; Alves, Glaydes Dos Reis; Cardoso, Gisela Cordeiro Pereira

    2017-04-01

    This paper aims to analyze the potential, limits and challenges of regional governance in the implementation process of health care networks in three Brazilian regions: Alto Solimões (Amazonas), Belém (Pará) and an interstate region comprising Tocantins, Pará and Maranhão states (Topama). The study is based on the evaluation study on the implementation of the Quality Health Care Network Development and Improvement Project (QualiSUS-Rede). This is a qualitative multiple case study with the analysis of official documents and use of semi-structured interviews with key stakeholders conducted from July to December 2014. Governance review encompassed three components: stakeholders involved, especially local steering groups and their regional coordination capacity; strategies used for strengthening regional governance, anchored on the intervention's modeling; and implementation of local health care networks. Results point that the regional managing commissions were the main governance strategy and that the QualiSUS-Rede Project strengthened regional governance and integration differently in every case, depending on stakeholders' administration and consensus capacity on regional and political priorities.

  3. Authentication Architecture for Region-Wide e-Health System with Smartcards and a PKI

    Science.gov (United States)

    Zúquete, André; Gomes, Helder; Cunha, João Paulo Silva

    This paper describes the design and implementation of an e-Health authentication architecture using smartcards and a PKI. This architecture was developed to authenticate e-Health Professionals accessing the RTS (Rede Telemática da Saúde), a regional platform for sharing clinical data among a set of affiliated health institutions. The architecture had to accommodate specific RTS requirements, namely the security of Professionals' credentials, the mobility of Professionals, and the scalability to accommodate new health institutions. The adopted solution uses short-lived certificates and cross-certification agreements between RTS and e-Health institutions for authenticating Professionals accessing the RTS. These certificates carry as well the Professional's role at their home institution for role-based authorization. Trust agreements between e-Health institutions and RTS are necessary in order to make the certificates recognized by the RTS. As a proof of concept, a prototype was implemented with Windows technology. The presented authentication architecture is intended to be applied to other medical telematic systems.

  4. Injection Safety among Primary Health Care Workers in Jazan Region, Saudi Arabia

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    AA Ismail

    2014-07-01

    Full Text Available Background: Occupational exposure to percutaneous injuries is a substantial source of infections with blood-borne pathogens among health-care workers. Few studies evaluated injection safety practices in Saudi Arabia. Objective: To examine the structure and process of injection safety at primary health care level in Jazan health district, to evaluate knowledge, attitudes, and practices of primary health care physicians and nurses towards injection safety, and to determine the incidence of needle stick injuries among health care workers in Jazan region, Saudi Arabia. Methods: A cross-sectional study was conducted in Jazan primary health care centers (PHCCs, Saudi Arabia from September 2011 to March 2012. Data were collected using an observational checklist and data collection sheet. Jazan city health district was chosen at random from the 14 health sectors in Jazan region. All the 33 (10 urban, and 23 rural PHCCs of Jazan city were included in this study to get the predetermined sample size of health care workers. 200 health care workers (HCWs were recruited (29% physicians, and 71% nurses. Results: Syringes in the PHCCs were disposable (100%, individually packed (92%, and available at all volumes (98%. Methods of safe disposal of needles and sharps were also operated through contracting with professional companies in 84.8% of instances. Urban PHCCs had more posts for injection safety promotion than rural centers (p=0.02. Continuous Medical Education (CME programs on infection control were present in only 60% of PHCCs. At least 95% of HCWs in Jazan believed that sharp objects should be kept in a puncture-proof container, kept in a closed container, or disposed by a professional company. More than 80% of HCWs washed their hands by soap and water and cleaned them by alcohol before giving injection, and also got the three doses of hepatitis B vaccine.The rate of needle stick injury in the past year was 14%, without a significant difference between

  5. Regional variations in the health, environmental, and climate benefits of wind and solar generation.

    Science.gov (United States)

    Siler-Evans, Kyle; Azevedo, Inês Lima; Morgan, M Granger; Apt, Jay

    2013-07-16

    When wind or solar energy displace conventional generation, the reduction in emissions varies dramatically across the United States. Although the Southwest has the greatest solar resource, a solar panel in New Jersey displaces significantly more sulfur dioxide, nitrogen oxides, and particulate matter than a panel in Arizona, resulting in 15 times more health and environmental benefits. A wind turbine in West Virginia displaces twice as much carbon dioxide as the same turbine in California. Depending on location, we estimate that the combined health, environmental, and climate benefits from wind or solar range from $10/MWh to $100/MWh, and the sites with the highest energy output do not yield the greatest social benefits in many cases. We estimate that the social benefits from existing wind farms are roughly 60% higher than the cost of the Production Tax Credit, an important federal subsidy for wind energy. However, that same investment could achieve greater health, environmental, and climate benefits if it were differentiated by region.

  6. Regional Decentralisation in the Greek Health Care System: Rhetoric and Reality

    Science.gov (United States)

    Athanasiadis, Athanasios; Kostopoulou, Stella; Philalithis, Anastas

    2015-01-01

    Decentralisation is a complex, yet basic feature of health care systems in many countries entailing the transfer of authority or dispersal of power in public planning, management and decision making from higher to lower levels of government. This paper describes the attempts made in Greece from 1923 until today to decentralise its highly centralised health care system, drawing on a thorough documentary analysis of legislative acts and official reports regarding regional health policy. The analysis shows that, although decentralisation has been attempted on several occasions, in the end it was abandoned every time. The first ever implementation of a decentralised system of governance in 2001 was also curtailed, resulting in only minor decentralisation of authority and real powers. It is suggested that decentralisation has been impeded by many factors, especially obstruction by opposition from key interest groups, absence of policy continuity between governments, the inability to tackle the bureaucratic and highly centralised system and lack of political will. PMID:26153163

  7. Characteristics and health of homeless families: the ENFAMS survey in the Paris region, France 2013.

    Science.gov (United States)

    Vandentorren, Stéphanie; Le Méner, Erwan; Oppenchaim, Nicolas; Arnaud, Amandine; Jangal, Candy; Caum, Carme; Vuillermoz, Cécile; Martin-Fernandez, Judith; Lioret, Sandrine; Roze, Mathilde; Le Strat, Yann; Guyavarch, Emmanuelle

    2016-02-01

    The objectives were to estimate the size of homeless family population in Paris region, to describe their living conditions and health and to analyse the impact of homelessness on children's growth and development, which was never investigated in France. A cross-sectional survey was conducted on a random sample of homeless sheltered families in 2013. Families were interviewed in 17 languages and a nurse took anthropometric measures, blood samples and collected health data from child health reports. The population size was estimated at 10 280 families. Half were single-parent female families and 94% were born outside France. Most families had experienced housing instability and 94% were living below the poverty line (828 euros/month). Malnutrition was a major problem: the prevalence of food insecurity was high (77% of parents and 69% of children), as well as anaemia (50% of mothers and 38% of children), overweight (38% of mothers and 22% of children) and obesity (32% of mothers and 4% of children). High rates of depressive disorders were found in 30% of homeless mothers and 20% of children had signs of possible mental health disorders. These first results highlight the important number of families among the homeless population in Paris region. Families differed from other homeless people regarding social characteristics such as birthplace, single-parent status and residential instability that are likely to influence schooling, social ties, health and access to care. These results demonstrate the need for urgent actions targeting homeless families, in terms of reducing housing instability and providing adequate care, especially for children. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  8. [Public health impact of a remote diagnosis system implemented in regional and district hospitals in Paraguay].

    Science.gov (United States)

    Galván, Pedro; Velázquez, Miguel; Benítez, Gualberto; Ortellado, José; Rivas, Ronald; Barrios, Antonio; Hilario, Enrique

    2017-06-08

    Determine the viability of a remote diagnosis system implemented to provide health care to remote and scattered populations in Paraguay. The study was conducted in all regional and general hospitals in Paraguay, and in the main district hospitals in the country's 18 health regions. Clinical data, tomographic images, sonography, and electrocardiograms (ECGs) of patients who needed a diagnosis by a specialized physician were entered into the system. This information was sent to specialists in diagnostic imaging and in cardiology for remote diagnosis and the report was then forwarded to the hospitals connected to the system. The cost-benefit and impact of the remote diagnosis tool was analyzed from the perspective of the National Health System. Between January 2014 and May 2015, a total of 34 096 remote diagnoses were made in 25 hospitals in the Ministry of Health's telemedicine system. The average unit cost of remote diagnosis was US$2.6 per ECG, tomography, and sonography, while the unit cost of "face-to-face" diagnosis was US$11.8 per ECG, US$68.6 per tomography, and US$21.5 per sonography. As a result of remote diagnosis, unit costs were 4.5 times lower for ECGs; 26.4 times lower for tomography, and 8.3 times lower for sonography. In monetary terms, implementation of the remote diagnosis system during the 16 months of the study led to average savings of US$2 420 037. Paraguay has a remote diagnosis system for electrocardiography, tomography, and sonography, using low-cost information and communications technologies (ICTs) based on free software that is scalable to other types of remote diagnostic studies of interest for public health. Implementation of remote diagnosis helped to strengthen the integrated network of health services and programs, enabling professionals to optimize their time and productivity, while improving quality, increasing access and equity, and reducing costs.

  9. Organizational capacity for community development in regional health authorities: a conceptual model.

    Science.gov (United States)

    Germann, Kathy; Wilson, Doug

    2004-09-01

    The value of community development (CD) practices is well documented in the health promotion literature; it is a foundational strategy outlined in the Ottawa Charter for Health Promotion. Despite the importance of collaborative action with communities to enhance individual and community health and well-being, there exists a major gap between the evidence for CD and the actual extent to which CD is carried out by health organizations. In this paper it is argued that the gap exists because we have failed to turn the evaluative gaze inward-to examine the capacity of health organizations themselves to facilitate CD processes. This study was designed to explicate key elements that contribute to organizational capacity for community development (OC-CD). Twenty-two front-line CD workers and managers responsible for CD initiatives from five regional health authorities in Alberta, Canada, were interviewed. Based on the study findings, a multidimensional model for conceptualizing OC-CD is presented. Central to the model are four inter-related dimensions: (i) organizational commitment to CD, rooted in particular values and beliefs, leadership and shared understanding of CD; (ii) supportive structures and systems, such as job design, flexible planning processes, evaluation mechanisms and collaborative processes; (iii) allocation of resources for CD; and (iv) working relationships and processes that model CD within the health organization. These four dimensions contribute to successful CD practice in numerous ways, but perhaps most importantly by supporting the empowerment and autonomy of the pivotal organizational player in health promotion practice: the front-line worker.

  10. Regional differences in the mid-Victorian diet and their impact on health.

    Science.gov (United States)

    Greaves, Peter

    2018-03-01

    The aim of this study was to examine the impact of regional diets on the health of the poor in mid-Victorian Britain. Contemporary surveys of regional diets and living condition were reviewed. This information was compared with mortality data from Britain over the same period. Although there was an overall improvement in life expectancy during the latter part of the 19th century, there were large regional differences in lifestyle, diet and mortality rates. Dietary surveys showed that the poor labouring population in isolated rural areas of England, in the mainland and islands of Scotland and in the west of Ireland enjoyed the most nutritious diets. These regions also showed the lowest mortality rates in Britain. This was not simply the result of better sanitation and less mortality from food and waterborne infections but also fewer deaths from pulmonary tuberculosis, which is typically associated with better nutrition. These more isolated regions where a peasant-style culture provided abundant locally produced cheap foodstuffs such as potatoes, vegetables, whole grains, and milk and fish, were in the process of disappearing in the face of increasing urbanisation. This was to the detriment of many rural poor during the latter half of the century. Conversely, increasing urbanisation, with its improved transport links, brought greater availability and diversity of foods to many others. It was this that that led to an improved nutrition and life expectancy for the majority in urbanising Britain, despite the detrimental effects of increasing food refinement.

  11. Regional disparities in child mortality within China 1996-2004: epidemiological profile and health care coverage.

    Science.gov (United States)

    Feng, Xing Lin; Guo, Sufang; Yang, Qing; Xu, Ling; Zhu, Jun; Guo, Yan

    2011-07-01

    China was one of the 68 "countdown" countries prioritized to attain Millennium Development Goals (MDG 4). The aim of this study was to analyze data on child survival and health care coverage of proven cost-effective interventions in China, with a focus on national disparities. National maternal and child mortality surveillance data were used to estimate child mortality. Coverage for proven interventions was analyzed based on data from the National Health Services Survey, National Nutrition and Health Survey, and National Immunization Survey. Consultations and qualitative field observations by experts were used to complement the Survey data. Analysis of the data revealed a significant reduction in the overall under-5 (U5) child mortality rate in China from 1996 to 2007, but also great regional disparities, with the risk of child mortality in rural areas II-IV being two- to sixfold higher than that in urban areas. Rural areas II-IV also accounted for approximately 80% of the mortality burden. More than 60% of child mortality occurred during the neonatal period, with 70% of this occurring during the first week of life. The leading causes of neonatal mortality were asphyxia at birth and premature birth; during the post-neonatal period, these were diarrhea and pneumonia, especially in less developed rural areas. Utilization of health care services in terms of both quantity and quality was positively correlated with the region's development level. A large proportion of children were affected by inadequate feeding, and the lack of safe water and essential sanitary facilities are vital indirect factors contributing to the increase in child mortality. The simulation analysis revealed that increasing access to and the quality of the most effective interventions combined with relatively low costs in the context of a comprehensive approach has the potential to reduce U5 deaths by 34%. China is on track to meet MDG 4; however, great disparities in health care do exist within

  12. Tuberculosis Laboratory Diagnosis Quality Assurance among Public Health Facilities in West Amhara Region, Ethiopia.

    Science.gov (United States)

    Shiferaw, Melashu Balew; Hailu, Hiwot Amare; Fola, Abebe Alemu; Derebe, Mulatu Melese; Kebede, Aimro Tadese; Kebede, Abayneh Admas; Emiru, Manamnot Agegne; Gelaw, Zelalem Dessie

    2015-01-01

    Reliable smear microscopy is an important component of Directly Observed Treatment Scheme (DOTS) strategy for TB control program in countries with limited resources. Despite external quality assessment is established in Ethiopia, there is lower TB detection rate (48%) in Amhara region compared to the World Health Organization (WHO) estimate (70%). This highlights the quality of smear microscopy needs to be evaluated. Therefore, the aim of this study was to assess the quality of sputum smear microscopy performance among health center laboratories in West Amhara region, Ethiopia. A cross sectional study was conducted from July 08, 2013 to July 07, 2014. Data were collected from 201 public health center laboratories using a structured questionnaire. Slides were collected based on Lot Quality Assurance Sampling (LQAS) method and rechecked blindly by trained laboratory technologists. The data were entered into EPI info V.7 and smear quality indicators and AFB results were analyzed by SPSS version 20. Among 201 laboratories enrolled in this study, 47 (23.4%) laboratories had major errors. Forty one (20.4%) laboratories had a total of 67 false negative and 29 (14.4%) laboratories had a total of 68 false positive results. Specimen quality, smear thickness and evenness were found poor in 134 (66.7%), 133 (66.2%) and 126 (62.7%) laboratories, respectively. Unavailability of microscope lens cleaning solution (AOR: 2.90; 95% CI: 1.25-6.75; P: 0.013) and dirty smears (AOR: 2.65; 95% CI: 1.14-6.18; P: 0.024) were correlated with false negative results whereas no previous EQA participation (AOR: 3.43; 95% CI: 1. 39-8.45; P: 0.007) was associated with false positive results. The performance of health facilities for sputum smear microscopy was relatively poor in West Amhara region. Hence, strengthening the EQA program and technical support on sputum smear microscopy are recommended to ensure quality tuberculosis diagnostic service.

  13. Tuberculosis Laboratory Diagnosis Quality Assurance among Public Health Facilities in West Amhara Region, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Melashu Balew Shiferaw

    Full Text Available Reliable smear microscopy is an important component of Directly Observed Treatment Scheme (DOTS strategy for TB control program in countries with limited resources. Despite external quality assessment is established in Ethiopia, there is lower TB detection rate (48% in Amhara region compared to the World Health Organization (WHO estimate (70%. This highlights the quality of smear microscopy needs to be evaluated. Therefore, the aim of this study was to assess the quality of sputum smear microscopy performance among health center laboratories in West Amhara region, Ethiopia.A cross sectional study was conducted from July 08, 2013 to July 07, 2014. Data were collected from 201 public health center laboratories using a structured questionnaire. Slides were collected based on Lot Quality Assurance Sampling (LQAS method and rechecked blindly by trained laboratory technologists. The data were entered into EPI info V.7 and smear quality indicators and AFB results were analyzed by SPSS version 20.Among 201 laboratories enrolled in this study, 47 (23.4% laboratories had major errors. Forty one (20.4% laboratories had a total of 67 false negative and 29 (14.4% laboratories had a total of 68 false positive results. Specimen quality, smear thickness and evenness were found poor in 134 (66.7%, 133 (66.2% and 126 (62.7% laboratories, respectively. Unavailability of microscope lens cleaning solution (AOR: 2.90; 95% CI: 1.25-6.75; P: 0.013 and dirty smears (AOR: 2.65; 95% CI: 1.14-6.18; P: 0.024 were correlated with false negative results whereas no previous EQA participation (AOR: 3.43; 95% CI: 1. 39-8.45; P: 0.007 was associated with false positive results.The performance of health facilities for sputum smear microscopy was relatively poor in West Amhara region. Hence, strengthening the EQA program and technical support on sputum smear microscopy are recommended to ensure quality tuberculosis diagnostic service.

  14. Combined Regional Investments Could Substantially Enhance Health System Performance And Be Financially Affordable.

    Science.gov (United States)

    Homer, Jack; Milstein, Bobby; Hirsch, Gary B; Fisher, Elliott S

    2016-08-01

    Leaders across the United States face a difficult challenge choosing among possible approaches to transform health system performance in their regions. The ReThink Health Dynamics Model simulates how alternative scenarios could unfold through 2040. This article compares the likely consequences if four interventions were enacted in layered combinations in a prototypical midsize US city. We estimated the effects of efforts to deliver higher-value care; reinvest savings and expand global payment; enable healthier behaviors; and expand socioeconomic opportunities. Results suggest that there may be an effective and affordable way to unlock much greater health and economic potential, ultimately reducing severe illness by 20 percent, lowering health care costs by 14 percent, and improving economic productivity by 9 percent. This would require combined investments in clinical and population-level initiatives, coupled with financial agreements that reduce incentives for costly care and reinvest a share of the savings to ensure adequate long-term financing. Project HOPE—The People-to-People Health Foundation, Inc.

  15. Health service support for breastfeeding in the northern region of Ghana

    Directory of Open Access Journals (Sweden)

    Paul Armah Aryee

    2013-01-01

    Full Text Available The Baby-Friendly Hospital Initiative (BFHI is a global effort to improve the role of maternity services and to enable mothers to breastfeed their infants, thus ensuring the best start in life for their infants. The foundation for the BFHI is the Ten Steps to Successful Breastfeeding (BF. It has been shown, however, that there is the tendency of health facilities backsliding and even reverting to the old patterns of maternity care and practices and may be ineffective and discouraging to successful BF practices. The study was therefore conducted to ascertain and measure the extent of compliance with the Ten Steps to BF in designated Baby Friendly Health facilities in the Northern Region of Ghana. The study followed a cross-sectional design and was set in the Savelugu/Nanton, Tolon/Kunbungu Districts and Tamale Metropolis in the Northern Region. Nine (9 designated Baby Friendly facilities participated in the study; for which observation lists were completed and verified by interviewer-administered questionnaires to sixty-one (61 Health Care Workers (HCWs and two hundred and seventy (270 breastfeeding mothers. The overall compliance with the Ten Steps was 85.6% (S.E, 4.2% indicating high compliance, with 66.7% of the health facilities being highly compliant whilst 33.3% were moderately compliant. During the study there were no posters or other materials promoting breast-milk substitutes, bottles and pacifiers displayed in the facilities. The study highlighted a high degree of compliance with most of the BF policies (Ten Steps to successful breastfeeding and of the correct implementation of these policies in the designated baby friendly health facilities. Nevertheless, some elements relevant to Steps 4 and 5 require further work to make the needed improvement.

  16. Health service support for breastfeeding in the northern region of Ghana

    Directory of Open Access Journals (Sweden)

    Paul Armah Aryee

    2013-11-01

    Full Text Available The Baby-Friendly Hospital Initiative (BFHI is a global effort to improve the role of maternity services and to enable mothers to breastfeed their infants, thus ensuring the best start in life for their infants. The foundation for the BFHI is the Ten Steps to Successful Breastfeeding (BF. It has been shown, however, that there is the tendency of health facilities backsliding and even reverting to the old patterns of maternity care and practices and may be ineffective and discouraging to successful BF practices. The study was therefore conducted to ascertain and measure the extent of compliance with the Ten Steps to BF in designated Baby Friendly Health facilities in the Northern Region of Ghana. The study followed a cross-sectional design and was set in the Savelugu/Nanton, Tolon/Kunbungu Districts and Tamale Metropolis in the Northern Region. Nine (9 designated Baby Friendly facilities participated in the study; for which observation lists were completed and verified by interviewer-administered questionnaires to sixty-one (61 Health Care Workers (HCWs and two hundred and seventy (270 breastfeeding mothers. The overall compliance with the Ten Steps was 85.6% (S.E, 4.2% indicating high compliance, with 66.7% of the health facilities being highly compliant whilst 33.3% were moderately compliant. During the study there were no posters or other materials promoting breast-milk substitutes, bottles and pacifiers displayed in the facilities. The study highlighted a high degree of compliance with most of the BF policies (Ten Steps to successful breastfeeding and of the correct implementation of these policies in the designated baby friendly health facilities. Nevertheless, some elements relevant to Steps 4 and 5 require further work to make the needed improvement.

  17. Bibliometric analysis of regional Latin America's scientific output in Public Health through SCImago Journal & Country Rank

    Science.gov (United States)

    2014-01-01

    Background In the greater framework of the essential functions of Public Health, our focus is on a systematic, objective, external evaluation of Latin American scientific output, to compare its publications in the area of Public Health with those of other major geographic zones. We aim to describe the regional distribution of output in Public Health, and the level of visibility and specialization, for Latin America; it can then be characterized and compared in the international context. Methods The primary source of information was the Scopus database, using the category “Public Health, Environmental and Occupational Health”, in the period 1996–2011. Data were obtained through the portal of SCImago Journal and Country Rank. Using a set of qualitative (citation-based), quantitative (document recount) and collaborative (authors from more than one country) indicators, we derived complementary data. The methodology serves as an analytical tool for researchers and scientific policy-makers. Results The contribution of Latin America to the arsenal of world science lies more or less midway on the international scale in terms of its output and visibility. Revealed as its greatest strengths are the high level of specialization in Public Health and the sustained growth of output. The main limitations identified were a relative decrease in collaboration and low visibility. Conclusions Collaboration is a key factor behind the development of scientific activity in Latin America. Although this finding can be useful for formulating research policy in Latin American countries, it also underlines the need for further research into patterns of scientific communication in this region, to arrive at more specific recommendations. PMID:24950735

  18. Regional health care planning: a methodology to cluster facilities using community utilization patterns.

    Science.gov (United States)

    Delamater, Paul L; Shortridge, Ashton M; Messina, Joseph P

    2013-08-22

    Community-based health care planning and regulation necessitates grouping facilities and areal units into regions of similar health care use. Limited research has explored the methodologies used in creating these regions. We offer a new methodology that clusters facilities based on similarities in patient utilization patterns and geographic location. Our case study focused on Hospital Groups in Michigan, the allocation units used for predicting future inpatient hospital bed demand in the state's Bed Need Methodology. The scientific, practical, and political concerns that were considered throughout the formulation and development of the methodology are detailed. The clustering methodology employs a 2-step K-means + Ward's clustering algorithm to group hospitals. The final number of clusters is selected using a heuristic that integrates both a statistical-based measure of cluster fit and characteristics of the resulting Hospital Groups. Using recent hospital utilization data, the clustering methodology identified 33 Hospital Groups in Michigan. Despite being developed within the politically charged climate of Certificate of Need regulation, we have provided an objective, replicable, and sustainable methodology to create Hospital Groups. Because the methodology is built upon theoretically sound principles of clustering analysis and health care service utilization, it is highly transferable across applications and suitable for grouping facilities or areal units.

  19. [STUDY OF HEALTH LITERACY OF RURAL RESIDENTS OF ALMATY OBLAST (REGION), KAZAKHSTAN: ROLE OF FINANCIAL WELLBEING IN THE FORMATION OF HEALTH LITERACY OF POPULATION].

    Science.gov (United States)

    Baisunova, G; Turdaliyeva, B; Tulebayev, K; Zagulova, D

    2016-10-01

    Aim of the study was to explore the relationships between health literacy (HL) and financial wellbeing in residents of Almaty oblast (region). The survey was conducted among 826 residents of Almaty region aged 18 y.o. Over 56.5% were female residents. To estimate health literacy, self assessed health, financial wellbeing and attitude towards health /work -questionnaire HLS-EU-Q was used. The results confirmed a significant relationship between financial wellbeing, health literacy and health outcomes residents of Almaty region. Relationships between HL and self- assessed health and attitudes towards health /work balance were observed only in respondents with low financial deprivation index, in respondents with low financial wellbeing (high financial deprivation index) no such relationships were observed. Higher financial deprivation index and lower health literacy were observed in respondents for whom work meant more than health. Lower financial deprivation index and higher health literacy were in those respondents for whom health meant more than work. Improvement of HL and motivation for healthy behavior are important challenges for public health. To answer them population's financial wellbeing improvement alone is not enough, as complex change of consumer behavior in healthcare system is needed. HL enhancing in disadvantaged population groups should inform about possibilities of free healthcare services, medications and about the structure of public healthcare service.

  20. Medicine and democracy: The importance of institutional quality in the relationship between health expenditure and health outcomes in the MENA region.

    Science.gov (United States)

    Bousmah, Marwân-Al-Qays; Ventelou, Bruno; Abu-Zaineh, Mohammad

    2016-08-01

    Evidence suggests that the effect of health expenditure on health outcomes is highly context-specific and may be driven by other factors. We construct a panel dataset of 18 countries from the Middle East and North Africa region for the period 1995-2012. Panel data models are used to estimate the macro-level determinants of health outcomes. The core finding of the paper is that increasing health expenditure leads to health outcomes improvements only to the extent that the quality of institutions within a country is sufficiently high. The sensitivity of the results is assessed using various measures of health outcomes as well as institutional variables. Overall, it appears that increasing health care expenditure in the MENA region is a necessary but not sufficient condition for health outcomes improvements. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. What’s in a word? The framing of health at the regional level: ASEAN, EU, SADC and UNASUR

    Science.gov (United States)

    Amaya, Ana B; Rollet, Vincent; Kingah, Stephen

    2015-01-01

    The Association of Southeast Asian Nations, the European Union, the Southern African Development Community and the Union of South American Nations have increasingly been involved in health diplomacy in the past decade, yet little is known about how they frame health as a foreign policy issue and how this has an impact on their prioritisation of policies. For this, we conducted a review of existing grey and peer-reviewed literature that address regional integration and health, as well as a documentary review according to security, development, trade, human rights, moral/ethical reasonings and global public goods frames identified in the literature. The policy frames identified responded to the challenges these regions currently face. The Association of Southeast Asian Nation’s struggle with re-emerging diseases has led to favouring a securitisation approach to health, the European Union approaches health as a cross-cutting policy issue, the Southern African Development Community presents health as a driver for development, and while the Union of South American Nations emphasises health as a human right and addresses the social determinants of health as an ethical imperative. Overall, these policy frames were useful in analysing the framing of health in foreign policy at the regional level. However, within our analysis, we identified a new frame that approaches health as an intersectoral issue. The impact of regional organisations’ forward will depend on their ability to harness their convening power and speak in a coherent voice on health matters. PMID:26635496

  2. What's in a word? The framing of health at the regional level: ASEAN, EU, SADC and UNASUR.

    Science.gov (United States)

    Amaya, Ana B; Rollet, Vincent; Kingah, Stephen

    2015-12-01

    The Association of Southeast Asian Nations, the European Union, the Southern African Development Community and the Union of South American Nations have increasingly been involved in health diplomacy in the past decade, yet little is known about how they frame health as a foreign policy issue and how this has an impact on their prioritisation of policies. For this, we conducted a review of existing grey and peer-reviewed literature that address regional integration and health, as well as a documentary review according to security, development, trade, human rights, moral/ethical reasonings and global public goods frames identified in the literature. The policy frames identified responded to the challenges these regions currently face. The Association of Southeast Asian Nation's struggle with re-emerging diseases has led to favouring a securitisation approach to health, the European Union approaches health as a cross-cutting policy issue, the Southern African Development Community presents health as a driver for development, and while the Union of South American Nations emphasises health as a human right and addresses the social determinants of health as an ethical imperative. Overall, these policy frames were useful in analysing the framing of health in foreign policy at the regional level. However, within our analysis, we identified a new frame that approaches health as an intersectoral issue. The impact of regional organisations' forward will depend on their ability to harness their convening power and speak in a coherent voice on health matters.

  3. Level of infertility in regions according to Ministry of Public Health data

    Directory of Open Access Journals (Sweden)

    Tymchenko O.I.

    2014-09-01

    Full Text Available The aim of the research: estimation of morbidity and prevalence, risks of female and male infertility among the different regions of Ukraine. Materials and methods. The Morbidity and prevalence of female and male infertility were calculated according to Ministry of Public Health official statistics (2002-2012 per 1 000 of population of reproductive age (15-44. Relative risk including 95% confidence interval was calculated for each region in comparison with whole Ukraine. Results. In Ukraine infertility level grows. Over the years interrelation of female infertility prevalence to male decreases. In 2002-2012 prevalence of infertility was 400,1±0,59 per 100 000 of women and 87,41±0,28 per 100 000 of men aged 15-44 years, including infertility morbidity - 122,8±0,33 and 33,63±0,17 per 100 000 accordingly. It was detected the increased risk of female and male infertility deve¬lopment in Odessa, Dnipropetrovsk and Zaporozhzhye regions, and decreased risk in Lviv, Rivne, Kyiv, Cherkassy, Kirovograd, Mykolaiv, Sumy, Kharkiv, Lugansk and Donetsk regions.

  4. Improving physical health international students enrolled in a technical college in Baikal region

    Directory of Open Access Journals (Sweden)

    M.M. Kolokoltsev

    2014-02-01

    Full Text Available Purpose : to improve the physical health of foreign students enrolled in a technical college Baikal region using an extended motor mode. Material : in the experiment participated 57 students attending the training of South-East Asia, 74 - from Central Asia and 455 - Slavs, natives of the Irkutsk region. Results : it was found poor fitness and low functional performance among foreign students. For this purpose they had used advanced motoring. It included, besides training curriculum additional group activities in the form of sports, participating in sports events and guided independent study physical education. Conclusion : the end of follow foreign students involved in the extended motor mode, significantly outperform their peers engaged on normal functional parameters (heart rate, a test with 20 squats, the recovery time after exercise, dynamometry hands, breath tests, adaptive capacity as well as motor qualities.

  5. Indices of dental health in children and adolescents from Saratov and the Saratov region

    Directory of Open Access Journals (Sweden)

    Firsova I.V.

    2013-09-01

    Full Text Available Objective: to determine the level of dental health in children and adolescents living in the Saratov region. Material and methods. To assess the intensity and prevalence of major dental diseases 1510 patients have been examined by the method recommended by the WHO Collaborating Centre in Russia. Results. A comparative analysis of caries and occurrence of different types of teeth-maxillary anomalies among children aged from 3 to 18 years. Conclusion. The epidemiology of major dental diseases in the Saratov region is characterized by the significant spread of caries from 70 to 94,6% in the different age groups. The proportion of people with malocclusion among the surveyed reaches 46,6%.

