... Energy Regulatory Commission Wisconsin Electric Power Company, Wisconsin Gas LLC, Wisconsin Public Service Corporation: Complainants; ANR Pipeline Company: Respondent; Notice of Complaint April 6, 2010....206 (2009), Wisconsin Electric Power Company, Wisconsin Gas LLC, and Wisconsin Public Service...
Pursel, Kevin J; Jacobson, Martin; Stephenson, Kathy
The purpose of this study is to describe a reimbursement model that was developed by one Health Maintenance Organization (HMO) to transition from fee-for-service to add a combination of pay for performance and reporting model of reimbursement for chiropractic care. The previous incentive program used by the HMO provided best-practice education and additional reimbursement incentives for achieving the National Committee for Quality Assurance Back Pain Recognition Program (NCQA-BPRP) recognition status. However, this model had not leveled costs between doctors of chiropractic (DCs). Therefore, the HMO management aimed to develop a reimbursement model to incentivize providers to embrace existing best-practice models and report existing quality metrics. The development goals included the following: it should (1) be as financially predictable as the previous system, (2) cost no more on a per-member basis, (3) meet the coverage needs of its members, and (4) be able to be operationalized. The model should also reward DCs who embraced best practices with compensation, not simply tied to providing more procedures, the new program needed to (1) cause little or no disruption in current billing, (2) be grounded achievable and defined expectations for improvement in quality, and (3) be voluntary, without being unduly punitive, should the DC choose not to participate in the program. The generated model was named the Comprehensive Chiropractic Quality Reimbursement Methodology (CCQRM; pronounced "Quorum"). In this hybrid model, additional reimbursement, beyond pay-for-procedures will be based on unique payment interpretations reporting selected, existing Physician Quality Reporting System (PQRS) codes, meaningful use of electronic health records, and achieving NCQA-BPRP recognition. This model aims to compensate providers using pay-for-performance, pay-for-quality reporting, pay-for-procedure methods. The CCQRM reimbursement model was developed to address the current needs of one
Oftedahl, Elizabeth; Benedict, Ruth; Katcher, Murray L
The National Center for Health Statistics developed and conducted (2000-2002) the National Survey of Children with Special Health Care Needs (CSHCN), a module of the State and Local Area Integrated Telephone Survey (SLAITS). The purpose of this paper is to present the Wisconsin-specific data derived from analysis of the national survey and to make a comparison with the United States as a whole. In Wisconsin, approximately one fifth (21%) of households have CSHCN, and 13.4% of children have a special health care need; US comparison data are 20% and 12.8%, respectively. When examined by type of special need, Wisconsin shows slightly higher proportions of CSHCN in all categories, when compared with U.S. data, with the exception of limitation in activity. Families in Wisconsin with CSHCN are more likely to report being involved with medical decision making and satisfied with services they receive (67%); having a medical home (57%); having adequate insurance; easy use of community-based service systems (81%); and receiving services to make transition to adult life (7.5%). Though Wisconsin has a slightly higher proportion of CSHCN than the United States as a whole, a greater proportion of Wisconsin families receive important services. These measurements allow us to strive for further improvement through coordination of services in the private health care delivery sector with public health programs.
... Energy Regulatory Commission Wisconsin Public Service Corporation; Notices of Intent To File License.... d. Submitted By: Wisconsin Public Service Corporation. e. Name of Projects: Tomahawk Hydroelectric..., Vice President, Energy Supply Operations, Wisconsin Public Service Corporation, P.O. Box 19001, 700...
... Energy Regulatory Commission Wisconsin Public Service Corporation; Notice of Application for Amendment of..., 2011. d. Applicant: Wisconsin Public Service Corporation. e. Name of Project: High Falls Project. f.... 791a-825r. h. Applicant Contact: James Nuthals, Wisconsin Public Service Corporation, 700 North Adams...
Cruz, Evelyn; Guhleman, Patricia; Onheiber, Patrice Mocny
For at least 20 years, the probability that an infant born in Wisconsin would die during the first year of life has been approximately three times greater for infants born to African American women than for those born to White women. Over the same period of time, other states have made improvements in African American infant mortality, whereas Wisconsin's ranking has fallen to last place. Various state and local efforts have been made to address the issue; however, it is only in the last 2 to 3 years that Wisconsin's high rate of African American infant mortality has become an agreed-upon health priority. This article discusses the factors that have converged to bring African American infant mortality to the forefront of Wisconsin public health policy and programs. Particular attention is given to the role of Wisconsin's Minority Health Program in relation to public health leadership and coalition building. Key actions currently underway to implement effective, evidence-based solutions are also described.
... Energy Regulatory Commission Wisconsin Public Service Corporation; Notice of Application for Amendment of... Filed: June 30, 2010. d. Applicant: Wisconsin Public Service Corporation. e. Name of Project: Tomahawk... the following hydroelectric application has been filed with the Commission and is available for public...
Senier, Laura; Kearney, Matthew; Orne, Jason
This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin. We show the geographic distribution, funding patterns, and utilization trends for outreach clinics over a 20-year period. Interviews with program planners and outreach clinic staff show how external and internal constraints limited the program's capacity. We compare clinic operations to the conceptual models guiding program design. Our findings show that state health officials had to scale back financial support for outreach clinic activities while healthcare providers faced increasing pressure from administrators to reduce investments in charity care. These external and internal constraints led to a decline in the overall number of patients served. We also find that redistribution of clinics to the Milwaukee area increased utilization among Hispanics but not among African-Americans. Our interviews suggest that these patterns may be a function of shortcomings embedded in the planning models. Planning models have three shortcomings. First, they do not identify the mitigation of health disparities as a specific goal. Second, they fail to acknowledge that partners face escalating profit-seeking mandates that may limit their capacity to provide charity services. Finally, they underemphasize the importance of seeking trusted partners, especially in working with communities that have been historically marginalized. There has been little discussion about equitably leveraging genetic advances that improve healthcare quality and efficacy. The role of State Health Agencies in mitigating disparities in access to genetic services has been largely ignored in the sociological literature.
Haq, Cynthia; Baumann, Linda; Olsen, Christopher W; Brown, Lori DiPrete; Kraus, Connie; Bousquet, Gilles; Conway, James; Easterday, B C
Globalization, migration, and widespread health disparities call for interdisciplinary approaches to improve health care at home and abroad. Health professions students are pursuing study abroad in increasing numbers, and universities are responding with programs to address these needs. The University of Wisconsin (UW)-Madison schools of medicine and public health, nursing, pharmacy, veterinary medicine, and the division of international studies have created an interdisciplinary center for global health (CGH). The CGH provides health professions and graduate students with courses, field experiences, and a new Certificate in Global Health. Educational programs have catalyzed a network of enthusiastic UW global health scholars. Partnerships with colleagues in less economically developed countries provide the foundation for education, research, and service programs. Participants have collaborated to improve the education of health professionals and nutrition in Uganda; explore the interplay between culture, community development, and health in Ecuador; improve animal health and address domestic violence in Mexico; and examine successful public health efforts in Thailand. These programs supply students with opportunities to understand the complex determinants of health and structure of health systems, develop adaptability and cross-cultural communication skills, experience learning and working in interdisciplinary teams, and promote equity and reduce health disparities at home and abroad. Based on the principles of equity, sustainability, and reciprocity, the CGH provides a strong foundation to address global health challenges through networking and collaboration among students, staff, and faculty within the UW and beyond.
Wisk, Lauren E.; Walsh, Matthew; McWilliams, Christine; Eggers, Shoshannah; Olson, Melissa
Objectives. We used objective oral health screening and survey data to explore individual-, psychosocial-, and community-level predictors of oral health status in a statewide population of adults. Methods. We examined oral health status in a sample of 1453 adult Wisconsin residents who participated in the Survey of the Health of Wisconsin Oral Health Screening project, conducted with the Wisconsin Department of Health Services during 2010. Results. We found significant disparities in oral health status across all individual-, psychosocial-, and community-level predictors. More than 15% of participants had untreated cavities, and 20% did not receive needed oral health care. Individuals who self-reported unmet need for dental care were 4 times as likely to have untreated cavities as were those who did not report such a need, after controlling for sociodemographic and behavioral factors. Conclusions. Our results suggested that costs were a primary predictor of access to care and poor oral health status. The results underscored the role that primary care, in conjunction with dental health care providers, could play in promoting oral health care, particularly in reducing barriers (e.g., the costs associated with unmet dental care) and promoting preventive health behaviors (e.g., teeth brushing). PMID:25905843
Henkel, Jane R.
This report was written for the Advisory Committee on Mentally Ill Inmates of the Wisconsin State Legislative Council's Special Committee on Mental Health Issues. It describes mental health services to inmates of Wisconsin's state prisons. Part I describes the organization of state level responsibilities for corrections, including the state…
Trapskin, Kari; Johnson, Curtis; Cory, Patrick; Sorum, Sarah; Decker, Chris
To describe the Wisconsin Pharmacy Quality Collaborative (WPQC), a quality-based network of pharmacies and payers with the common goals of improving medication use and safety, reducing health care costs for payers and patients, and increasing professional recognition and compensation for pharmacist-provided services. Wisconsin between 2006 and 2009. Community (independent, chain, and health-system) pharmacies and private and public health care payers/purchasers with support from the McKesson Corporation. This initiative aligns incentives for pharmacies and payers through implementation of 12 quality-based pharmacy requirements as conditions of pharmacy participation in a practice-advancement pilot. Payers compensate network pharmacies that meet the quality-based requirements for two levels of pharmacy professional services (level 1, intervention-based services; level 2, comprehensive medication review and assessment services). The pilot project is designed to measure the following outcomes: medication-use quality improvements, frequency and types of services provided, drug therapy problems, patient safety, cost savings, identification of factors that facilitate pharmacist participation, and patient satisfaction. The Pharmacy Society of Wisconsin created the WPQC network, which consists of 53 pharmacies, 106 trained pharmacists, 45 student pharmacists, 6 pharmacy technicians, and 2 initial payers. A quality assurance process is followed approximately quarterly to audit the 12 network quality requirements. An evaluation of this collaboration is being conducted. This program demonstrates that collaboration among payers and pharmacists is possible and can result in the development of an incentive-aligned program that stresses quality patient care, standardized services, and professional service compensation for pharmacists. This combination of a quality-based credentialing process with a professional services reimbursement schedule is unique and has the promise to
Adams, Alexandra K; Christens, Brian; Meinen, Amy; Korth, Amy; Remington, Patrick L; Lindberg, Sara; Schoeller, Dale
Obesity rates have increased dramatically, especially among children and disadvantaged populations. Obesity is a complex issue, creating a compelling need for prevention efforts in communities to move from single isolated programs to comprehensive multisystem interventions. To address these issues, we have established a childhood Obesity Prevention Initiative (Initiative) for Wisconsin. This Initiative seeks to test community change frameworks that can support multisystem interventions and provide data for local action as a means for influencing policies, systems, and environments that support individuals’ healthy eating and physical activity. The Initiative is comprised of three components: (1) infrastructure to support a statewide obesity prevention and health promotion network with state- and local-level public messaging and dissemination of evidence-based solutions (healthTIDE); (2) piloting a local, multisetting community-led intervention study in 2 Wisconsin counties; and (3) developing a geocoded statewide childhood obesity and fitness surveillance system. This Initiative is using a new model that involves both coalition action and community organizing to align resources to achieve health improvement at local and state levels. We expect that it will help lead to the implementation of cohesive and sustainable policy, system, and environment health promotion and obesity prevention strategies in communities statewide, and it has the potential to help Wisconsin become a national model for multisetting community interventions to address obesity. Addressing individual-level health through population-level changes ultimately will result in reductions in the prevalence of childhood obesity, current and future health care costs, and chronic disease mortality.