  6. Hygienic assessment of ambient air quality and health risks to population of Krasnoyarsk region

    Directory of Open Access Journals (Sweden)

    D.V. Goryaev

    2016-06-01

    Full Text Available This study fulfills the hygienic assessment of ambient air quality in the populated areas of the Krasnoyarsk Region. It is shown that the total number of emission sources in the region is more than 23 600 units, what is higher than in previous years. Around 90.7 % out of them correspond to the set standards of permissible emissions. Air monitoring was carried by the establishments of Roshydromet, Rospotrebnadzor and by other organizations at 94 observation posts in eight urban districts and 2 municipal districts of the region. The status of the ambient air in a sequence of the populated areas of Krasnoyarsk region, namely in the cities Achinsk, Kansk, Krasnoyarsk, Lesosibirsk, Minusinsk, Norilsk, is characterized by the presence of certain pollutants, the level of which exceeds the hygienic standards. Prioritized pollutants are benzo(apyrene, suspended solids, nitrogen, and sulfur dioxide, formaldehyde and others. In the settlements the economic entities violate the legal requirements in the field of sanitary and epidemiological welfare of the population. The probability of the population’s health deterioration grows along with the growth of risk factors. The risks of respiratory diseases, immune system, blood and blood-forming organs and the additional mortality are assessed as unacceptable. Ensuring air quality of the urban residential areas and municipal districts of the Krasnoyarsk Territory requires the introducing the complex measures to improve it. The established levels of human health risk associated with exposure to polluted air are an additional criterion for selection of the priority objects when planning the implementation of risk-based model for supervisory activities in the field of sanitary and epidemiological welfare of the population.

  7. [Regional features of food standards and health risks associated with chemical contamination of food].

    Science.gov (United States)

    Klepikov, O V; Khatuaev, R O; Istomin, A V; Rumyantseva, L A

    In the article there are presented results of a study of the balance of food consumption by the population of the Voronezh region, the assessment of the level of contamination of food products and both carcinogenic and non-carcinogenic and public health risk caused by this contamination. There was evaluated the level of nutrition-dependent diseases. A special feature of this study is a comparative analysis of data obtained during the two five-year periods of 1995-1999 and 2010-2014, that permitted to reveal changes in food consumption, the dynamics of morbidity rate associated with the nutritional factor.

  8. The impact of newspaper advertising on a regional antenatal health campaign.

    Science.gov (United States)

    Berry, J M

    1984-01-01

    In 1981 the West Midlands Health services undertook a publicity campaign aimed at helping women to understand more about keeping healthy during pregnancy and encouraging them to seek early ante-natal care. A series of full page advertisements on ante-natal care were placed in local newspapers in the Region. Set out here are the findings of two studies of the impact of the publicity campaign. The first shows how far people's knowledge of what to do during pregnancy was altered by the publicity, and the second shows what people thought of the advertisements themselves and the further information sent to them on request.

  9. How serious are health impacts in one of the most polluted regions of Central Europe?

    Science.gov (United States)

    Jiřík, Vítězslav; Dalecká, Andrea; Vašendová, Veronika; Janoutová, Jana; Janout, Vladimír

    2017-03-01

    The long-term exposure to pollutants in ambient air is associated with higher mortality and occurrence of respiratory and cardiopulmonary diseases. The longitudinal cross-section study focuses on the associations between long-term exposures to carcinogenic and non-carcinogenic pollutants and the prevalence and incidence of such specific diseases including immunodeficiencies. The data on health status from industrial and non-industrial regions were obtained from health documentation for a 5-year period from 2007 to 2011 and represent the whole population living in polluted (1,249,323 inhabitants) and unpolluted (631,387 inhabitants) regions. The data on concentrations of PM10, PM2,5, NO2, SO2, benzene and benzo[a]pyrene were collected. The concentrations of pollutants were estimated from measured data by using dispersion models. The average population-weighted concentration of pollutants, which is representative for a defined geographic area and time period from 2007 to 2011, was calculated from the obtained data. The logistic regression and the Mantel-Haenszel χ2 test were used to determine the odds ratios (OR) and p-values for a linear trend. Moreover, the relative risks of mortality and morbidity to specific diseases were calculated according to theoretical dose-response association published by World Health Organization (WHO). The probability of incidence of chronic obstructive pulmonary disease and bronchial asthma is statistically significantly higher in the population living in the polluted region compared to the population living in the unpolluted region. The association between long-term exposure to pollutants and the prevalence of immunodeficiency with predominantly antibody defects (D80) was confirmed. The strongest association was found for exposures to particulate matter (PM2,5). The prevalence of immunodeficiency with predominantly antibody defects was also observed in both regions depending on the age of the population and statistically significant

  10. Factors associated with public awareness of the Crown Health Program in the Al-Jouf Region.

    Science.gov (United States)

    Memish, Ziad A; Saeedi, Mohammad Y; Al Madani, Ahmed J; Junod, Bernard; Jamo, Abdelgadier; Abid, Omer; Alanazi, Faisal M; Alrewally, Fayez G; Mandil, Ahmed M A

    2015-01-01

    A community-based intervention, the Crown Health Project (CHP), was developed by the Ministry of Health. It was implemented on a small-scale in Al-Jouf Region in Northern Kingdom of Saudi Arabia to assess its feasibility and effectiveness so that it can be scaled up. This study primarily aimed at investigating factors associated with the awareness of CHP in order to improve subsequent campaigns for the program in Al-Jouf and other regions. A secondary aim was to assess possible changes of public awareness during intensification of the awareness campaign between October 2011 and May 2012. A pre- and post-questionnaire cross-sectional approach was undertaken, and the intervention was an awareness campaign. Variables collected included demographic characteristics (e.g., age, gender, education, occupation, urban/rural residence) and CHP awareness (its existence, sources of knowledge about CHP, its goals and objectives, its target diseases, location of activities, participation in such activities). Logistic regression was used to analyze the awareness of the program according to participant characteristics, with a time of the survey as a variable. Awareness of the program was found to be 11 times higher among postsurvey respondents than presurvey respondents. Respondents of the second survey were better at correctly identifying "health education" as the main goal of the CHP (odds ratio [OR], 4.1; 95% confidence interval [CI], 3.1-5.5), "noncommunicable diseases" as the main diseases targeted (OR, 4.8; 95% CI, 3.6-6.4) and "attention to health" as the purpose (OR, 6.0; 95% CI, 4.0-8.9). The different activities of the CHP were successful in dramatically increasing awareness of the CHP program in Al-Jouf.

  11. Factors associated with public awareness of the Crown Health Program in the Al-Jouf Region

    Directory of Open Access Journals (Sweden)

    Ziad A Memish

    2015-01-01

    Full Text Available Objectives: A community-based intervention, the Crown Health Project (CHP, was developed by the Ministry of Health. It was implemented on a small-scale in Al-Jouf Region in Northern Kingdom of Saudi Arabia to assess its feasibility and effectiveness so that it can be scaled up. This study primarily aimed at investigating factors associated with the awareness of CHP in order to improve subsequent campaigns for the program in Al-Jouf and other regions. A secondary aim was to assess possible changes of public awareness during intensification of the awareness campaign between October 2011 and May 2012. Methods: A pre- and post-questionnaire cross-sectional approach was undertaken, and the intervention was an awareness campaign. Variables collected included demographic characteristics (e.g., age, gender, education, occupation, urban/rural residence and CHP awareness (its existence, sources of knowledge about CHP, its goals and objectives, its target diseases, location of activities, participation in such activities. Logistic regression was used to analyze the awareness of the program according to participant characteristics, with a time of the survey as a variable. Results: Awareness of the program was found to be 11 times higher among postsurvey respondents than presurvey respondents. Respondents of the second survey were better at correctly identifying "health education" as the main goal of the CHP (odds ratio [OR], 4.1; 95% confidence interval [CI], 3.1-5.5, "noncommunicable diseases" as the main diseases targeted (OR, 4.8; 95% CI, 3.6-6.4 and "attention to health" as the purpose (OR, 6.0; 95% CI, 4.0-8.9. Conclusion: The different activities of the CHP were successful in dramatically increasing awareness of the CHP program in Al-Jouf.

  12. Polio Eradication Initiative (PEI) contribution in strengthening public health laboratories systems in the African region.

    Science.gov (United States)

    Gumede, Nicksy; Coulibaly, Sheick Oumar; Yahaya, Ali Ahmed; Ndihokubwayo, Jean-Bosco; Nsubuga, Peter; Okeibunor, Joseph; Dosseh, Annick; Salla, Mbaye; Mihigo, Richard; Mkanda, Pascal; Byabamazima, Charles

    2016-10-10

    The laboratory has always played a very critical role in diagnosis of the diseases. The success of any disease programme is based on a functional laboratory network. Health laboratory services are an integral component of the health system. Efficiency and effectiveness of both clinical and public health functions including surveillance, diagnosis, prevention, treatment, research and health promotion are influenced by reliable laboratory services. The establishment of the African Regional polio laboratory for the Polio Eradication Initiative (PEI) has contributed in supporting countries in their efforts to strengthen laboratory capacity. On the eve of the closing of the program, we have shown through this article, examples of this contribution in two countries of the African region: Côte d'Ivoire and the Democratic Republic of Congo. Descriptive studies were carried out in Côte d'Ivoire (RCI) and Democratic Republic of Congo (DRC) from October to December 2014. Questionnaires and self-administered and in-depth interviews and group discussions as well as records and observation were used to collect information during laboratory visits and assessments. The PEI financial support allows to maintain the majority of the 14 (DRC) and 12 (RCI) staff involved in the polio laboratory as full or in part time members. Through laboratory technical staff training supported by the PEI, skills and knowledge were gained to reinforce laboratories capacity and performance in quality laboratory functioning, processes and techniques such as cell culture. In the same way, infrastructure was improved and equipment provided. General laboratory quality standards, including the entire laboratory key elements was improved through the PEI accreditation process. The Polio Eradication Initiative (PEI) is a good example of contribution in strengthening public health laboratories systems in the African region. It has established strong Polio Laboratory network that contributed to the

  13. Highways and outposts: economic development and health threats in the central Brazilian Amazon region

    Directory of Open Access Journals (Sweden)

    Damacena Giseli N

    2010-06-01

    Full Text Available Abstract Background Economic development is often evoked as a driving force that has the capacity to improve the social and health conditions of remote areas. However, development projects produce uneven impacts on local communities, according to their different positions within society. This study examines the spatial distribution of three major health threats in the Brazilian Amazon region that may undergo changes through highway construction. Homicide mortality, AIDS incidence and malaria prevalence rates were calculated for 70 municipalities located within the areas of influence of the Cuiabá-Santarém highway (BR-163, i.e. in the western part of the state of Pará state and the northern part of Mato Grosso. Results The municipalities were characterized using social and economic indicators such as gross domestic product (GDP, urban and indigenous populations, and recent migration. The municipalities' connections to the region's main transportation routes (BR-163 and Trans-Amazonian highways, along with the Amazon and Tapajós rivers were identified by tagging the municipalities that have boundaries crossing these routes, using GIS overlay operations. Multiple regression was used to identify the major driving forces and constraints relating to the distribution of health threats. The main explanatory variables for higher malaria prevalence were: proximity to the Trans-Amazonian highway, high proportion of indigenous population and low proportion of migrants. High homicide rates were associated with high proportions of migrants, while connection to the Amazon River played a protective role. AIDS incidence was higher in municipalities with recent increases in GDP and high proportions of urban population. Conclusions Highways induce social and environmental changes and play different roles in spreading and maintaining diseases and health threats. The most remote areas are still protected against violence but are vulnerable to malaria. Rapid

  14. Highways and outposts: economic development and health threats in the central Brazilian Amazon region.

    Science.gov (United States)

    Barcellos, Christovam; Feitosa, Patrícia; Damacena, Giseli N; Andreazzi, Marco A

    2010-06-17

    Economic development is often evoked as a driving force that has the capacity to improve the social and health conditions of remote areas. However, development projects produce uneven impacts on local communities, according to their different positions within society. This study examines the spatial distribution of three major health threats in the Brazilian Amazon region that may undergo changes through highway construction. Homicide mortality, AIDS incidence and malaria prevalence rates were calculated for 70 municipalities located within the areas of influence of the Cuiabá-Santarém highway (BR-163), i.e. in the western part of the state of Pará state and the northern part of Mato Grosso. The municipalities were characterized using social and economic indicators such as gross domestic product (GDP), urban and indigenous populations, and recent migration. The municipalities' connections to the region's main transportation routes (BR-163 and Trans-Amazonian highways, along with the Amazon and Tapajós rivers) were identified by tagging the municipalities that have boundaries crossing these routes, using GIS overlay operations. Multiple regression was used to identify the major driving forces and constraints relating to the distribution of health threats. The main explanatory variables for higher malaria prevalence were: proximity to the Trans-Amazonian highway, high proportion of indigenous population and low proportion of migrants. High homicide rates were associated with high proportions of migrants, while connection to the Amazon River played a protective role. AIDS incidence was higher in municipalities with recent increases in GDP and high proportions of urban population. Highways induce social and environmental changes and play different roles in spreading and maintaining diseases and health threats. The most remote areas are still protected against violence but are vulnerable to malaria. Rapid economic and demographic growth increases the risk of AIDS

  15. Emergency Department Telepsychiatry Service Model for a Rural Regional Health System: The First Steps.

    Science.gov (United States)

    Meyer, James D; McKean, Alastair J S; Blegen, Rebecca N; Demaerschalk, Bart M

    2018-05-09

    Emergency departments (EDs) have recognized an increasing number of patients presenting with mental health (MH) concerns. This trend imposes greater demands upon EDs already operating at capacity. Many ED providers do not feel they are optimally prepared to provide the necessary MH care. One consideration in response to this dilemma is to use advanced telemedicine technology for psychiatric consultation. We examined a rural- and community-based health system operating 21 EDs, none of which has direct access to psychiatric consultation. Dedicated beds to MH range from zero (in EDs with only 3 beds) to 6 (in an ED with 38 beds). We conducted a needs assessment of this health system. This included a survey of emergency room providers with a 67% response rate and site visits to directly observe patient flow and communication with ED staff. A visioning workshop provided input from ED staff. Data were also obtained, which reflected ED admissions for the year 2015. The data provide a summary of provider concerns, a summary of MH presentations and diagnosis, and age groupings. The data also provide a time when most MH concerns present to the ED. Based upon these results, a proposed model for delivering comprehensive regional emergency telepsychiatry and behavioral health services is proposed. Emergency telepsychiatry services may be a tenable solution for addressing the shortage of psychiatric consultation to EDs in light of increasing demand for MH treatment in the ED.

  16. Dynamic analysis of interhospital collaboration and competition: empirical evidence from an Italian regional health system.

    Science.gov (United States)

    Mascia, Daniele; Di Vincenzo, Fausto; Cicchetti, Americo

    2012-05-01

    Policymakers stimulate competition in universalistic health-care systems while encouraging the formation of service provision networks among hospital organizations. This article addresses a gap in the extant literature by empirically analyzing simultaneous collaboration and competition between hospitals within the Italian National Health Service, where important procompetition reforms have been implemented. To explore how rising competition between hospitals relates to their propensity to collaborate with other local providers. Longitudinal data on interhospital collaboration and competition collected in an Italian region from 2003 to 2007 are analyzed. Social network analysis techniques are applied to study the structure and dynamics of interhospital collaboration. Negative binomial regressions are employed to explore how interhospital competition relates to the collaborative network over time. Competition among providers does not hinder interhospital collaboration. Collaboration is primarily local, with resource complementarity and differentials in the volume of activity and hospital performance explaining the propensity to collaborate. Formation of collaborative networks among hospitals is not hampered by reforms aimed at fostering market forces. Because procompetition reforms elicit peculiar forms of managed competition in universalistic health systems, studies are needed to clarify whether the positive association between interhospital competition and collaboration can be generalized to other health-care settings. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. User experiences with different regional health information exchange systems in Finland.

    Science.gov (United States)

    Hyppönen, Hannele; Reponen, Jarmo; Lääveri, Tinja; Kaipio, Johanna

    2014-01-01

    The interest in cross-organizational Health Information Exchange (HIE) is increasing at regional, national and cross-European levels. The purpose of our study was to compare user experiences (usability) of different regional health information exchange system (RHIE) types as well as the factors related to the experienced level of success of different RHIE system types. A web-based questionnaire was sent to 95% of Finnish physicians aged between 25 and 65 years of age. RHIE systems were mainly available in the public sector and only in certain regions. Those 1693 physicians were selected from the 3929 respondents of the original study, who met these criteria. The preferred means (paper/fax vs. electronic) of cross-organizational HIE, and replies to the 11 questions measuring RHIE success were used as the main dependent variables. Two thirds (73%) of the primary care physicians and one third (33%) of the specialized care physicians replied using an electronic RHIE system rather than paper or fax as a primary means of cross-organizational HIE. Respondents from regions where a regional virtual EHR (type 3) RHIE system was employed had used electronic means rather than paper HIE to a larger extend compared to their colleagues in regions where a master patient index-type (type 1) or web distribution model (type 2) RHIE system was used. Users of three local EHR systems preferred electronic HIE to paper to a larger extend than users of other EHR systems. Experiences with an integrated RHIE system (type 3) were more positive than those with other types or RHIE systems. The study revealed User preferences for the integrated virtual RHIE-system (type 3) over the master index model (type 1) or web distribution model (type 2). Success of individual HIE tasks of writing, sending and reading were impacted by the way these functionalities were realized in the EHR systems. To meet the expectations of increased efficiency, continuity, safety and quality of care, designers of HIE

  18. Central African Field Epidemiology and Laboratory Training Program: building and strengthening regional workforce capacity in public health.

    Science.gov (United States)

    Andze, Gervais Ondobo; Namsenmo, Abel; Illunga, Benoit Kebella; Kazambu, Ditu; Delissaint, Dieula; Kuaban, Christopher; Mbopi-Kéou, Francois-Xavier; Gabsa, Wilfred; Mulumba, Leopold; Bangamingo, Jean Pierre; Ngulefac, John; Dahlke, Melissa; Mukanga, David; Nsubuga, Peter

    2011-01-01

    The Central African Field Epidemiology and Laboratory Training Program (CAFELTP) is a 2-year public health leadership capacity building training program. It was established in October 2010 to enhance capacity for applied epidemiology and public health laboratory services in three countries: Cameroon, Central African Republic, and the Democratic Republic of Congo. The aim of the program is to develop a trained public health workforce to assure that acute public health events are detected, investigated, and responded to quickly and effectively. The program consists of 25% didactic and 75% practical training (field based activities). Although the program is still in its infancy, the residents have already responded to six outbreak investigations in the region, evaluated 18 public health surveillance systems and public health programs, and completed 18 management projects. Through these various activities, information is shared to understand similarities and differences in the region leading to new and innovative approaches in public health. The program provides opportunities for regional and international networking in field epidemiology and laboratory activities, and is particularly beneficial for countries that may not have the immediate resources to host an individual country program. Several of the trainees from the first cohort already hold leadership positions within the ministries of health and national laboratories, and will return to their assignments better equipped to face the public health challenges in the region. They bring with them knowledge, practical training, and experiences gained through the program to shape the future of the public health landscape in their countries.

  19. Health Insurance Instability Among Older Immigrants: Region of Origin Disparities in Coverage

    Science.gov (United States)

    Hardy, Melissa

    2015-01-01

    Objectives. We provide a detailed analysis of how the dynamics of health insurance coverage (HIC) at older ages differs among Latino, Asian, and European immigrants in the United States. Method. Using Survey of Income and Program Participation data from the 2004 and 2008 panels, we estimate discrete-time event history models to examine first and second transitions into and out of HIC, highlighting substantial differences in hazard rates among immigrants aged 50–64 from Asia, Latin America, and Europe. Results. We find that the likelihood of having HIC at first observation and the rates of gaining and losing coverage within a relatively short time frame are least favorable for older Latino immigrants, although immigrants from all three regions are at a disadvantage relative to native-born non-Hispanic Whites. This disparity among immigrant groups persists even when lower rates of citizenship, greater difficulty with English, and low-skill job placements are taken into account. Discussion. Factors that have contributed to the lower rates and shorter durations of HIC among older immigrants, particularly those from Latin America, may not be easily resolved by the Affordable Care Act. The importance of region of origin and assimilation characteristics for the risk of being uninsured in later life argues that immigration and health care policy should be jointly addressed. PMID:25637934

  20. A pilot study on the views of elderly regional Australians of personally controlled electronic health records.

    Science.gov (United States)

    Kerai, Paresh; Wood, Pene; Martin, Mary

    2014-03-01

    Australia introduced its version of personal health records in July 2012. Success of the personally controlled electronic health record (PCEHR) relies on acceptance during the early stages. The main aim of this study was to investigate the views of a sample of elderly people in a non-metropolitan region in Australia on the PCEHR, and to assess their acceptance levels of this concept. A self-administered questionnaire was distributed to a non-probability convenience sample of respondents recruited from meetings of Probus, a community club for active business and professional retirees. Approximately three-quarters of the respondents had computer and Internet access at home. If not accessed at home a computer at a general practitioner's practice was seen as beneficial in accessing the PCEHR. Respondents felt that access to their health record would help them make decisions about their own health and improve their communication with healthcare providers. The majority of respondents were in favour of the PCEHR although some expressed concerns about the security of their PCEHR. There was mixed opinion surrounding the access by health professionals to an individual's PCEHR. This study has revealed important information about views of the PCEHR. While the respondents were generally in favour of the concept, there were still some concerns about the security of the PCEHR suggesting further reassurance may be required. The study also highlighted some measures, in particular provision of General Practitioner computer access points and print-out facilities that may need to be considered during these initial implementation stages in order to improve adoption rates once the technology is fully available. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. [Evolution of Asthma Prevalence and Sociodemographic and Health Factors Associated in Madrid Region (1996-2013)].

    Science.gov (United States)

    López Pereira, Patricia; Gandarillas Grande, Ana María; Díez Gañán, Lucía; Ordobás Gavín, María

    2017-05-25

    Asthma is an important public health issue. The goal of this study is to analyse the trends in self-reported asthma prevalence in the Madrid Region and its association with socio-demographic and health factors. Data from the "Non-Communicable Disease Risk Factor Surveillance System" in adult population (SIVFRENT-A) 1996-2013 were used. Prevalences and 95% CI were estimated for: current asthma, cumulative prevalence of asthma and asthma attack in the last 12 months, in five periods. Changes in inter-period prevalence were estimated by calculating prevalence ratios (PR) with 95% CI by Poisson regression. The association between asthma prevalence socio-demographic and health variables was evaluated by multivariate logistic regression. Current prevalence of asthma and cumulative prevalence of asthma increased per study period an average of 14%. Asthma attack prevalence in the last 12 months increased an average of 19%. It was associated (statistically significant) to an increase of current prevalence of asthma, cumulative prevalence of asthma and asthma attack prevalence in the last 12 months: being a woman, ORa: 1.55; ORa: 1.35 and ORa: 1.46 respectively; have poor self-perceived health, ORa: 3.09; ORa: 2.63 and ORa: 2.89; and intense physical activity, ORa: 1.48; ORa: 1.32 and ORa: 1.49. In the case of current prevalence of asthma and cumulative prevalence of asthma also be studying, ORa: 1.34 and ORa: 1.46 respectively. Self-reported asthma prevalence increased in the last decades. The prevalence was higher in woman, persons with poor self-perceived health and adults with intense physical activity.

  2. Regional Projections of Extreme Apparent Temperature Days in Africa and the Related Potential Risk to Human Health

    CSIR Research Space (South Africa)

    Garland, Rebecca M

    2015-10-01

    Full Text Available Regional climate modelling was used to produce high resolution climate projections for Africa, under a “business as usual scenario”, that were translated into potential health impacts utilizing a heat index that relates apparent temperature...

  3. Muscle strength and regional lean body mass influence on mineral bone health in young male adults.

    Science.gov (United States)

    Guimarães, Bianca Rosa; Pimenta, Luciana Duarte; Massini, Danilo Alexandre; Dos Santos, Daniel; Siqueira, Leandro Oliveira da Cruz; Simionato, Astor Reis; Dos Santos, Luiz Gustavo Almeida; Neiva, Cassiano Merussi; Pessôa Filho, Dalton Muller

    2018-01-01

    The relationship between muscle strength and bone mineral content (BMC) and bone mineral density (BMD) is supposed from the assumption of the mechanical stress influence on bone tissue metabolism. However, the direct relationship is not well established in younger men, since the enhancement of force able to produce effective changes in bone health, still needs to be further studied. This study aimed to analyze the influence of muscle strength on BMC and BMD in undergraduate students. Thirty six men (24.9 ± 8.6 y/o) were evaluated for regional and whole-body composition by dual energy X-ray absorptiometry (DXA). One repetition maximum tests (1RM) were assessed on flat bench-press (BP), lat-pull down (LPD), leg-curl (LC), knee extension (KE), and leg-press 45° (LP45) exercises. Linear regression modelled the relationships of BMD and BMC to the regional body composition and 1RM values. Measurements of dispersion and error (R2adj and standard error of estimate (SEE)) were tested, setting ρ at ≤0.05. The BMD mean value for whole-body was 1.12±0.09 g/cm2 and BMC attained 2477.9 ± 379.2 g. The regional lean mass (LM) in upper-limbs (UL) (= 6.80±1.21 kg) was related to BMC and BMD for UL (R2adj = 0.74, pBMC and BMD for LL (R2adj = 0.68, pBMC (R2adj = 0.47, pBMC (R2adj = 0.36, pBMC and BMD in young men, strengthening the relationship between force and LM, and suggesting both to parametrizes bone mineral health.

  4. State of equity: childhood immunization in the World Health Organization African Region.

    Science.gov (United States)

    Casey, Rebecca Mary; Hampton, Lee McCalla; Anya, Blanche-Philomene Melanga; Gacic-Dobo, Marta; Diallo, Mamadou Saliou; Wallace, Aaron Stuart

    2017-01-01

    In 2010, the Global Vaccine Action Plan called on all countries to reach and sustain 90% national coverage and 80% coverage in all districts for the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) by 2015 and for all vaccines in national immunization schedules by 2020. The aims of this study are to analyze recent trends in national vaccination coverage in the World Health Organization African Region andto assess how these trends differ by country income category. We compared national vaccination coverage estimates for DTP3 and the first dose of measles-containing vaccine (MCV) obtained from the World Health Organization (WHO)/United Nations Children's Fund (UNICEF) joint estimates of national immunization coverage for all African Region countries. Using United Nations (UN) population estimates of surviving infants and country income category for the corresponding year, we calculated population-weighted average vaccination coverage by country income category (i.e., low, lower middle, and upper middle-income) for the years 2000, 2005, 2010 and 2015. DTP3 coverage in the African Region increased from 52% in 2000 to 76% in 2015,and MCV1 coverage increased from 53% to 74% during the same period, but with considerable differences among countries. Thirty-six African Region countries were low income in 2000 with an average DTP3 coverage of 50% while 26 were low income in 2015 with an average coverage of 80%. Five countries were lower middle-income in 2000 with an average DTP3 coverage of 84% while 12 were lower middle-income in 2015 with an average coverage of 69%. Five countries were upper middle-income in 2000 with an average DTP3 coverage of 73% and eight were upper middle-income in 2015 with an average coverage of 76%. Disparities in vaccination coverage by country persist in the African Region, with countries that were lower middle-income having the lowest coverage on average in 2015. Monitoring and addressing these disparities is essential for meeting

  5. The “Picardie en Forme” Network: Federating Regional Health-enhancing Sports Resources

    Science.gov (United States)

    Weissland, Thierry; Passavant, Éric; Allal, Aziz; Amiard, Valérie; Antczak, Boris; Manzo, Julie

    2016-06-08

    Initiated by the Regional Olympic and Sports Committee and the Regional Directorate of Youth, Sports and Social Cohesion, the “Picardie en Forme” network has been working since 2011 in favour of adults of all ages, with chronic noncommunicable or similar diseases, to encourage a gradual return to reassuring and perennial regular physical activity,. A first step consisted of organizing a care pathway based on two principles: inform general practitioners so that they can encourage their patients to be physically active by referring them to the network, develop a range of local sports by accrediting certain clubs with sports instructors who have been trained in the management of this specific population. In 2013, 121 users entered the network at the request of 61 doctors. 48 sports instructors were trained and 20 associations obtained the Picardie en Forme label. Comparison of the results of tests performed on entry in the network and then eight months later shows a general physical reconditioning of users, increasing their motivation and perceived physical value. However, despite these encouraging results, the network has difficulty retaining users, and maintaining the involvement of general practitioners and certain local partners. This article discusses the relevance of initial approaches and describes the changes made to sustain this regional network, which, for the first time, links sport, health and users.

  6. Regional inequalities in self-rated health in Russia: What is the role of social and economic capital?

    Science.gov (United States)

    Lyytikäinen, Laura; Kemppainen, Teemu

    2016-07-01

    Using the data from the European Social Survey (round 6, 2012), this article studies regional inequalities in self-rated health in Russia and examines the role that socio-demographic factors and economic and social capital play in these differences. Also, the regional variation in the determinants of self-rated health is analysed. The article argues that there are considerable and statistically significant unadjusted differences in self-rated health across Russian Federal Districts. We elaborated these differences by regression adjustments, with the result that some of the differences were explained by our predictors and some were amplified. The odds for good self-rated health were lower in the Volga than in Central Russia due to age and socio-economic composition. In contrast, the regression adjustments amplified the differences of the Northwest and the South in comparison to the Central District. The odds for good self-rated health were considerably lower in the Far Eastern part of the country than in the Central District, independently of the adjustments. While social and economic capital predicted good self-rated health at the individual level, they did not explain regional differences. Interaction analyses revealed regional variation in some of the determinants of self-rated health. Most notably, the effects of age, trade union membership and volunteering depended on the regional context. This article argues that the healthcare reforms that transfer funding responsibilities to regional administration may be dangerous for the already less affluent and less healthy rural regions. Thus, regional governance has a growing importance in preventing increases in health inequalities. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Environment monitoring and residents health condition monitoring of nuclear power plant Bohunice region

    International Nuclear Information System (INIS)

    Letkovicova, M.; Rehak, R.; Stehlikova, B.; Celko, M.; Hraska, S.; Klocok, L.; Kostial, J.; Prikazsky, V.; Vidovic, J.; Zirko, M.; Beno, T.; Mitosinka, J.

    1998-01-01

    The report contents final environment evaluation and selected characteristic of residents health physics of nuclear power plant Bohunice region. Evaluated data were elaborated during analytical period 1993-1997.Task solving which results are documented in this final report was going on between 1996- 1998. The report deals in individual stages with the following: Information obtaining and completing which characterize demographic situation of the area for the 1993-1997 period; Datum obtaining and completing which contain selected health physics characteristics of the area residents; Database structures for individual data archiving from monitoring and collection; Brief description of geographic information system for graphic presentation of evaluation results based on topographic base; Digital mapping structure description; Results and evaluation of radionuclide monitoring in environment performed by Environmental radiation measurements laboratory by the nuclear power plant Bohunice for the 1993-1997 period. Demographic situation evaluation and selected health physics characteristics of the area of nuclear power plant residents for the 1993-1997 period are summarized in the final part of the document. Monitoring results and their evaluation is processed in graph, table, text description and map output forms. Map outputs are processed in the geographic information system Arc View GIS 3.0a environment

  8. [Financing of regional occupational health service centers: structure and financial criteria in years 2000-2001].

    Science.gov (United States)

    Rydlewska-Liszkowska, Izabela

    2003-01-01

    The rational planning and financing of occupational health services at the national level have to be based on an appropriate system of information about individual units and their financial status that could illustrate their financial administration. This is required not only in view of the internal needs of public money management, but also in view of the national health accounts. The major task in this regard is to assess the level and structure of financing to individual units and to check the soundness of criteria used in the process of supplying financial means. The results of such an analysis can be a valuable source of information for planning carried out also by the institutions which provide funds to cover the cost of tasks performed by individual units. The aim of the project implemented by the Nofer Institute of Occupational Medicine was to collect, process and analyze data on the level and structure of financing of provincial occupational medicine centers. In this paper, the objectives, methodology and analytical tools are discussed. The results and structural data on the level and structure of financing of regional occupational health services centers covering a two-year period are presented. At the same time, the criteria for allocating funds were identified, which made it possible to evaluate the situation and to propose new solutions.

  9. Regional variations in the health, environmental, and climate benefits of wind and solar generation

    Science.gov (United States)

    Siler-Evans, Kyle; Azevedo, Inês Lima; Morgan, M. Granger; Apt, Jay

    2013-01-01

    When wind or solar energy displace conventional generation, the reduction in emissions varies dramatically across the United States. Although the Southwest has the greatest solar resource, a solar panel in New Jersey displaces significantly more sulfur dioxide, nitrogen oxides, and particulate matter than a panel in Arizona, resulting in 15 times more health and environmental benefits. A wind turbine in West Virginia displaces twice as much carbon dioxide as the same turbine in California. Depending on location, we estimate that the combined health, environmental, and climate benefits from wind or solar range from $10/MWh to $100/MWh, and the sites with the highest energy output do not yield the greatest social benefits in many cases. We estimate that the social benefits from existing wind farms are roughly 60% higher than the cost of the Production Tax Credit, an important federal subsidy for wind energy. However, that same investment could achieve greater health, environmental, and climate benefits if it were differentiated by region. PMID:23798431

  10. Smokeless tobacco: a major public health problem in the SEA region: a review.

    Science.gov (United States)

    Gupta, Prakash C; Ray, Cecily S; Sinha, Dhirendra N; Singh, Poonam K

    2011-01-01

    Smokeless tobacco use is on the upswing in some parts of the world, including parts of SEAR. It is therefore important to monitor this problem and understand the possible consequences on public health. Material for this review was obtained from documents and data of the World Health Organization, co-authors, colleagues, and searches on key words in PubMed and on Google. Smokeless tobacco use in SEAR, as betel quid with tobacco, declined with increased marketing of cigarettes from the early twentieth century. Smokeless tobacco use began to increase in the 1970s in South Asia, with the marketing of new products made from areca nut and tobacco and convenient packaging. As a consequence, oral precancerous conditions and cancer incidence in young adults have increased significantly. Thailand's successful policies in reducing betel quid use through school health education from the 1920s and in preventing imports of smokeless tobacco products from 1992 are worth emulating by many SEAR countries. India, the largest manufacturing country of smokeless tobacco in the Region, is considering ways to regulate its production. Best practices require the simultaneous control of smokeless and smoking forms of tobacco. Governments in SEAR would do well to adopt strong measures now to control this problem.

  11. A multi-dimensional environment-health risk analysis system for the English regions

    Science.gov (United States)

    Vitolo, Claudia; Scutari, Marco; Ghalaieny, Mohamed; Tucker, Allan; Russell, Andrew

    2017-04-01

    There is an overwhelming body of evidence that environmental pollution, and air pollution in particular, is a significant threat to health worldwide. While in developed countries the introduction of environmental legislation and sustainable technologies aims to mitigate adverse effects, developing countries are at higher risk. Within the scope of the British Council funded KEHRA project, work is on-going to develop a reproducible and reliable system to assess health risks due to exposure to pollution under climate change and across countries. Our approach is based on the use of Bayesian Networks. We used these graphical models to explore and model the statistical dependence structure of the intricate environment-health nexus. We developed a robust modelling workflow in the R programming language to facilitate reproducibility and tested it on the English regions in the United Kingdom. Preliminary results are encouraging, showing that the model tests generally well in sample (training data spans the period 1981-2005) and has good predictive power when tested out of sample (testing data spans the period 2006-2014). We plan to show the results of this preliminary analysis as well as test the model under future climate change scenarios. Future work will also investigate the transferability of the model from a data-rich (England) to a data-poor environment (Kazakhstan).

  12. Groundwater chemistry and human health risk assessment in the mining region of East Singhbhum, Jharkhand, India.

    Science.gov (United States)

    Singh, Umesh Kumar; Ramanathan, A L; Subramanian, V

    2018-08-01

    Groundwater chemistry of mining region of East Singhbhum district having complex contaminant sources were investigated based on heavy metals loads and other hydrochemical constituents. This study aimed to identify the degree of heavy metals exposure and their potential health risk to local population. The results of hydrochemical analysis showed that Na + , K + , and Ca 2+ ions are the dominant cations in the groundwater, while HCO 3 - , F - and Cl - ions dominate the anionic part of the groundwater. The weathering process was considered the dominant factor to determine the major ionic composition in the study area. Compositional analysis for heavy metal has identified that groundwater of the study area is contaminated by Cd, Pb and Cr elements. Source of these metals have been identified as an anthropogenic inputs from mining activities and mineral processing units. Health risk analysis of individual heavy metal for chronic daily intake (CDI) and hazard quotient (HQ) was found in the order of Cr > As > Cd > Pb which is indicating high health risk for the population. In addition, Hazard Index (HI) analysis for heavy metals was found significantly high (>1) which is considered as a threat for human population because they have the tendency to accumulate in the body and cause variety of diseases like kidney problem, dysfunction of liver and renal cortex as well as cancer. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. E-Cigarettes: Implications for Health Promotion in the Asian Pacific Region.

    Science.gov (United States)

    Jancey, Jonine; Maycock, Bruce; McCausland, Kahlia; Howat, Peter

    2018-03-01

    Since their introduction to the United States in 2007, electronic cigarettes (e-cigarettes) use has grown exponentially. This rapid growth in e-cigarette use has been heralded by some as a potential important public health measure that could ultimately replace tobacco cigarettes, while others recommend a cautionary approach until there is clear evidence they will not become "new tobacco" bringing a possible myriad of other problems. E-cigarettes may have real benefits, however they do expose users and those nearby to organic compounds, solvents and particulate matter, with there being limited data relating to their health impact. It is unclear as to whether this relatively new device has the potential to exacerbate nicotine addictions, or play a part in reducing harm and smoking cessation. The fundamental requirement of public health practice is to do no harm and from the inconclusive evidence we have to date on e-cigarettes, it appears a cautious approach is warranted. This commentary reviews evidence that supports a cautious approach to e-cigarette availability in Australia and the Asian Pacific region.

  14. Aviation investigation report : hard landing : fuel leak and fire[Sundance Balloons International Firefly 12B (hot air balloon) C-FNVM, Winnipeg, Manitoba, 15 nm NE, 11 August 2007

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-08-15

    This investigation report discussed an incident in Winnipeg in which a hot air balloon attempting to land during strong winds was dragged on its side for approximately 700 feet. The balloon's burners struck the ground as the balloon came to a stop, after which a propane leak occurred. An intense, uncontrolled fire ensued as balloon passengers were exiting from the partially-inverted basket. The pilot and 2 passengers suffered serious injuries, while another 4 passengers suffered minor injuries. The balloon's 2 propane tanks and a fire extinguisher canister exploded during the fire, which destroyed the balloon's basket. The rigging of the balloon was examined and no failures were discovered. Pressure tests showed that the balloon's hoses started leaking at the crimped sleeve fittings at 150 psi. While the pilot had been informed of potentially heavy winds and thunderstorms, changes in wind speed and direction occurred earlier than the forecasted time of 10:00. It was concluded that standards are needed to ensure balloon cabin safety. Balloon operators do not currently require the use of protective helmets or gloves in case of dragged landings. A review will be conducted to address the issue of proposed emergency fuel shut-offs for balloons carrying fare-paying passengers. 2 figs.

  15. Evaluation method for regional water cycle health based on nature-society water cycle theory

    Science.gov (United States)

    Zhang, Shanghong; Fan, Weiwei; Yi, Yujun; Zhao, Yong; Liu, Jiahong

    2017-08-01

    Regional water cycles increasingly reflect the dual influences of natural and social processes, and are affected by global climate change and expanding human activities. Understanding how to maintain a healthy state of the water cycle has become an important proposition for sustainable development of human society. In this paper, natural-social attributes of the water cycle are synthesized and 19 evaluation indices are selected from four dimensions, i.e., water-based ecosystem integrity, water quality, water resource abundance and water resource use. A hierarchical water-cycle health evaluation system is established. An analytic hierarchy process is used to set the weight of the criteria layer and index layer, and the health threshold for each index is defined. Finally, a water-cycle health composite-index assessment model and fuzzy recognition model are constructed based on the comprehensive index method and fuzzy mathematics theory. The model is used to evaluate the state of health of the water cycle in Beijing during 2010-2014 and in the planning year (late 2014), considering the transfer of 1 billion m3 of water by the South-to-North Water Diversion Project (SNWDP). The results show health scores for Beijing of 2.87, 3.10, 3.38, 3.11 and 3.02 during 2010-2014. The results of fuzzy recognition show that the sub-healthy grade accounted for 54%, 49%, 61% and 49% of the total score, and all years had a sub-healthy state. Results of the criteria layer analysis show that water ecosystem function, water quality and water use were all at the sub-healthy level and that water abundance was at the lowest, or sick, level. With the water transfer from the SNWDP, the health score of the water cycle in Beijing reached 4.04. The healthy grade accounted for 60% of the total score, and the water cycle system was generally in a healthy state. Beijing's water cycle health level is expected to further improve with increasing water diversion from the SNWDP and industrial

  16. Potential Impacts of Future Climate Change on Regional Air Quality and Public Health over China

    Science.gov (United States)

    Hong, C.; Zhang, Q.; Zhang, Y.; He, K.

    2017-12-01

    Future climate change would affect public health through changing air quality. Climate extremes and poor weather conditions are likely to occur at a higher frequency in China under a changing climate, but the air pollution-related health impacts due to future climate change remain unclear. Here the potential impacts of future climate change on regional air quality and public health over China is projected using a coupling of climate, air quality and epidemiological models. We present the first assessment of China's future air quality in a changing climate under the Representative Concentration Pathway 4.5 (RCP4.5) scenario using the dynamical downscaling technique. In RCP4.5 scenario, we estimate that climate change from 2006-2010 to 2046-2050 is likely to adversely affect air quality covering more than 86% of population and 55% of land area in China, causing an average increase of 3% in O3 and PM2.5 concentrations, which are found to be associated with the warmer climate and the more stable atmosphere. Our estimate of air pollution-related mortality due to climate change in 2050 is 26,000 people per year in China. Of which, the PM2.5-related mortality is 18,700 people per year, and the O3-related mortality is 7,300 people per year. The climate-induced air pollution and health impacts vary spatially. The climate impacts are even more pronounced on the urban areas where is densely populated and polluted. 90% of the health loss is concentrated in 20% of land areas in China. We use a simple statistical analysis method to quantify the contributions of climate extremes and find more intense climate extremes play an important role in climate-induced air pollution-related health impacts. Our results indicate that global climate change will likely alter the level of pollutant management required to meet future air quality targets as well as the efforts to protect public health in China.

  17. Health disparities among the western, central and eastern rural regions of China after a decade of health promotion and disease prevention programming.

    Science.gov (United States)

    Zhang, Xi-Fan; Tian, Xiang-Yang; Cheng, Yu-Lan; Feng, Zhan-Chun; Wang, Liang; Southerland, Jodi

    2015-08-01

    Health disparities between the western, central and eastern regions of rural China, and the impact of national health improvement policies and programming were assessed. A total of 400 counties were randomly sampled. ANOVA and Logistic regression modeling were employed to estimate differences in health outcomes and determinants. Significant differences were found between the western, central and eastern rural regions in community infrastructure and health outcomes. From 2000 to 2010, health indicators in rural China were improved significantly, and the infant mortality rate (IMR), maternal mortality rate (MMR) and under 5 mortality rate (U5MR) had fallen by 62.79%, 71.74% and 61.92%, respectively. Central rural China had the greatest decrease in IMR (65.05%); whereas, western rural China had the greatest reduction in MMR (72.99%) but smallest reduction in U5MR (57.36%). Despite these improvements, Logistic regression analysis showed regional differences in key health outcome indicators (odds ratios): IMR (central: 2.13; western: 5.31), U5MR (central: 2.25; western: 5.69), MMR (central: 1.94; western: 3.31), and prevalence of infectious diseases (central: 1.62; western: 3.58). The community infrastructure and health outcomes of the western and central rural regions of China have been improved markedly during the first decade of the 21st century. However, health disparities still exist across the three regions. National efforts to increase per capita income, community empowerment and mobilization, community infrastructure, capacity of rural health facilities, and health literacy would be effective policy options to attain health equity.

  18. Hygienic assessment of drinking water quality and risks to public health in Krasnoyarsk region

    Directory of Open Access Journals (Sweden)

    D.V. Goryaev

    2016-09-01

    Full Text Available The article presents the hygienic assessment of water quality in water sources of the Krasnoyarsk region used for centralized drinking water supply. It is shown that the exceeding of hygienic standards was registered at such indicators as iron (iron content is noted at the level to 1.8 mg/dm 3 or 6 MPC; fluorine (up to 6 MPC; ammonia and ammonium nitrogen (up to 2 MPC, nitrates (up to 5 MPC, organochlorine compounds (chloroform, carbon tetrachloride up to 5 MPC, manganese (up to 5.5 MPC, aluminium (up to 2 MPC. In water carcinogenic contaminants are recorded in significant concentrations: benzo(apyrene, cadmium, arsenic, nickel, lead. It is determined that the total lifetime carcinogenic risk to public health in the cities and districts of the Krasnoyarsk region due to oral intake from drinking water of chemicals of carcinogenic nature is negligible in 22 areas, and requires no additional measures to reduce. 23 territories of the region have carcinogenic risk ranged 1.0E-6 to 1.0E-5, which meets the criteria of acceptable risk. 9 territories (the town of Borodino, Lesosibirsk, Yeniseisk, Kazachinskiy, Partizansky, Pirovskiy, Rybinskiy, Sayanskiy, Uyarskiy areas show the level of lifetime individual cancer risk from 1.0E-5 to 2.0E-4, which is unacceptable for the population in general. The main contribution to the risk level (80.8–98.4 % makes the contents of arsenic in the drinking water. There is an increased risk of district (NI=1.2 and NI=1.17, respectively; bone and teeth from residents of the Sukhobuzimsky district (NI=1.04. High hazard indexes due to the nitrate and fluoride. Providing the population of urban districts and municipal districts of the Krasnoyarsk region with safe drinking water requires a set of various measures with the development and implementation of programs on improvement of water supply of populated areas

  19. Walking to work in Canada: health benefits, socio-economic characteristics and urban-regional variations.

    Science.gov (United States)

    Kitchen, Peter; Williams, Allison; Chowhan, James

    2011-04-04

    There is mounting concern over increasing rates of physical inactivity and overweight/obesity among children and adult in Canada. There is a clear link between the amount of walking a person does and his or her health. The purpose of this paper is to assess the health factors, socio-economic characteristics and urban-regional variations of walking to work among adults in Canada. Data is drawn from two cycles of the Canadian Community Health Survey: 2001 and 2005. The study population is divided into three groups: non-walkers, lower-duration walkers and high-duration walkers. Logistic regression modeling tests the association between levels of walking and health related outcomes (diabetes, high blood pressure, stress, BMI, physical activity), socio-economic characteristics (sex, age, income, education) and place of residence (selected Census Metropolitan Areas). In 2005, the presence of diabetes and high blood pressure was not associated with any form of walking. Adults within the normal weight range were more likely to be high-duration walkers. Females and younger people were more likely to be lower-duration walkers but less likely to be high-duration walkers. There was a strong association between SES (particularly relative disadvantage) and walking to work. In both 2001 and 2005, the conditions influencing walking to work were especially prevalent in Canada's largest city, Toronto, as well as in several small to medium sized urban areas including Halifax, Kingston, Hamilton, Regina, Calgary and Victoria. A number of strategies can be followed to increase levels of walking in Canada. It is clear that for many people walking to work is not possible. However, strategies can be developed to encourage adults to incorporate walking into their daily work and commuting routines. These include mass transit walking and workplace walking programs.

  20. Walking to work in Canada: health benefits, socio-economic characteristics and urban-regional variations

    Directory of Open Access Journals (Sweden)

    Williams Allison

    2011-04-01

    Full Text Available Abstract Background There is mounting concern over increasing rates of physical inactivity and overweight/obesity among children and adult in Canada. There is a clear link between the amount of walking a person does and his or her health. The purpose of this paper is to assess the health factors, socio-economic characteristics and urban-regional variations of walking to work among adults in Canada. Methods Data is drawn from two cycles of the Canadian Community Health Survey: 2001 and 2005. The study population is divided into three groups: non-walkers, lower-duration walkers and high-duration walkers. Logistic regression modeling tests the association between levels of walking and health related outcomes (diabetes, high blood pressure, stress, BMI, physical activity, socio-economic characteristics (sex, age, income, education and place of residence (selected Census Metropolitan Areas. Results In 2005, the presence of diabetes and high blood pressure was not associated with any form of walking. Adults within the normal weight range were more likely to be high-duration walkers. Females and younger people were more likely to be lower-duration walkers but less likely to be high-duration walkers. There was a strong association between SES (particularly relative disadvantage and walking to work. In both 2001 and 2005, the conditions influencing walking to work were especially prevalent in Canada's largest city, Toronto, as well as in several small to medium sized urban areas including Halifax, Kingston, Hamilton, Regina, Calgary and Victoria. Conclusion A number of strategies can be followed to increase levels of walking in Canada. It is clear that for many people walking to work is not possible. However, strategies can be developed to encourage adults to incorporate walking into their daily work and commuting routines. These include mass transit walking and workplace walking programs.

  1. [Current status and problems of regional maternal and child health education in the curriculum of midwifery education].

    Science.gov (United States)

    Murayama, I

    1989-01-01

    According to the evaluations made by medical Technical Junior Colleges in Japan, general objectives in midwifery education are met, but their curriculum does not cater to each region's health care needs sufficiently. Japanese midwifery students can either attend a 6 month training program offered at 80 different locations, or enroll in a 1 year special-major program at one of the 10 Medical Technical Junior Colleges affiliated with National Universities. According to the curriculum revised in 1971, midwifery students are required to take the following courses and hours in 6 months. Intro. to Maternal and Child Health (15 hours), Maternal and Child Health Medicine (60 hours), Lecture on Midwifery (105 hrs), Practice in Midwifery (135 hrs), Midwifery Business Administration (60 hrs), Maternal and Child Health Administration including internship (225 hrs), Regional Maternal and Child Health including internship (105 hrs) and Family Sociology (15 hours). Regional Maternal and Child Health course (RMCH) is effectively taught only if all the maternal and child health courses and lecture on midwifery are taken beforehand. Objectives for RMCH course are becoming able to assess the state of maternal and child health care in the region and give constructive criticism and suggestions for improvement including legal aspects, acquiring positive attitudes and necessary skills for advancing and having understanding of regional health care and that of midwives' role of it. While the curriculum prepares the students for meeting the patients' physical needs, the students are not ready to cope with their psychological and socio-physiological problems surrounding individuals, families and communities. Changes and diversification of regional communities should be taken into consideration also in the curriculum. Increase in nuclear families, increase in working wives, isolation and/or over-crowding of high rise apartment living are some of the examples. Midwifery activity is also

  2. The Length of Child Anxiety Treatment in a Regional Health System.

    Science.gov (United States)

    Whiteside, Stephen P H; Ale, Chelsea M; Young, Brennan; Olsen, Mark W; Biggs, Bridget K; Gregg, Melissa S; Geske, Jennifer R; Homan, Kendra

    2016-12-01

    Anxiety disorders are often undertreated due to unsuccessful dissemination of evidence-based treatments (EBTs). Lack of empirical data regarding the typical length of treatment in clinical settings may hamper the development of clinically relevant protocols. The current study examined billing records for 335 children ages 7-17 years to quantify the treatment received for newly diagnosed anxiety disorders within a regional health system. The vast majority of patients did not receive a sufficient number of appointments to complete the typical cognitive behavioral therapy protocol or reach the sessions introducing exposure. Although half of the sample received pharmacotherapy, the vast majority received fewer follow-up appointments than participants in pharmacotherapy research studies. Further, the type of treatment (i.e., number of sessions and medication) differed depending on utilization of specialty care. These results underscore the need to develop brief and flexible EBT protocols that can be standardized and implemented in community practice.

  3. Decreasing influenza impact in lodges: 1997-2000 Calgary Regional Health Authority.

    Science.gov (United States)

    McLeod, L; Lau, W W

    2001-01-01

    Influenza causes high morbidity and hospitalization rates in residents of seniors lodges, I causing increased pressure on emergency departments and hospital beds every winter. This quasi-experimental study assessed the prevention of influenza outbreaks and their consequences in Calgary lodges. A multidisciplinary team worked to improve communication between health professionals, increase resident and staff immunization coverage, obtain weights and creatinines prior to influenza season, and facilitate amantadine prophylaxis during influenza A outbreaks. We had an increase in standing orders for amantadine and up to 56% of residents from one lodge had documented creatinine levels. Amantadine was administered to residents within two days of outbreak notification. Influenza morbidity in lodge outbreaks decreased from a rate of 37% to 9% over the three years and hospitalization rates decreased from 9% to 1%. We recommend that other regions consider a similar approach to decreasing influenza morbidity and hospitalization in lodge residents.

  4. Fracking and public health: Evidence from gonorrhea incidence in the Marcellus Shale region.

    Science.gov (United States)

    Komarek, Tim; Cseh, Attila

    2017-11-01

    The United States (US) began to experience a boom in natural gas production in the 2000s due to the advent of hydraulic fracturing (fracking) and horizontal drilling technology. While the natural gas boom affected many people through lower energy prices, the strongest effects were concentrated in smaller communities where the fracking occurred. We analyze one potential cost to communities where fracking takes place: an increase of sexually transmitted diseases. We use a quasi-natural experiment within the Marcellus shale region plus panel data estimation techniques to quantify the impact of fracking activity on local gonorrhea incidences. We found fracking activity to be associated with an increase in gonorrhea. Our findings may be useful to public health officials. To make informed decisions about resource extraction, policy makers as well as regulators and communities need to be informed of all the benefits as well as the costs.

  5. Regional inequalities in self-rated health and disability in younger and older generations in Turkey: the contribution of wealth and education

    NARCIS (Netherlands)

    Ergin, Isil; Kunst, Anton E.

    2015-01-01

    In Turkey, large regional inequalities were found in maternal and child health. Yet, evidence on regional inequalities in adult health in Turkey remains fragmentary. This study aims to assess regional and rural/urban inequalities in the prevalence of poor self-rated health and in disability among

  6. Harnessing genomics to improve health in the Eastern Mediterranean Region – an executive course in genomics policy

    Directory of Open Access Journals (Sweden)

    Singer Peter A

    2005-01-01

    Full Text Available Abstract Background While innovations in medicine, science and technology have resulted in improved health and quality of life for many people, the benefits of modern medicine continue to elude millions of people in many parts of the world. To assess the potential of genomics to address health needs in EMR, the World Health Organization's Eastern Mediterranean Regional Office and the University of Toronto Joint Centre for Bioethics jointly organized a Genomics and Public Health Policy Executive Course, held September 20th–23rd, 2003, in Muscat, Oman. The 4-day course was sponsored by WHO-EMRO with additional support from the Canadian Program in Genomics and Global Health. The overall objective of the course was to collectively explore how to best harness genomics to improve health in the region. This article presents the course findings and recommendations for genomics policy in EMR. Methods The course brought together senior representatives from academia, biotechnology companies, regulatory bodies, media, voluntary, and legal organizations to engage in discussion. Topics covered included scientific advances in genomics, followed by innovations in business models, public sector perspectives, ethics, legal issues and national innovation systems. Results A set of recommendations, summarized below, was formulated for the Regional Office, the Member States and for individuals. • Advocacy for genomics and biotechnology for political leadership; • Networking between member states to share information, expertise, training, and regional cooperation in biotechnology; coordination of national surveys for assessment of health biotechnology innovation systems, science capacity, government policies, legislation and regulations, intellectual property policies, private sector activity; • Creation in each member country of an effective National Body on genomics, biotechnology and health to: - formulate national biotechnology strategies - raise

  7. Orthotics, prosthesis and mobility aids (OPM dispensation in the Regional Health Department of the 3RD Region of Sao Paulo State

    Directory of Open Access Journals (Sweden)

    Camila Caminha Caro

    2014-12-01

    Full Text Available Objective: To identify the process of dispensation of orthotics, prostheses and mobility aids (OPM by the Unified Health System (SUS in the Regional Health Department of the 3rd Region (DRSIII of Sao Paulo state; perform a mapping of the existing physical rehabilitation services in that region; and subsequently correlate the data with applicable laws. Methodology: This is an exploratory cross-sectional qualitative study whose subjects were the main professionals involved in the process of OPM dispensation, or responsible for their acquisition flow in the cities of that region. Data collection was carried out through a semi-structured questionnaire, developed by the researchers themselves, composed of questions aiming to identify the physical rehabilitation centers in the towns, the staff members involved, the provision of assistive technology through SUS, delivery time and existence of waiting lists. Results and discussion: The data were statistically measured, categorized, described and correlated with the current legislation aimed to guarantee access to assistive technology. We observed that the practice around this resource in the 3rd region concentrates in a single care center, causing long waits and poor efficiency of the services provided, in addition to maintaining a paternalistic aspect. Conclusion: This study provides evidence that, although the right to access to assistive technology is legally guaranteed, there are still many difficulties and challenges around this practice.

  8. A COMPARATIVE STUDY of HEALTH UNITS of the 6TH GREEK HEALTH REGION DURING an ECONOMIC CRISIS PERIOD through DATA ENVELOPMENT ANALYSIS METHOD

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    Georgios I. Farantos

    2016-12-01

    Full Text Available The aim of the present study is to investigate the change in relative efficiency through a comparative study on the efficiency of health units within a Greek health region during an economic crisis environment, with the aid of a new application. The study is designed to collect data from the 6th Greek health region and to process that data with the use of Data Envelopment Analysis software. The study methodology extends to the application of the study of efficiency of organisations and the integration of the analysis in an interpretation framework within the economic crisis. The study refers to similar hospital clinics (pathological within one of the largest Greek health regions in order for the results to be comparable. We estimate and calculate the DEA sizes based on the CRS, VRS and SE models of the Health Units of a Greek health region, with the use of a new application which calculates the change of overall relative Efficiency during the crisis. The study of the change in the efficiency of health units leads to useful conclusions on the negative changes in the observed efficiency of the units and the integration of the studies on the change of efficiency in the Integrated crisis management. The study ranks the efficient and inefficient units and suggests ways of improvement. This study allows for further case studies in the future and the completion of the integrated crisis management model through comparative studies on the efficiency of systems.

  9. Environmental aspects of health care in the Grampian NHS region and the place of telehealth

    Science.gov (United States)

    Wootton, Richard; Tait, Alex; Croft, Amanda

    2010-01-01

    Detailed information about the composition of the carbon footprint of the NHS in the Grampian health region, and in Scotland generally, is not available at present. Based on the limited information available, our best guess is that travel emissions in Grampian are substantial, perhaps 49,000 tonnes CO2 per year. This is equivalent to 233 million km of car travel per year. A well-established telemedicine network in the Grampian region, which saves over 2000 patient journeys a year from community hospitals, avoids about 260,000 km travel per year, or about 59 tonnes CO2 per year. Therefore using telehealth as it has been used historically (primarily to facilitate hospital-to-hospital interactions) seems unlikely to have a major environmental impact – although of course there may be other good reasons for persevering with conventional telehealth. On the other hand, telehealth might be useful in reducing staff travel and to a lesser extent, visitor travel. It looks particularly promising for reducing outpatient travel, where substantial carbon savings might be made by reconfiguring the way that certain services are provided. PMID:20511579

  10. Climate Change, Extreme Weather Events, and Human Health Implications in the Asia Pacific Region.

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    Hashim, Jamal Hisham; Hashim, Zailina

    2016-03-01

    The Asia Pacific region is regarded as the most disaster-prone area of the world. Since 2000, 1.2 billion people have been exposed to hydrometeorological hazards alone through 1215 disaster events. The impacts of climate change on meteorological phenomena and environmental consequences are well documented. However, the impacts on health are more elusive. Nevertheless, climate change is believed to alter weather patterns on the regional scale, giving rise to extreme weather events. The impacts from extreme weather events are definitely more acute and traumatic in nature, leading to deaths and injuries, as well as debilitating and fatal communicable diseases. Extreme weather events include heat waves, cold waves, floods, droughts, hurricanes, tropical cyclones, heavy rain, and snowfalls. Globally, within the 20-year period from 1993 to 2012, more than 530 000 people died as a direct result of almost 15 000 extreme weather events, with losses of more than US$2.5 trillion in purchasing power parity. © 2015 APJPH.

  11. Health surveillance of personnel engaged in decontamination of depleted uranium contaminated regions

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    Djurovic, B. [Military Medical Academy, Radiological Protection Dept., Belgrade, Serbia and Montenegro (Yugoslavia); Spasic-Jokic, V. [ESLA Accelerator Installation, Lab. of Physics, VINCA Institute of Nuclear Sciences, Belgrade, Serbia and Montenegro (Yugoslavia); Fortuna, D.; Milenkovic, M. [NBH Military Educational Center, Krusevac, Serbia and Montenegro (Yugoslavia)

    2006-07-01

    After the NATO actions against Serbia and Montenegro, 112 locations were highly contaminated with depleted uranium-112 locations in Kosovo, 7 in the south of Serbia and 1 in Montenegro. Contaminated regions were marked, isolated and some of them decontaminated. In this paper we present the health surveillance protocol created for personnel engaged in decontamination of contaminated regions of Pljackovica and Bratoselce. They were examined and selected before decontamination and only healthy professionals (36 and 28) were engaged. Examination included: general clinical assessment, complete blood count with differential white blood cells; biochemical analysis of blood and urine, specifically renal and liver functions tests, cytogenetic tests (chromosomal aberration and micronucleus test), and laser fluorometry of 24-h urine sample and gamma spectrometry of the same if the levels were elevated. After the decontamination in the first group no clinical or biochemical changes were found, but in 3 of 36 were found unstable chromosomal aberrations. In the second group, in 3 of 28 were found unstable chromosomal aberrations and in 3 of them laser fluorometry analysis showed elevated levels of uranium (>3 {mu}g/l in two, and >5 {mu}g/l in one of them). Gamma spectrometry showed that it was not depleted, but naturally occurring uranium. Additionally performed analysis showed they were from the same village which is in the zone of highly elevated uranium level in ground and water. Three months later no chromosomal changes were found. (authors)

  12. Mapping the Health Information Landscape in a Rural, Culturally Diverse Region: Implications for Interventions to Reduce Information Inequality.

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    Ramírez, A Susana; Estrada, Erendira; Ruiz, Ariana

    2017-08-01

    The media is an important source of health information, especially critical in rural communities with geographically-dispersed populations that are harder to reach through other channels. Yet health information is unequally distributed; these information disparities are compounded in rural areas, which may contribute to health disparities. We identify and describe health-related news in a culturally-diverse rural California county characterized by high levels of poverty, unemployment, low educational attainment, and over half of Mexican-origin. We conducted a census of all available print news sources and then used content analysis to identify and characterize all health information printed in a 6-month study period. A total of 570 health-related articles were published. Five newspapers accounted for more than 80% of published health-related articles (n = 466); only one targeted the majority Latino population. The most common topic was access to health care/insurance/policy (33%), followed by diet/nutrition (13%), infectious disease (10%), and general prevention (9%). Just over one-quarter of health-related articles included useful information. Differences across newspaper types existed: independent newspapers reported more on health-related events compared with chain newspapers, and both ethnic-targeted newspapers and independently-published papers were more likely to include useful information compared with chain newspapers. While this region suffers from high rates of obesity and diabetes, there were relatively few articles on obesity and diabetes themselves, or linking behavioral risk factors with these conditions. One area we found absent from coverage pertained to the numerous environmental health threats prevalent in this heavily polluted, agricultural area (just 40 articles discussed environmental health threats). We also discovered that coverage of social determinants of health was lacking (just 24 of the 570 health articles), which was notable in a

  13. Emerging and Reemerging Diseases in the World Health Organization (WHO) Eastern Mediterranean Region-Progress, Challenges, and WHO Initiatives.