Full Text Available Abstract Background The primary objectives of this study were to assess Wisconsin's primary care residents' attitudes toward international health training, the interest among faculty to provide IH training, and the preferred modality of IH training. Methods Surveys were administered using 505 residents and 413 medical faculty in primary care residencies in Wisconsin. Results from 128 residents and 118 medical school faculty members were collected during the spring of 2007 and analyzed. Results In total, 25% of residents (128/505 and 28% of faculty (118/413 responded to the survey. A majority of residents (58% and faculty (63% were interested in global health issues. Among residents, 63% planned on spending professional time working abroad. Few residents (9% and faculty (11% assess their residencies as preparing residents well to address topics relating to international health. The survey indicates that adequate faculty in Wisconsin could provide mentorship in international health as 47% (55 of faculty had experience working as a physician internationally, 49% (58 of faculty spend more than 25% clinical time caring for patient from underserved communities and 39% (46 would be willing to be involved with developing curriculum, lecturing and/or mentoring residents in international health. Conclusion Overall, the majority of the respondents expressed high interest in IH and few felt prepared to address IH issues indicating a need for increased training in this area. The findings of this survey are likely relevant as a prototype for other primary care residencies.
Chikani, Vatsal; Reding, Douglas; Gunderson, Paul; McCarty, Catherine A.
Background: The aim of the present study is to investigate the association between psychosocial work characteristics and health functioning and cardiovascular disease risk factors among rural women of central Wisconsin and compare psychosocial work characteristics between farm and nonfarm women. Methods: Stratified sampling was used to select a…
Beyer, Kirsten M M; Malecki, Kristen M; Hoormann, Kelly A; Szabo, Aniko; Nattinger, Ann B
Socioeconomic disparities in colorectal and breast cancer screening persist, partially accounting for disparities in cancer outcomes. Some neighborhood characteristics--particularly area level socioeconomic factors--have been linked to cancer screening behavior, but few studies have examined the relationship between perceived neighborhood quality and screening behavior, which may provide more insight into the ways in which neighborhood environments shape cancer related behaviors. This study examines the relationship between several aspects of the perceived neighborhood environment and breast and colorectal cancer screening behavior among a population-based sample of Wisconsin residents. A sub-goal was to compare the relevance of different perceived neighborhood factors for different screening tests. This is a cross-sectional study of 2008-2012 data from the Survey of the Health of Wisconsin, a population-based annual survey of Wisconsin residents. An average risk sample of Black, Hispanic and White women age 50 and older (n = 1265) were selected. Survey regression analyses examined predictors of screening, as well as adherence to screening guidelines. Models controlled for individual socio-demographic information and insurance status. Perceptions of social and physical disorder, including fear of crime and visible garbage, were associated with screening rates. Findings emphasize the particular importance of these factors for colorectal cancer screening, indicating the necessity of improving screening rates in areas characterized by social disorganization, crime, and physical disorder. Additional work should be done to further investigate the pathways that explain the linkage between neighborhood conditions, perceived neighborhood risks and cancer screening behavior.
Hanrahan, Lawrence P; Anderson, Henry A; Busby, Brian; Bekkedal, Marni; Sieger, Thomas; Stephenson, Laura; Knobeloch, Lynda; Werner, Mark; Imm, Pamela; Olson, Joseph
In this article we describe the development of an information system for environmental childhood cancer surveillance. The Wisconsin Cancer Registry annually receives more than 25,000 incident case reports. Approximately 269 cases per year involve children. Over time, there has been considerable community interest in understanding the role the environment plays as a cause of these cancer cases. Wisconsin's Public Health Information Network (WI-PHIN) is a robust web portal integrating both Health Alert Network and National Electronic Disease Surveillance System components. WI-PHIN is the information technology platform for all public health surveillance programs. Functions include the secure, automated exchange of cancer case data between public health-based and hospital-based cancer registrars; web-based supplemental data entry for environmental exposure confirmation and hypothesis testing; automated data analysis, visualization, and exposure-outcome record linkage; directories of public health and clinical personnel for role-based access control of sensitive surveillance information; public health information dissemination and alerting; and information technology security and critical infrastructure protection. For hypothesis generation, cancer case data are sent electronically to WI-PHIN and populate the integrated data repository. Environmental data are linked and the exposure-disease relationships are explored using statistical tools for ecologic exposure risk assessment. For hypothesis testing, case-control interviews collect exposure histories, including parental employment and residential histories. This information technology approach can thus serve as the basis for building a comprehensive system to assess environmental cancer etiology.
Charles H. Perry
This resource update provides an overview of forest resources in Wisconsin based on an inventory conducted by the U.S. Forest Service, Forest Inventory and Analysis (FIA) program at the Northern Research Station in cooperation with the Wisconsin Department of Natural Resources. Data estimates are based on field data collected using the FIA annualized sample design and...
In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services. PMID:11953795
Zey, J.N.; Ahrenholz, S.; Klemme, J.C.
On October 1, 1980, the National Institute for Occupational Safety and Health (NIOSH) received a request from the International Brotherhood of Boilermakers Union, Local 1849, for a Health Hazard Evaluation of the Babcock and Wilcox Co., Tubular Products Division, Milwaukee, Wisconsin. The request involved the potential for employee exposure to biocides, dispersant and anti-scaling agents as they are added to four separate circulating water systems which cool four annealing furnaces, two reheat furnaces and one air compressor. NIOSH conducted a combined environmental and medical survey at the Milwaukee facility on November 19-20, 1980. While conducting a walk-through survey on November 19, 1980, NIOSH observed that furnace operators working near cooling systems were potentially exposed to cooling system chemicals. The furnace operators were included in employee monitoring on November 20, 1980. All concentrations obtained were below current environmental criteria. Medical interview data suggested that workers may have been exposed to potentially hazardous levels of DMF in the past.
Costrell, Robert M.
District costs for teachers' health insurance are, on average, higher then employer costs for private-sector professionals. How much of this is attributable to collective bargaining? This article examines the question using data from the National Compensation Survey (NCS) of the Bureau of Labor Statistics (BLS) and the state of Wisconsin. In…
Bhagavatula, Pradeep; Xiang, Qun; Szabo, Aniko; Eichmiller, Fredrick; Kuthy, Raymond A; Okunseri, Christopher E
Studies on rural-urban differences in dental care have primarily focused on differences in utilization rates and preventive dental services. Little is known about rural-urban differences in the use of wider range of dental procedures. This study examined patterns of preventive, restorative, endodontic, and extraction procedures provided to children enrolled in Delta Dental of Wisconsin (DDWI). We analyzed DDWI enrollment and claims data for children aged 0-18 years from 2002 to 2008. We modified and used a rural and urban classification based on ZIP codes developed by the Wisconsin Area Health Education Center (AHEC). We categorized the ZIP codes into 6 AHEC categories (3 rural and 3 urban). Descriptive and multivariable analysis using generalized linear mixed models (GLMM) were used to examine the patterns of dental procedures provided to children. Tukey-Kramer adjustment was used to control for multiple comparisons. Approximately, 50%, 67% and 68% of enrollees in inner-city Milwaukee, Rural 1 (less than 2500 people), and suburban-Milwaukee had at least one annual dental visit, respectively. Children in inner city-Milwaukee had the lowest utilization rates for all procedures examined, except for endodontic procedures. Compared to children from inner-city Milwaukee, children in other locations had significantly more preventive procedures. Children in Rural 1-ZIP codes had more restorative, endodontic and extraction procedures, compared to children from all other regions. We found significant geographic variation in dental procedures received by children enrolled in DDWI.
Background Studies on rural–urban differences in dental care have primarily focused on differences in utilization rates and preventive dental services. Little is known about rural–urban differences in the use of wider range of dental procedures. This study examined patterns of preventive, restorative, endodontic, and extraction procedures provided to children enrolled in Delta Dental of Wisconsin (DDWI). Methods We analyzed DDWI enrollment and claims data for children aged 0-18 years from 2002 to 2008. We modified and used a rural and urban classification based on ZIP codes developed by the Wisconsin Area Health Education Center (AHEC). We categorized the ZIP codes into 6 AHEC categories (3 rural and 3 urban). Descriptive and multivariable analysis using generalized linear mixed models (GLMM) were used to examine the patterns of dental procedures provided to children. Tukey-Kramer adjustment was used to control for multiple comparisons. Results Approximately, 50%, 67% and 68 % of enrollees in inner-city Milwaukee, Rural 1 (less than 2500 people), and suburban-Milwaukee had at least one annual dental visit, respectively. Children in inner city-Milwaukee had the lowest utilization rates for all procedures examined, except for endodontic procedures. Compared to children from inner-city Milwaukee, children in other locations had significantly more preventive procedures. Children in Rural 1-ZIP codes had more restorative, endodontic and extraction procedures, compared to children from all other regions. Conclusions We found significant geographic variation in dental procedures received by children enrolled in DDWI. PMID:23259637
Ameri, Cinzia; Fiorini, Fulvio
The gradual emergence of marketing activities in public health demonstrates an increased interest in this discipline, despite the lack of an adequate and universally recognized theoretical model. For a correct approach to marketing techniques, it is opportune to start from the health service, meant as a service rendered. This leads to the need to analyse the salient features of the services. The former is the intangibility, or rather the ex ante difficulty of making the patient understand the true nature of the performance carried out by the health care worker. Another characteristic of all the services is the extreme importance of the regulator, which means who performs the service (in our case, the health care professional). Indeed the operator is of crucial importance in health care: being one of the key issues, he becomes a part of the service itself. Each service is different because the people who deliver it are different, furthermore there are many variables that can affect the performance. Hence it arises the difficulty in measuring the services quality as well as in establishing reference standards.