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    Buliva, Evans; Elhakim, Mohamed; Tran Minh, Nhu Nguyen; Elkholy, Amgad; Mala, Peter; Abubakar, Abdinasir; Malik, Sk Md Mamunur Rahman

    2017-01-01

    The Eastern Mediterranean Region (EMR) of the World Health Organization (WHO) continues to be a hotspot for emerging and reemerging infectious diseases and the need to prevent, detect, and respond to any infectious diseases that pose a threat to global health security remains a priority. Many risk factors contribute in the emergence and rapid spread of epidemic diseases in the Region including acute and protracted humanitarian emergencies, resulting in fragile health systems, increased population mobility, rapid urbanization, climate change, weak surveillance and limited laboratory diagnostic capacity, and increased human-animal interaction. In EMR, several infectious disease outbreaks were detected, investigated, and rapidly contained over the past 5 years including: yellow fever in Sudan, Middle East respiratory syndrome in Bahrain, Oman, Qatar, Saudi Arabia, United Arab Emirates, and Yemen, cholera in Iraq, avian influenza A (H5N1) infection in Egypt, and dengue fever in Yemen, Sudan, and Pakistan. Dengue fever remains an important public health concern, with at least eight countries in the region being endemic for the disease. The emergence of MERS-CoV in the region in 2012 and its continued transmission currently poses one of the greatest threats. In response to the growing frequency, duration, and scale of disease outbreaks, WHO has worked closely with member states in the areas of improving public health preparedness, surveillance systems, outbreak response, and addressing critical knowledge gaps. A Regional network for experts and technical institutions has been established to facilitate support for international outbreak response. Major challenges are faced as a result of protracted humanitarian crises in the region. Funding gaps, lack of integrated approaches, weak surveillance systems, and absence of comprehensive response plans are other areas of concern. Accelerated efforts are needed by Regional countries, with the continuous support of WHO, to

  14. Changes in public health preparedness services provided to local health departments by regional offices in North Carolina: a comparison of two cross-sectional studies.

    Science.gov (United States)

    Donovan, Catherine V; Markiewicz, Milissa; Horney, Jennifer A

    2014-05-28

    In 2011, seven decentralized Public Health Regional Surveillance Teams (PHRSTs) were restructured into four centralized Public Health Preparedness and Response (PHP&R) regional offices to realign preparedness priorities and essential services with appropriate infrastructure; field-based staff was reduced, saving approximately $1 million. The objective of this study was to understand the impact that restructuring had on services provided to local health departments (LHDs) throughout North Carolina. A survey to document services that regional offices provide to LHDs in North Carolina was administered by the North Carolina Preparedness and Emergency Response Research Center in 2013. The results were compared to a similar survey from 2009, which identified services provided by regional teams prior to restructuring. Of 69 types of assistance, 14 (20%) were received by 50% or more LHDs in 2012. Compared to 2009, there was a significant decrease in the proportion of LHDs receiving 67% (n = 47) of services. The size of the region served by regional offices was shown to inversely impact the proportion of LHDs receiving services for 25% of services. There was a slight significant decline in perceived quality of the services provided by regional teams in 2012 as comparison to 2009. Following a system-wide review of preparedness in North Carolina, the state's regional teams were reorganized to refine their focus to planning, exercises, and training. Some services, most notably under the functions of epidemiology and surveillance and public health event response, are now provided by other state offices. However, the study results indicate that several services that are still under the domain of the regional offices were received by fewer LHDs in 2012 than 2009. This decrease may be due to the larger number of counties now served by the four regional offices.

  15. Prevalence of mental illness within families in a regional child-focussed mental health service.

    Science.gov (United States)

    Naughton, Michael F A; Maybery, Darryl J; Goodyear, Melinda

    2018-04-01

    Nearly 50% of all mental illnesses begin in childhood before the age of 14 years, and over 20% of parents have a mental illness. Few studies have examined the co-occurrence of mental illnesses in parents and children. In the present study, we examined the extent of mental illness within families of 152 clients attending an Australian regional child and adolescent mental health service (CAMHS). A cross-sectional study design was employed involving a case record review and clinician-completed questionnaire of the children and youth attending a CAMHS. It was found that 79% of these children were living with a parent with mental illness. The predominant diagnosis of both child and parent was an anxiety or mood disorder, and many families had co-occurring risk factors of domestic violence and limited social supports. The findings in this Australian cohort are similar to those of other international research. While novel in nature, the present study has highlighted the extent of both mental illness and scarce supports for both children and parents in the same family. The findings indicate the need for a coordinated multiservice delivery of appropriate and consistent family-focussed interventions, responding to both mental illness and social supports for children and parents. Further research should examine specific components of family need and support, as seen through the eyes of the child and their parent. © 2017 Australian College of Mental Health Nurses Inc.

  16. Adverse child health impacts resulting from food adulterations in the Greater China Region.

    Science.gov (United States)

    Li, Wai Chin; Chow, Chin Fung

    2017-09-01

    Food adulteration has a long history in human society, and it still occurs in modern times. Because children are relatively vulnerable to food adulterants, studying the health impacts of food adulteration on children is important. This article provides an overview of the child health impacts of food adulterants in two recent food adulteration incidents in the Greater China Region: (1) a plasticizer incident in Taiwan and (2) a 2,4,6-triamino-1,3,5-triazine (melamine)-tainted milk incident in China. The involved food adulterants, di-(2-ethylhexyl) phthalate (DEHP), diisononyl phthalate (DiNP) and melamine, are harmful to the hippocampus, kidneys, reproductive organs and immune system of children, and they also increase the risk of cancer. To detect food adulteration and to avoid further harm caused by food adulteration, simple screening methods have been developed, and they have recently emerged as a new focus area for research. This article also summarizes the simple screening methods used to analyse the aforementioned food adulterants and reports how governments reacted to the recent food incidents. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  17. Phytoestrogens dietary intake and health status of retiree from middle-notrh Slovakia region

    Directory of Open Access Journals (Sweden)

    Jozef Čurlej

    2015-12-01

    Full Text Available Phytoestrogens found in foods of plant origin presents chemical substances that possess a wide range of biochemical benefits. It has been found that they contribute in different health related problems. A wide range of commonly consumed foods contain appreciable amounts of phytoestrogens. Consumption of diet rich to phytoestrogen acts as a protective factor against many diseases such as cardiovascular diseases, post-menopausal symptoms in the context of osteoporosis, cancerous illnesses of colon, prostate and breast. Three main classes of phytoestrogens covers: isoflavones, lignans and coumestans. Selected nine major phytoestrogens had been analyzed simultaneously in the same foods. Questionnaire designed to determine intake frequency as well as amount of selected foods and the most common diseases presented in the population has been used to find relationships between dietary habits and health status. Evaluation of selected goals in the present study has been realized in cooperation with 140 respondents in retired age (divided into Males - covered by 34 individuals and Females - 106 individuals, comming from middle-north Slovakia region. On the base of collected data it can be concluded, that evaluated population is presented by high values of lignans intake and particularly secoisolariciresinol, mainly caused by relative high proportion of cereals and linseed in the diet. Furthermore, the relationship between phytoestrogens intake and eating habits as well as its contribution in protection against selected diseases was demonstrated. Normal 0 21 false false false CS JA X-NONE

  18. Regional characterization of freshwater Use in LCA: modeling direct impacts on human health.

    Science.gov (United States)

    Boulay, Anne-Marie; Bulle, Cécile; Bayart, Jean-Baptiste; Deschênes, Louise; Margni, Manuele

    2011-10-15

    Life cycle assessment (LCA) is a methodology that quantifies potential environmental impacts for comparative purposes in a decision-making context. While potential environmental impacts from pollutant emissions into water are characterized in LCA, impacts from water unavailability are not yet fully quantified. Water use can make the resource unavailable to other users by displacement or quality degradation. A reduction in water availability to human users can potentially affect human health. If financial resources are available, there can be adaptations that may, in turn, shift the environmental burdens to other life cycle stages and impact categories. This paper proposes a model to evaluate these potential impacts in an LCA context. It considers the water that is withdrawn and released, its quality and scarcity in order to evaluate the loss of functionality associated with water uses. Regionalized results are presented for impacts on human health for two modeling approaches regarding affected users, including or not domestic uses, and expressed in disability-adjusted life years (DALY). A consumption and quality based scarcity indicator is also proposed as a midpoint. An illustrative example is presented for the production of corrugated board with different effluents, demonstrating the importance of considering quality, process effluents and the difference between the modeling approaches.

  19. British Columbia capital regional district 100% smokefree bylaw: a successful public health campaign despite industry opposition.

    Science.gov (United States)

    Drope, J; Glantz, S

    2003-09-01

    To describe how the British Columbia Capital Regional District successfully passed, implemented, and enforced a 100% smokefree bylaw in all public places, including restaurants and bars, despite an aggressive campaign by the tobacco industry (acting through the hospitality industry) to stop it. Information was obtained from news reports, internal tobacco industry documents, reports, public documents, and interviews with key players. Tobacco industry documents were accessed between February and April 2002. This project was approved by the University of California San Francisco committee on human research. As in the USA and elsewhere in the world, the tobacco industry in British Columbia, Canada, recruited and created hospitality associations to fight against the district smokefree bylaw. They used the classic industry rhetoric of individual rights and freedoms, economic devastation, and ventilation as a solution. Public health authorities were able to counter industry strategies with a strong education campaign, well written bylaws, and persistent enforcement. It is possible to overcome serious opposition orchestrated by the tobacco industry and develop and implement a 100% smokefree bylaw in Canada. Doing so requires attention to detail in drafting the bylaw, as well as a public education campaign on the health dangers of secondhand smoke and active enforcement to overcome organised resistance to the bylaw. Jurisdictions considering smokefree bylaws should anticipate this opposition when developing and implementing their bylaws.

  20. Modeling best practices in chronic disease management: the Arthritis Program at Southlake Regional Health Centre.

    Science.gov (United States)

    Bain, Lorna; Mierdel, Sandra; Thorne, Carter

    2012-01-01

    Researchers, hospital administrators and governments are striving to define competencies in interprofessional care and education, as well as to identify effective models in chronic disease management. For more than 25 years The Arthritis Program (TAP) at Southlake Regional Health Centre in Newmarket, Ontario, has actively practiced within these two interrelated priorities, which are now at the top of the healthcare agenda in Ontario and Canada. The approximately 135 different rheumatic conditions are the primary cause of long-term disability in Canada, affecting those from youth to the senior years, with an economic burden estimated at $4.4 billion (CAD$) annually, and growing. For the benefit of healthcare managers and their clients with chronic conditions, this article discusses TAP's history and demonstrable success, predicated on an educational model of patient self-management and self-efficacy. Also outlined are TAP's contributions in supporting evidence-based best practices in interprofessional collaboration and chronic disease management; approaches that are arguably understudied and under-practiced. Next steps for TAP include a larger role in empirical research in chronic-disease management and integration of a formal training program to benefit health professionals launching or expanding their interprofessional programs using TAP as the dynamic clinical example.

  1. Visualization maps for the evolution of research hotspots in the field of regional health information networks.

    Science.gov (United States)

    Wang, Yanjun; Zheng, Jianzhong; Zhang, Ailian; Zhou, Wei; Dong, Haiyuan

    2018-03-01

    The aim of this study was to reveal research hotspots in the field of regional health information networks (RHINs) and use visualization techniques to explore their evolution over time and differences between countries. We conducted a literature review for a 50-year period and compared the prevalence of certain index terms during the periods 1963-1993 and 1994-2014 and in six countries. We applied keyword frequency analysis, keyword co-occurrence analysis, multidimensional scaling analysis, and network visualization technology. The total number of keywords was found to increase with time. From 1994 to 2014, the research priorities shifted from hospital planning to community health planning. The number of keywords reflecting information-based research increased. The density of the knowledge network increased significantly, and partial keywords condensed into knowledge groups. All six countries focus on keywords including Information Systems; Telemedicine; Information Service; Medical Records Systems, Computerized; Internet; etc.; however, the level of development and some research priorities are different. RHIN research has generally increased in popularity over the past 50 years. The research hotspots are evolving and are at different levels of development in different countries. Knowledge network mapping and perceptual maps provide useful information for scholars, managers, and policy-makers.

  2. Health work: portrait of community workers in the Northeast region of Brazil.

    Science.gov (United States)

    Simas, Paloma Ribeiro Pires; Pinto, Isabela Cardoso de Matos

    2017-06-01

    The aim of this study was to characterize the profile of community health workers in northeastern Brazil and aspects related to the management of their work. This is a cross-sectional study, which included 535 community agents who were distributed in 107 primary health units in northeastern Brazil. The data were extracted from eight blocks of questions related to the community agents' perceptions about social-demographic, economic and political factors; their contracts and remuneration; their evaluation as workers; their working conditions and their training. The results indicate that the majority of community agents in the northeast region were hired by direct administration. The main form of hiring community agents was by public exam, followed by public selection. Direct administration is the main form of hiring; however, new modalities, such as the public and private law foundations, social organizations, and inter-municipal consortiums are alternatives that have been adopted by managers which can produce a number of weaknesses due to flexible labor relations.

  3. Newborn care practices at home and in health facilities in 4 regions of Ethiopia.

    Science.gov (United States)

    Callaghan-Koru, Jennifer A; Seifu, Abiy; Tholandi, Maya; de Graft-Johnson, Joseph; Daniel, Ephrem; Rawlins, Barbara; Worku, Bogale; Baqui, Abdullah H

    2013-12-01

    Ethiopia is one of the ten countries with the highest number of neonatal deaths globally, and only 1 in 10 women deliver with a skilled attendant. Promotion of essential newborn care practices is one strategy for improving newborn health outcomes that can be delivered in communities as well as facilities. This article describes newborn care practices reported by recently-delivered women (RDWs) in four regions of Ethiopia. We conducted a household survey with two-stage cluster sampling to assess newborn care practices among women who delivered a live baby in the period 1 to 7 months prior to data collection. The majority of women made one antenatal care (ANC) visit to a health facility, although less than half made four or more visits and women were most likely to deliver their babies at home. About one-fifth of RDWs in this survey had contact with Health Extension Workers (HEWS) during ANC, but nurse/midwives were the most common providers, and few women had postnatal contact with any health provider. Common beneficial newborn care practices included exclusive breastfeeding (87.6%), wrapping the baby before delivery of the placenta (82.3%), and dry cord care (65.2%). Practices contrary to WHO recommendations that were reported in this population of recent mothers include bathing during the first 24 hours of life (74.7%), application of butter and other substances to the cord (19.9%), and discarding of colostrum milk (44.5%). The results suggest that there are not large differences for most essential newborn care indicators between facility and home deliveries, with the exception of delayed bathing and skin-to-skin care. Improving newborn care and newborn health outcomes in Ethiopia will likely require a multifaceted approach. Given low facility delivery rates, community-based promotion of preventive newborn care practices, which has been effective in other settings, is an important strategy. For this strategy to be successful, the coverage of counseling delivered

  4. Motivation and satisfaction among community health workers in Morogoro Region, Tanzania: nuanced needs and varied ambitions.

    Science.gov (United States)

    Mpembeni, Rose N M; Bhatnagar, Aarushi; LeFevre, Amnesty; Chitama, Dereck; Urassa, David P; Kilewo, Charles; Mdee, Rebecca M; Semu, Helen; Winch, Peter J; Killewo, Japhet; Baqui, Abdullah H; George, Asha

    2015-06-05

    In 2012, the Ministry of Health and Social Welfare (MOHSW), Tanzania, approved national guidelines and training materials for community health workers (CHWs) in integrated maternal, newborn and child health (Integrated MNCH), with CHWs trained and deployed across five districts of Morogoro Region soon after. To inform future scale up, this study assessed motivation and satisfaction among these CHWs. A survey of all CHWs trained by the Integrated MNCH Programme was conducted in the last quarter of 2013. Motivation and satisfaction were assessed using a five-point Likert scale with 29 and 27 items based on a literature review and discussions with CHW programme stakeholders. Exploratory factor analysis was conducted to identify motivation and satisfaction determinants. Out of 238 eligible CHWs, 96 % were included in the study. Findings showed that respondents were motivated to become CHWs due to altruism (work on MNCH, desire to serve God, work hard) and intrinsic needs (help community, improve health, pride) than due to external stimuli (monetary incentives, skill utilization, community respect or hope for employment). CHWs were satisfied by relationships with health workers and communities, job aids and the capacity to provide services. CHWs were dissatisfied with the lack of transportation, communication devices and financial incentives for carrying out their tasks. Factors influencing motivation and satisfaction did not differ across CHW socio-demographic characteristics. Nonetheless, older and less educated CHWs were more likely to be motivated by altruism, intrinsic needs and skill utilization, community respect and hope for employment. Less educated CHWs were more satisfied with service and quality factors and more wealthy CHWs satisfied with job aids. A combination of financial and non-financial incentives is required to support motivation and satisfaction among CHWs. Although CHWs joined mainly due to their altruistic nature, they became discontented with

  5. Health care workers indicate ill preparedness for Ebola Virus Disease outbreak in Ashanti Region of Ghana

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    Augustina Angelina Annan

    2017-06-01

    Full Text Available Abstract Background The recent Ebola Virus Disease (EVD epidemic that hit some countries in West Africa underscores the need to train front line high-risk health workers on disease prevention skills. Although Ghana did not record (and is yet to any case, and several health workers have received numerous training schemes, there is no record of any study that assessed preparedness of healthcare workers (HCWS regarding EVD and any emergency prone disease in Ghana. We therefore conducted a hospital based cross sectional study involving 101 HCWs from two facilities in Kumasi, Ghana to assess the level of preparedness of HCWs to respond to any possible EVD. Methods We administered a face-to-face questionnaire using an adapted WHO (2015 and CDC (2014 Checklist for Ebola Preparedness and assessed overall knowledge gaps, and preparedness of the Ghanaian HCWs in selected health facilities of the Ashanti Region of Ghana from October to December 2015. Results A total 92 (91.09% HCWs indicated they were not adequately trained to handle an EVD suspected case. Only 25.74% (n = 26 considered their facilities sufficiently equipped to handle and manage EVD patients. When asked which disinfectant to use after attending to and caring for a suspected patient with EVD, only 8.91% (n = 9 could correctly identify the right disinfectant (χ2 = 28.52, p = 0.001. Conclusion Our study demonstrates poor knowledge and ill preparedness and unwillingness of many HCWs to attend to EVD. Beyond knowledge acquisition, there is the need for more training from time to time to fully prepare HCWs to handle any possible EVD case.

  6. Integrated Health Care Systems and Indigenous Medicine: Reflections from the Sub-Sahara African Region

    Directory of Open Access Journals (Sweden)

    Beth Maina Ahlberg

    2017-09-01

    Full Text Available Indigenous or traditional medicine has, since the 1970s, been widely regarded as a resource likely to contribute to strengthening the health care systems in low income countries. This paper examines the state of traditional medicine using evidence from three case studies in Central Kenya. While the cases are too few to represent the broad diversity of cultures and related healing systems in the Sub-Sahara African Region, the way they seem to refute the main assumptions in the integration discourse is important, also because studies from other countries in the region report perspectives, similar to the case studies in Kenya. It is often argued that people continue to use traditional medicine because it is affordable, available, and culturally familiar. Its integration into the health care system would therefore promote cultural familiarity. The case studies however point to the loss of essential cultural elements central to traditional medicine in this particular area while users travel long distances to reach the healers. In addition, there are significant paradigm differences that may present obstacles to integration of the two systems. More problematic however is that integration is, as in many development interventions, a top-down policy that is rarely based on contextual realities and conditions. Instead, integration is often defined and dominated by biomedical professionals and health planners who may be unfamiliar or even hostile to some aspects of traditional medicine. Furthermore, integration efforts have tended to embrace selected components mostly herbal medicine. This has led to isolating herbal medicine from spiritualism, which may in turn affect the holistic perspective of traditional medicine. While familiarity and relevance may explain the continued use of traditional medicine, its services may not be as readily available, accessible, or even affordable as is often asserted. Globalization set in motion through colonization and

  7. How institutional forces, ideas and actors shaped population health planning in Australian regional primary health care organisations.

    Science.gov (United States)

    Javanparast, Sara; Freeman, Toby; Baum, Fran; Labonté, Ronald; Ziersch, Anna; Mackean, Tamara; Reed, Richard; Sanders, David

    2018-03-20

    Worldwide, there are competing norms driving health system changes and reorganisation. One such norm is that of health systems' responsibilities for population health as distinct from a focus on clinical services. In this paper we report on a case study of population health planning in Australian primary health care (PHC) organisations (Medicare Locals, 2011-2015). Drawing on institutional theory, we describe how institutional forces, ideas and actors shaped such planning. We reviewed the planning documents of the 61 Medicare Locals and rated population health activities in each Medicare Local. We also conducted an online survey and 50 interviews with Medicare Local senior staff, and an interview and focus group with Federal Department of Health staff. Despite policy emphasis on population health, Medicare Locals reported higher levels of effort and capacity in providing clinical services. Health promotion and social determinants of health activities were undertaken on an ad hoc basis. Regulatory conditions imposed by the federal government including funding priorities and time schedules, were the predominant forces constraining population health planning. In some Medicare Locals, this was in conflict with the normative values and what Medicare Locals felt ought to be done. The alignment between the governmental and the cultural-cognitive forces of a narrow biomedical approach privileged clinical practice and ascribed less legitimacy to action on social determinants of health. Our study also shed light on the range of PHC actors and how their agency influenced Medicare Locals' performance in population health. The presence of senior staff or community boards with a strong commitment to population health were important in directing action towards population health and equity. There are numerous institutional, normative and cultural factors influencing population health planning. The experience of Australian Medicare Locals highlights the difficulties of planning in

  8. Analysis of the Unified Health System funding and expenditure in the municipalities of the "Rota dos Bandeirantes" health region, State of São Paulo, Brazil.

    Science.gov (United States)

    Santos, João Alves Dos; Mendes, Áquilas Nogueira; Pereira, Antônio Carlos; Paranhos, Luiz Renato

    2017-04-01

    The national scenario of lack of resources in the Brazilian Unified Health System (SUS) has led to major differences in the municipalities funding models. Thus, this study aims to analyze SUS funding and expenditure in seven cities of the Rota dos Bandeirantes health region, State of São Paulo, SP, Brazil, from 2009 to 2012. Settled expenditure indicators were collected from the Public Health Budgets Information System (SIOPS) for analysis, showing descriptive data with absolute and relative frequency calculations. We identified that the per capita income available for the city of Barueri is almost tenfold that of the city of Carapicuíba, and that Barueri's health expenditure per capita is more than double that of the regional average and almost fivefold that of Carapicuíba. The Federal Government is responsible for 95.4% of all funding to municipalities. Most of the available income of the municipalities in the region include their own taxes and state transfers. All the municipalities showed a significant positive trend, both for available income and health expenditure. The regional average of own revenue spent on health is 27.3%. Carapicuíba achieved a level of 37.5%, which is much higher than the minimum of 15% required by the Federal Constitution.

  9. Tackling regional health inequalities in france by resource allocation : a case for complementary instrumental and process-based approaches?

    Science.gov (United States)

    Bellanger, Martine M; Jourdain, Alain

    2004-01-01

    This article aims to evaluate the results of two different approaches underlying the attempts to reduce health inequalities in France. In the 'instrumental' approach, resource allocation is based on an indicator to assess the well-being or the quality of life associated with healthcare provision, the argument being that additional resources would respond to needs that could then be treated quickly and efficiently. This governs the distribution of regional hospital budgets. In the second approach, health professionals and users in a given region are involved in a consensus process to define those priorities to be included in programme formulation. This 'procedural' approach is employed in the case of the regional health programmes. In this second approach, the evaluation of the results runs parallel with an analysis of the process using Rawlsian principles, whereas the first approach is based on the classical economic model.At this stage, a pragmatic analysis based on both the comparison of regional hospital budgets during the period 1992-2003 (calculated using a 'RAWP [resource allocation working party]-like' formula) and the evolution of regional health policies through the evaluation of programmes for the prevention of suicide, alcohol-related diseases and cancers provides a partial assessment of the impact of the two types of approaches, the second having a greater effect on the reduction of regional inequalities.

  10. Global and regional health effects of future food production under climate change: a modelling study.

    Science.gov (United States)

    Springmann, Marco; Mason-D'Croz, Daniel; Robinson, Sherman; Garnett, Tara; Godfray, H Charles J; Gollin, Douglas; Rayner, Mike; Ballon, Paola; Scarborough, Peter

    2016-05-07

    One of the most important consequences of climate change could be its effects on agriculture. Although much research has focused on questions of food security, less has been devoted to assessing the wider health impacts of future changes in agricultural production. In this modelling study, we estimate excess mortality attributable to agriculturally mediated changes in dietary and weight-related risk factors by cause of death for 155 world regions in the year 2050. For this modelling study, we linked a detailed agricultural modelling framework, the International Model for Policy Analysis of Agricultural Commodities and Trade (IMPACT), to a comparative risk assessment of changes in fruit and vegetable consumption, red meat consumption, and bodyweight for deaths from coronary heart disease, stroke, cancer, and an aggregate of other causes. We calculated the change in the number of deaths attributable to climate-related changes in weight and diets for the combination of four emissions pathways (a high emissions pathway, two medium emissions pathways, and a low emissions pathway) and three socioeconomic pathways (sustainable development, middle of the road, and more fragmented development), which each included six scenarios with variable climatic inputs. The model projects that by 2050, climate change will lead to per-person reductions of 3·2% (SD 0·4%) in global food availability, 4·0% (0·7%) in fruit and vegetable consumption, and 0·7% (0·1%) in red meat consumption. These changes will be associated with 529,000 climate-related deaths worldwide (95% CI 314,000-736,000), representing a 28% (95% CI 26-33) reduction in the number of deaths that would be avoided because of changes in dietary and weight-related risk factors between 2010 and 2050. Twice as many climate-related deaths were associated with reductions in fruit and vegetable consumption than with climate-related increases in the prevalence of underweight, and most climate-related deaths were projected to

  11. Promoting survival: A grounded theory study of consequences of modern health practices in Ouramanat region of Iranian Kurdistan.

    Science.gov (United States)

    Mohammadpur, Ahmad; Rezaei, Mehdi; Sadeghi, Rasoul

    2010-05-14

    The aim of this qualitative study is to explore the way people using modern health care perceive its consequences in Ouraman-e-Takht region of Iranian Kurdistan. Ouraman-e-Takht is a rural, highly mountainous and dry region located in the southwest Kurdistan province of Iran. Recently, modern health practices have been introduced to the region. The purpose of this study was to investigate, from the Ouramains' point of view, the impact that modern health services and practices have had on the Ouraman traditional way of life. Interview data from respondents were analyzed by using grounded theory. Promoting survival was the core category that explained the impact that modern health practices have had on the Ouraman region. The people of Ouraman interpreted modern health practices as increasing their quality of life and promoting their survival. Results are organized around this core category in a paradigm model consisting of conditions, interactions, and consequences. This model can be used to understand the impact of change from the introduction of modern health on a traditional society.

  12. Regional health workforce monitoring as governance innovation: a German model to coordinate sectoral demand, skill mix and mobility.

    Science.gov (United States)

    Kuhlmann, E; Lauxen, O; Larsen, C

    2016-11-28

    As health workforce policy is gaining momentum, data sources and monitoring systems have significantly improved in the European Union and internationally. Yet data remain poorly connected to policy-making and implementation and often do not adequately support integrated approaches. This brings the importance of governance and the need for innovation into play. The present case study introduces a regional health workforce monitor in the German Federal State of Rhineland-Palatinate and seeks to explore the capacity of monitoring to innovate health workforce governance. The monitor applies an approach from the European Network on Regional Labour Market Monitoring to the health workforce. The novel aspect of this model is an integrated, procedural approach that promotes a 'learning system' of governance based on three interconnected pillars: mixed methods and bottom-up data collection, strong stakeholder involvement with complex communication tools and shared decision- and policy-making. Selected empirical examples illustrate the approach and the tools focusing on two aspects: the connection between sectoral, occupational and mobility data to analyse skill/qualification mixes and the supply-demand matches and the connection between monitoring and stakeholder-driven policy. Regional health workforce monitoring can promote effective governance in high-income countries like Germany with overall high density of health workers but maldistribution of staff and skills. The regional stakeholder networks are cost-effective and easily accessible and might therefore be appealing also to low- and middle-income countries.

  13. Promoting survival: A grounded theory study of consequences of modern health practices in Ouramanat region of Iranian Kurdistan

    Science.gov (United States)

    Mohammadpur, Ahmad; Rezaei, Mehdi; Sadeghi, Rasoul

    2010-01-01

    The aim of this qualitative study is to explore the way people using modern health care perceive its consequences in Ouraman-e-Takht region of Iranian Kurdistan. Ouraman-e-Takht is a rural, highly mountainous and dry region located in the southwest Kurdistan province of Iran. Recently, modern health practices have been introduced to the region. The purpose of this study was to investigate, from the Ouramains' point of view, the impact that modern health services and practices have had on the Ouraman traditional way of life. Interview data from respondents were analyzed by using grounded theory. Promoting survival was the core category that explained the impact that modern health practices have had on the Ouraman region. The people of Ouraman interpreted modern health practices as increasing their quality of life and promoting their survival. Results are organized around this core category in a paradigm model consisting of conditions, interactions, and consequences. This model can be used to understand the impact of change from the introduction of modern health on a traditional society. PMID:20640020

  14. Hospitalizations for ambulatory care sensitive conditions and quality of primary care: their relation with socioeconomic and health care variables in the Madrid regional health service (Spain).

    Science.gov (United States)

    Magán, Purificación; Alberquilla, Angel; Otero, Angel; Ribera, José Manuel

    2011-01-01

    Hospitalizations for ambulatory care sensitive conditions (ACSH) have been proposed as an indirect indicator of the effectiveness and quality of care provided by primary health care. To investigate the association of ACSH rates with population socioeconomic factors and with characteristics of primary health care. Cross-sectional, ecologic study. Using hospital discharge data, ACSH were selected from the list of conditions validated for Spain. All 34 health districts in the Region of Madrid, Spain. Individuals aged 65 years or older residing in the region of Madrid between 2001 and 2003, inclusive. Age- and gender-adjusted ACSH rates in each health district. The adjusted ACSH rate per 1000 population was 35.37 in men and 20.45 in women. In the Poisson regression analysis, an inverse relation was seen between ACSH rates and the socioeconomic variables. Physician workload was the only health care variable with a statistically significant relation (rate ratio of 1.066 [95% CI; 1.041-1.091]). These results were similar in the analyses disaggregated by gender. In the multivariate analyses that included health care variables, none of the health care variables were statistically significant. ACSH may be more closely related with socioeconomic variables than with characteristics of primary care activity. Therefore, other factors outside the health system must be considered to improve health outcomes in the population.

  15. Towards an adaptation action plan : climate change and health in the Toronto-Niagara region : summary for policy makers

    International Nuclear Information System (INIS)

    Chiotti, Q.; Morton, I.; Maarouf, A.

    2002-10-01

    The current science regarding climate change and its potential health effects was assessed in an effort to provide information to decision-makers dealing with health infrastructure in the Toronto-Niagara region. This report also presents an assessment of how the health care system can adapt to handle the increased demand for services resulting from the projected negative human health effects of climate change. The first part of the report presents some background information on climate change and health issues and demonstrates how the current health care infrastructure cannot deal effectively with the full range of health effects that may occur in heavily populated areas such as the Toronto-Niagara region. The second part of the report summarizes the scientific knowledge about the expected impacts of climate change and associated health effects, such as heat stress, extreme weather events, poor air quality, vector-borne diseases, food and water-borne diseases, and increased exposure to ultra-violet radiation. It was noted that children and the elderly are most vulnerable. The final part of the report outlines an adaptation action plan to improve the health care infrastructure through public education and communication, surveillance and monitoring, ecosystem intervention, infrastructure development, technical engineering, and medical intervention. 100 refs., 1 fig

  16. Civil war and child health: regional and ethnic dimensions of child immunization and malnutrition in Angola.

    Science.gov (United States)

    Agadjanian, Victor; Prata, Ndola

    2003-06-01

    This study arises from a general proposition that different levels and types of exposure to war are crucial in shaping health outcomes in a population under war-induced duress. We analyze civil war-related regional and ethnolinguistic differentials in age-adequate immunization (complete vaccination for age) and levels of malnutrition in Angola. Our analysis is based on data from a nationally representative survey conducted in 1996, some 2 years after the end of one of the most destructive periods of hostilities in the history of Angolan civil war. The data show that despite Angola's unique mineral wealth, the nation's levels of child age-adequate immunization is lower and malnutrition rates are higher than in most of sub-Saharan Africa. To examine age-adequate immunization and chronic malnutrition we fit logistic regression models that include the regional degree of war impact and ethnolinguistic group, in addition to rural-urban differences and other conventional sociodemographic characteristics. The tests reveal a significant disadvantage of rural children relative to urban children in both immunization and chronic malnutrition. Net of the rural-urban differences, we also detect a significant disadvantage of children residing in parts of the country that had been most affected by the fighting. The tests also point to a lower level of immunization and higher level of chronic malnutrition among children from the ethnolinguistic group commonly identified with the opposition. These associations tend to be stronger among children who were born and/or grew up during war than among children who were born after peace was re-established.

  17. Water quality and amphibian health in the Big Bend region of the Rio Grande Basin

    Science.gov (United States)

    Sharma, Bibek; Hu, F.; Carr, J.A.; Patino, Reynaldo

    2011-01-01

    Male and female Rio Grande leopard frogs (Rana berlandieri) were collected in May 2005 from the main stem and tributaries of the Rio Grande in the Big Bend region of Texas. Frogs were examined for (1) incidence of testicular ovarian follicles in males; (2) thyroid epithelial cell height, a potential index of exposure to thyroid-disrupting contaminants; and (3) incidence of liver melanomacrophage aggregates, a general index of exposure to contaminants. Standard parameters of surface water quality and concentrations of selected elements, including heavy metals, were determined at each frog collection site. Heavy metals also were measured in whole-frog composite extracts. Water cadmium concentrations in most sites and chloride concentrations in the main stem exceeded federal criteria for freshwater aquatic life. Mercury was detected in frogs from the two collection sites in Terlingua Creek. There was a seventeen percent incidence of testicular ovarian follicles in male frogs. Mean thyroid epithelial cell height was greater in frogs from one of the Terlingua Creek sites (Terlingua Abajo). No differences were observed in the incidence of hepatic macrophage aggregates among sites. In conclusion, although potential cause-effect relationships between indices of habitat quality and amphibian health could not be established, the results of this study raise concerns about the general quality of the aquatic habitat and the potential long-term consequences to the aquatic biota of the Big Bend region. The presence of ovarian follicles in male frogs is noteworthy but further study is necessary to determine whether this phenomenon is natural or anthropogenically induced.

  18. Regional and urban downscaling of global climate scenarios for health impact assessments

    Energy Technology Data Exchange (ETDEWEB)

    San Jose, R.; Perez, J.L.; Perez, L.; Gonzalez, R.M.; Pecci, J.; Garzon, A.; Palacios, M.

    2015-07-01

    In this contribution we have used global climate RCP IPCC scenarios to produce climate and air pollution maps at regional (25 km resolution) and urban scale with 200 m spatial resolution over Europe and five European cities in order to investigate the impact on meteorological variables and pollutant concentrations . We have used the very well known mesoscale meeorological model WRF-Chem (NOAA, US). We have used 2011 as control past year and two RCP scenarios from CCSM global climate model with 4.5 W/m2 and 8.5 W/m2 for 2030, 2050 and 2100 years. After running WRF-Chem model, using the boundary conditions provided by RCP scenarios with the emissions of 2011, we have performed a detailed downscaling process using CALMET diagnostic model to obtain a full 200 m spatial resolution map of five European cities (London, Antwerp, Madrid, Milan, and Helsinki). We will show the results and the health impacts for future RCP IPCC climate scenarios in comparison with the 2011 control year information for climate and health indicators. Finnally, we have also investigated the impact of the aerosol effects in the short wave radiation mean value. Two simulations with the WRF-Chem model have been performed over Europe in 2010. A baseline simulation without any feedback effects and a second simulation including the direct effects affecting the solar radiation reaching the surface as well as the indirect aerosol effect with potential impacts on increasing or decreasing the precipitation rates. Aerosol effects produce an increase of incoming radiation over Atlantic Ocean (up to 70%) because the prescribed aerosol concentrations in the WRF-Chem without feedbacks is substantially higher than the aerosol concentrations produced when we activate the feedback effects. The decrease in solar radiation in the Sahara area (10%) is found to be produced because the prescribed aerosol concentration in the {sup n}o feedback{sup s}imulation is lower than when we activate the feedback effects. (Author)

  19. Occupational safety and health practices among flower greenhouses workers from Alto Tietê region (Brazil)

    International Nuclear Information System (INIS)

    Ribeiro, Marcela G.; Colasso, Camilla G.; Monteiro, Paula P.; Filho, Walter R. Pedreira; Yonamine, Maurício

    2012-01-01

    In this preliminary study the occupational safety and health practices among flower greenhouses workers were evaluated. The study was carried out in the alto Tietê region, located at the Sao Paulo State, Brazil. Inadequate welfare facilities; poor pesticide storage, use and disposal conditions; use of highly toxic pesticides; lack of adequate data regarding pesticide use; and incorrect use and maintenance of PPE were observed in most of the visited greenhouses. These results suggest that, in greenhouses, workers may be at higher risk of pesticide exposure, due to many factors that can intensify the exposure such as the lack of control on reentry intervals after pesticide application. Specific regulations are needed to ensure better OSH practices on pesticide use and to improve working conditions in greenhouses, in order to deal with the peculiarities of greenhouse working environment. Some of the special requirements for greenhouses workers' protection are the establishment of ventilation criteria for restricted entry interval; clear reentry restrictions; and EPI for workers other than applicators that need to enter the greenhouse before expiring REI interval. Another important way to improve OSH practices among workers includes the distribution of simple guidelines on the dos and don'ts regarding OSH practices in greenhouses and extensively training interventions to change the perception of hazards and the behavior towards risk. - Highlights: ► Occupational safety and health practices among flower greenhouses workers were evaluated. ► Lack of clear reentry restrictions can intensify the exposure in greenhouses. ► Specific regulations dealing with the peculiarities of greenhouse working environment are needed. ► Distribution of simple guidelines relying on greenhouse working can improve OSH practices. ► Training interventions are important to change the workers' perception of hazards and behavior towards risk.

  20. Can administrative health utilisation data provide an accurate diabetes prevalence estimate for a geographical region?

    Science.gov (United States)

    Chan, Wing Cheuk; Papaconstantinou, Dean; Lee, Mildred; Telfer, Kendra; Jo, Emmanuel; Drury, Paul L; Tobias, Martin

    2018-05-01

    To validate the New Zealand Ministry of Health (MoH) Virtual Diabetes Register (VDR) using longitudinal laboratory results and to develop an improved algorithm for estimating diabetes prevalence at a population level. The assigned diabetes status of individuals based on the 2014 version of the MoH VDR is compared to the diabetes status based on the laboratory results stored in the Auckland regional laboratory result repository (TestSafe) using the New Zealand diabetes diagnostic criteria. The existing VDR algorithm is refined by reviewing the sensitivity and positive predictive value of the each of the VDR algorithm rules individually and as a combination. The diabetes prevalence estimate based on the original 2014 MoH VDR was 17% higher (n = 108,505) than the corresponding TestSafe prevalence estimate (n = 92,707). Compared to the diabetes prevalence based on TestSafe, the original VDR has a sensitivity of 89%, specificity of 96%, positive predictive value of 76% and negative predictive value of 98%. The modified VDR algorithm has improved the positive predictive value by 6.1% and the specificity by 1.4% with modest reductions in sensitivity of 2.2% and negative predictive value of 0.3%. At an aggregated level the overall diabetes prevalence estimated by the modified VDR is 5.7% higher than the corresponding estimate based on TestSafe. The Ministry of Health Virtual Diabetes Register algorithm has been refined to provide a more accurate diabetes prevalence estimate at a population level. The comparison highlights the potential value of a national population long term condition register constructed from both laboratory results and administrative data. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Regional and urban down scaling of global climate scenarios for health impact assessments

    Energy Technology Data Exchange (ETDEWEB)

    San Jose, R.; Perez, J. L.; Perez, L.; Gonzalez, R. M.; Pecci, J.; Garzon, A.; Palacios, M.

    2015-07-01

    In this contribution we have used global climate RCP IPCC scenarios to produce climate and air pollution maps at regional (25 km resolution) and urban scale with 200 m spatial resolution over Europe and five European cities in order to investigate the impact on meteorological variables and pollutant concentrations . We have used the very well known mesoscale meteorological model WRF-Chem (NOAA, US). We have used 2011 as control past year and two RCP scenarios from CCSM global climate model with 4.5 W/m2 and 8.5 W/m2 for 2030, 2050 and 2100 years. After running WRF-Chem model, using the boundary conditions provided by RCP scenarios with the emissions of 2011, we have performed a detailed down scaling process using CALMET diagnostic model to obtain a full 200 m spatial resolution map of five European cities (London, Antwerp, Madrid, Milan, and Helsinki). We will show the results and the health impacts for future RCP IPCC climate scenarios in comparison with the 2011 control year information for climate and health indicators. Finally, we have also investigated the impact of the aerosol effects in the short wave radiation mean value. Two simulations with the WRF-Chem model have been performed over Europe in 2010. A baseline simulation without any feedback effects and a second simulation including the direct effects affecting the solar radiation reaching the surface as well as the indirect aerosol effect with potential impacts on increasing or decreasing the precipitation rates. Aerosol effects produce an increase of incoming radiation over Atlantic Ocean (up to 70%) because the prescribed aerosol concentrations in the WRF-Chem without feedbacks is substantially higher than the aerosol concentrations produced when we activate the feedback effects. The decrease in solar radiation in the Sahara area (10%) is found to be produced because the prescribed aerosol concentration in the no feedback simulation is lower than when we activate the feedback effects. (Author)

  2. Does regional disadvantage affect health-related sport and physical activity level? A multi-level analysis of individual behaviour.

    Science.gov (United States)

    Wicker, Pamela; Downward, Paul; Lera-López, Fernando

    2017-11-01

    This study examines the role of regional government quality in health-related participation in sport and physical activity among adults (18-64 years) in 28 European countries. The importance of the analysis rests in the relative autonomy that regional and local governments have over policy decisions connected with sport and physical activity. While existing studies have focussed on economic and infrastructural investment and expenditure, this research investigates the quality of regional governments across 208 regions within 28 European countries. The individual-level data stem from the 2013 Eurobarometer 80.2 (n = 18,675) and were combined with regional-level data from Eurostat. An individual's level of participation in sport and physical activity was measured by three variables reflecting whether an individual's activity level is below, meets, or exceeds the recommendations of the World Health Organization. The results of multi-level analyses reveal that regional government quality has a significant and positive association with individual participation in sport and physical activity at a level meeting or exceeding the guidelines. The impact is much larger than that of regional gross domestic product per capita, indicating that regional disadvantage in terms of political quality is more relevant than being disadvantaged in terms of economic wealth.

  3. Exploring the determinants of health and wellbeing in communities living in proximity to coal seam gas developments in regional Queensland.

    Science.gov (United States)

    Mactaggart, Fiona; McDermott, Liane; Tynan, Anna; Gericke, Christian A

    2017-08-03

    There is some concern that coal seam gas mining may affect health and wellbeing through changes in social determinants such as living and working conditions, local economy and the environment. The onward impact of these conditions on health and wellbeing is often not monitored to the same degree as direct environmental health impacts in the mining context, but merits attention. This study reports on the findings from a recurrent theme that emerged from analysis of the qualitative component of a comprehensive Health Needs Assessment (HNA) conducted in regional Queensland: that health and wellbeing of communities was reportedly affected by nearby coal seam gas (CSG) development beyond direct environmental impacts. Qualitative analysis was initially completed using the Framework Method to explore key themes from 11 focus group discussions, 19 in-depth interviews, and 45 key informant interviews with health and wellbeing service providers and community members. A key theme emerged from the analysis that forms the basis of this paper. This study is part of a larger comprehensive HNA involving qualitative and quantitative data collection to explore the health and wellbeing needs of three communities living in proximity to CSG development in regional Queensland, Australia. Communities faced social, economic and environmental impacts from the rapid growth of CSG development, which were perceived to have direct and indirect effects on individual lifestyle factors such as alcohol and drug abuse, family relationships, social capital and mental health; and community-level factors including social connectedness, civic engagement and trust. Outer regional communities discussed the effects of mining activity on the fabric of their town and community, whereas the inner regional community that had a longer history of industrial activity discussed the impacts on families and individual health and wellbeing. The findings from this study may inform future health service planning in

  4. Exploring the determinants of health and wellbeing in communities living in proximity to coal seam gas developments in regional Queensland

    Directory of Open Access Journals (Sweden)

    Fiona Mactaggart

    2017-08-01

    Full Text Available Abstract Background There is some concern that coal seam gas mining may affect health and wellbeing through changes in social determinants such as living and working conditions, local economy and the environment. The onward impact of these conditions on health and wellbeing is often not monitored to the same degree as direct environmental health impacts in the mining context, but merits attention. This study reports on the findings from a recurrent theme that emerged from analysis of the qualitative component of a comprehensive Health Needs Assessment (HNA conducted in regional Queensland: that health and wellbeing of communities was reportedly affected by nearby coal seam gas (CSG development beyond direct environmental impacts. Methods Qualitative analysis was initially completed using the Framework Method to explore key themes from 11 focus group discussions, 19 in-depth interviews, and 45 key informant interviews with health and wellbeing service providers and community members. A key theme emerged from the analysis that forms the basis of this paper. This study is part of a larger comprehensive HNA involving qualitative and quantitative data collection to explore the health and wellbeing needs of three communities living in proximity to CSG development in regional Queensland, Australia. Results Communities faced social, economic and environmental impacts from the rapid growth of CSG development, which were perceived to have direct and indirect effects on individual lifestyle factors such as alcohol and drug abuse, family relationships, social capital and mental health; and community-level factors including social connectedness, civic engagement and trust. Conclusions Outer regional communities discussed the effects of mining activity on the fabric of their town and community, whereas the inner regional community that had a longer history of industrial activity discussed the impacts on families and individual health and wellbeing. The

  5. Elimination of neglected tropical diseases in the South-East Asia Region of the World Health Organization.

    Science.gov (United States)

    Narain, Jai P; Dash, A P; Parnell, B; Bhattacharya, S K; Barua, S; Bhatia, R; Savioli, L

    2010-03-01

    The neglected tropical diseases (NTDs), which affect the very poor, pose a major public health problem in the South-East Asia Region of the World Health Organization (WHO). Although more than a dozen NTDs affect the region, over the past five years four of them in particular - leprosy, lymphatic filariasis, visceral leishmaniasis (kala-azar) and yaws - have been targeted for elimination. These four were selected for a number of reasons. First, they affect the WHO South-East Asia Region disproportionately. For example, every year around 67% of all new leprosy cases and 60% of all new cases of visceral leishmaniasis worldwide occur in countries of the region, where as many as 850 million inhabitants are at risk of contracting lymphatic filariasis. In addition, several epidemiological, technological and historical factors that are unique to the region make each of these four diseases amenable to elimination. Safe and effective tools and interventions to achieve these targets are available and concerted efforts to scale them up, singly or in an integrated manner, are likely to lead to success. The World Health Assembly and the WHO Regional Committee, through a series of resolutions, have already expressed regional and global commitments for the elimination of these diseases as public health problems. Such action is expected to have a quick and dramatic impact on poverty reduction and to contribute to the achievement of the Millennium Development Goals. This paper reviews the policy rationale for disease control in the WHO South-East Asia Region, the progress made so far, the lessons learnt along the way, and the remaining challenges and opportunities.

  6. Health of children living in Panfilov distract of Almaty region after Chernobyl accident and nuclear explosions at Lobnor test site

    International Nuclear Information System (INIS)

    Mit, A.A.; Chasnikov, I.Ya.; Chastnicova, S.S.; Mukhametzhanov, M.M.; Zhantagulova, T.K.

    1999-01-01

    It is known that Panfilov district of Almaty region was affected with radiation contamination during nuclear explosions at Lobnor test site and after Chernobyl accident, which impaired the health of its population [1]. In addition, the children's mortality rate was turned out to be the highest one among other districts of the region. This report presents some other information related to an increase of children's sickness rate in Panfilov district

  7. Implementation of a guideline for local health policy making by regional health services: exploring determinants of use by a web survey.

    Science.gov (United States)

    Kuunders, Theo J M; Jacobs, Monique A M; Goor, Ien A M van de; Bon-Martens, Marja J H van; Oers, Hans A M van; Paulussen, Theo G W M

    2017-08-15

    Previous evaluation showed insufficient use of a national guideline for integrated local health policy by Regional Health Services (RHS) in the Netherlands. The guideline focuses on five health topics and includes five checklists to support integrated municipal health policies. This study explores the determinants of guideline use by regional Dutch health professionals. A web survey was send to 304 RHS health professionals. The questionnaire was based on a theory- and research-based framework of determinants of public health innovations. Main outcomes were guideline use and completeness of use, defined as the number of health topics and checklists used. Associations between determinants and (completeness of) guideline use were explored by multivariate regression models. The survey was started by 120 professionals (39%). Finally, results from 73 respondents (24%) were eligible for analyses. All 28 Dutch RHS organizations were represented in the final dataset. About half of the respondents (48%) used the guideline. The average score for completeness of use (potential range 1-10) was 2.37 (sd = 1.78; range 1-7). Knowledge, perceived task responsibility and usability were significantly related to guideline use in univariate analyses. Only usability remained significant in the multivariate model on guideline use. Only self-efficacy accounted for significant proportions of variance in completeness of use. The results imply that strategies to improve guideline use by RHSs should primarily target perceived usability. Self-efficacy appeared the primary target for improving completeness of guideline use. Methods for targeting these determinants in RHSs are discussed.

  8. Parent-child communication about sexual and reproductive health: evidence from the Brong Ahafo region, Ghana.

    Science.gov (United States)

    Manu, Abubakar A; Mba, Chuks Jonathan; Asare, Gloria Quansah; Odoi-Agyarko, Kwasi; Asante, Rexford Kofi Oduro

    2015-03-07

    Young people aged 10-24 years represent one-third of the Ghanaian population. Many are sexually active and are at considerable risk of negative health outcomes due to inadequate sexual and reproductive health knowledge. Although growing international evidence suggests that parent-child sexual communication has positive influence on young people's sexual behaviours, this subject has been poorly studied among Ghanaian families. This study explored the extent and patterns of parent-child sexual communication, and the topics commonly discussed by parents. A cross-sectional design was used to sample 790 parent-child dyads through a two-stage cluster sampling technique with probability proportional to size. Interviewer-administered questionnaire method was used to gather quantitative data on parent-child communication about sex. Twenty sexual topics were investigated to describe the patterns and frequency of communication. The Pearson's chi-square and z-test for two-sample proportions were used to assess sexual communication differences between parents and young people. Qualitative data were used to flesh-out relevant issues which standard questionnaire could not cover satisfactorily. About 82.3% of parents had at some point in time discussed sexual and reproductive health issues with their children; nonetheless, the discussions centered on a few topics. Whereas child-report indicated that 78.8% of mothers had discussed sexual communication with their children, 53.5% of fathers had done so. Parental discussions on the 20 sexual topics ranged from 5.2%-73.6%. Conversely, young people's report indicates that mother-discussed topics ranged between 1.9%-69.5%, while father-discussed topics ranged from 0.4% to 46.0%. Sexual abstinence was the most frequently discussed topic (73.6%), followed by menstruation 63.3% and HIV/AIDS 61.5%; while condom (5.2%) and other contraceptive use (9.3%) were hardly discussed. The most common trigger of communication cited by parent

  9. [Effects of land use structure change on regional ecological health--taking Shapingba County as an example].

    Science.gov (United States)

    Wang, Cheng; Wei, Chaofu; Gao, Ming; Luo, Guanglian; Jiang, Wei

    2005-12-01

    Land resource is the carrier for the exchange of matter, energy and information flows, while the change velocity and the intensity of land use has strong effects on the ecological processes such as matter circulation, energy flow, and biologic diversity. Land use structure change will alter the type, area, and spatial distribution of ecosystem, and in the meantime, result in the changes of regional ecological health. Employing the principles and methods of landscape ecology, and through endowing relative ecological value to land use type, this paper analyzed the charaeteristics of recent 10 years land use change in Shapingba County of Chongqing, and discussed the effects of land use change on regional ecological health, aimed to provide scientific references for land use planning and sustainable land resource utilization. The results indicated that transformation often occurred among different land use types, and the land use structure in each transformation phase differed quite obviously. Under different land use structure, there was a great disparity in relative ecological value of sub-ecosystems, which played various roles in regional ecological health. In general, the regional relative ecological value embodied both increase and decrease. In the future, the relative ecological value of sub-ecosystem would represent three tendencies, i.e., increase first and decrease then, continuous decrease, and continuous increase. The situation of regional ecological health would gradually become better.

  10. Health laboratories in the Tanga region of Tanzania: the quality of diagnostic services for malaria and other communicable diseases

    DEFF Research Database (Denmark)

    Ishengoma, D R S; Rwegoshora, R T; Mdira, K Y

    2009-01-01

    Although critical for good case management and the monitoring of health interventions, the health-laboratory services in sub-Saharan Africa are grossly compromised by poor infrastructures and a lack of trained personnel, essential reagents and other supplies. The availability and quality of diagn......Although critical for good case management and the monitoring of health interventions, the health-laboratory services in sub-Saharan Africa are grossly compromised by poor infrastructures and a lack of trained personnel, essential reagents and other supplies. The availability and quality...... of diagnostic services in 37 health laboratories in three districts of the Tanga region of Tanzania have recently been assessed. The results of the survey, which involved interviews with health workers, observations and a documentary review, revealed that malaria accounted for >50% of admissions and out...

  11. Towards good dementia care: Awareness and uptake of an online Dementia Pathways tool for rural and regional primary health practitioners.

    Science.gov (United States)

    Ollerenshaw, Alison; Wong Shee, Anna; Yates, Mark

    2018-04-01

    To explore the awareness and usage of an online dementia pathways tool (including decision tree and region-specific dementia services) for primary health practitioners (GPs and nurses) in regional Victoria. Quantitative pilot study using surveys and Google Analytics. A large regional area (48 000 square kilometres, population 220 000) in Victoria. Two hundred and sixty-three GPs and 160 practice nurses were invited to participate, with 42 respondents (GPs, n = 21; practice nurses, n = 21). Primary care practitioners' awareness and usage of the dementia pathways tool. Survey respondents that had used the tool (n = 14) reported accessing information about diagnosis, management and referral. Practitioners reported improvements in knowledge, skills and confidence about core dementia topics. There were 9683 page views between August 2013 and February 2015 (monthly average: 509 page views). The average time spent on page was 2.03 min, with many visitors (68%) spending more than 4 min at the site. This research demonstrates that the tool has been well received by practitioners and has been consistently used since its launch. Health practitioners' valued the content and the availability of local resources. Primary health practitioners reported that the dementia pathways tool provided access to region-specific referral and management resources for all stages of dementia. Such tools have broad transferability in other health areas with further research needed to determine their contribution to learning in the practice setting and over time. © 2017 National Rural Health Alliance Inc.

  12. [Vaginal infections in a Family Health Clinic in the Metropolitan Region, Chile].

    Science.gov (United States)

    Villaseca, Rodrigo; Ovalle, Alfredo; Amaya, Fernando; Labra, Bayron; Escalona, Natalia; Lizana, Paola; Montoya, M José; Lillo, Eduardo; Martínez, M Angélica

    2015-02-01

    Vaginal infections are a frequent cause for consultation, but their prevalence and etiology vary in different populations. To determine the prevalence and etiologies of vaginal infection in women attending a family health center in the Metropolitan Region of Chile. The microbiological diagnosis was made by wet mount and Gram stain. Diagnosis of trichomoniasis was performed by wet mount, culture and polymerase chain reaction. 101 women aged 15-54, not selected by signs or symptoms of vaginal infection, 46 of them pregnant were included. In 47 women (46.5%), vaginal infections were diagnosed. An association was observed between age and frequency of vaginal infection. The proportion of infections among pregnant and non-pregnant women was similar. The most frequent infections were bacterial vaginosis (16.8%), vulvovaginal candidiasis (11.9%) and co-infections (6.9%). We found 5.9% of intermediate microbiota cases, 3% of trichomoniasis and 2% of aerobic vaginitis. Symptoms of vaginal infection had poor agreement with microbiological findings. Otherwise physical signs had good agreement with the presence of infection, but low to moderate concordance with a specific etiology. We found a high prevalence of vaginal infections in the study population. It is necessary to improve the definitions and criteria of microbiological diagnosis of co-infections and intermediate microbiota, for them to be diagnosed in the clinical practice. More descriptive questionnaires are recommended to enhance the usefulness of clinical examination.

  13. National Differences in Regional Emergency Department Boarding Times: Are US Emergency Departments Prepared for a Public Health Emergency?

    Science.gov (United States)

    Love, Jennifer S; Karp, David; Delgado, M Kit; Margolis, Gregg; Wiebe, Douglas J; Carr, Brendan G

    2016-08-01

    Boarding admitted patients decreases emergency department (ED) capacity to accommodate daily patient surge. Boarding in regional hospitals may decrease the ability to meet community needs during a public health emergency. This study examined differences in regional patient boarding times across the United States and in regions at risk for public health emergencies. A retrospective cross-sectional analysis was performed by using 2012 ED visit data from the American Hospital Association (AHA) database and 2012 hospital ED boarding data from the Centers for Medicare and Medicaid Services Hospital Compare database. Hospitals were grouped into hospital referral regions (HRRs). The primary outcome was mean ED boarding time per HRR. Spatial hot spot analysis examined boarding time spatial clustering. A total of 3317 of 4671 (71%) hospitals were included in the study cohort. A total of 45 high-boarding-time HRRs clustered along the East/West coasts and 67 low-boarding-time HRRs clustered in the Midwest/Northern Plains regions. A total of 86% of HRRs at risk for a terrorist event had high boarding times and 36% of HRRs with frequent natural disasters had high boarding times. Urban, coastal areas have the longest boarding times and are clustered with other high-boarding-time HRRs. Longer boarding times suggest a heightened level of vulnerability and a need to enhance surge capacity because these regions have difficulty meeting daily emergency care demands and are at increased risk for disasters. (Disaster Med Public Health Preparedness. 2016;10:576-582).

  14. Examining leadership as a strategy to enhance health care service delivery in regional hospitals in South Africa

    Science.gov (United States)

    Govender, Sagaren; Gerwel Proches, Cecile N; Kader, Abdulla

    2018-01-01

    Background Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. Purpose This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province. Methods The mixed-method research approach was utilized. Purposive sampling and stratified random sampling were employed in the research setting, and in-depth, semistructured interviews and questionnaires were used to collect data. Data were analyzed using the Nvivo computer software package for in-depth interviews and the Statistical Package for the Social Sciences (SPSS) software for the quantitative analysis. Results The research findings showed that the current leadership framework adopted by the health care leaders in regional hospitals in KZN is weak and is contributing to poor health care service delivery. Conclusion This study, therefore, aimed to address the current challenges and weaknesses that are impacting negatively on health care service delivery in regional hospitals in the KZN Province and made recommendations for improvement. PMID:29535529

  15. Examining leadership as a strategy to enhance health care service delivery in regional hospitals in South Africa.

    Science.gov (United States)

    Govender, Sagaren; Gerwel Proches, Cecile N; Kader, Abdulla

    2018-01-01

    Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province. The mixed-method research approach was utilized. Purposive sampling and stratified random sampling were employed in the research setting, and in-depth, semistructured interviews and questionnaires were used to collect data. Data were analyzed using the Nvivo computer software package for in-depth interviews and the Statistical Package for the Social Sciences (SPSS) software for the quantitative analysis. The research findings showed that the current leadership framework adopted by the health care leaders in regional hospitals in KZN is weak and is contributing to poor health care service delivery. This study, therefore, aimed to address the current challenges and weaknesses that are impacting negatively on health care service delivery in regional hospitals in the KZN Province and made recommendations for improvement.

  16. Inequalities in Health Services Usage in a National Health System Scheme: The Case of a Southern Social European Region.

    Science.gov (United States)

    Morteruel, Maite; Rodriguez-Alvarez, Elena; Martin, Unai; Bacigalupe, Amaia

    Health services can reduce inequalities caused by other determinants of health or increase them due to the effect of the inverse care law-the principle that the availability of good quality care tends to vary inversely with the need for it in the population served. The purpose of the research was to describe inequalities in the use of nursing services, medical services in primary care, specialist care, and services not fully covered by the Basque public health system in Spain. A cross-sectional study of adults aged at least 25 years who completed the 2013 Basque Health Survey (N = 10,454) was conducted. Age-standardized prevalence and prevalence ratios for use of services that are covered and noncovered in the health system were computed. The association of health services usage with socioeconomic variables was estimated using a Poisson regression model with robust variance. The relative index of inequality (RII) was used to measure the magnitude of socioeconomic status inequalities in health service use. All analyses were carried out separately for men and women. Individuals with lower socioeconomic status were more likely to use primary care (RII = 0.87, 95% CI [0.79, 0.97]) and less likely to use specialist services (RII = 0.82, 95% CI [0.75, 0.89]). Across noncovered health services, inequalities between the highest and lowest social groups were significant in all cases and especially marked in men's use of physiotherapists (RII = 0.46, 95% CI [0.35, 0.61]) and podiatrists (RII = 0.24, 95%CI [0.15, 0.38]). There are significant inequalities in primary and specialist health service use based on individual socioeconomic status, particularly for services that are not provided free of charge within the existing health system. This suggests that health service systems that are not explicitly designed to provide universal access may actually amplify preexisting social and health inequalities within their target populations.

  17. E-health: Determinants, opportunities, challenges and the way forward for countries in the WHO African Region

    Directory of Open Access Journals (Sweden)

    Gatwiri Doris

    2005-12-01

    Full Text Available Abstract Background The implementation of the 58th World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO African Region due to lack of information and communications technology (ICT and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i explore the key determinants of personal computers (PCs, telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. Methods The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP, the World Bank and the International Telecommunications Union (ITU sources. Results There were a number of main findings: (i the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test positive effect on the number of PCs in a country; (ii the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v there were major inequalities in ICT connectivity between upper-middle, lower-middle and

  18. Review of emergency obstetric care interventions in health facilities in the Upper East Region of Ghana: a questionnaire survey.

    Science.gov (United States)

    Kyei-Onanjiri, Minerva; Carolan-Olah, Mary; Awoonor-Williams, John Koku; McCann, Terence V

    2018-03-15

    Maternal morbidity and mortality is most prevalent in resource-poor settings such as sub-Saharan Africa and southern Asia. In sub-Saharan Africa, Ghana is one of the countries still facing particular challenges in reducing its maternal morbidity and mortality. Access to emergency obstetric care (EmOC) interventions has been identified as a means of improving maternal health outcomes. Assessing the range of interventions provided in health facilities is, therefore, important in determining capacity to treat obstetric emergencies. The aim of this study was to examine the availability of emergency obstetric care interventions in the Upper East Region of Ghana. A cross-sectional survey of 120 health facilities was undertaken. Status of emergency obstetric care was assessed through an interviewer administered questionnaire to directors/in-charge officers of maternity care units in selected facilities. Data were analysed using descriptive statistics. Eighty per cent of health facilities did not meet the criteria for provision of emergency obstetric care. Comparatively, private health facilities generally provided EmOC interventions less frequently than public health facilities. Other challenges identified include inadequate skill mix of maternity health personnel, poor referral processes, a lack of reliable communication systems and poor emergency transport systems. Multiple factors combine to limit women's access to a range of essential maternal health services. The availability of EmOC interventions was found to be low across the region; however, EmOC facilities could be increased by nearly one-third through modest investments in some existing facilities. Also, the key challenges identified in this study can be improved by enhancing pre-existing health system structures such as Community-based Health Planning and Services (CHPS), training more midwifery personnel, strengthening in-service training and implementation of referral audits as part of health service

  19. Genetic variability and health of Norway spruce stands in the Regional Directorate of the State Forests in Krosno

    Directory of Open Access Journals (Sweden)

    Gutkowska Justyna

    2017-03-01

    Full Text Available The study was conducted in 2015 in six spruce stands situated in different forest districts administratively belonging to the Regional Directorate of State Forests in Krosno. Each spruce population was represented by 30 trees and assessed in terms of their current health status. Genetic analyses were performed on shoot samples from each tree using nine nuclear DNA markers and one mitochondrial DNA marker (nad1. The health status of the trees was described according to the classification developed by Szczepkowski and Tarasiuk (2005 and the correlation between health classes and the level of genetic variability was computed with STATISTICA (α = 0.05.