... IHS Home for Patients Find Health Care Find Health Care IMPORTANT If you are having a health emergency ... services, continuous nursing services and that provides comprehensive health care including diagnosis and treatment. Health Locations An ambulatory ...
School health services reduce absenteeism and improve academic achievement according to research. If you have school-aged children, youâll want to listen to this podcast to learn more about healthy school environments and the link between health and academic achievement. Created: 9/13/2017 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Date Released: 9/13/2017.
Stephenson, Rob; Tsui, Amy Ong; Sulzbach, Sara; Bardsley, Phil; Bekele, Getachew; Giday, Tilahun; Ahmed, Rehana; Gopalkrishnan, Gopi; Feyesitan, Bamikale
Networks of franchised health establishments, providing a standardized set of services, are being implemented in developing countries. This article examines associations between franchise membership and family planning and reproductive health outcomes for both the member provider and the client. Regression models are fitted examining associations between franchise membership and family planning and reproductive health outcomes at the service provider and client levels in three settings. Franchising has a positive association with both general and family planning client volumes, and the number of family planning brands available. Similar associations with franchise membership are not found for reproductive health service outcomes. In some settings, client satisfaction is higher at franchised than other types of health establishments, although the association between franchise membership and client outcomes varies across the settings. Franchise membership has apparent benefits for both the provider and the client, providing an opportunity to expand access to reproductive health services, although greater attention is needed to shift the focus from family planning to a broader reproductive health context.
Department of Veterans Affairs — This service provides web services used to obtain MyHealtheVet related data. The service does not support multiple Vista sites data access. Users of this service are...
Beyer, Kirsten M M; Kaltenbach, Andrea; Szabo, Aniko; Bogar, Sandra; Nieto, F Javier; Malecki, Kristen M
Green space is now widely viewed as a health-promoting characteristic of residential environments, and has been linked to mental health benefits such as recovery from mental fatigue and reduced stress, particularly through experimental work in environmental psychology. Few population level studies have examined the relationships between green space and mental health. Further, few studies have considered the role of green space in non-urban settings. This study contributes a population-level perspective from the United States to examine the relationship between environmental green space and mental health outcomes in a study area that includes a spectrum of urban to rural environments. Multivariate survey regression analyses examine the association between green space and mental health using the unique, population-based Survey of the Health of Wisconsin database. Analyses were adjusted for length of residence in the neighborhood to reduce the impact of neighborhood selection bias. Higher levels of neighborhood green space were associated with significantly lower levels of symptomology for depression, anxiety and stress, after controlling for a wide range of confounding factors. Results suggest that "greening" could be a potential population mental health improvement strategy in the United States.
Zasa, R J
Indisputably, marketing plays an important role in today's competitive health service industry. It is essential for every medical group manager to learn about the marketing process and his role in pursuing marketing in his medical group. Conducting internal and external assessments, developing promotional techniques and strategies, organizing and implementing a plan, and evaluating results are all critical areas in the marketing effort. When each critical area is carefully examined and steps are properly taken, a marketing approach will be totally consistent with delivery of high-quality patient care services.
Lystbæk, Christian Tang
Technology developments create rich opportunities for health service providers to introduce service robots in health care. While the potential benefits of applying robots in health care are extensive, the research into the conceptions of health service robot and its importance for the uptake...... of robotics technology in health care is limited. This article develops a model of the basic conceptions of health service robots that can be used to understand different assumptions and values attached to health care technology in general and health service robots in particular. The article takes...... a discursive approach in order to develop a conceptual framework for understanding the social values of health service robots. First a discursive approach is proposed to develop a typology of conceptions of health service robots. Second, a model identifying four basic conceptions of health service robots...
VanWormer, Jeffrey J; Acharya, Amit; Greenlee, Robert T; Nieto, Francisco Javier
Poor oral health is an increasingly recognized risk factor for cardiovascular disease (CVD) and type 2 diabetes (T2D), but little is known about the association between toothbrushing or flossing and cardiometabolic disease risk. The purpose of this study was to examine the degree to which an oral hygiene index was associated with CVD and T2D risk scores among disease-free adults in the Survey of the Health of Wisconsin. All variables were measured in 2008-2010 in this cross-sectional design. Based on toothbrushing and flossing frequency, an oral hygiene index (poor, fair, good, excellent) was created as the primary predictor variable. The outcomes, CVD and T2D risk score, were based on previous estimates from large cohort studies. There were 712 and 296 individuals with complete data available for linear regression analyses in the CVD and T2D samples, respectively. After covariate adjustment, the final model indicated that participants in the excellent (β ± SE = -0.019 ± 0.008, P = 0.020) oral hygiene category had a significantly lower CVD risk score as compared to participants in the poor oral hygiene category. Sensitivity analyses indicated that both toothbrushing and flossing were independently associated with CVD risk score, and various modifiable risk factors. Oral hygiene was not significantly associated with T2D risk score. Regular toothbrushing and flossing are associated with a more favorable CVD risk profile, but more experimental research is needed in this area to precisely determine the effects of various oral self-care maintenance behaviors on the control of individual cardiometabolic risk factors. These findings may inform future joint medical-dental initiatives designed to close gaps in the primary prevention of oral and systemic diseases. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Lystbæk, Christian Tang
Technology developments create rich opportunities for health service providers to introduce service robots in health care. While the potential benefits of applying robots in health care are extensive, the research into the conceptions of health service robot and its importance for the uptake...... the two dimensions we identify four basic conceptions of health service robots, conceptualizing health service robots as critical, practical, desirable or affectionate, respectively. The article concludes with an outline of managerial concerns and points of departure for future research. Keywords: Service...... of robotics technology in health care is limited. This article develops a model of the basic conceptions of health service robots that can be used to understand different assumptions and values attached to health care technology in general and health service robots in particular. The article takes...
This publication provides an overview of forest resource attributes for Wisconsin based on an annual inventory conducted by the Forest Inventory and Analysis (FIA) program at the Northern Research Station of the U.S. Forest Service. These estimates, along with web-posted core tables, will be updated annually. For more information please refer to page 4 of this report...
C.H. Perry; V.A. Everson
Figure 2 was revised by the author in August 2008. This publication provides an overview of forest resource attributes for Wisconsin based on an annual inventory conducted by the Forest Inventory and Analysis program at the Northern Research Station of the U.S. Forest Service from 2002-2006. These estimates, along with associated core tables postedon the Internet, are...
C.H. Perry; V.A. Everson
This publication provides an overview of forest resource attributes for Wisconsin based on an annual inventory conducted by the Forest Inventory and Analysis (FIA) program of the U.S. Forest Service, Northern Research Station. These estimates, along with web-posted core tables, are updated annually. For more information please refer to page 4 of this report.
This publication provides an overview of forest resource attributes for Wisconsin based on an annual inventory conducted by the Forest Inventory and Analysis (FIA) program at the Northern Research Station of the U.S. Forest Service. These estimates, along with web-posted core tables, will be updated annually. For more information, please refer to page 4 of this report...
Schnell-Inderst, Petra; Hunger, Theresa; Hintringer, Katharina; Schwarzer, Ruth; Seifert-Klauss, Vanadin Regina; Gothe, Holger; Wasem, Jürgen; Siebert, Uwe
The German statutory health insurance (GKV) reimburses all health care services that are deemed sufficient, appropriate, and efficient. According to the German Medical Association (BÄK), individual health services (IGeL) are services that are not under liability of the GKV, medically necessary or recommendable or at least justifiable. They have to be explicitly requested by the patient and have to be paid out of pocket. The following questions regarding IGeL in the outpatient health care of GKV insurants are addressed in the present report: What is the empirical evidence regarding offers, utilization, practice, acceptance, and the relation between physician and patient, as well as the economic relevance of IGeL?What ethical, social, and legal aspects are related to IGeL? FOR TWO OF THE MOST COMMON IGEL, THE SCREENING FOR GLAUCOMA AND THE SCREENING FOR OVARIAN AND ENDOMETRIAL CANCER BY VAGINAL ULTRASOUND (VUS), THE FOLLOWING QUESTIONS ARE ADDRESSED: What is the evidence for the clinical effectiveness?Are there sub-populations for whom screening might be beneficial? The evaluation is divided into two parts. For the first part a systematic literature review of primary studies and publications concerning ethical, social and legal aspects is performed. In the second part, rapid assessments of the clinical effectiveness for the two examples, glaucoma and VUS screening, are prepared. Therefore, in a first step, HTA-reports and systematic reviews are searched, followed by a search for original studies published after the end of the research period of the most recent HTA-report included. 29 studies were included for the first question. Between 19 and 53% of GKV members receive IGeL offers, of which three-quarters are realised. 16 to 19% of the insurants ask actively for IGeL. Intraocular tension measurement is the most common single IGeL service, accounting for up to 40% of the offers. It is followed by ultrasound assessments with up to 25% of the offers. Cancer screening
Full Text Available Background: The German statutory health insurance (GKV reimburses all health care services that are deemed sufficient, appropriate, and efficient. According to the German Medical Association (BÄK, individual health services (IGeL are services that are not under liability of the GKV, medically necessary or recommendable or at least justifiable. They have to be explicitly requested by the patient and have to be paid out of pocket. Research questions: The following questions regarding IGeL in the outpatient health care of GKV insurants are addressed in the present report: What is the empirical evidence regarding offers, utilization, practice, acceptance, and the relation between physician and patient, as well as the economic relevance of IGeL? What ethical, social, and legal aspects are related to IGeL? For two of the most common IGeL, the screening for glaucoma and the screening for ovarian and endometrial cancer by vaginal ultrasound (VUS, the following questions are addressed: What is the evidence for the clinical effectiveness? Are there sub-populations for whom screening might be beneficial? Methods: The evaluation is divided into two parts. For the first part a systematic literature review of primary studies and publications concerning ethical, social and legal aspects is performed. In the second part, rapid assessments of the clinical effectiveness for the two examples, glaucoma and VUS screening, are prepared. Therefore, in a first step, HTA-reports and systematic reviews are searched, followed by a search for original studies published after the end of the research period of the most recent HTA-report included. Results: 29 studies were included for the first question. Between 19 and 53% of GKV members receive IGeL offers, of which three-quarters are realised. 16 to 19% of the insurants ask actively for IGeL. Intraocular tension measurement is the most common single IGeL service, accounting for up to 40% of the offers. It is followed by
Skitsou, Alexandra; Bekos, Christos; Charalambous, George
Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions......, ongoing education of health professionals along with relevant education of the community and the broad application of triage in the emergency departments will all contribute to delivering health services more effectively. Keywords: Cyprus, health services, patient rights...