  20. An integrated healthcare service for asylum seekers and refugees in the South-Eastern Region of Melbourne: Monash Health Refugee Health and Wellbeing.

    Science.gov (United States)

    McBride, Jacquie; Block, Andrew; Russo, Alana

    2017-09-01

    Asylum seekers and refugees generally have poorer health than the broader Australian population. However, these groups experience a range of barriers to accessing universal health services. Generalist and specialist refugee health services have been established in Australia to improve the health of humanitarian migrant groups. This article describes a refugee health service established in a high-settlement region of Melbourne, Australia, and explores clients' experiences with the service. Client feedback was captured through interviews (n=18) and surveys (n=159). Participants reported high levels of satisfaction with the service, and highlighted the value in having trusting relationships with staff, access to bicultural workers, onsite interpreting services and integrated care. The findings indicate that it is possible to engage asylum seekers and refugees through healthcare delivery that is responsive to the unique needs of this priority population.

  1. Towards guideline implementation for integrated local health policies : Evaluation of an experimental implementation strategy in regional health services

    NARCIS (Netherlands)

    Kuunders, T.J.M.; Cloin, J.C.M.; van Bon, M.J.H.; Paulussen, T.G.W.M.; van Oers, J.A.M.; van de Goor, L.A.M.

    2017-01-01

    To enhance implementation of a Guideline for integrated local health policy, a draft implementation strategy (DIS) was developed. It was hypothesized that the DIS would be feasible and effective to enhance the use of a Guideline for integrated local health policy. To examine its feasibility and

  2. Water Security, Climate Forcings and Public Health Impacts in Emerging Regions

    Science.gov (United States)

    Serman, E. A.; Akanda, A. S.; Craver, V.; Boving, T. B.

    2014-12-01

    Our world is rapidly urbanizing, with more than 80% of world's population is expected to be living in a city by the end of the century. A majority of these nations are rapidly urbanizing due to massive rural-to-urban migratory trends, with rapid development of unplanned urban settlements, or slums, with lack of adequate water or sanitation facilities and other municipal amenities. With global environmental change, natural disasters will expose millions more to drought, floods, and disease epidemics, and existing vulnerabilities will worsen. At the same time, rapid urbanization and fast changing land-use leads to widespread damage of infrastructure by stormwater, especially in lowlands and economically poor areas. The factor that consistently stands out among different cities from both the developed and the developing worlds is that the slums are typically the most vulnerable to water related natural hazards and climatic threats, such as water scarcity and quality issues in drought conditions, or water and sanitation breakdown and stormwater contamination problems. Onsite or decentralized water, wastewater and stormwater treatment as well as point-of-use water treatment options can be an economic, safe, and reliable alternative to conventional large-scale treatment especially, in urban fringes as well as rural areas. These systems can be designed to fit communities in terms of their economic, cultural, environmental, and demographic resources. As part of this study, we develop a database of urban water quality and quantity indices such as with urban land-use, water usage, climate, and socio-economic characteristics in various emerging regions in the world. We analyze past and current data to identify and quantify long-term trends and the impacts of large-scale climatic and anthropogenic changes on urban hydrology and health impacts. We specifically focus on five major cities from distinct groups of countries and geographies: Providence, RI, USA from the developed

  3. The characteristics and activities of child and adolescent mental health services in Italy: a regional survey.

    Science.gov (United States)

    Pedrini, Laura; Colasurdo, Giovanni; Costa, Stefano; Fabiani, Michela; Ferraresi, Linda; Franzoni, Emilio; Masina, Francesca; Moschen, Renato; Neviani, Vittoria; Palazzi, Stefano; Parisi, Roberto; Parmeggiani, Antonia; Preti, Antonio; Ricciutello, Cosimo; Rocchi, Marco Bl; Sisti, Davide; Squarcia, Antonio; Trebbi, Stefano; Turchetti, Donatella; Visconti, Paola; Tullini, Andrea; de Girolamo, Giovanni

    2012-01-30

    To date, no studies have assessed in detail the characteristics, organisation, and functioning of Child and Adolescent Mental Health Services (CAMHS). This information gap represents a major limitation for researchers and clinicians because most mental disorders have their onset in childhood or adolescence, and effective interventions can therefore represent a major factor in avoiding chronicity. Interventions and mental health care are delivered by and through services, and not by individual, private clinicians, and drawbacks or limitations of services generally translate in inappropriateness and ineffectiveness of treatments and interventions: therefore information about services is essential to improve the quality of care and ultimately the course and outcome of mental disorders in childhood and adolescence.The present paper reports the results of the first study aimed at providing detailed, updated and comprehensive data on CAMHS of a densely populated Italian region (over 4 million inhabitants) with a target population of 633,725 subjects aged 0-17 years. Unit Chiefs of all the CAMHS filled in a structured 'Facility Form', with activity data referring to 2008 (data for inpatient facilities referred to 2009), which were then analysed in detail. Eleven CAMHS were operative, including 110 outpatient units, with a ratio of approximately 20 child psychiatrists and 23 psychologists per 100,000 inhabitants aged 0-17 years. All outpatient units were well equipped and organized and all granted free service access. In 2008, approximately 6% of the target population was in contact with outpatient CAMHS, showing substantial homogeneity across the eleven areas thereby. Most patients in contact in 2008 received a language disorder- or learning disability diagnosis (41%). First-ever contacts accounted for 30% of annual visits across all units. Hospital bed availability was 5 per 100,000 inhabitants aged 0-17 years. The percentage of young people in contact with CAMHS for

  4. The characteristics and activities of child and adolescent mental health services in Italy: a regional survey

    Directory of Open Access Journals (Sweden)

    Pedrini Laura

    2012-01-01

    Full Text Available Abstract Background To date, no studies have assessed in detail the characteristics, organisation, and functioning of Child and Adolescent Mental Health Services (CAMHS. This information gap represents a major limitation for researchers and clinicians because most mental disorders have their onset in childhood or adolescence, and effective interventions can therefore represent a major factor in avoiding chronicity. Interventions and mental health care are delivered by and through services, and not by individual, private clinicians, and drawbacks or limitations of services generally translate in inappropriateness and ineffectiveness of treatments and interventions: therefore information about services is essential to improve the quality of care and ultimately the course and outcome of mental disorders in childhood and adolescence. The present paper reports the results of the first study aimed at providing detailed, updated and comprehensive data on CAMHS of a densely populated Italian region (over 4 million inhabitants with a target population of 633,725 subjects aged 0-17 years. Methods Unit Chiefs of all the CAMHS filled in a structured 'Facility Form', with activity data referring to 2008 (data for inpatient facilities referred to 2009, which were then analysed in detail. Results Eleven CAMHS were operative, including 110 outpatient units, with a ratio of approximately 20 child psychiatrists and 23 psychologists per 100,000 inhabitants aged 0-17 years. All outpatient units were well equipped and organized and all granted free service access. In 2008, approximately 6% of the target population was in contact with outpatient CAMHS, showing substantial homogeneity across the eleven areas thereby. Most patients in contact in 2008 received a language disorder- or learning disability diagnosis (41%. First-ever contacts accounted for 30% of annual visits across all units. Hospital bed availability was 5 per 100,000 inhabitants aged 0-17 years

  5. [Cooperation according to French Law "hospital, patients, health and territories": Pharmacists' involvement in Aquitaine region].

    Science.gov (United States)

    d'Elbée, M; Baumevieille, M; Dumartin, C

    2017-06-01

    In 2009, the French Act "Hospital, Patients, Health and Territories" (loi "Hôpital, Patients, Santé et Territoires") reorganized the outpatient care pathway and defined missions aimed at improving cooperation between pharmaceutical and medical professionals. Five years later, we conducted a survey among community pharmacists in order to assess the appropriation of these missions and the way cooperation was implemented. We also aimed to investigate factors that could hamper or ease the development of these activities in order to identify actions needed to improve pharmacists' involvement. In partnership with the local health authorities "Agence régionale de santé", we conducted a survey via an online questionnaire sent to pharmacy holders in July 2014 in Aquitaine region. Information was collected about the pharmacies, involvement in collaborative activities, and barriers to cooperation. Overall, 20% (249) of pharmacists responded to the survey. They owned predominantly rural pharmacies (46%) or neighborhood pharmacies (41%), with two pharmacists per pharmacy (48%). Regarding collaborative activities, the majority of pharmacists (78%) had conducted interviews with their patients taking vitamin K antagonist therapy and they were willing to continue (87%). The implication was less common concerning other actions such as referent pharmacist for nursing homes (19%) or activities relating to therapeutic educational programs for patients with chronic conditions (34%). The vast majority of respondents (85%) were not aware of opportunities to become a correspondent pharmacist. The main obstacles for engaging in these activities were the lack of time, lack of knowledge about these missions and the lack of remuneration. We identified differences in pharmacists' involvement in collaborative activities depending on selected characteristics of the pharmacies. The findings of this survey underlined pharmacists' acceptance of these missions and suggest that better information

  6. Achieving value for money in health: a comparative analysis of OECD countries and regional countries.

    Science.gov (United States)

    Çelik, Yusuf; Khan, Mahmud; Hikmet, Neşet

    2017-10-01

    To measure efficiency gains in health sector over the years 1995 to 2013 in OECD, EU, non-member European countries. An output-oriented DEA model with variable return to scale, and residuals estimated by regression equations were used to estimate efficiencies of health systems. Slacks for health care outputs and inputs were calculated by using DEA multistage method of estimating country efficiency scores. Better health outcomes of countries were related with higher efficiency. Japan, France, or Sweden were found to be peer-efficient countries when compared to other developed countries like Germany and United States. Increasing life expectancy beyond a certain high level becomes very difficult to achieve. Despite declining marginal productivity of inputs on health outcomes, some developed countries and developing countries were found to have lowered their inefficiencies in the use of health inputs. Although there was no systematic relationship between political system of countries and health system efficiency, the objectives of countries on social and health policy and the way of achieving these objectives might be a factor increasing the efficiency of health systems. Economic and political stability might be as important as health expenditure in improving health system goals. A better understanding of the value created by health expenditures, especially in developed countries, will require analysis of specific health interventions that can increase value for money in health. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  7. The Health Extension Program and Its Association with Change in Utilization of Selected Maternal Health Services in Tigray Region, Ethiopia: A Segmented Linear Regression Analysis

    Science.gov (United States)

    Gebrehiwot, Tesfay Gebregzabher; San Sebastian, Miguel; Edin, Kerstin; Goicolea, Isabel

    2015-01-01

    Background In 2003, the Ethiopian Ministry of Health established the Health Extension Program (HEP), with the goal of improving access to health care and health promotion activities in rural areas of the country. This paper aims to assess the association of the HEP with improved utilization of maternal health services in Northern Ethiopia using institution-based retrospective data. Methods Average quarterly total attendances for antenatal care (ANC), delivery care (DC) and post-natal care (PNC) at health posts and health care centres were studied from 2002 to 2012. Regression analysis was applied to two models to assess whether trends were statistically significant. One model was used to estimate the level and trend changes associated with the immediate period of intervention, while changes related to the post-intervention period were estimated by the other. Results The total number of consultations for ANC, DC and PNC increased constantly, particularly after the late-intervention period. Increases were higher for ANC and PNC at health post level and for DC at health centres. A positive statistically significant upward trend was found for DC and PNC in all facilities (p<0.01). The positive trend was also present in ANC at health centres (p = 0.04), but not at health posts. Conclusion Our findings revealed an increase in the use of antenatal, delivery and post-natal care after the introduction of the HEP. We are aware that other factors, that we could not control for, might be explaining that increase. The figures for DC and PNC are however low and more needs to be done in order to increase the access to the health care system as well as the demand for these services by the population. Strengthening of the health information system in the region needs also to be prioritized. PMID:26218074

  8. Local health practices and the knowledge of medicinal plants in a Brazilian semi-arid region: environmental benefits to human health.

    Science.gov (United States)

    Zank, Sofia; Peroni, Nivaldo; de Araújo, Elcida Lima; Hanazaki, Natalia

    2015-02-23

    The concept of eco-cultural health considers the dynamic interaction between humans and ecosystems, emphasizing the implications of the health of the ecosystem for the health and well-being of human populations. Ethnobotanical studies focusing on folk medicine and medicinal plants can contribute to the field of eco-cultural health if they incorporate the perspective and local knowledge of communities. We investigated the local health practices in three rural communities living within the vicinity of a protected area of sustainable use in a semi-arid region of Brazil. We analyzed the opinions of local health experts on the elements that influence human health and on how the environment contributes to this influence. We also analyzed and compared the local knowledge of medicinal plants, as knowledge of this type is an important factor when considering the interaction between environmental and human health. We performed structured interviews and free-listings with 66 local health experts. We used content analysis to systematize the elements of the influences on human health. We compared the richness of the plants cited among communities and analyzed the differences among the three communities regarding the ways in which the plants were obtained and the environments in which plants were collected. The local experts identified several influences of the environment on human health. These influences can be associated with ecosystem services, such as climatic conditions, water and air quality, recreation and medicinal and food resources. We identified 192 medicinal plant species, most of which were gathered from wild ecosystems. The most important environments for the three communities were the plateau mountain and backyards. The informants had a broad and integrated view of health, perceiving the importance of conserving the environment within the National Forest of Araripe for the health and well-being of the local populations.

  9. Newborns health in the Danube Region: Environment, biomonitoring, interventions and economic benefits in a large prospective birth cohort study

    Czech Academy of Sciences Publication Activity Database

    Andersen, Z.J.; Šrám, Radim; Ščasný, M.; Gurzau, E.S.; Fucic, A.; Gribaldo, L.; Rössner ml., Pavel; Rössnerová, Andrea; Kohlová, M.B.; Máca, V.; Zvěřinová, I.; Gajdošová, D.; Moshammer, H.; Rudnai, P.; Knudsen, L. E.

    2016-01-01

    Roč. 88, mar. (2016), s. 112-122 ISSN 0160-4120 Institutional support: RVO:68378041 Keywords : birth cohort * environment * biomonitoring * air pollution * danube region * childhood health Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 7.088, year: 2016

  10. Effects of global financial crisis on funding for health development in nineteen countries of the WHO African Region.

    Science.gov (United States)

    Kirigia, Joses M; Nganda, Benjamin M; Mwikisa, Chris N; Cardoso, Bernardino

    2011-04-13

    There is ample evidence in Asia and Latin America showing that past economic crises resulted in cuts in expenditures on health, lower utilization of health services, and deterioration of child and maternal nutrition and health outcomes. Evidence on the impact of past economic crises on health sector in Africa is lacking. The objectives of this article are to present the findings of a quick survey conducted among countries of the WHO African Region to monitor the effects of global financial crisis on funding for health development; and to discuss the way forward. This is a descriptive study. A questionnaire was prepared and sent by email to all the 46 Member States in the WHO African Region through the WHO Country Office for facilitation and follow up. The questionnaires were completed by directors of policy and planning in ministries of health. The data were entered and analyzed in Excel spreadsheet. The main limitations of this study were that authors did not ask whether other relevant sectors were consulted in the process of completing the survey questionnaire; and that the overall response rate was low. The main findings were as follows: the response rate was 41.3% (19/46 countries); 36.8% (7/19) indicated they had been notified by the Ministry of Finance that the budget for health would be cut; 15.8% (3/19) had been notified by partners of their intention to cut health funding; 61.1% (11/18) indicated that the prices of medicines had increased recently; 83.3% (15/18) indicated that the prices of basic food stuffs had increased recently; 38.8% (7/18) indicated that their local currency had been devalued against the US dollar; 47.1% (8/17) affirmed that the levels of unemployment had increased since the onset of global financial crisis; and 64.7% (11/17) indicated that the ministry of health had taken some measures already, either in reaction to the global financing crisis, or in anticipation. A rapid assessment, like the one reported in this article, of the

  11. [Tuberculosis control in the Central Health Region of Catalonia during the period 1986-2000].

    Science.gov (United States)

    Miret Cuadras, P; Pina Gutiérrez, J M; López Sanmartín, J L; Sala Farré, M R

    2003-10-01

    To assess tuberculosis control in the Central Health Region, Catalonia, Spain, from the implementation of the area's Tuberculosis Control Program in 1986 until the year 2000. To study the epidemiological profile of tuberculosis and the outcome of the following control measures in sputum smear-positive patients: final outcome of treatment and monitoring, and the percentage of patients for whom a contact investigation (CI) was carried out. Tuberculosis control is considered effective if the sum of noncompliant patients, plus the cases in which treatment failed, plus the patients transferred out remains below 10% of the cohort of patients studied, and if a CI has been conducted in at least 80% of this cohort. The number of cases reported was 6326, of which 7% were retreatments. A total of 5865 new cases was detected. Of these, 5652 (96%) were patients born in Spain. The number of cases reported annually peaked in 1990 (474) and then declined continuously until 2000, when it was 54% lower (220). Foreign-born patients numbered 213 (4%), and 95% of them came from countries with a high prevalence of tuberculosis. In the cohort of patients studied between 1997 and 2000, the sum of noncompliant patients, plus cases in which treatment failed, plus the patients transferred out came to 11%. Since 1994, a CI has been carried out for over 80% of patients, and this figure reached 92% in 2000. We consider that a substantial degree of tuberculosis control has been achieved given the decline in tuberculosis morbidity among people born in Spain, the fact that the percentage of noncompliant patients, treatment failures and transfers was only slightly over 10%, and that a CI has been conducted for over 80% of patients since 1994 (92% in 2000).

  12. Decreasing medication turnaround time with digital scanning technology in a canadian health region.

    Science.gov (United States)

    Neville, Heather; Nodwell, Lisa; Alsharif, Sahar

    2014-11-01

    Reducing medication turnaround time can improve efficiency, patient safety, and quality of care in the hospital setting. Digital scanning technology (DST) can be used to electronically transmit scanned prescriber orders to a pharmacy computer queue for verification and processing, which may help to improve medication turnaround time. To evaluate medication turnaround time before and after implementation of DST for all medications and for antibiotics only. Medication turnaround times were evaluated retrospectively for periods before (June 6-10, 2011) and after (September 26-30, 2011) implementation of DST at 2 hospital sites in 1 health region. Medication turnaround time was defined as the time from composition of a medication order by the prescriber to its verification by the pharmacy (phase 1) and the time from prescriber composition to administration to the patient by a nurse (total). Median turnaround times were analyzed with SPSS software using the Mann-Whitney U test. In total, 304 and 244 medication orders were audited before and after DST implementation, respectively. Median phase 1 turnaround time for all medications declined significantly, from 2 h 23 min before DST implementation to 1 h 33 min after DST implementation (p < 0.001). Antibiotics were also processed significantly faster (1 h 51 min versus 1 h 9 min, p = 0.015). However, total turnaround time for all medications did not differ significantly (5 h 15 min versus 5 h 0 min, p = 0.42). Implementation of DST was associated with a 50-min decrease in medication turnaround time for the period from when an order was prescribed to the time it was processed by the pharmacy. Regular evaluation of medication turnaround times is recommended to compare with benchmarks, to ensure that hospital standards are being met, and to measure the effects of policy changes and implementation of new technology on medication-use processes.

  13. Evaporative concentration of arsenic in groundwater: health and environmental implications, La Laguna Region, Mexico.

    Science.gov (United States)

    Ortega-Guerrero, Adrián

    2017-10-01

    High arsenic concentrations in groundwater have been documented in La Laguna Region (LLR) in arid northern Mexico, where arsenic poisoning is both chronic and endemic. A heated debate has continued for decades on its origin. LLR consisted of a series of ancient connected lakes that developed at the end of a topographic depression under closed basin conditions. This study addresses the isotopic, chemical composition of the groundwater and geochemical modeling in the southeasternmost part of the LLR to determine the origin of arsenic. Groundwater samples were obtained from a carbonate and granular aquifers and from a clayey aquitard at terminal Viesca Lake. Results show that groundwater originated as meteoric water that reached the lakes mainly via abundant springs in the carbonate aquifer and perennial flooding of the Nazas-Aguanaval Rivers. Paleo-lake water underwent progressive evaporation as demonstrated by the enrichment of δ 18 O, δ 2 H and characteristic geochemical patterns in the granular aquifer and aquitard that resulted in highly saline (>90,000 mS/cm), arsenic-rich (up to 5000 μg/L) paleo-groundwater (>30,000 years BP). However, adsorption or co-precipitation on iron oxides, clay-mineral surfaces and organic carbon limited arsenic concentration in the groundwater. Arsenic-rich groundwater and other solutes are advancing progressively from the lacustrine margins toward the main granular aquifer, due to reversal of hydraulic gradients caused by intensive groundwater exploitation and the reduction in freshwater runoff provoked by dam construction on the main rivers. Desorption of arsenic will incorporate additional concentrations of arsenic into the groundwater and continue to have significant negative effects on human health and the environment.

  14. Empathy and burnout of emergency professionals of a health region: A cross-sectional study.

    Science.gov (United States)

    Yuguero, Oriol; Forné, Carles; Esquerda, Montserrat; Pifarré, Josep; Abadías, María José; Viñas, Joan

    2017-09-01

    The objective of this study is to assess the association between levels of empathy and burnout of emergency professionals in all the assistance levels.A cross-sectional observational study was conducted in the health region of Lleida and the Pyrenees with 100 professionals from the field of Urgency. Participation reached 40.8%. Empathy and burnout were measured using the Spanish versions of the Jefferson Scale of Physician Empathy (JSPE) and Maslach Burnout Inventory (MBI) respectively. The total MBI score and its 3 dimensions (emotional exhaustion, depersonalization, and personal accomplishment) were analyzed. The JSPE and MBI scores were categorized into tertiles that were identified as "low," "moderate," and "high" levels.The median (interquartile range) was 112 (102-123) and 37 (27-53.5) for the JSPE and MBI scores respectively. Professionals with high burnout (MBI≥47) showed the lowest levels of empathy, that is, JSPE score of 105 (98-114); those with moderate burnout (31≤MBI empathy were associated with the lowest levels of burnout, especially in depersonalization, and to a lesser extent in personal accomplishment. There were no differences in empathy and burnout for any of the other study variables.Our findings suggest that the empathy of emergency professionals is associated with burnout. Hence, reducing professional burnout could help keep emergency professionals' empathy levels high, which in turn would ensure a better quality of care. Nevertheless, it would be necessary to carry out prospective studies to describe the profiles of burnout and empathy as well as their association and evolution.

  15. Extracorporeal cardiopulmonary resuscitation after out-of-hospital cardiac arrest in a Danish health region.

    Science.gov (United States)

    Fjølner, J; Greisen, J; Jørgensen, M R S; Terkelsen, C J; Ilkjaer, L B; Hansen, T M; Eiskjaer, H; Christensen, S; Gjedsted, J

    2017-02-01

    Extracorporeal Cardiopulmonary Resuscitation (ECPR) has emerged as a feasible rescue therapy for refractory, normothermic out-of-hospital cardiac arrest (OHCA). Reported survival rates vary and comparison between studies is hampered by heterogeneous study populations, differences in bystander intervention and in pre-hospital emergency service organisation. We aimed to describe the first experiences, treatment details, complications and outcome with ECPR for OHCA in a Danish health region. Retrospective study of adult patients admitted at Aarhus University Hospital, Denmark between 1 January 2011 and 1 July 2015 with witnessed, refractory, normothermic OHCA treated with ECPR. OHCA was managed with pre-hospital advanced airway management and mechanical chest compression during transport. Relevant pre-hospital and in-hospital data were collected with special focus on low-flow time and ECPR duration. Survival to hospital discharge with Cerebral Performance Category (CPC) of 1 and 2 at hospital discharge was the primary endpoint. Twenty-one patients were included. Median pre-hospital low-flow time was 54 min [range 5-100] and median total low-flow time was 121 min [range 55-192]. Seven patients survived (33%). Survivors had a CPC score of 1 or 2 at hospital discharge. Five survivors had a shockable initial rhythm. In all survivors coronary occlusion was the presumed cause of cardiac arrest. Extracorporeal cardiopulmonary resuscitation is feasible as a rescue therapy in normothermic refractory OHCA in highly selected patients. Low-flow time was longer than previously reported. Survival with favourable neurological outcome is possible despite prolonged low-flow duration. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  16. Concentrations and potential health hazards of organochlorine pesticides in (shallow) groundwater of Taihu Lake region, China.

    Science.gov (United States)

    Wu, Chunfa; Luo, Yongming; Gui, Tong; Huang, Yujuan

    2014-02-01

    A total of 27 shallow groundwater samples were collected from the Taihu Lake region (TLR), to determine the concentrations of 14 organochlorine pesticide (OCP) species, identify their possible sources, and estimate health risk of drinking the shallow groundwater. All OCP species occurred in the shallow groundwater of TLR with high detection frequency except p, p'-dichlorodiphenyldichlorothane (p, p'-DDD) and p, p'-dichlorodiphenyltrichloroethane (p, p'-DDT). DDTs and hexachlorocyclohexanes (HCHs) were the dominant OCP contaminants in the shallow groundwater of TLR, and they account for 44.2% total OCPs. The low α-HCH/γ-HCH ratio, high β-HCH/(α+γ)-HCH ratio and β-HCH being the dominant HCH isomers for the majority of samples suggest that the HCHs were mainly from the historical use of lindane after a period of degradation. p, p'-DDE being the dominant DDT metabolite for all the samples indicated that the DDTs were mainly from the historical residues. Compositional analysis also suggested that there were fresh input sources of heptachlors, aldrins and endrins in addition to the historical residues. Correlation analysis indicated the hexachlorobenzene (HCB) impurity in the shallow groundwater of TLR was likely from the historical application of lindane and technical HCH (a mixture of HCH isomers that is produced by photochlorination of benzene). Carcinogenic risk values for α-HCH, heptachlor, heptachlor epoxide, aldrins and dieldrin in the shallow groundwater in majority area of TLR were found to be >10(-6), posing a potentially serious cancer risk to those dependant on shallow groundwater for drinking water. © 2013.

  17. Knowledge of Cervical Cancer Screening among Health Care Workers Providing Services Across Different Socio-economic Regions of China.

    Science.gov (United States)

    Di, Jiang-Li; Rutherford, Shannon; Wu, Jiu-Ling; Song, Bo; Ma, Lan; Chen, Jing-Yi; Chu, Cordia

    2016-01-01

    China carries a heavy burden of cervical cancer (CC) and substantial disparities exist across regions within the country. In order to reduce regional disparities in CC, the government of China launched the National Cervical Cancer Screening Program in Rural Areas (NCCSPRA) in 2009. Critical to the success of the program are the health care workers who play a pivotal role in preventing and managing CC by encouraging and motivating women to use screening services and by providing identification and treatment services. This study aimed to assess cervical cancer knowledge among these health care workers at the county level in maternal and child health (MCH) hospitals across different socio-economic regions of China. A cross-sectional survey was conducted and self-administered questionnaires were sent to all health care workers (a total of 66) providing cervical cancer screening services in 6 county level MCH hospitals in Liaoning, Hubei and Shaanxi provinces, representing eastern, central and western regions of China; 64 (97.0%, 64/66) of the workers responded. ANOVA and Chi-square test were used to compare the knowledge rate and scores in subgroups. The knowledge level of the respondents was generally low. The overall combined knowledge rate was 46.9%. The knowledge rates for risk factors, prevention, clinical symptoms, screening and diagnostic tests and understanding of positive results were 31.3%, 37.5%, 18.1%, 56.3% and 84.4%, respectively. Statistically significant differences in scores or rates of CC knowledge were seen across the different regions. The total and sectional scores in the less developed regions were statistically significantly lower than in the other regions. The majority of the health care workers who provide CC screening service in NCCSPRA at county level MCH hospitals do not have adequately equipped with knowledge about CC. Given the importance of knowledge to the program's success in reducing CC burden in rural women in China, efforts are

  18. Regional differences in the validity of self-reported use of health care in Belgium: selection versus reporting bias

    Directory of Open Access Journals (Sweden)

    J. Van der Heyden

    2016-08-01

    Full Text Available Abstract Background The Health Care Module of the European Health Interview Survey (EHIS is aimed to obtain comparable information on the use of inpatient and ambulatory care in all EU member states. In this study we assessed the validity of self-reported information on the use of health care, collected through this instrument, in the Belgian Health Interview Survey (BHIS, and explored the impact of selection and reporting bias on the validity of regional differences in health care use observed in the BHIS. Methods To assess reporting bias, self-reported BHIS 2008 data were linked with register-based data from the Belgian compulsory health insurance (BCHI. The latter were compared with similar estimates from a random sample of the BCHI to investigate the selection bias. Outcome indicators included the prevalence of a contact with a GP, specialist, dentist and a physiotherapist, as well as inpatient and day patient hospitalisation. The validity of the estimates and the regional differences were explored through measures of agreement and logistic regression analyses. Results Validity of self-reported health care use varies by type of health service and is more affected by reporting than by selection bias. Compared to health insurance estimates, self-reported results underestimate the percentage of people with a specialist contact in the past year (50.5 % versus 65.0 % and a day patient hospitalisation (7.8 % versus 13.9 %. Inversely, survey results overestimated the percentage of people having visited a dentist in the past year: 58.3 % versus 48.6 %. The best concordance was obtained for an inpatient hospitalisation (kappa 0.75. Survey data overestimate the higher prevalence of a contact with a specialist [OR 1.51 (95 % CI 1.33–1.72 for self-report and 1.08 (95 % CI 1.05–1.15 for register] and underestimate the lower prevalence of a contact with a GP [ORs 0.59 (95 % CI 0.51–0.70 and 0.41 (95 % CI 0.39–0.42 respectively] in

  19. The influence of patients' complexity and general practitioners' characteristics on referrals to outpatient health services in an Italian region

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    Francesca Valent

    2015-09-01

    Full Text Available BACKGROUND. Patient referrals to outpatient health services may affect both health outcomes and health expenditures. General practitioners (GP have a crucial role in driving the use of outpatient services and recognizing factors which affect referrals is important for health managers and planners. OBJECTIVES. We investigated patient- and physician-related determinants of patient referrals in an Italian region. METHODS. This was cross-sectional study based on the individual linkage of administrative databases from the health information system of the Friuli Venezia Giulia region. For each GP of the region, the association of the number of patient referrals to different types of outpatient services with the proportion of patients with chronic conditions, with the number of hospital admissions and drug prescriptions in 2012, and with GP's characteristics was investigated through multilevel multivariable Poisson regression models. RESULTS. Some chronic conditions (e.g., cancer, autoimmune diseases, endocrine diseases, digestive system diseases were positively associated with the number of referrals, as were hospital admissions and drug prescriptions. Time since GP's graduation was inversely related with referrals. CONCLUSION. Patient complexity and GP's experience affect referral rates. These factors should be considered in case of a reorganization of the general practice structure in Friuli Venezia Giulia.

  20. [Logic model of the Franche-Comté Regional Health Project: advantages and limitations for the evaluation process].

    Science.gov (United States)

    Michaud, Claude; Sannino, Nadine; Duboudin, Cédric; Baudier, François; Guillin, Caroline; Billondeau, Christine; Mansion, Sylvie

    2014-01-01

    The French "Hospitals, patients, health and territories" law of July 2009 created the Regional Health Project (PRS) to support regional health policy, and requires evaluation of these projects. The construction of these projects, which includes prevention planning, care planning, and medical and social welfare planning, presents an unprecedented complexity in France, where evaluation programmes are still in their infancy. To support future evaluations, the Franche-Comté Regional Health Agency (ARS FC), assisted by the expertise of EFECT Consultants, decided to reconstruct the PRS logic model. This article analyzes the advantages and limitations of this approach. The resulting logic model allows visualization of the strategy adopted to achieve the Franche-Comté PRS ambitions and expected results. The model highlights four main aspects of structural change to the health system, often poorly visible in PRS presentation documents. This model also establishes links with the usual public policy evaluation issues and facilitates their prioritization. This approach also provides a better understanding of the importance of analysis of the programme construction in order to be effective rather than direct analysis of the effects, which constitutes the natural tendency of current practice. The main controversial limit concerns the retrospective design of the PRS framework, both in terms of the reliability of interpretation and adoption by actors not directly involved in this initiative.