Full Text Available Adolescents represent a large proportion of the population. As they mature and become sexually active, they face more serious health risks. Most face these risks with too little factual information, too little guidance about sexual responsibility and multiple barriers to accessing health care. A typical descriptive and explanatory design was used to determine what the characteristics of an accessible adolescent health service should be. Important results and conclusions that were reached indicate that the adolescent want a medical doctor and a registered nurse to be part of the health team treating them and they want to be served in the language of their choice. Family planning, treatment of sexually transmitted diseases and psychiatric services for the prevention of suicide are services that should be included in an adolescent accessible health service. The provision of health education concerning sexual transmitted diseases and AIDS is a necessity. The service should be available thought out the week (included Saturdays and within easy reach. It is recommended that minor changes in existing services be made, that will contribute towards making a health delivery service an adolescent accessible service. An adolescent accessible health service can in turn make a real contribution to the community’s efforts to improve the health of its adolescents and can prove to be a rewarding professional experience to the health worker.
Adolescents represent a large proportion of the population. As they mature and become sexually active, they face more serious health risks. Most face these risks with too little factual information, too little guidance about sexual responsibility and multiple barriers to accessing health care. A typical descriptive and explanatory design was used to determine what the characteristics of an accessible adolescent health service should be. Important results and conclusions that were reached indicate that the adolescent want a medical doctor and a registered nurse to be part of the health team treating them and they want to be served in the language of their choice. Family planning, treatment of sexually transmitted diseases and psychiatric services for the prevention of suicide are services that should be included in an adolescent accessible health service. The provision of health education concerning sexual transmitted diseases and AIDS is a necessity. The service should be available thought out the week (included Saturdays) and within easy reach. It is recommended that minor changes in existing services be made, that will contribute towards making a health delivery service an adolescent accessible service. An adolescent accessible health service can in turn make a real contribution to the community's efforts to improve the health of its adolescents and can prove to be a rewarding professional experience to the health worker.
Merlino, James I; Raman, Ananth
The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life.
Hollederer, A; Wildner, M
There is a great need for health services research in the public health system and in the German public health service. However, the public health service is underrepresented in health services research in Germany. This has several structural, historical and disciplinary-related reasons. The public health service is characterised by a broad range of activities, high qualification requirements and changing framework conditions. The concept of health services research is similar to that of the public health service and public health system, because it includes the principles of multidisciplinarity, multiprofessionalism and daily routine orientation. This article focuses on a specified system theory based model of health services research for the public health system and public health service. The model is based on established models of the health services research and health system research, which are further developed according to specific requirements of the public health service. It provides a theoretical foundation for health services research on the macro-, meso- and microlevels in public health service and the public health system. Prospects for public health service are seen in the development from "old public health" to "new public health" as well as in the integration of health services research and health system research. There is a significant potential for development in a better linkage between university research and public health service as is the case for the "Pettenkofer School of Public Health Munich". © Georg Thieme Verlag KG Stuttgart · New York.
Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge
Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.
Kosen, S; Gunawan, S
In Indonesia, rapid economic development has led to a reduction in poverty among the 195 million inhabitants. While population increased more than 50% from 1971 to 1990, the annual growth rate, crude birth rate, and total fertility rates have declined rapidly. Life expectancy has increased from 45.7 years in 1971 to 62.7 in 1994 as crude death rates and infant and child mortality rates have declined. Causes of death have shifted from infectious to chronic diseases, but in 1992 major causes of death in children under 5 years old were preventable, and the maternal mortality rate was 425/100,000. Policies which guide the development of health care call for improvements in quality of life, adherence to humanitarian principles, use of scientifically approved traditional medicine, and provision of public health through a three-tiered system. Health care is financed by the government and the community, and managed care has been encouraged. Foreign aid has bolstered development in the health sector. Adequate sanitation has been achieved for 35% of the population, and 65% of urban and 35% of rural residents have reasonable access to clean water. Improvements in health indicators include 55% contraceptive prevalence, reduction in prevalence of anemia during pregnancy, 55.8% of pregnant women receiving prenatal care, a decrease in protein-energy malnutrition among children under five, and high vaccination coverage. Remaining public health problems include malaria, tuberculosis, dengue hemorrhagic fever, an increase in HIV/AIDS, iodine-deficiency, an increasing number of traffic fatalities, and an increasing number of smokers. New health policies have been instituted to meet these challenges as Indonesia's need for a productive and competitive labor force increases.
Forensic mental health services: Current service provision and planning for a prison mental health service in the Eastern Cape. Kiran Sukeri, Orlando A. Betancourt, Robin Emsley, Mohammed Nagdee, Helmut Erlacher ...
Haro, A. S.
Discusses the need to apply modern scientific management to health administration in order to effectively manage programs utilizing increased preventive and curative capabilities. The value of having maximum information in order to make decisions, and problems of determining information content are reviewed. For journal availability, see SO 506…
Roemer, M I
Implementation of social insurance for financing health services has yielded different patterns depending on a country's economic level and its government's political ideology. By the late 19th century, thousands of small sickness funds operated in Europe, and in 1883 Germany's Chancellor Bismarck led the enactment of a law mandating enrollment by low-income workers. Other countries followed, with France completing Western European coverage in 1928. The Russian Revolution in 1917 led to a National Health Service covering everyone from general revenues by 1937. New Zealand legislated universal population coverage in 1939. After World War II, Scandinavian countries extended coverage to everyone and Britain introduced its National Health Service covering everyone with comprehensive care and financed by general revenues in 1948. Outside of Europe Japan adopted health insurance in 1922, covering everyone in 1946. Chile was the first developing country to enact statutory health insurance in 1924 for industrial workers, with extension to all low-income people with its "Servicio Nacional de Salud" in 1952. India covered 3.5 percent of its large population with the Employees' State Insurance Corporation in 1948, and China after its 1949 revolution developed four types of health insurance for designated groups of workers and dependents. Sub-Saharan African countries took limited health insurance actions in the late 1960s and 1970s. By 1980, some 85 countries had enacted social security programs to finance or deliver health services or both.
Franco, Zeno E; Ahmed, Syed M; Maurana, Cheryl A; DeFino, Mia C; Brewer, Devon D
Social Network Analysis (SNA) provides an important, underutilized approach to evaluating Community Academic Partnerships for Health (CAPHs). This study examines administrative data from 140 CAPHs funded by the Healthier Wisconsin Partnership Program (HWPP). Funder data was normalized to maximize number of interconnections between funded projects and 318 non-redundant community partner organizations in a dual mode analysis, examining the period from 2003-2013.Two strategic planning periods, 2003-2008 vs. 2009-2014, allowed temporal comparison. Connectivity of the network was largely unchanged over time, with most projects and partner organizations connected to a single large component in both time periods. Inter-partner ties formed in HWPP projects were transient. Most community partners were only involved in projects during one strategic time period. Community organizations participating in both time periods were involved in significantly more projects during the first time period than partners participating in the first time period only (Cohen's d = 0.93). This approach represents a significant step toward using objective (non-survey) data for large clusters of health partnerships and has implications for translational science in community settings. Considerations for government, funders, and communities are offered. Examining partnerships within health priority areas, orphaned projects, and faculty ties to these networks are areas for future research. © 2015 Wiley Periodicals, Inc.
Niles, Anne G., Ed.
The development of the telephone dial access service is described, including initial services, procedures, library service, promotion and publicity, evaluation, and experimental programs, as well as arrangements with other states, institutions, and agencies and a study of the feasibility of a national dial access library. The major portion of the…
Zwick, D I
Federal health services grants amounted to about $1.8 billion in fiscal year 1985. The total amount was about $100 million less, about 6 percent, than in 1980. Reductions in the health planning program accounted for most of the decline in absolute dollars. The four formula grants to State agencies amounted to about $1.0 billion in 1985, about 60 percent of the total. The largest formula grants were for maternal and child health services and for alcohol, drug abuse, and mental health services. Project grants to selected State and local agencies amounted to about $.8 billion. There was 12 such grants in 1985 (compared with 34 in 1980). The largest, for community health services, equaled almost half the total. In real, inflation-adjusted dollars, the decline in Federal funds for these programs exceeded a third during the 5-year period. The overall dollar total in real terms in 1985 approximated the 1970 level. The ratio of formula grants to project grants in 1985 was similar to that in 1965. Studies of the impact of changes in Federal grants have found that while the development of health programs has been seriously constrained in most cases, their nature has not been substantially altered. In some cases broader program approaches and allocations have been favored. Established modes of operations and administration have generally been strengthened. Some efficiencies but few savings in administration have been identified. Replacement of reduced Federal funding by the States has been modest but has increased over time, especially for direct service activities. These changes reflect the important influence of professionalism in the health fields and the varying strengths of political interest and influence among program supporters. The long-term impact on program innovation is not yet clear.
Hardeman, F.; Hurtgen, C.; Vanhavere, F.; Vanmarcke, H.
SCK-CEN's programme on health-physics (1) offers complete services in health-physics measurements according to international quality standards; (2) contributes to improve continuously these measurement techniques and follows up international recommendations and legislation concerning the surveillance of workers; (3) provides support and advise to nuclear and non-nuclear industry on issues of radioactive contamination. Progress and achievements in 1997 are summarised
Slesinger, D P; Ofstead, C
FAMILY HEALTH/LA CLINICA de los Campesinos, Inc., is a federally funded migrant health clinic in the heart of Wisconsin's farmland that has offered outpatient health care since 1973 and an accompanying "voucher" program since 1988. The charges for outpatient care are based on the ability to pay. The clinic issues vouchers not only to migrant workers living and working in remote parts of the State but also to patients needing services the clinic does not offer. Between 1 April 1992 and 30 Marc...
On April 18th, independent Zimbabwe celebrated its 3rd birthday. In 1980, within days after taking power, Robert Mugabe's government announced that health care was to be free to everyone earning less then Z150 (60 British pounds) a month--the vast majority of the population. Although the free services are a good public relations policy, more important was the decision to expand the health services at grassroots level and to shift emphasis from an urban based curative system to rural based preventive care. Zimbabwe desperately needs doctors. According to the World Health Organization (WHO), the country has some 1400 registered doctors, roughly 1 for every 6000 people. Yet, of the 1400, under 300 work in the government health services and many of those are based in Harare, the capital. Of Zimbabwe's 28 district hospitals, only 14 have a full-time doctor. In some rural areas, there is 1 doctor/100,000 or more people. The nature of the country's health problems, coupled with the government's severe shortage of cash, shows why nursing is so crucial to Zimbabwe's development. If the rural communities, which make up 85% of the population, were to have easy access to a qualified nurse, or even a nursing assistant, the quality of life would double. The only thing that is more important is a clean water supply. Possibly the most important role for nurses in Zimbabwe is that of education. Nurses can spread awareness of basic hygiene, raise the skill of local people in dealing with minor health problems independently, carry out immunization programs, offer contraceptive advice, give guidance on breastfeeding and infant nutrition, and work with practitioners of traditional African medicines to make sure they possess basic scientific knowledge. Rebuilding after the war was not a major problem for the Mugabe health ministry, for in many areas there was simply nothing to rebuild. There were never any health services. A far greater problem has been the top heavy structure of the
Since the early 1980-ties it has been tried to utilise smart cards in health care. All industrialised countries participated in those efforts. The most sustainable analyses took place in Europe--specifically in the United Kingdom, France, and Germany. The first systems installed (the service access cards in F and G, the Health Professional Card in F) are already conceptionally outdated today. The senior understanding of the great importance of smart cards for security of electronic communication in health care does contrast to a hesitating behaviour of the key players in health care and health politics in Germany. There are clear hints that this may relate to the low informatics knowledge of current senior management.
Background: There is no adequate health service or counseling specifically suitable for adolescents in Ethiopia. Adolescents' satisfaction on the health service provided is important to increase utilization and quality of care. The objective of this study was to assess health service utilization, reported satisfaction and ...
Litzelman, Kristin; Skinner, Halcyon G; Gangnon, Ronald E; Nieto, F Javier; Malecki, Kristen; Witt, Whitney P
Informal caregivers play a critical role in the care of individuals who are aging or have disabilities and are at increased risk for poor health outcomes. This study sought to determine whether and to what extent: (1) global stress and health-related quality of life (HRQoL) differed between caregivers and non-caregivers; (2) global stress mediated the relationship between caregiving status and HRQoL; and (3) caregiver strain (i.e., stress attributable to caregiving) was associated with worse HRQoL after accounting for global stress. Cross-sectional data were from the 2008-2010 Survey of the Health of Wisconsin, a representative sample of adults aged 21-74 years. Participants (n = 1,364) completed questionnaires about caregiving status, sociodemographics, global stress, and HRQoL. Staged generalized additive models assessed the impact of caregiving on HRQoL and the role of caregiver strain and global stress in this relationship. In the last 12 months, 17.2% of the sample reported caregiving. Caregivers reported worse mental HRQoL than non-caregivers (β -1.88, p = 0.02); global stress mediated this relationship (p stress (p stress, rather than caregiving per se, contributes to poor HRQoL among caregivers, above and beyond the effect of caregiving strain. Screening, monitoring, and reducing stress in multiple life domains presents an opportunity to improve HRQoL outcomes for caregivers.
Effective health services form the backbone of health interventions. Accessibility, quality, capacity, organization, availability of human and physical resources and equity in the provision of health services are essential for a healthcare system to deliver desired health and related sustainable development outcomes. This paper focuses on the impact of health services trade on the realization of sustainable development goals and the various modalities through which this impact may occur. The ...
Strazicich, Mirko, Ed.
This publication provides a standard by which California migrant education health staff can plan, implement, and evaluate a health program for students in grades K-12. Following sections which describe current state legislation, the need for health services, and California's objectives and activities regarding health services for migrant students…
Hauff, Alicia J; Secor-Turner, Molly
The effects of homelessness on health are well documented, although less is known about the challenges of health care delivery from the perspective of service providers. Using data from a larger health needs assessment, the purpose of this study was to describe homeless health care needs and barriers to access utilizing qualitative data collected from shelter staff (n = 10) and health service staff (n = 14). Shelter staff members described many unmet health needs and barriers to health care access, and discussed needs for other supportive services in the area. Health service providers also described multiple health and service needs, and the need for a recuperative care setting for this population. Although a variety of resources are currently available for homeless health service delivery, barriers to access and gaps in care still exist. Recommendations for program planning are discussed and examined in the context of contributing factors and health care reform.
Mitchell, P; Malak, A; Small, D
This paper presents results from research that explored the roles of bilingual professionals in community mental health services in the Sydney metropolitan area of New South Wales. There were two main objectives to the research: (i) to identify and describe the roles of bilingual professionals that are important in improving the quality of community mental health services for clients from non-English-speaking backgrounds (NESB); and (ii) to identify and describe the factors that facilitate and inhibit the conduct of these roles. Data collection involved indepth interviews with bilingual professionals and team leaders in community mental health services and various other community health services; and various staff responsible for policy and service development with regard to cultural diversity. Bilingual mental health workers were found to have at least four critical roles. These were (i) direct clinical service provision to NESB clients; (ii) mental health promotion and community development; (iii) cultural consultancy; and (iv) service development. Respondents reported that the latter three roles were seriously underdeveloped compared to the clinical service provision role. It is critical that service managers implement strategies to make better use of the linguistic and cultural skills of bilingual professionals. In addition to their role in clinical service provision ways must be found to facilitate the community-focused, cultural consultancy and service development roles of bilingual professionals employed in mental health services.
According to this study, living conditions and access to health services have improved in Thailand. However, improvements have been greater in urban areas, and migration from rural to urban areas has been responsive to the unequal distribution of economic opportunities. The health service needs vary between urban and rural populations. Migrants to cities are in good health. Disadvantaged populations in rural areas need the same opportunities as those available in cities. Cities need to strengthen health services targeted to the young, and especially females. Urbanization is likely to increase throughout Southeast Asia over the coming years. Southeast Asia is well advanced in the fertility and mortality transitions, but less advanced in the urbanization transition. The urban transition has implications for the supply and demand for health services. Described are the variation in demographic structures of urban and rural areas, the concentration of resources in urban areas, the patterns of urbanization, and the potential paths through which urbanization is related to the distribution of health services in Thailand. A broad overview is given for Southeast Asia. Demand for services is a function of the age and sex composition of population, resources available, and preferences for particular types of services. Supply of services is related to government health allocation decisions and private health supplier's locations of services. Urbanization affects the distribution of health services mainly through demand, and is an outcome of economic development. Migration is the main contributor to Thai urbanization.
Full Text Available Mary-Louise Jung1, Karla Loria11Division of Industrial Marketing, e-Commerce and Logistics, Lulea University of Technology, SwedenObjective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health.Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM, in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted.Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use.Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide.Keywords: health services, elderly, technology, Internet, TAM, patient acceptance, health-seeking behavior
Olsen, Jonathan R; Cook, Penny A; Forster, Sue; Phillips-Howard, Penelope A
Teenage pregnancy rates in the UK are the highest in Western Europe. Causes of teenage pregnancies are multifaceted with complex interplay of social, lifestyle and wider determinants influencing risk. Improving access to sexual health services through community services is an important factor in attempting to tackle this issue, but few studies have examined factors that influence this. Geospatial analysis was conducted on community sexual health service users and teenage conceptions from local sexual health services were recorded. Univariate and multinomial regression was performed to test associations between service type and socio-economic status. No significant differences in accessibility of services between teenage girls who have conceived and those seeking sexual health services were found. Females aged 17 and under were more likely to use a young people's sexual health service than mainstream services (P health services. The study supports policy for locating young person services within the most deprived areas of a community.
Laxy, Michael; Malecki, Kristen C; Givens, Marjory L; Walsh, Matthew C; Nieto, F Javier
Neighborhood-level characteristics such as economic hardship and the retail food environment are assumed to be correlated and to influence consumers' dietary behavior and health status, but few studies have investigated these different relationships comprehensively in a single study. This work aims to investigate the association between neighborhood-level economic hardship, the retail food environment, fast food consumption, and obesity prevalence. Linking data from the population-based Survey of the Health of Wisconsin (SHOW, n = 1,570, 2008-10) and a commercially available business database, the Wisconsin Retail Food Environment Index (WRFEI) was defined as the mean distance from each participating household to the three closest supermarkets divided by the mean distance to the three closest convenience stores or fast food restaurants. Based on US census data, neighborhood-level economic hardship was defined by the Economic Hardship Index (EHI). Relationships were analyzed using multivariate linear and logistic regression models. SHOW residents living in neighborhoods with the highest economic hardship faced a less favorable retail food environment (WRFEI = 2.53) than residents from neighborhoods with the lowest economic hardship (WRFEI = 1.77; p-trend fast food restaurants and self-reported fast food consumption (≥ 2 times/week, OR = 0.59-0.62, p = 0.05-0.09) in urban residents. Participants reporting higher frequency of fast food consumption (≥ 2 times vs. food environment. However inconsistent or non-significant relationships between the retail food environment, fast food consumption, and obesity were observed. More research is needed to enhance methodological approaches to assess the retail food environment and to understand the complex relationship between neighborhood characteristics, health behaviors, and health outcomes.