  1. Health Impacts of Climate Change in Pacific Island Countries: A Regional Assessment of Vulnerabilities and Adaptation Priorities.

    Science.gov (United States)

    McIver, Lachlan; Kim, Rokho; Woodward, Alistair; Hales, Simon; Spickett, Jeffery; Katscherian, Dianne; Hashizume, Masahiro; Honda, Yasushi; Kim, Ho; Iddings, Steven; Naicker, Jyotishma; Bambrick, Hilary; McMichael, Anthony J; Ebi, Kristie L

    2016-11-01

    Between 2010 and 2012, the World Health Organization Division of Pacific Technical Support led a regional climate change and health vulnerability assessment and adaptation planning project, in collaboration with health sector partners, in 13 Pacific island countries-Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Nauru, Niue, Palau, Samoa, Solomon Islands, Tonga, Tuvalu, and Vanuatu. We assessed the vulnerabilities of Pacific island countries to the health impacts of climate change and planned adaptation strategies to minimize such threats to health. This assessment involved a combination of quantitative and qualitative techniques. The former included descriptive epidemiology, time series analyses, Poisson regression, and spatial modeling of climate and climate-sensitive disease data, in the few instances where this was possible; the latter included wide stakeholder consultations, iterative consensus building, and expert opinion. Vulnerabilities were ranked using a "likelihood versus impact" matrix, and adaptation strategies were prioritized and planned accordingly. The highest-priority climate-sensitive health risks in Pacific island countries included trauma from extreme weather events, heat-related illnesses, compromised safety and security of water and food, vector-borne diseases, zoonoses, respiratory illnesses, psychosocial ill-health, non-communicable diseases, population pressures, and health system deficiencies. Adaptation strategies relating to these climate change and health risks could be clustered according to categories common to many countries in the Pacific region. Pacific island countries are among the most vulnerable in the world to the health impacts of climate change. This vulnerability is a function of their unique geographic, demographic, and socioeconomic characteristics combined with their exposure to changing weather patterns associated with climate change, the health risks entailed, and the limited capacity

  2. Preparing non-government organization workers to conduct health checks for people with serious mental illness in regional Australia.

    Science.gov (United States)

    Jones, Martin; Kruger, Mellissa; Walsh, Sandra M

    2016-06-01

    WHAT IS KNOWN ON THE SUBJECT?: People diagnosed with schizophrenia or bipolar disorder have a life expectancy 10-15 years less than the general population. In rural and remote Australia, there is a shortage of health care professionals to provide physical health care for people living with a serious mental illness (SMI). A large proportion of the care for people living with a SMI is provided by non-government organizations (NGOs), often employing workers without formal qualifications. There has been minimal research regarding the experiences of NGO workers who have been trained to complete health checks to help people living with SMI to access primary care services. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to examine the experiences of preparing NGO workers to use the health improvement profile (HIP) to support the physical health of people with SMI. It builds on previous studies that examined the use of the HIP by trained/qualified staff. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This study highlights that NGO employees may have an important role in helping people with a SMI to address their physical health. Engaging lay workers to use the HIP increases their awareness of the importance of providing good physical health care for people with SMI. The use of a tool, such as the HIP, prepares NGO workers to support the physical health needs and enables them to describe meaningful improvements in the health of people with a SMI. Background The life expectancy of people living with a serious mental illness (SMI) is up to 10-15 years less than the general population. They experience difficulties in accessing timely and appropriate physical health care. People with SMI living in regional Australia experience additional barriers to accessing services. This is in part due to the difficulties associated with recruiting and retaining health professionals in regional Australia. Aim To explore the regional non-government organization (NGO

  3. Regional Variation in Use of Complementary Health Approaches by U.S. Adults

    Science.gov (United States)

    ... on Vital and Health Statistics Annual Reports Health Survey Research Methods Conference Reports from the National Medical Care Utilization ... Trager psychophysical integration, naturopathy, progressive relaxation, special diets, traditional healers, and yoga (with meditation or deep breathing), ...

  4. The coexistence of traditional medicine and biomedicine: A study with local health experts in two Brazilian regions.

    Science.gov (United States)

    Zank, Sofia; Hanazaki, Natalia

    2017-01-01

    This study investigated the combined use of traditional medicine and biomedicine by local experts in Chapada do Araripe communities (Ceará State) and maroon communities (Santa Catarina State), Brazil. The objective was to understand the perception of local health specialists regarding the number of healers, demand for healers and use of medicinal plants, and the dependence of different environments to obtain such plants. We also aimed to understand the role of medicinal plants to treat different categories of diseases and if there is a complementary use of medicinal plants and allopathic biomedicine, according to the context of each group. The research was conducted with local health specialists that answered structured interviews, created free lists and participated in guided tours to collect cited plants. Sixty-six local health specialists were identified in the Araripe communities and 22 specialists in the maroon communities. In the maroon communities, a greater number of specialists thought there was a decrease in the number and demand for healers, as well as the use of medicinal plants, due to changes in traditional livelihoods, since they are located in a region where the effects of the modernization were more intense. In the Chapada do Araripe communities the specialists knew more plants extracted from native vegetation, whereas in the maroon communities cultivated plants were better known, which may reflect the environmental conditions and the history of each region. Medicinal plants are preferred to treat simpler health problems that do not require medical care, such as gastrointestinal problems, general pain, flues and colds. The biomedicine is used principally for problems with blood pressure, general pains and endocrine and nutritional diseases. Even with the particularities of each region, in general the use of medicinal plants and biomedicines occurred in a complementary form in both regions; however, this coexistence may result from these different

  5. The coexistence of traditional medicine and biomedicine: A study with local health experts in two Brazilian regions

    Science.gov (United States)

    Zank, Sofia; Hanazaki, Natalia

    2017-01-01

    This study investigated the combined use of traditional medicine and biomedicine by local experts in Chapada do Araripe communities (Ceará State) and maroon communities (Santa Catarina State), Brazil. The objective was to understand the perception of local health specialists regarding the number of healers, demand for healers and use of medicinal plants, and the dependence of different environments to obtain such plants. We also aimed to understand the role of medicinal plants to treat different categories of diseases and if there is a complementary use of medicinal plants and allopathic biomedicine, according to the context of each group. The research was conducted with local health specialists that answered structured interviews, created free lists and participated in guided tours to collect cited plants. Sixty-six local health specialists were identified in the Araripe communities and 22 specialists in the maroon communities. In the maroon communities, a greater number of specialists thought there was a decrease in the number and demand for healers, as well as the use of medicinal plants, due to changes in traditional livelihoods, since they are located in a region where the effects of the modernization were more intense. In the Chapada do Araripe communities the specialists knew more plants extracted from native vegetation, whereas in the maroon communities cultivated plants were better known, which may reflect the environmental conditions and the history of each region. Medicinal plants are preferred to treat simpler health problems that do not require medical care, such as gastrointestinal problems, general pain, flues and colds. The biomedicine is used principally for problems with blood pressure, general pains and endocrine and nutritional diseases. Even with the particularities of each region, in general the use of medicinal plants and biomedicines occurred in a complementary form in both regions; however, this coexistence may result from these different

  6. Condicionantes estruturais da regionalização na saúde: tipologia dos Colegiados de Gestão Regional Structural conditions for regionalization in health care: typology of Regional Management Boards

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    Ana Luiza d'Ávila Viana

    2010-08-01

    Full Text Available O atraso na implementação da estratégia da regionalização e a fragilidade de iniciativas combinadas de descentralização e regionalização no Brasil requerem explicação. O artigo levanta algumas hipóteses para elucidar essa intricada questão e analisa os condicionantes estruturais do processo de regionalização em curso nos estados. Para isso, elabora uma tipologia nacional das regiões de saúde que as diferenciam segundo graus de desenvolvimento econômico, social e características da rede de saúde, dos municípios que compõem os Colegiados de Gestão Regional (CGR formalmente implantados até janeiro de 2010. Para a construção da tipologia, adotaram-se os modelos de análise fatorial e de análise de agrupamentos (cluster analysis. Foram identificados cinco grandes grupos socioeconômicos de CGR, descritos de acordo com sua distribuição regional, população, despesa em saúde, perfil da oferta (incluindo mix público e privado e cobertura de serviços de saúde. Os resultados encontrados servem como norteadores da constituição de redes de atenção à saúde e de novas iniciativas no campo regional, de forma a aprimorar a política de regionalização e favorecer a construção de instrumentos de regulação diversificados, flexíveis e, sobretudo, mais ajustados às realidades regionais.An explanation is required for the delay in implementing the regionalization strategy and the fragile nature of the combined decentralization and regionalization initiatives in Brazil. The article raises some hypotheses to clarify this intricate issue and reviews the structural conditioning factors of the regionalization process ongoing in the states. A national typology of the health care regions is prepared, differentiating them according to the degree of socio-economic development and the characteristics of the health care network and of the municipalities that form the Regional Management Boards (CGR, formally implanted by January

  7. Integrating views on support for mid-level health worker performance: a concept mapping study with regional health system actors in rural Guatemala.

    Science.gov (United States)

    Hernández, Alison R; Hurtig, Anna-Karin; Dahlblom, Kjerstin; San Sebastián, Miguel

    2015-10-08

    Mid-level health workers are on the front-lines in underserved areas in many LMICs, and their performance is critical for improving the health of vulnerable populations. However, improving performance in low-resource settings is complex and highly dependent on the organizational context of local health systems. This study aims to examine the views of actors from different levels of a regional health system in Guatemala on actions to support the performance of auxiliary nurses, a cadre of mid-level health workers with a prominent role in public sector service delivery. A concept mapping study was carried out to develop an integrated view on organizational support and identify locally relevant strategies for strengthening performance. A total of 93 regional and district managers, and primary and secondary care health workers participated in generating ideas on actions needed to support auxiliary nurses' performance. Ideas were consolidated into 30 action items, which were structured through sorting and rating exercises, involving a total of 135 of managers and health workers. Maps depicting participants' integrated views on domains of action and dynamics in sub-groups' interests were generated using a sequence of multivariate statistical analyses, and interpreted by regional managers. The combined input of health system actors provided a multi-faceted view of actions needed to support performance, which were organized in six domains, including: Communication and coordination, Tools to orient work, Organizational climate of support, Motivation through recognition, Professional development and Skills development. The nature of relationships across hierarchical levels was identified as a cross-cutting theme. Pattern matching and go-zone maps indicated directions for action based on areas of consensus and difference across sub-groups of actors. This study indicates that auxiliary nurses' performance is interconnected with the performance of other health system actors who

  8. SALUD: A spatial microsimulation application to support regional health planning in Austria

    OpenAIRE

    Tomintz, Melanie N.; Kosar, B.; Garcia-Barrios, Victor M.

    2013-01-01

    The Austrian Federal Ministry of Health aims to improve the health of all people living in Austria and to decrease health and social inequalities. This leads to a careful planning and distribution of the available health care resources to meet government aims. The research project SALUD, funded by the Federal Ministry for Transport, Innovation and Technology and the Austrian Science Fund, focuses on building a Spatial Microsimulation Model for Austria by combining survey and census data to mo...

  9. The expanded program on immunization service delivery in the Dschang health district, west region of Cameroon: a cross sectional survey

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    Walter Ebile Akoh

    2016-08-01

    Full Text Available Abstract Background Vaccination is the most effective intervention strategy, and the provision of vaccination at fixed posts and outreach posts is a backbone of a sustainable vaccination system in developing countries. Access to immunization services is still limited in Cameroon. Several health districts in the west region have recorded new epidemic outbreaks, including the occurrence of a wild polio virus epidemic outbreak in 2013. The aim of this study was to assess immunization service delivery in one of the largest health districts in the west region of Cameroon; the Dschang Health district. Methods It was a cross sectional study conducted in 2013, in 42 health facilities covering 18 health areas in the Dschang Health District. Data were collected with questionnaires administered to health personnel face to face and an observation grid was used to assess resources and tools. Data were entered and analyzed in Epi Info. Results A total of 42 health facilities were assessed and 77 health personnel were interviewed. Overall, 29 (69.0 % health facilities organized one vaccination session monthly, 2 (4.8 % organized an outreach within the last 3 months prior to the study, 15 (35.7 % did not have a vaccination micro plan, 24 (32.9 % health personnel had not been supervised for at least the last 6 months prior to the study, 7 (16.7 % health facilities did not have a functional refrigerator, 1 (2.4 % did not have a vaccine carrier, 23 (54.8 % did not have a means of transport (vehicle or motorcycle and 12 (28.6 % did not have an EPI guideline. The knowledge of health personnel on vaccine and cold chain management, and on diseases of the EPI under epidemiological surveillance was found to be limited. Conclusion The frequency and strategic provision of immunization services in the Dschang Health district is inadequate. Resource availability for an adequate provision of immunization services is insufficient. The knowledge of health personnel

  10. Performance of health product risk management and surveillance conducted by health personnel at sub-district health promotion hospitals in the northeast region of Thailand

    OpenAIRE

    Kanjanarach, Tipaporn; Jaisa-ard, Raksaworn; Poonaovarat, Nantawan

    2014-01-01

    Tipaporn Kanjanarach,1,2 Raksaworn Jaisa-ard,1,2 Nantawan Poonaovarat3 1Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand; 2Center for Research and Development of Herbal Health Products, Khon Kaen University, Khon Kaen, Thailand; 3Health Consumer Protection, Chaiyapum Health Provincial Office, Chaiyapum, Thailand Background: Health personnel at sub-district health promotion hospitals (SD-HPHs) are assigned to take responsibility for 15 activities related to health...

  11. The Role of Public Health Nutrition in Achieving the Sustainable Development Goals in the Asia Pacific Region.

    Science.gov (United States)

    Binns, Colin; Lee, Mi Kyung; Low, Wah Yun; Zerfas, Alfred

    2017-10-01

    The Sustainable Development Goals (SDGs) replaced the Millennium Development Goals (MDCs) in 2015, which included several goals and targets primarily related to nutrition: to eradicate extreme poverty and hunger and to reduce child mortality and improve maternal health. In the Asia-Pacific Academic Consortium for Public Health (APACPH) member countries as a group, infant and child mortality were reduced by more than 65% between 1990 and 2015, achieving the MDG target of two-thirds reduction, although these goals were not achieved by several smaller countries. The SDGs are broader in focus than the MDGs, but include several goals that relate directly to nutrition: 2 (zero hunger-food), 3 (good health and well-being-healthy life), and 12 (responsible consumption and production-sustainability). Other SDGs that are closely related to nutrition are 4 and 5 (quality education and equality in gender-education and health for girls and mothers, which is very important for infant health) and 13 (climate action). Goal 3 is "good health and well-being," which includes targets for child mortality, maternal mortality, and reducing chronic disease. The Global Burden of Disease Project has confirmed that the majority of risk for these targets can be attributed to nutrition-related targets. Dietary Guidelines were developed to address public health nutrition risk in the Asia Pacific region at the 48th APACPH 2016 conference and they are relevant to the achievement of the SDGs. Iron deficiency increases the risk of maternal death from haemorrhage, a cause of 300000 deaths world-wide each year. Improving diets and iron supplementation are important public health interventions in the APACPH region. Chronic disease and obesity rates in the APACPH region are now a major challenge and healthy life course nutrition is a major public health priority in answering this challenge. This article discusses the role of public health nutrition in achieving the SDGs. It also examines the role of

  12. Federalism and regional health care expenditures: an empirical analysis for the Swiss cantons.

    Science.gov (United States)

    Crivelli, Luca; Filippini, Massimo; Mosca, Ilaria

    2006-05-01

    Switzerland (7.2 million inhabitants) is a federal state composed of 26 cantons. The autonomy of cantons and a particular health insurance system create strong heterogeneity in terms of regulation and organisation of health care services. In this study we use a single-equation approach to model the per capita cantonal expenditures on health care services and postulate that per capita health expenditures depend on some economic, demographic and structural factors. The empirical analysis demonstrates that a larger share of old people tends to increase health costs and that physicians paid on a fee-for-service basis swell expenditures, thus highlighting a possible phenomenon of supply-induced demand.

  13. The contribution of the polio eradication initiative to narrowing the gaps in the health workforce in the African Region.

    Science.gov (United States)

    Kamso, Jean; Mvika, Eddy S; Ota, M O C; Okeibunor, Joseph; Mkanda, Pascal; Mihigo, Richard

    2016-10-10

    The Global Polio Eradication Initiative (GPEI) massively invested to overcome the crippling disease in countries of the WHO African Region. In the context of economic crisis, almost all countries in the Region lack an adequate health workforce. Large amounts were invested by GPEI in human resources. This paper shows how the human resources funded by polio contributed to narrowing the gaps in health workforce and helped strengthening and supporting other priority health programmes in Angola, Chad, DRC, Nigeria, Tanzania, and Togo. The health workforce strengthening methods used in the five different countries included the following: policy development and strategic planning, microplanning, capacity building of public health and community workers, implementation and services, monitoring and evaluation, advocacy and social mobilization, and programme review. Staff funded by polio helped with achieving good coverage in vitamin A and insecticide-treated mosquito nets (Angola, Chad); improvement of EPI and integrated disease surveillance indicators, improved quality of data (all five countries), administrative support, smooth introduction of new vaccines, increased case detection, and early isolation of patients suffering from the Guinea worm (Chad); reduction of cholera, extension of directly observed TB short course treatment (Democratic Republic of Congo); significant staff performance improvement (Nigeria). GPEI investment achieved far beyond its primary goal, and contributed to narrowing the gaps in the health workforce in countries of the African Region, as demonstrated by the best practice documentation exercise. We recommend that expertise and experience of polio funded staff should be leveraged to strengthen, expand and support other public health programmes. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  14. Practical implementation of good practice in health, environment and safety management in enterprise in the Lodz region.

    Science.gov (United States)

    Michalak, Jacek

    2002-10-01

    Good practice in health, environment and safety management in enterprise (GP HESME) is the process that aims at continuous improvement in health, environment and safety performance, involving all stakeholders within and outside the enterprise. The GP HESME system is intended to function at different levels: international, national, local community, and enterprise. The most important issues at the first stage of GP HESME implementation in the Lodz region are described. Also, the proposals of future activities in Lodz are presented. Practical implementation of GP HESME requires close co-operation among all stakeholders: local authorities, employers, employees, research institutions, and the state inspectorate. The WHO and the Nofer Institute of Occupational Medicine (NIOM) are initiating implementation, delivering professional consultation, education and training of stakeholders in the NIOM School of Public Health. The implementation of GP HESME in the Lodz region started in 1999 from a WHO meeting on criteria and indicators, followed by close collaboration of NIOM with the city's Department of Public Health. 'Directions of Actions for Health of Lodz Citizens' is now the city's official document that includes GP HESME as an important part of public health policy in Lodz. Several conferences were organized by NIOM together with the Professional Managers' Club, Labor Inspection, and the city's Department of Public Health to assess the most important needs of enterprises. The employers and managerial staff, who predominated among the participants, stated the need for tailored sets of indicators and economic appraisal of GP HESME activities. Special attention is paid to GP HESME in supermarkets and community-owned enterprises, e.g., a local transportation company. A special program for small- and medium-size enterprises will be the next step of GP HESME in the Lodz region. The implementation of GP HESME is possible if the efforts of local authorities; research

  15. [Scientific information, medical education and health policies: the Pan-American Health Organization and the creation of the Regional Library of Medicine--Bireme].

    Science.gov (United States)

    Pires-Alves, Fernando

    2008-01-01

    This article examines the creation and the first years of functioning of the Regional Library of Medicine (Biblioteca Regional de Medicina--Bireme--PAHO), today Latin-American Center for Information in Health Sciences, during 1963-1982. In the course of this analysis, Bireme is being characterized as both an apparatus and an arena for negotiation present in the most general processes of development expressed in international cooperation, information in science and technology, health policies and in the movement for expansion and reform of medical teaching. The narrative has as initial landmark the conception of a regional library of medicine for Latin America according to a model proposed by the National Library of Medicine. The article qualifies the first years of Bireme's existence as the history of the reception of this model, a trajectory that reflected the criticism of that time against the way the health care services were organized and their human resources were educated. Finally, beginning in 1976, a new model resulted in a real modification of Bireme's programmatic agenda, implying in very distinct contributions for the functioning of the regime of information in health sciences in force in Brazil and Latin America.

  16. Mapping mHealth (mobile health) and mobile penetrations in sub-Saharan Africa for strategic regional collaboration in mHealth scale-up: an application of exploratory spatial data analysis.

    Science.gov (United States)

    Lee, Seohyun; Cho, Yoon-Min; Kim, Sun-Young

    2017-08-22

    Mobile health (mHealth), a term used for healthcare delivery via mobile devices, has gained attention as an innovative technology for better access to healthcare and support for performance of health workers in the global health context. Despite large expansion of mHealth across sub-Saharan Africa, regional collaboration for scale-up has not made progress since last decade. As a groundwork for strategic planning for regional collaboration, the study attempted to identify spatial patterns of mHealth implementation in sub-Saharan Africa using an exploratory spatial data analysis. In order to obtain comprehensive data on the total number of mHelath programs implemented between 2006 and 2016 in each of the 48 sub-Saharan Africa countries, we performed a systematic data collection from various sources, including: the WHO eHealth Database, the World Bank Projects & Operations Database, and the USAID mHealth Database. Additional spatial analysis was performed for mobile cellular subscriptions per 100 people to suggest strategic regional collaboration for improving mobile penetration rates along with the mHealth initiative. Global Moran's I and Local Indicator of Spatial Association (LISA) were calculated for mHealth programs and mobile subscriptions per 100 population to investigate spatial autocorrelation, which indicates the presence of local clustering and spatial disparities. From our systematic data collection, the total number of mHealth programs implemented in sub-Saharan Africa between 2006 and 2016 was 487 (same programs implemented in multiple countries were counted separately). Of these, the eastern region with 17 countries and the western region with 16 countries had 287 and 145 mHealth programs, respectively. Despite low levels of global autocorrelation, LISA enabled us to detect meaningful local clusters. Overall, the eastern part of sub-Saharan Africa shows high-high association for mHealth programs. As for mobile subscription rates per 100 population, the

  17. The Health Extension Program and Its Association with Change in Utilization of Selected Maternal Health Services in Tigray Region, Ethiopia: A Segmented Linear Regression Analysis.

    Science.gov (United States)

    Gebrehiwot, Tesfay Gebregzabher; San Sebastian, Miguel; Edin, Kerstin; Goicolea, Isabel

    2015-01-01

    In 2003, the Ethiopian Ministry of Health established the Health Extension Program (HEP), with the goal of improving access to health care and health promotion activities in rural areas of the country. This paper aims to assess the association of the HEP with improved utilization of maternal health services in Northern Ethiopia using institution-based retrospective data. Average quarterly total attendances for antenatal care (ANC), delivery care (DC) and post-natal care (PNC) at health posts and health care centres were studied from 2002 to 2012. Regression analysis was applied to two models to assess whether trends were statistically significant. One model was used to estimate the level and trend changes associated with the immediate period of intervention, while changes related to the post-intervention period were estimated by the other. The total number of consultations for ANC, DC and PNC increased constantly, particularly after the late-intervention period. Increases were higher for ANC and PNC at health post level and for DC at health centres. A positive statistically significant upward trend was found for DC and PNC in all facilities (pintroduction of the HEP. We are aware that other factors, that we could not control for, might be explaining that increase. The figures for DC and PNC are however low and more needs to be done in order to increase the access to the health care system as well as the demand for these services by the population. Strengthening of the health information system in the region needs also to be prioritized.

  18. Assessing the implementation of the family care team in the district health system of health region 2, Thailand

    Directory of Open Access Journals (Sweden)

    Nithra Kitreerawutiwong

    2018-02-01

    Full Text Available Background: The family care team (FCT was established to improve the quality of care. This study aimed to explore the perceptions of FCT implementation and describe the challenges inherent in implementing the FCT. Methods: Forty in-depth interviews were conducted. The interviewees consisted of five primary care managers in the provincial medical health office, five directors of community hospitals, five administrators in district health offices, ten subdistrict health-promoting hospital directors, representatives from ten local organizations, and five heads of village health volunteers. Data were collected in accordance with semistructured interview guidelines and analyzed by thematic analysis. Results: Participants’ expressed their opinions through five themes: (1 the role and scope of practice, (2 the communication in collaboration of the FCT, (3 the management of the FCT, (4 the impact of the FCT on the team members’ feelings and primary care performance, and (5 the main challenges, including the insufficiency of a teamwork culture and a biomedical approach. Conclusion: The information suggests the importance of issues such as the clarification of the team members’ roles and managers’ roles, communication within and across FCTs, and the preparation for training of interprofessionals to enhance collaborative management to achieve the optimal care for people in the district health system.

  19. Landscape of Research on Older Adults' Health in the Arab Region: Is It Demography-Driven or Development-Dependent?

    Science.gov (United States)

    Sibai, Abla Mehio; Rizk, Anthony; Costanian, Christy; Beard, John Roland

    2017-07-01

    To describe the quantity, methods, themes, and collaboration profiles of research on older adults' health in the Arab world, and map research productivity against demographic, economic, and development indicators. A scoping review of research on older adults' health drawing from 7 databases and covering the period 1994-2013. Aging research output has increased 6-fold over the study period, with middle-income countries showing the sharpest rise. The majority of the reviewed publications are descriptive in nature, oriented toward examining the extent of disease or factors associated with various morbidity and mortality outcomes (88.5%). Despite the increasing regional instability, there is a dearth of studies on "seniors in emergencies." Collaboration with international coauthors (16.0%) has been more frequent than with regional coauthors (4.2%). Correlation analysis suggests that research production has been more strongly influenced by literacy rates than by population aging indicators, Gross Domestic Product, or government investment in research and development. This study lays the basis for a "roadmap" for research on older adults' health in the Arab region. It calls for cooperation among various stakeholders to produce a targeted and well-informed research agenda that is more responsive to emerging and context-specific needs of older adults in the region. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Establishment of the South-Eastern Norway Regional Health Authority Resource Center for Children with Prenatal Alcohol/Drug Exposure

    Directory of Open Access Journals (Sweden)

    Gro C. C. Løhaugen

    2015-01-01

    Full Text Available This paper presents a new initiative in the South-Eastern Health Region of Norway to establish a regional resource center focusing on services for children and adolescents aged 2–18 years with prenatal exposure to alcohol or other drugs. In Norway, the prevalence of fetal alcohol spectrum (FAS is not known but has been estimated to be between 1 and 2 children per 1000 births, while the prevalence of prenatal exposure to illicit drugs is unknown. The resource center is the first of its kind in Scandinavia and will have three main objectives: (1 provide hospital staff, community health and child welfare personnel, and special educators with information, educational courses, and seminars focused on the identification, diagnosis, and treatment of children with a history of prenatal alcohol/drug exposure; (2 provide specialized health services, such as diagnostic services and intervention planning, for children referred from hospitals in the South-Eastern Health Region of Norway; and (3 initiate multicenter studies focusing on the diagnostic process and evaluation of interventions.

  1. The foot-health of people with diabetes in a regional Australian population: a prospective clinical audit

    Directory of Open Access Journals (Sweden)

    Perrin Byron M

    2012-03-01

    Full Text Available Abstract Background There is limited understanding of the foot-health of people with diabetes in Australian regional areas. The aim of this study was to document the foot-health of people with diabetes who attend publically funded podiatric services in a regional Australian population. Methods A three month prospective clinical audit was undertaken by the publically-funded podiatric services of a large regional area of Victoria, Australia. The primary variables of interest were the University of Texas (UT diabetic foot risk classification of each patient and the incidence of new foot ulceration during the study period. Age, gender, diabetes type, duration of diabetes and the podiatric service the patients attended were the other variables of interest. Results Five hundred and seventy six patients were seen during the three month period. Over 49% had a UT risk classification at a level at least peripheral neuropathy or more serious diabetes-related foot morbidity. Higher risk at baseline was associated with longer duration of diabetes (F = 31.7, p χ2 = 40.3, p 0.001 and type 1 diabetes (χ2 = 37.3, p 0.001. A prior history of foot pathology was the overwhelming predictor for incident ulceration during the time period (OR 8.1 (95% CI 3.6 to 18.2, p Conclusions The publically funded podiatric services of this large regional area of Australia deal with a disproportionally large number of people with diabetes at high risk of future diabetes-related foot complications. These findings may be useful in ensuring appropriate allocation of resources for future public health services involved in diabetic foot health service delivery in regional areas.

  2. OOMM--Object-Oriented Matrix Modelling: an instrument for the integration of the Brasilia Regional Health Information System.

    Science.gov (United States)

    Cammarota, M; Huppes, V; Gaia, S; Degoulet, P

    1998-01-01

    The development of Health Information Systems is widely determined by the establishment of the underlying information models. An Object-Oriented Matrix Model (OOMM) is described which target is to facilitate the integration of the overall health system. The model is based on information modules named micro-databases that are structured in a three-dimensional network: planning, health structures and information systems. The modelling tool has been developed as a layer on top of a relational database system. A visual browser facilitates the development and maintenance of the information model. The modelling approach has been applied to the Brasilia University Hospital since 1991. The extension of the modelling approach to the Brasilia regional health system is considered.

  3. Measuring Efficiency of Health Systems of the Middle East and North Africa (MENA) Region Using Stochastic Frontier Analysis.

    Science.gov (United States)

    Hamidi, Samer; Akinci, Fevzi

    2016-06-01

    The main purpose of this study is to measure the technical efficiency of twenty health systems in the Middle East and North Africa (MENA) region to inform evidence-based health policy decisions. In addition, the effects of alternative stochastic frontier model specification on the empirical results are examined. We conducted a stochastic frontier analysis to estimate the country-level technical efficiencies using secondary panel data for 20 MENA countries for the period of 1995-2012 from the World Bank database. We also tested the effect of alternative frontier model specification using three random-effects approaches: a time-invariant model where efficiency effects are assumed to be static with regard to time, and a time-varying efficiency model where efficiency effects have temporal variation, and one model to account for heterogeneity. The average estimated technical inefficiency of health systems in the MENA region was 6.9 % with a range of 5.7-7.9 % across the three models. Among the top performers, Lebanon, Qatar, and Morocco are ranked consistently high according to the three different inefficiency model specifications. On the opposite side, Sudan, Yemen and Djibouti ranked among the worst performers. On average, the two most technically efficient countries were Qatar and Lebanon. We found that the estimated technical efficiency scores vary substantially across alternative parametric models. Based on the findings reported in this study, most MENA countries appear to be operating, on average, with a reasonably high degree of technical efficiency compared with other countries in the region. However, there is evidence to suggest that there are considerable efficiency gains yet to be made by some MENA countries. Additional empirical research is needed to inform future health policies aimed at improving both the efficiency and sustainability of the health systems in the MENA region.

  4. A prospective evaluation of first people's health promotion program design in the goulburn-murray rivers region.

    Science.gov (United States)

    Doyle, Joyce; Atkinson-Briggs, Sharon; Atkinson, Petah; Firebrace, Bradley; Calleja, Julie; Reilly, Rachel; Cargo, Margaret; Riley, Therese; Crumpen, Tui; Rowley, Kevin

    2016-11-10

    Aboriginal Community Controlled Organisations (ACCOs) provide community-focussed and culturally safe services for First Peoples in Australia, including crisis intervention and health promotion activities, in a holistic manner. The ecological model of health promotion goes some way towards describing the complexity of such health programs. The aims of this project were to: 1) identify the aims and purpose of existing health promotion programs conducted by an alliance of ACCOs in northern Victoria, Australia; and 2) evaluate the extent to which these programs are consistent with an ecological model of health promotion, addressing both individual and environmental determinants of health. The project arose from a long history of collaborative research. Three ACCOs and a university formed the Health Promotion Alliance to evaluate their health promotion programs. Local community members were trained in, and contributed to developing culturally sensitive methods for, data collection. Information on the aims and design of 88 health promotion activities making up 12 different programs across the ACCOs was systematically and prospectively collected. There was a wide range of activities addressing environmental and social determinants of health, as well as physical activity, nutrition and weight loss. The design of the great majority of activities had a minimal Western influence and were designed within a local Aboriginal cultural framework. The most common focus of the activities was social connectedness (76 %). Physical activity was represented in two thirds of the activities, and nutrition, weight loss and culture were each a focus of about half of the activities. A modified coding procedure designed to assess the ecological nature of these programs showed that they recruited from multiple settings; targeted a range of individual, social and environmental determinants; and used numerous and innovative strategies to achieve change. First Peoples' health promotion in the

  5. A prospective evaluation of first people’s health promotion program design in the goulburn-murray rivers region

    Directory of Open Access Journals (Sweden)

    Joyce Doyle

    2016-11-01

    achieve change. Conclusion First Peoples’ health promotion in the Goulburn-Murray Rivers region encompasses a broad range of social, cultural, lifestyle and community development activities, including reclaiming and strengthening cultural identity and social connectedness as a response to colonisation.