The Defense Health Services (DHS) Steering Committee has considered the concept of Mentoring as part of an effort to assist in the development of future health leaders in the Australian Defense Force (ADF...
Gunnarsson, Kristina; Andersson, Ing-Marie; Josephson, Malin
Small-scale enterprises are less often covered by occupational health services and have insufficient awareness about health and risks in the work environment. This study investigated how Swedish entrepreneurs in small-scale enterprises use occupational health services. The study used a questionnaire sent in two waves, 5 years apart. At baseline, 496 entrepreneurs responded, and 251 participated 5 years later. The questionnaire included items about affiliation with and use of occupational health services, physical and psychosocial work environments, work environment management, sources of work environment information, and membership in professional networks. Only 3% of entrepreneurs without employees and 19% of entrepreneurs with employees were affiliated with an occupational health service. Entrepreneurs affiliated with occupational health services were more active in work environment management and gathering information about the work environment. The occupational health services most used were health examinations, health care, and ergonomic risk assessments. Affiliation with occupational health services was 6% at both measurements, 4% at baseline, and 10% 5 years later. 2011, SLACK Incorporated.
Wisconsin State Dept. of Public Instruction, Madison.
The following curriculum units comprise this course book: (1) Germans in a New Home, (2) Contributions of the Germans in Wisconsin, (3) A Letter to Germany, (4) Germans Come to Kingston, (5) First a Soldier, Then a Man of the Church (about Heinrich von Rohr), (6) A Visiting German, and (7) Germans and Music. Each unit begins with a reading of…
Keune, Hans; Oosterbroek, Bram; Derkzen, Marthe; Subramanian, Suneetha; Payyappalimana, Unnikrishnan; Martens, Pim; Huynen, Maud; Burkhard, Benjamin; Maes, Joachim
The practice of mapping ecosystem services (ES) in relation to health outcomes is only in its early developing phases. Examples are provided of health outcomes, health proxies and related biophysical indicators. This chapter also covers main health mapping challenges, design options and
Utilization of maternal health services in rural primary health centers in Sub- Saharan Africa. ... their pregnancies were normal during antenatal care visits, hostile attitude of health workers, poverty and mode of payment. Majority of the PHCs provided antenatal, normal delivery, and post natal services. Rural mothers lacked ...
Jung, Mary-Louise; Loria, Karla
Objective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health. Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted. Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use. Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide. PMID:21289860
May 5, 1999 ... Objective: To identify current problems in laboratory services and elicit suggestions from the technicians aimed at improving the services in health centres within Amhara region, north Ethiopia. Design: Cross-sectional study using a pre-tested questionnaire. Settings: Twenty seven health centres in Amhara ...
The successful implementation and operation of health care networks and the efficient and effective provision of health care services is dependent upon a number of different factors: Telecommunications infrastructure and technology, medical applications and services, user acceptance, education and training, product and applications/services development and service provision aspects. The business model and market development regarding policy and legal issues also must be considered in the development and deployment of telemedicine services to become an everyday practice. This chapter presents the initiatives, role and contribution of the Greek Telecommunications Company in the health care services area and also refers to specific case-studies focusing upon the key factors and issues of applications related to the telecommunications, informatics, and health care sectors, which can also be the drivers to create opportunities for Citizens, Society and the Industry.
O'Mullane, Denis; And Others
Data on the relative levels of men's and women's dental health are scarce, but the available data do indicate differences in tooth loss and health-related behavior patterns. Better methods for recording and reporting this information are recommended. (MSE)
... 42 Public Health 1 2010-10-01 2010-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...
Full Text Available The aim of this paper is to give a short description of the most important developments of mental health services in Finland during the 1990s, examine their influences on the organisation and provision of services, and describe shortly some national efforts to handle the new situation. The Finnish mental health service system experienced profound changes in the beginning of the 1990s. These included the integration of mental health services, being earlier under own separate administration, with other specialised health services, decentralisation of the financing of health services, and de-institutionalisation of the services. The same time Finland underwent the deepest economic recession in Western Europe, which resulted in cut-offs especially in the mental health budgets. Conducting extensive national research and development programmes in the field of mental health has been one typically Finnish way of supporting the mental health service development. The first of these national programmes was the Schizophrenia Project 1981–97, whose main aims were to decrease the incidence of new long-term patients and the prevalence of old long-stay patients by developing an integrated treatment model. The Suicide Prevention Project 1986–96 aimed at raising awareness of this special problem and decreasing by 20% the proportionally high suicide rate in Finland. The National Depression Programme 1994–98 focused at this clearly increasing public health concern by several research and development project targeted both to the general population and specifically to children, primary care and specialised services. The latest, still on-going Meaningful Life Programme 1998–2003 which main aim is, by multi-sectoral co-operation, to improve the quality of life for people suffering from or living with the threat of mental disorders. Furthermore, the government launched in 1999 a new Goal and Action Programme for Social Welfare and Health Care 2000–2003, in
Full Text Available Background and objectives : Health Services cost analyzing is an important management tool for evidence-based decision making in health system. This study was conducted with the purpose of cost analyzing and identifying the proportion of different factors on total cost of health services that are provided in urban health centers in Tabriz. Material and Methods : This study was a descriptive and analytic study. Activity Based Costing method (ABC was used for cost analyzing. This cross–sectional survey analyzed and identified the proportion of different factors on total cost of health services that are provided in Tabriz urban health centers. The statistical population of this study was comprised of urban community health centers in Tabriz. In this study, a multi-stage sampling method was used to collect data. Excel software was used for data analyzing. The results were described with tables and graphs. Results : The study results showed the portion of different factors in various health services. Human factors by 58%, physical space 8%, medical equipment 1.3% were allocated with high portion of expenditures and costs of health services in Tabriz urban health centers. Conclusion : Based on study results, since the human factors included the highest portion of health services costs and expenditures in Tabriz urban health centers, balancing workload with staff number, institutionalizing performance-based management and using multidisciplinary staffs may lead to reduced costs of services.
Bulk and air samples were analyzed for carbon-tetrachloride (56235), chloroform (67663), ethylene-dichloride (107062), 1,2-dichloroethylene (540590), carbon-disulfide (75150), methyl-bromide (74839), methylene-chloride (75092), and ethylene-dibromide (106934) in a grain shipment (SIC-5153) in Superior, Wisconsin in February, 1984. The grain was aboard railcars located in a railroad yard waiting to be unloaded. The evaluation was requested by a union local and the district's Congressman due to concern that the grain had been heavily treated with chemical fumigants. The author notes that the measured concentrations should not be interpreted as worker exposures as the samples were collected for identification purposes only and were taken at locations considered unrealistic for a worker's breathing zone. Recommendations include requiring workers opening fumigated railcars to wear self contained breathing apparatus and implementing a method of tracking grain fumigation during passage through the grain handling system.
In this article, the author shares a painting unit she introduced to her students. In this unit, her students painted pictures of barns and discussed the historical significance of barns in Wisconsin.
Spyrou, Stergiani; Bamidis, Panagiotis; Kilintzis, Vassilis; Lekka, Irini; Maglaveras, Nicos; Pappas, Costas
In this paper, a model of reliability assessment of services in Home Health Care Delivery is presented. Reliability is an important quality dimension for services and is included in non-functional requirements of a system. A stochastic Markov model for reliability assessment is applied to patient communication services, in the field of home health care delivery. The methodology includes the specification of scenarios, the definition of failures in scenarios as well as the application of the analytical model. The results of the methodology reveal the critical states of the Home Health Care System and recommendations for improvement of the services are proposed. The model gives valuable results in predicting service reliability and, independently of the error types, it can be applied to all fields of Regional Health Network (RHN).
Health interventions addressed to the population as a whole from health care services are scarce and only exceptionally involve coordination among public health services (vaccinations and, in some autonomous communities, secondary breast cancer prevention). Health education programs addressed to schools are one of the most frequent interventions but their outcomes are not systematically evaluated. However, primary health care services carry out many clinical preventive activities. While the aims of these activities are laudable, the interventions themselves have substantial limitations, because they are an important source of dependency, a powerful incentive to consume drugs, and are also inefficient and inequitable ways of spending health resources. These limitations justify the testing of combined approaches between public health services and citizens' collectives to improve and protect community health. Developing community health programs based on cooperation between primary health care services and public health services requires strategies that produce appreciable results in the short term to both health sectors, as well as to the population, so that these programs stimulate the process and encourage further development. The settings in which collaboration is most promising are population health surveillance and monitoring in basic health areas, control of communicable diseases and epidemic outbreaks, health promotion and health protection programs through simultaneous clinical and community-based interventions, and improved management of all health services in local communities through joint evaluation. The resources needed to carry out these activities should be drawn from a reduction of clinical preventive activities that reduce workload and from an increase in the number and quality of the public health workforce.
Jepson, Lisa; Juszczak, Linda; Fisher, Martin
Describes the mental-health and medical services provided at a high-school-based service center. Five years after the center's inception mental health visits had quadrupled. One third of students utilizing the center reported substance abuse within their family. Other reasons for center use included pregnancy, suicidal ideation, obesity,…
This study determines the prevalence of types of sicknesses and diseases affecting patients visiting health service facilities and the available health services within the Selebi Phikwe Ni-Cu mine area, Botswana. Through the administration of questionnaires and structured questions, attempts were made to establish and ...
Fuller Jeffrey D
Full Text Available Abstract Background Farmers represent a subgroup of rural and remote communities at higher risk of suicide attributed to insecure economic futures, self-reliant cultures and poor access to health services. Early intervention models are required that tap into existing farming networks. This study describes service networks in rural shires that relate to the mental health needs of farming families. This serves as a baseline to inform service network improvements. Methods A network survey of mental health related links between agricultural support, health and other human services in four drought declared shires in comparable districts in rural New South Wales, Australia. Mental health links covered information exchange, referral recommendations and program development. Results 87 agencies from 111 (78% completed a survey. 79% indicated that two thirds of their clients needed assistance for mental health related problems. The highest mean number of interagency links concerned information exchange and the frequency of these links between sectors was monthly to three monthly. The effectiveness of agricultural support and health sector links were rated as less effective by the agricultural support sector than by the health sector (p Conclusion Aligning with agricultural agencies is important to build effective mental health service pathways to address the needs of farming populations. Work is required to ensure that these agricultural support agencies have operational and effective links to primary mental health care services. Network analysis provides a baseline to inform this work. With interventions such as local mental health training and joint service planning to promote network development we would expect to see over time an increase in the mean number of links, the frequency in which these links are used and the rated effectiveness of these links.
Objective:: Mental health treatment today incorporates neurobiology, genetics, neuro-imaging, and pharmacologic mechanisms, offering more options to patients. For some, these modern approaches are not viable choices due to reasons such as limited access to care, cost, intolerable side effects, and, in the pediatric population, fears of potential long-term effects. With the growing prevalence of chronic health conditions, concerns for age of onset, (McGorry, Purcell, Goldstone, & Amminger, 201...
The work of health service access points highlights the process of exclusion through marginalisation, the phenomenon of precarity and anthropological tensions between hospitality and inhospitality or between the desirable and undesirable. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Kulyk, Olga Anatoliyivna
In oktober heeft een workshop 'Kwaliteitseisen Digitale Hulpverlening in het Kader van e-health Sense' plaatsgevonden tijdens de digitale leerweek van Soa Aids Nederland en V&VN. Tijdens een focusgroepdiscussie met sociaal-verpleegkundigen seksuele gezondheid kwamen vragen aan de orde over het
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National... Services Administration (HRSA), Parklawn Building (and via audio conference call), 5600 Fishers Lane, Room... and Services Administration, Parklawn Building, Room 13-64, 5600 Fishers Lane, Rockville, Maryland...
Purcell, Rachael; McGirr, Joe
To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.
Ameri, Cinzia; Fiorini, Fulvio
The marketing mix is the combination of the marketing variables that a firm employs with the purpose to achieve the expected volume of business within its market. In the sale of goods, four variables compose the marketing mix (4 Ps): Product, Price, Point of sale and Promotion. In the case of providing services, three further elements play a role: Personnel, Physical Evidence and Processes (7 Ps). The marketing mix must be addressed to the consumers as well as to the employees of the providing firm. Furthermore, it must be interpreted as employees ability to satisfy customers (interactive marketing).
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Statement of Organization, Functions and Delegations of Authority; Correction AGENCY: Health Resources and Services Administration (HRSA), HHS. ACTION: Notice; correction. SUMMARY: HRSA published a document in the Federal...
positioning (choosing to be receptive in anal sex if HIV-positive and penetrative if HIV-negative). • Address alcohol, recreational drug and tobacco use. • Screen and address mental health issues. (e.g. depression). • Screen and treat ...
Background: data from different studies showed health care behaviour and estimated per capita health care expenditure for the general population, but the specific data for infants at different levels of care are lacking. The objectives of this study were to describe mothers' health service utilization during pregnancy and ...
The general conditions influencing the quality assurance and audit in Polish occupational health services are presented. The factors promoting or hampering the implementation of quality assurance and audits are also discussed. The major influence on the transformation of Polish occupational health services in exorted by employers who are committed to cover the costs of the obligatory prophylactic examination of their employees. This is the factor which also contributes to the improvement of quality if services. The definitions of the most important terms are reviewed to highlight their accordance with the needs of occupational health services in Poland. The examples of audit are presented and the elements of selected methods of auditing are suggested to be adopted in Poland.
Dabelko, Holly I.; DeCoster, Vaughn A.
The purpose of this study is to provide a profile of individuals with diabetes who receive services in adult day centers. This exploratory study uses an administrative data set (N = 280) from five programs in central Ohio to examine four areas: demographics, health and mental health, financial and social resources, and disenrollment status. Older…
Somasundaram, D J; van de Put, W A; Eisenbruch, M; de Jong, J T
Cambodia has undergone massive psychosocial trauma in the last few decades, but has had virtually no western-style mental health services. For the first time in Cambodia a number of mental health clinics in rural areas have been started. This experience is used to discuss the risks and opportunities in introducing these services in the present war-torn situation. Basic statistics from the clinics are presented in the context of the historical and traditional setting, and the effort to maintain a culturally informed approach is described. The contrasting results in the clinics are analyzed in relation to factors intrinsic to the health care system and those related to the local population in order to highlight the issues involved in establishing future mental health services, both locally in other provinces and in situations similar to Cambodia. The efficacy of introducing low-cost, basic mental health care is shown, and related to the need to find solutions for prevailing problems on the psychosocial level. They can be introduced with modest means, and can be complementary to local health beliefs and traditional healing. In introducing mental health services, an approach is needed which adapts to the absorption potential of the health system as well as to the patients' need to find meaningful help. Existing resources, from the traditional healing sector to rudimentary village structures, cannot be neglected in the rehabilitation of the community, or in interventions to help the individual patient.
Full Text Available Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture—in the form of a primer—of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being.
Coutts, Christopher; Hahn, Micah
Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture-in the form of a primer-of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being.
The Public Health Service must assume the role of the overall Public Health Coordinator, seeking to afford the highest level of health protection both to the nearby population as well as to the more distant groups. Data will be given relative to the limited experience the PHS has had in the removal of populations from areas of suspected hazards. Problems inherent in the evacuation of civilians of all ages will be discussed. (author)
Anderson, E A; Zwelling, L A
Quality management has become one of the most important and most debated topics within the service sector. This is especially true for health care, as the controversy rages on how the existing American system should be restructured. Health care reform aimed at reducing costs and ensuring access to all Americans cannot be allowed to jeopardize the quality of care. As such, total quality management (TQM) has become a vital ingredient to strategic planning within the health care domain. At the heart of any such quality improvement effort is the issue of measurement. TQM cannot be effectively utilized as a competitive weapon unless quality can be accurately defined, measured, evaluated, and monitored over time. Through such analysis a hospital can elect how to expend its limited resources toward those quality improvement projects which will impact customer perceptions of service quality the most. Thus, the purpose of this report is to establish a framework by which to approach the issue of quality measurement, delineate the various components of quality that exist in health care, and explore how these elements affect one another. We propose that the issue of quality measurement in health care be approached as an integration of service quality attributes common to other service organizations and technical quality attributes unique to health care. We hope that this research will serve as a first step toward the synthesis of the various quality attributes inherent in the health care domain and encourage other researchers to address the interactions of the various quality attributes.
Off-Site Radiological Safety Programs conducted on past Plowshare experimental projects by the Southwestern Radiological Health Laboratory for the AEC will be presented. Emphasis will be placed on the evaluation of the potential radiation hazard to off-site residents, the development of an appropriate safety plan, pre- and post-shot surveillance activities, and the necessity for a comprehensive and continuing community relations program. In consideration of the possible wide use of nuclear explosives in industrial applications, a new approach to off-site radiological safety will be discussed. (author)
... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a... Receive Care? § 136a.15 Health Service Delivery Areas. (a) The Indian Health Service will designate and... Federal Indian reservations and areas surrounding those reservations as Health Service Delivery Areas. (b...
Full Text Available A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4–6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data, along with institutional interaction with policy makers.
Jancloes, Michel; Thomson, Madeleine; Costa, María Máñez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary
A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4–6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers. PMID:24776719
Daniel, Jamie Owen
Like thousands of other people from around the country and around the world, this author was heartened and inspired by the tenacity, immediacy, and creativity of the pushback by Wisconsin's public-sector unions against Governor Scott Walker's efforts to limit their collective bargaining rights. And like many others who made the trek to Madison to…
Charles, H. (Hobie) Perry; Gary J. Brand
The annual forest inventory of Wisconsin continues, and this document reports 2001-05 moving averages for most variables and comparisons between 2000 and 2005 for growth, removals, and mortality. Summary resource tables can be generated through the Forest Inventory Mapmaker website at http://ncrs2.fs.fed.us/4801/fiadb/index. htm. Estimates from this inventory show a...
Martins, Jo M; Isouard, Godfrey; Freshman, Brenda
This article identifies three relevant and valid constructs that are associated with personal and organisational performance that can be used in the training of current and future health service managers: personal engagement at work, emotional intelligence and conflict resolution. A review was undertaken of the literature in human resources management to identify key concepts that bind and strengthen the management of organisations. A curriculum content analysis was then performed of postgraduate health management courses in Australia to assess the extent of inclusion in these areas. Three concepts and practices of relevance to the human dimension of health management, namely personal engagement at work, emotional intelligence and conflict resolution, were found to: (1) have concept validity; (2) be associated with personal and organisational performance; and (3) be capable of being imparted by training. The analysis indicated that none of the competencies and/or skills identified has been given emphasis in postgraduate health management courses in Australia. Competence in the management of human relationships in health services has been given low priority in university postgraduate training in health management in Australia. The current situation poses challenges to all stakeholders of health services.
Full Text Available Orientation: The community service initiative, a 1-year placement of health graduates, significantly improved human resource availability in the South African public health sector, even though the process was fraught with challenges. Although experiences in the curative health sector were assessed, the experiences of environmental health practitioners were yet to be studied. Research purpose: This study assessed the experiences of environmental health practitioners during their community service year. Motivation for the study: Anecdotal evidence suggested problems with the process. This study endeavoured to identify the challenges whilst taking cognisance of its effectiveness. Method: A total of n = 40 environmental health graduates from the Durban University of Technology who had concluded community service completed questionnaires in this crosssectional quantitative study. Descriptive statistics, means and standard deviations were used to analyse the data. Main findings: The timing of community service placements was critical as 58% of respondents had to repay study loans. The placement of married respondents (10% outside KwaZuluNatal, however, could have had impacts on family structures. Only 68% felt stimulated by their job functions, and there arose challenges with accommodation and overtime duties. Respondents felt that their tertiary education did equip them and that engagement with senior personnel helped in their professional development. Even though most of the review of the community service year appeared to be positive, a majority of respondents did not intend to continue working or recommending their workplaces. Future career pathing showed that 79% would prefer to be employed outside the public sector. Practical and managerial implications: The process needs to be reviewed to strengthen human resource management and enhance retention in the often overloaded and under-resourced South African public health sector. Contribution
Jocelyne Kane Berman
Full Text Available Despite their numerical superiority women do not occupy positions o f power and authority in the health services generally. This is perceived as being due to a variety of factors which prevent women from realising their ful l potential as managers. In other parts of the world, as well as in South Africa, middle class white males have dominated health services, since medicine became a form al science, usurping the traditional role of women healers. Some research indicates that women are inclined to practice “feminine " management styles. It is suggested that the femine I masculine dichotomy is artificial and that qualities which ensure effective management should not be regarded as genderlinked. Leaders in the health services should strive for interdisciplinary, mixed-gender education and training at all levels. Identification and development of management potential in women health-care professionals, role-modelling and sponsor-mentor relationships should be encouraged to allow women to acquire the full range of management skills and to achieve positions of power and authority in the health services.