  6. Soft Skills in Health Careers Programs: A Case Study of A Regional Vocational Technical High School

    Science.gov (United States)

    Park, Chong Myung

    2017-01-01

    The purpose of this study is to develop an understanding of the ways in which educational experiences might differ between a regional vocational technical high school (RVTH) and short-term career-training programs. A particular regional vocational technical high school was selected for its outstanding academic records and placement rates, and a…

  7. Puberty, Health and Sexual Education in Australian Regional Primary Schools: Year 5 and 6 Teacher Perceptions

    Science.gov (United States)

    Duffy, Bernadette; Fotinatos, Nina; Smith, Amanda; Burke, Jenene

    2013-01-01

    The research reported in this paper investigates why teachers in regional primary schools in the Ballarat region of Victoria, Australia, are choosing to outsource the teaching of sexuality education. A survey was conducted of 29 Year 5 and Year 6 teachers from local primary schools. The teachers provided information about: their confidence in…

  8. Connecting agriculture and health care at the regional level: contributions from transition theory and institutional entrepreneurship

    NARCIS (Netherlands)

    Hassink, J.; Grin, J.; Hulsink, W.

    2010-01-01

    The authors analyzed two types of regional cooperation. Regional foundations of care farms and care institutions collaborating with a group of farmers. The initiatives were analyzed with a conceptual framework based on transition sciences and institutional entrepreneurship. The presence of a

  9. Finnish experiences of health monitoring: local, regional, and national data sources for policy evaluation

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    Katri Kilpeläinen

    2016-02-01

    Full Text Available Background: Finland has a long tradition of gathering information about the health and welfare of the adult population. Design: Surveys and administrative registers form the basis for national and local health monitoring in Finland. Results: Different data sources are used in Finland to develop key indicators, which can be used to evaluate how the national health policy targets have been met in different parts of the country and in different population subgroups. Progress has been shown in chronic disease risk factors, such as smoking reduction. However, some health policy targets have not been met. Socioeconomic health differences, for example, have remained large compared with other European countries. Conclusion: Although data availability for key health indicators is good in Finland, there is a need for wider and more comprehensive use of this information by political decision-makers and healthcare professionals.

  10. Review of behavioral health integration in primary care at Baylor Scott and White Healthcare, Central Region

    OpenAIRE

    Jolly, John B.; Fluet, Norman R.; Reis, Michael D.; Stern, Charles H.; Thompson, Alexander W.; Jolly, Gillian A.

    2016-01-01

    The integration of behavioral health services in primary care has been referred to in many ways, but ultimately refers to common structures and processes. Behavioral health is integrated into primary care because it increases the effectiveness and efficiency of providing care and reduces costs in the care of primary care patients. Reimbursement is one factor, if not the main factor, that determines the level of integration that can be achieved. The federal health reform agenda supports change...

  11. Reproductive health service utilization and associated factors: the case of north Shewa zone youth, Amhara region, Ethiopia.

    Science.gov (United States)

    Negash, Wassie; Dessalegn, Muluken; Yitayew, Berhanu; Demsie, Mohammed; Wagnew, Maereg; Nyagero, Josephat

    2016-01-01

    Many youth are less informed, less experienced and less comfortable in utilizing reproductive health services. In the Sub-Saharan region the adolescents account for a higher proportion of new HIV infections and unmet need for reproductive health (RH) services. This study assessed reproductive health service utilization and associated factors among the youth in Amhara Region, Ethiopia. A community based cross-sectional study was conducted from June 15-July 30, 2014. Three hundred ninety one youth were selected by systematic random sampling technique and interviewed using structured questionnaire. Data were anlyzed using SPSS windows version 20. Multiple logistic regression was done to control potential confounding variables. P-values school and out-of-school youth were interviewed; 256 (65.5%) participants were in school and 209 (53.5%) were males. Almost all respondents (93.9%) had heard about reproductive health services and a third 129 (33%) had ever practiced sexual intercourse and 54.7% of them had utilized at least one reproductive health services. Never had sexual intercourse (AOR=3.693, 95%CI: 1.266, 10.775), families that asked their children about friends (parental monitoring) (AOR=1.892, 95%CI: 1.026, 3.491), know where service provided (AOR=3.273, 95%CI: 1.158, 9.247), youths who reads newspaper readers (AOR=3.787, 95%CI: 1.849were independent predictors of youth reproductive service utilization at 95 % CI and p-value <0.05%. Even though the youth have information about reproductive health services, youth reproductive health services utilization is very low. Therefore, building life skill, facilitating parent to child communication, establishing and strengthening of youth centres and increasing awareness for youth about those services are important steps to improve adolescents' reproductive health (RH) service utilization.

  12. Towards people-centred health services delivery: a Framework for Action for the World Health Organisation (WHO European Region

    Directory of Open Access Journals (Sweden)

    Viktoria Stein

    2013-12-01

    Full Text Available Integrated care has moved from the small niche it traditionally occupied in academia, accessible only to experts in the field and applied merely on a project specific or pilot effort basis, now onto the radar of politicians and health system planners the world over.

  13. The balanced scorecard as a strategic management tool: its application in the regional public health system in Campania.

    Science.gov (United States)

    Impagliazzo, Cira; Ippolito, Adelaide; Zoccoli, Paola

    2009-01-01

    Health, as a primary and advanced need, can only be guaranteed through the appropriate management of dedicated resources. As in any situation where funds are limited, it is vital to have logical frameworks and tools to set up structures capable of making a complex system like the health service work. Only through an appropriate and competent activity of governance can such structures be identified, organized, and rendered operational. This can be achieved by using ad hoc tools such as the Balanced Scorecard. Its application in the case of the Regional Government of Campania indicates that it is a valid tool in all circumstances except in situations of crisis.

  14. Medical tourism in the Caribbean region: a call to consider environmental health equity.

    Science.gov (United States)

    Johnston, R; Crooks, V A

    2013-03-01

    Medical tourism, which is the intentional travel by private-paying patients across international borders for medical treatment, is a sector that has been targeted for growth in many Caribbean countries. The international development of this industry has raised a core set of proposed health equity benefits and drawbacks for host countries. These benefits centre on the potential investment in health infrastructure and opportunities for health labour force development while drawbacks focus on the potential for reduced access to healthcare for locals and inefficient use of limited public resources to support the growth of the medical tourism industry. The development of the medical tourism sector in Caribbean countries raises additional health equity questions that have received little attention in existing international debates, specifically in regard to environmental health equity. In this viewpoint, we introduce questions of environmental health equity that clearly emerge in relation to the developing Caribbean medical tourism sector These questions acknowledge that the growth of this sector will have impacts on the social and physical environments, resources, and waste management infrastructure in countries. We contend that in addition to addressing the wider health equity concerns that have been consistently raised in existing debates surrounding the growth of medical tourism, planning for growth in this sector in the Caribbean must take environmental health equity into account in order to ensure that local populations, environments, and ecosystems are not harmed by facilities catering to international patients.

  15. Self-rated health and quality of life in adults attending regional disability services in Ireland.

    LENUS (Irish Health Repository)

    Boland, Máirín C

    2009-04-01

    There is limited background information on self-rated health in people with disability in Ireland. This paper examines self-rated health scores and dimensions of functioning in people attending disability services and compares scores to the general population in Ireland, which has not been done before.

  16. Express Assessment of Population Health in Environmentally Unfriendly Region of Kazakhstan

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    Sholpan K. Bakhtiyarova

    2013-01-01

    Full Text Available The article shows that the proximity of houses to Lake Balkhash affects somatic health – more than 80 % of inhabitants of nearby area had low level, while about the same number of people – 75 % of the inhabitants of more remote areas from the lake showed "average" and "below average" level of health

  17. Contribution of traditional birth attendants to the formal health system in Ethiopia: the case of Afar region.

    Science.gov (United States)

    Temesgen, Tedla Mulatu; Umer, Jemal Yousuf; Buda, Dawit Seyoum; Haregu, Tilahun Nigatu

    2012-01-01

    Traditional birth attendants (TBAs) have been a subject of discussion in the provision of maternal and newborn health care. The objective of this study was to assess the role of trained traditional birth attendants in maternal and newborn health care in Afar Regional State of Ethiopia. A qualitative study was used where 21 in-depth interviews and 6 focus group discussions were conducted with health service providers, trained traditional birth attendants, mothers, men, kebele leaders and district health personnel. The findings of this study indicate that trained traditional birth attendants are the backbone of the maternal and child health development in pastoralist communities. However, the current numbers are inadequate and cannot meet the needs of the pastoralist communities including antenatal care, delivery, postnatal care and family planning. In addition to service delivery, all respondents agreed on multiple contributions of trained TBAs, which include counselling, child care, immunisation, postnatal care, detection of complication and other social services. Without deployment of adequate numbers of trained health workers for delivery services, trained traditional birth attendants remain vital for the rural community in need of maternal and child health care services. With close supportive supervision and evaluation of the trainings, the TBAs can greatly contribute to decreasing maternal and newborn mortality rates.

  18. Voices from the Field: Regional Nurses Speak About Motivations, Careers and How to Entice Others to Pursue Mental Health Nursing.

    Science.gov (United States)

    Penman, Joy; Martinez, Lee; Papoulis, Debra; Cronin, Kathryn

    2018-01-30

    The aims of this study are three-fold: determine the factors that motivate nurses to pursue mental health nursing; identify the strategies that might attract nursing students and practising nurses to pursue mental health nursing as a professional career; and identify the difficulties of nurses in achieving their preferred clinical specialty. A descriptive qualitative study design with semi-structured interviews was used. Fifteen mental health nurses from rural and regional South Australia were interviewed. Interviews were transcribed verbatim, and thematic analysis was undertaken. Of the fifteen participants, thirteen were females and two were males; their average age was 50 years. The factors that motivated the participants to pursue mental health nursing were categorized as intrinsic and extrinsic. There were many strategies that might attract nursing students and nurses to the field, but the most popular suggestion was the provision of high quality meaningful clinical placements. Other strategies were to convey the personal satisfaction derived from being a mental health nurse, promote mental health nursing aggressively, and provide employment incentives. The study also highlighted the importance of addressing stigma, and greater education and support for nurses to pursue a mental health career.

  19. Job satisfaction and associated factors among health care providers at public health institutions in Harari region, eastern Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Geleto, Ayele; Baraki, Negga; Atomsa, Gudina Egata; Dessie, Yadeta

    2015-09-01

    Human factor is the primary resource of health care system. For optimal performance of health care system, the workforce needs to be satisfied with the job he/she is doing. This research was aimed to assess the level of job satisfaction and associated factors among health care providers at public health institutions in Harari region, Eastern Ethiopia. Health facility based cross-sectional study was conducted among 405 randomly selected health care providers in Harari regional state, Eastern Ethiopia. Data were collected by self-administered structured questionnaires. Epidata Version 3.1 was used for data entry and analysis was made with SPSS version 17. Level of job satisfaction was measured with a multi item scales derived from Wellness Council of America and Best Companies Group. The average/mean value was used as the cutoff point to determine whether the respondents were satisfied with their job or not. Multivariable logistic regression was used to analyze data and odds ratio with 95% CI at P ≤ 0.05 was used to identify associated factors with level of job satisfaction. Less than half 179 (44.2%) of the respondents were satisfied with their job. Being midwifery in profession [AOR = 1.20; 95% CI (1.11-2.23)], age less than 35 years [AOR = 2.0; 95% CI (1.67-2.88)], having good attitude to stay in the same ward for longer period [AOR = 3.21; 95 % CI (1.33, 5.41)], and safe working environment [AOR = 4.61; 95% CI (3.33, 6.92)] were found were found to be associated with job satisfaction. Less than half (44.2%) of the respondents were satisfied with their current job. Organizational management system, salary and payment and working environment were among factors that affects level of job satisfaction. Thus, regional health bureau and health facility administrators need to pay special attention to improve management system through the application of a health sector reform strategy.

  20. [Supply and demand of medical specialists in the health facilities of the Ministry of Health: national, regional and by type of specialty gaps].

    Science.gov (United States)

    Zevallos, Leslie; Pastor, Reyna; Moscoso, Betsy

    2011-06-01

    To characterize the supply, demand and the gap of medical specialists in facilities of the Ministry of Health of Peru (MINSA) at the national, regional and specialty type levels. Observational, descriptive study through which we calculated the supply of medical specialists using secondary sources of MINSA. The analysis of the demand for medical specialists was based on two methodologies: the need for specialists according to the guidelines of classification of the health facilities and according to the epidemiological and demographic profile. The arithmetic difference between the estimated demand and the supply was the procedure used to calculate the gap of medical specialists. The Ministry of Health has a total supply at the national level of 6,074 medical specialists of which 61.5% belong to the clinical specialties, 33.2% to the surgical specialties, 4.9% specialities related to aid to diagnosis and treatment and 0.4% to public health specialties. According to the categorization guideline there is a total demand of 11,176 medical specialists and according to the epidemiological and demographic profile of 11,738. The national estimated gaps found are similar in both methods, although they differ widely across regions and by type of specialty. At the regional level, the gaps are greater in Loreto, Piura, Puno and Madre de Dios when estimating the defficit in relation to the supply. Regarding the speciality, the gap is greater in the four basic specialties: gynecology and obstetrics, pediatrics, internal medicine and general surgery. There is a waid gap between supply and demand of medical specialists at the national and regional levels, as a whole representing approximately 45% of the current offer, regardless of the estimation method.

  1. Using key performance indicators as knowledge-management tools at a regional health-care authority level.

    Science.gov (United States)

    Berler, Alexander; Pavlopoulos, Sotiris; Koutsouris, Dimitris

    2005-06-01

    The advantages of the introduction of information and communication technologies in the complex health-care sector are already well-known and well-stated in the past. It is, nevertheless, paradoxical that although the medical community has embraced with satisfaction most of the technological discoveries allowing the improvement in patient care, this has not happened when talking about health-care informatics. Taking the above issue of concern, our work proposes an information model for knowledge management (KM) based upon the use of key performance indicators (KPIs) in health-care systems. Based upon the use of the balanced scorecard (BSC) framework (Kaplan/Norton) and quality assurance techniques in health care (Donabedian), this paper is proposing a patient journey centered approach that drives information flow at all levels of the day-to-day process of delivering effective and managed care, toward information assessment and knowledge discovery. In order to persuade health-care decision-makers to assess the added value of KM tools, those should be used to propose new performance measurement and performance management techniques at all levels of a health-care system. The proposed KPIs are forming a complete set of metrics that enable the performance management of a regional health-care system. In addition, the performance framework established is technically applied by the use of state-of-the-art KM tools such as data warehouses and business intelligence information systems. In that sense, the proposed infrastructure is, technologically speaking, an important KM tool that enables knowledge sharing amongst various health-care stakeholders and between different health-care groups. The use of BSC is an enabling framework toward a KM strategy in health care.

  2. Grau de cobertura dos planos de saúde e distribuição regional do gasto público em saúde Level of private health insurance coverage and regional distribution of public health expenditure

    Directory of Open Access Journals (Sweden)

    Samuel Kilsztajn

    2001-12-01

    Full Text Available O artigo analisa o grau de cobertura dos planos de saúde segundo as classes de rendimento mensal familiar e por unidade da federação e a distribuição dos recursos da Rede-SUS e do gasto público total em saúde por usuário dos serviços públicos de saúde nas regiões Norte-Nordeste e Centro-Sul do país. São apresentados e discutidos também os indicadores do gasto público total em saúde como percentual do PIB gerado nas regiões.This paper analyses the level of private health insurance coverage by classes of income and by states in Brazil and the distribution of the total public health expenditure by public health users in the North-Northeast and Central-South regions of the country. The paper also presents and discusses the total public health expenditure as a percentage of regional GDP.

  3. Age and cause mortality structure in the Italian regions at the beginning of the health transition: a research

    Directory of Open Access Journals (Sweden)

    Lorenzo Del Panta

    2013-05-01

    Full Text Available This paper aims at exploring Italian mortality structure (by age and cause of death at the regional level in the last decades of the 19th Century. These years, corresponding to the beginning of the health transition process, were crucial in the Italian experience. The analysis is based on a careful exploitation of the volume “Statistica delle cause delle morti 1888”, published in 1890, by the General Directorate of Statistics. This volume is the only one which offers for the Italian regions, before the second World war, death statistics classified according to both age and cause together. The principal objectives of this descriptive contribution are essentially to illustrate the territorial variation of mortality conditions in the first phase of the health transition process as well as to underline the relevance and the complexities of the causes specific mortality analysis to explain the geographical mortality differentials in terms of age and sex.

  4. Population Health in Regions Adjacent to the Semipalatinsk Nuclear Test Site

    National Research Council Canada - National Science Library

    1998-01-01

    ...) of the Union of Soviet Socialist Republics (USSR). Inhabitants of several Kazakhstan regions were contaminated in different years by radioactive fallout from atmospheric nuclear tests at the Semipalatinsk test site...

  5. 76 FR 81404 - Information From Foreign Regions Applying for Recognition of Animal Health Status

    Science.gov (United States)

    2011-12-28

    .... Livestock demographics and marketing practices in the region. The type and extent of disease surveillance in... targeting that pathogen would be minimal. In such a case, it would not be necessary for APHIS to receive...

  6. Regional Development Through Investments in the Health Infrastructure in Romania, 2007-2013 Programming Period

    Directory of Open Access Journals (Sweden)

    Catană Aida

    2017-01-01

    This paper presents the situation of the financed projects implemented with the financial support of Regional Operational Programme 2007-2013. The available date are presented using the statistical analysis. The comparative results are presented for each reagion.

  7. Inmunizaciones y equidad en el Plan Regional del Sistema Mesoamericano de Salud Pública Immunization and equity in the Regional Initiative of the Mesoamerican Health Initiative

    Directory of Open Access Journals (Sweden)

    Carlos Franco-Paredes

    2011-01-01

    Full Text Available Las cifras nacionales de inmunización indican altas coberturas de vacunación en Mesoamérica, sin embargo, hay evidencia creciente de que los grupos más vulnerables no son alcanzados por los programas de vacunación. La planeación de este proyecto se llevó a cabo entre junio y diciembre de 2009. La ejecución del proyecto se llevará a cabo en la población objetivo seleccionada a partir de junio de 2011. Está integrada por niños menores de cinco años y mujeres en edad fértil de las poblaciones más vulnerables en los países de Mesoamérica, identificadas geográficamente por un bajo índice de desarrollo humano o por la alta prevalencia de pobreza en el ámbito municipal, o a través del uso de métodos participativos para definir pobreza y vulnerabilidad en contextos locales. El Grupo de Trabajo ha definido tres líneas de acción para las intervenciones de enfermedades prevenibles por vacunación, para lograr una mejor cobertura efectiva en poblaciones vulnerables: 1 estudios piloto de coberturas para vacíos de conocimiento, 2 fortalecimiento de las políticas de vacunación, 3 ejecución de prácticas basadas en evidencia. El fortalecimiento de los sistemas de salud bajo la óptica de equidad en salud es el objetivo regional central del Grupo de Trabajo en inmunizaciones enfocado en un aumento de la cobertura efectiva.National immunization rates indicate high vaccine coverage in Mesoamerica, but there is growing evidence that the most vulnerable groups are not being reached by immunization programs. Therefore, there is likely low effective vaccine coverage in the region, leading to persistent and growing health inequity. The planning phase of this project was from June to December 2009. The project will be conducted in the target populations which includes children under five, pregnant women, and women of child-bearing age from the most vulnerable populations within countries of the Mesoamerican region, as indicated geographically

  8. Improving Public Health and Environment through Plastic Waste Management in Mumbai Metropolitan Region

    OpenAIRE

    Sanjay RODE

    2015-01-01

    The Mumbai Metropolitan Region is growing in terms of population, industry, educational and commercial units. The daily requirements of commodities and services by all units have increased fast. Plastic is used extensively for packing, protection and service of various commodities. The use of plastic is much higher by industry and households in region. In Brihan Mumbai Municipal Corporation, the density of population is higher. The concentration of small and large industries is more. Therefor...

  9. Under-reporting of notifiable infectious disease hospitalizations in a health board region in Ireland: room for improvement?

    LENUS (Irish Health Repository)

    Brabazon, E D

    2008-02-01

    Rapid notification of infectious diseases is essential for prompt public health action and for monitoring of these diseases in the Irish population at both a local and national level. Anecdotal evidence suggests, however, that the occurrence of notifiable infectious diseases is seriously underestimated. This study aims to assess the level of hospitalization for notifiable infectious diseases for a 6-year period in one health board region in Ireland and to assess whether or not there was any under-reporting during this period. All hospital in-patient admissions from 1997 to 2002 inclusive with a principal diagnosis relating to \\'infectious and parasitic diseases\\' (ICD codes 001-139) of residents from a health board region in Ireland were extracted from the Hospital In-Patient Enquiry System (HIPE). All notifiable infectious diseases were identified based on the 1981 Irish Infectious Disease Regulations and the data were analysed in the statistical package, JMP. These data were compared with the corresponding notification data. Analysis of the hospital in-patient admission data revealed a substantial burden associated with notifiable infectious diseases in this health board region: there were 2758 hospitalizations by 2454 residents, 17,034 bed days and 33 deaths. The statutory notification data comprises both general practitioner and hospital clinician reports of infectious disease. Therefore, only in cases where there are more hospitalizations than notifications can under-reporting be demonstrated. This occurred in nine out of 22 notifiable diseases and amounted to an additional 18% of notifications (or 572 cases) which were \\'missed\\' due to hospital clinician under-reporting. The majority of these under-reported cases were for viral meningitis (45%), infectious mononucleosis (27%), viral hepatitis C unspecified (15%) and acute encephalitis (5.8%). This study has highlighted the extent of under-reporting of hospitalized notifiable infectious diseases, in a

  10. Social inequalities and health in rural Chiapas, Mexico: agricultural economy, nutrition, and child health in La Fraylesca Region

    Directory of Open Access Journals (Sweden)

    Héctor Ochoa-Díaz López

    1999-04-01

    Full Text Available The objective of this study was to investigate the association between farmers' socioeconomic conditions and their children's health in La Fraylesca, Chiapas. Data were collected using a cross-sectional survey of 1046 households (5546 individuals sampled from locations in two counties situated in the study area. The survey included anthropometric measurements, a 24-hour dietary recall, stool tests, and childhood mortality data. Children of private farmers and "wealthy peasants" displayed better nutritional status, higher quality diet, lower prevalence of intestinal parasites, and a lower risk of dying than those whose parents were communal farmers, from ejidos, or "poor peasants". The results suggest that using volume of maize production as a classification method proved more valuable than land tenure to identify agricultural groups with different health status. It appears that the main determinants of health differentials are structural inequities in resource distribution. Thus, the impact of medical interventions on inequalities will be limited unless they are accompanied by redistribution of resources.

  11. Depression literacy and health-seeking attitudes in the Western Pacific region: a mixed-methods study.

    Science.gov (United States)

    Ho, Grace W K; Bressington, D; Leung, S F; Lam, K K C; Leung, A Y M; Molassiotis, A; Ligot, J; Ranoco, C; Sophal, C; Valimaki, M

    2018-06-02

    Depression literacy refers to the ability to recognize depression and make informed decisions about its treatment. To date, relatively little research has been done to examine depression literacy in the Western Pacific region. Given the pervasiveness of depression and the need to enhance mental health care in this region, it is important to gain a better understanding of depression literacy and health-seeking behaviors in this part of the world. This mixed-methods study utilized a convergent parallel design to examine depression literacy and the associated health-seeking attitudes among urban adults from three countries-Cambodia, Philippines, and Fiji. A total of 455 adults completed a quantitative survey on depression knowledge, attitudes, and professional help seeking. Separately, 56 interviewees from 6 focus groups provided qualitative data on their impression and knowledge of depression and mental illness within the context of their local communities. Overall, results showed that depression knowledge was comparatively lower in this region. Controlling for differences across countries, higher knowledge was significantly associated with more positive attitudes towards mental illness (B = - 0.28, p = 0.025) and professional help seeking (B = 0.20, p < 0.001). Financial stability, such as employment, was also a salient factor for help seeking. This study was the first to provide a baseline understanding on depression literacy and highlights the need to increase public knowledge on depression in the Western Pacific. Culturally congruent recommendations on enhancing depression literacy in this region, such as anti-stigma campaigns, use of financial incentives, and family-based approach in health education, are discussed.

  12. Towards a regional approach for animal health services provision and disaster risk reduction: the economics of the Caribvet network

    OpenAIRE

    Tago Pacheco, Damian; Percedo Abreu, M.I.; Gongora, Victor; Lancelot, Renaud; Lefrançois, Thierry; Surujbally, Nisa; Lazarus, C.; Morales, Paula; Frias Lepoureau, Maria Teresa; Vokaty, Sandra; Pradel, Jennifer

    2016-01-01

    Climate change is expected to increase the frequency and intensity of natural disasters (Mechler et al. 2010) that impact the socio-economic development of nations worldwide, including those in the Caribbean, a region particularly vulnerable to natural perils (Macpherson and Akpinar-Elci, 2013). Global changes and climate change are also expected to have a significant impact on animal and human health, especially distribution and impact of vector-borne and zoonotic diseases which are consider...

  13. Exploring the Health Needs of Aging LGBT Adults in the Cape Fear Region of North Carolina.

    Science.gov (United States)

    Rowan, Noell L; Beyer, Kelsey

    2017-01-01

    This study explored issues of culturally sensitive healthcare practice and needs among lesbian, gay, bisexual and transgender aging adults in coastal North Carolina. Survey data results indicated the largest problem was a history of verbally harassment and need for culturally sensitive healthcare. In conclusion, culturally sensitive interventions are needed to address the health disparities and unique needs of LGBT aging adults. Cultural sensitivity training for service providers is suggested as a vital step in addressing health disparities of aging LGBT adults. Implications for research include further exploration of health related needs of these often hidden and underserved population groups.

  14. Spatiotemporal analysis of the effect of climate change on vegetation health in the Drakensberg Mountain Region of South Africa.

    Science.gov (United States)

    Mukwada, Geoffrey; Manatsa, Desmond

    2018-05-24

    The impact of climate change on mountain ecosystems has been in the spotlight for the past three decades. Climate change is generally considered to be a threat to ecosystem health in mountain regions. Vegetation indices can be used to detect shifts in ecosystem phenology and climate change in mountain regions while satellite imagery can play an important role in this process. However, what has remained problematic is determining the extent to which ecosystem phenology is affected by climate change under increasingly warming conditions. In this paper, we use climate and vegetation indices that were derived from satellite data to investigate the link between ecosystem phenology and climate change in the Namahadi Catchment Area of the Drakensberg Mountain Region of South Africa. The time series for climate indices as well as those for gridded precipitation and temperature data were analyzed in order to determine climate shifts, and concomitant changes in vegetation health were assessed in the resultant epochs using vegetation indices. The results indicate that vegetation indices should only be used to assess trends in climate change under relatively pristine conditions, where human influence is limited. This knowledge is important for designing climate change monitoring strategies that are based on ecosystem phenology and vegetation health.

  15. Estimation of health and economic costs of air pollution over the Pearl River Delta region in China.

    Science.gov (United States)

    Lu, Xingcheng; Yao, Teng; Fung, Jimmy C H; Lin, Changqing

    2016-10-01

    The Pearl River Delta region (PRD) is the economic growth engine of China and also one of the most urbanized regions in the world. As a two-sided sword, rapid economic development causes air pollution and poses adverse health effects to the citizens in this area. This work estimated the negative health effects in the PRD caused by the four major ambient pollutants (SO2, NO2, O3 and PM10) from 2010 to 2013 by using a log linear exposure-response function and the WRF-CMAQ modeling system. Economic loss due to mortality and morbidity was evaluated by the value of statistical life (VSL) and cost of illness (COI) methods. The results show that the overall possible short-term all-cause mortality due to NO2, O3 and PM10 reached the highest in 2013 with the values being 13,217-22,800. The highest total economic loss, which ranged from 14,768 to 25,305million USD, occurred in 2013 and was equivalent to 1.4%-2.3% of the local gross domestic product. The monthly profile of cases of negative health effects varied by city and the types of ambient pollutants. The ratio of mortality attributed to air pollutants to total population was higher in urban areas than in rural areas. People living in the countryside should consider the possible adverse health effects of urban areas before they plan a move to the city. The results show that the health burden caused by the ambient pollutants over this region is serious and suggest that tighter control policies should be implemented in the future to reduce the level of air pollution. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Decentralising health workforce governance: balancing national and regional resources and interests

    NARCIS (Netherlands)

    Batenburg, R.

    2015-01-01

    Background: A strong drive towards decentralisation has emerged, but it seems that for different parts of health workforce governance, different arguments play a role that alternately favour centralised or decentralised development and implementation. What these arguments contain, and what patterns

  17. A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana

    DEFF Research Database (Denmark)

    Ahiabu, Mary-Anne; Tersbøl, Britt Pinkowski; Biritwum, Richard

    2016-01-01

    with the national average estimated in 2008. Interventions that reduce diagnostic uncertainty in illness management should be considered. The National Health Insurance Scheme, as the main purchaser of health services in Ghana, offers an opportunity that should be exploited to introduce policies in support......Resistance to antibiotics is increasing globally and is a threat to public health. Research has demonstrated a correlation between antibiotic use and resistance development. Developing countries are the most affected by resistance because of high infectious disease burden, limited access to quality...... assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern...

  18. Community mental health nurses’ experience of decentralised and integrated psychiatric-mental health care services in the Southern mental health region of Botswana (part 1

    Directory of Open Access Journals (Sweden)

    M.K. Maphorisa

    2002-09-01

    Full Text Available Since the inception of the decentralisation and integration of psychiatric mental health care services into the general health care delivery system in Botswana, there has never been a study to investigate what community mental health nurses are experiencing due to the policy. Many of these nurses have been leaving the scantily staffed mental health care services in increasing numbers to join other sectors of health or elsewhere since the beginning of the implementation of the policy. During the research study, phenomenological in-depth interviews were conducted with three groups of 12 community mental health nurses altogether. An open central question was posed to each group followed by probing questions to explore and describe these nurses’ experience of the decentralisation and integration of psychiatric-mental health care services. After the data was analysed, related literature was incorporated and guidelines for advanced psychiatric nurses were formulated and described to assist these nurses to cope with the decentralisation and integration of psychiatric-mental health care services. The guidelines were set up for the management of the community mental health nurses who are experiencing obstacles in the quest for mental health which also interfere with their capabilities as mental health care providers.

  19. Health care workers indicate ill preparedness for Ebola Virus Disease outbreak in Ashanti Region of Ghana

    OpenAIRE

    Augustina Angelina Annan; Denis Dekugmen Yar; Michael Owusu; Eno Akua Biney; Paa Kobina Forson; Portia Boakye Okyere; Akosua Adumea Gyimah; Ellis Owusu-Dabo

    2017-01-01

    Abstract Background The recent Ebola Virus Disease (EVD) epidemic that hit some countries in West Africa underscores the need to train front line high-risk health workers on disease prevention skills. Although Ghana did not record (and is yet to) any case, and several health workers have received numerous training schemes, there is no record of any study that assessed preparedness of healthcare workers (HCWS) regarding EVD and any emergency prone disease in Ghana. We therefore conducted a hos...

  20. Food and Health in Europe: a new basis for action. WHO Regional Office for Europe. 2004

    DEFF Research Database (Denmark)

    Robertson, Aileen

    sector to include sectors ranging from agriculture and food processing, manufacturing and trade to transport, retailing, catering and advertising. Food and nutrition policies should be coordinated so that public health is given due priority in the making of food policies by non-health sectors......, multisectoral food and nutrition policies to encourage the sustainable production of food, its safety and the provision of food of high nutritional quality for all....