Green, Jennifer Greif; McLaughlin, Katie A.; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A.; Kessler, Ronald C.
Objective: Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to…
This report reviews the findings since 1987 in the field of research related to the possible impact of nuclear war and nuclear explosions on health and health services. An annex contains the finding and conclusions of a 1989 United Nations study on the climatic and other effects of nuclear war. 1 tab
Liang Youxin; Xiang Quanyong
In China, the origin of occupational health started in the mid 1950s soon after the founding of the People's Republic of China. However, more complete concept and practice of occupational health was defined after the early 1980s, when China started her full-scale drive for economic reform and policy of openness. The integrity intends to cover occupational health, occupational medicine, industrial toxicology, industrial hygiene, occupational ergonomics, and occupational psychology as theoretical and practical components of occupational health. As a result, occupational health in China has undergone many changes and has improved over the past decades. These changes and improvements came about, most likely due to a new scheme, where a holistic approach of the recognition, regulation, and provision of occupational health services in a wider coverage is gradually formed and brought into effect. This presentation provides the current status of occupational health and safety problems, the latest legislative to occupational health and safety, and a general scenario of the organizational structure and function of occupational health services in China. It attempts to share with participants both our experience and lessons learned towards creating a more open and effective channel of ideas and information sharing
Arrivillaga, Marcela; Aristizabal, Juan Carlos; Pérez, Mauricio; Estrada, Victoria Eugenia
The aim of this study was to design and validate a health services access survey for households in Colombia to provide a methodological tool that allows the country to accumulate evidence of real-life access conditions experienced by the Colombian population. A validation study with experts and a pilot study were performed. It was conducted in the municipality of Jamundi, located in the department of Valle del Cauca, Colombia. Probabilistic, multistage and stratified cluster sampling was carried out. The final sample was 215 households. The survey was composed of 63 questions divided into five modules: socio-demographic profile of the head of the household or adult informant, household socioeconomic profile, access to preventive services, access to curative and rehabilitative services and household out of pocket expenditure. In descriptive terms, the promotion of preventive services only reached 44%; the use of these services was always highest among children younger than one year old and up to the age of ten. The perceived need for emergency medical care and hospitalisation was between 82% and 85%, but 36% perceived the quality of care to be low or very low. Delays were experienced in medical visits with GPs and specialists. The designed survey is valid, relevant and representative of access to health services in Colombia. Empirically, the pilot showed institutional weaknesses in a municipality of the country, indicating that health coverage does not in practice mean real and effective access to health services. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Valdmanis, Vivian; DeNicola, Arianna; Bernet, Patrick
In this paper, we assess the capacity of Florida's public health departments. We achieve this by using bootstrapped data envelopment analysis (DEA) applied to Johansen's definition of capacity utilization. Our purpose in this paper is to measure if there is, theoretically, enough excess capacity available to handle a possible surge in the demand for primary care services especially after the implementation of the Affordable Care Act that includes provisions for expanded public health services. We measure subunit service availability using a comprehensive data source available for all 67 county health departments in the provision of diagnostic care and primary health care. In this research we aim to address two related research questions. First, we structure our analysis so as to fix budgets. This is based on the assumption that State spending on social and health services could be limited, but patient needs are not. Our second research question is that, given the dearth of primary care providers in Florida if budgets are allowed to vary is there enough medical labor to provide care to clients. Using a non-parametric approach, we also apply bootstrapping to the concept of plant capacity which adds to the productivity research. To preview our findings, we report that there exists excess plant capacity for patient treatment and care, but question whether resources may be better suited for more traditional types of public health services.
... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the Federal...
Strengthening youth friendly health services through expanding method choice to include long-acting reversible contraceptives for Ethiopian youth. ... Odds of adopting LARCs at pre-intervention (0.70); rose to 1.30 for the post-intervention phase (p-value <0.0001); comparing intervention to non-intervention study arms.
Full Text Available The death of the English National Health Service (NHS has been pronounced many times over the years, but the time and cause of death and the murder weapon remains to be fully established. This article reviews some of these claims, and asks for clearer criteria and evidence to be presented.
Neofytou, M S; Neokleous, K; Aristodemou, A; Constantinou, I; Antoniou, Z; Schiza, E C; Pattichis, C S; Schizas, C N
There is a huge need for open source software solutions in the healthcare domain, given the flexibility, interoperability and resource savings characteristics they offer. In this context, this paper presents the development of three open source libraries - Specific Enablers (SEs) for eHealth applications that were developed under the European project titled "Future Internet Social and Technological Alignment Research" (FI-STAR) funded under the "Future Internet Public Private Partnership" (FI-PPP) program. The three SEs developed under the Electronic Health Record Application Support Service Enablers (EHR-EN) correspond to: a) an Electronic Health Record enabler (EHR SE), b) a patient summary enabler based on the EU project "European patient Summary Open Source services" (epSOS SE) supporting patient mobility and the offering of interoperable services, and c) a Picture Archiving and Communications System (PACS) enabler (PACS SE) based on the dcm4che open source system for the support of medical imaging functionality. The EHR SE follows the HL7 Clinical Document Architecture (CDA) V2.0 and supports the Integrating the Healthcare Enterprise (IHE) profiles (recently awarded in Connectathon 2015). These three FI-STAR platform enablers are designed to facilitate the deployment of innovative applications and value added services in the health care sector. They can be downloaded from the FI-STAR cataloque website. Work in progress focuses in the validation and evaluation scenarios for the proving and demonstration of the usability, applicability and adaptability of the proposed enablers.
toward existing services differentially impact men and women in this setting, influencing the perceived benefits of couples' sexual health ... homme-femme afin d'avoir une compréhension plus approfondie de la manière dont les normes des sexes influent sur .... abandonment or divorce, physical and emotional abuse, and ...
Medical doctors are bound by ethics in their clinical practice – health service delivery. They often discharge their contractual responsibilities under the provisions of their professional ethical code and personal morality. Ethical principles in clinical care include i) Respect for patient's autonomy ii) Doing good (beneficence) ...
... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Scientific Merit... nursing research. Applications are reviewed for scientific and technical merit, mission relevance, and the... Program Manager, Scientific Merit Review Board, Department of Veterans Affairs, Health Services Research...
Lusi Herawati Sunyoto Usman Mark Zuidgeest
as indicators. Flowmap tool is used to analyze catchment area of each health facility using different transport modes choice:becak and public transport for poor group and motorcycle and car for non-poor group with different travel time within 30, 60 and more than 60 minutes. It is concluded that there was an accessibility difference between poor and non-poor group. The accessibility to the health facilities of poor group was lower than non-poor group. This condition occurred because the government policy of equitable access to health service facility did not pay attention to accessibility of poor group.
Oborn, Eivor; Barrett, Michael; Darzi, Ara
Robots have long captured our imagination and are being used increasingly in health care. In this paper we summarize, organize and criticize the health care robotics literature and highlight how the social and technical elements of robots iteratively influence and redefine each other. We suggest the need for increased emphasis on sociological dimensions of using robots, recognizing how social and work relations are restructured during changes in practice. Further, we propose the usefulness of a 'service logic' in providing insight as to how robots can influence health care innovation. The Royal Society of Medicine Press Ltd 2011.
BACKGROUN D: Accessibility of health services for reproductive health (RH) is an important factor in increasing use of reproductive health services. Reports show that reproductive health services access in Ethiopia varies by region. A better understanding of the accessibility and utilization of existing reproductive health ...
Full Text Available The state policy in the health care area must take into account the complexity and specificity of the domain. Health means not only “to treat”, but also “to prevent” and “to recover and rehabilitate the individual physically”. Regardless of the adopted health insurance system, the health system is facing a big problem and this is the insufficient funds necessary to function properly. The underfunding may have various causes, from a wrong health policy, based on “treating” instead of “preventing”, by the misuse of funds. This papers intended to formulate assumptions that underpin the research I am conducting within the Doctoral Research Program held at the Valahia University of Targoviste, which aims at using the management control in increasing the health services performance. The application of the accounting and management control methods in determining health costs can be a beginning to streamline the system. This is also a result of the fact that health care is a public service with specific characteristics: it can not be subject only to market requirements but at the same time he must undergo an administrative savings, representing a typical case of market failure. The increased cost of treatment, as well as the decline in their quality can be determined by the discrepancy between the funding and payment mechanisms. Different payment systems currently available do nothing but perpetuate the shortcomings in the system. Switching to the introduction of cost and budgets by cost centers or object (if solved can be a step forward for a better management of resources. In this context, we consider as a necessity to be imposed the cost analysis on responsibility centers, the definition of the cost object and cost center identification and determination of direct costs and those indirect services to choose the basis for the allocation of cost centers and the determination of each actual cost per diagnosis.
... Map State Agencies Widgets Contact Us Help Home Behavioral Health Links + Federal Government Health and Human Services ... Associations Professional Associations Data and Publications International Agencies Behavioral Health Treatment Services Locator Welcome to the Behavioral ...
Charles H. Perry; Vern A. Everson; Brett J. Butler; Susan J. Crocker; Sally E. Dahir; Andrea L. Diss-Torrance; Grant M Domke; Dale D. Gormanson; Sarah K. Herrick; Steven S. Hubbard; Terry R. Mace; Patrick D. Miles; Mark D. Nelson; Richard B. Rodeout; Luke T. Saunders; Kirk M. Stueve; Barry T. Wilson; Christopher W. Woodall
The second full annual inventory of Wisconsin's forests reports more than 16.7 million acres of forest land with an average volume of more than 1,400 cubic feet per acre. Forest land is dominated by the oak/hickory forest-type group, which occupies slightly more than one quarter of the total forest land area; the maple/beech/birch forest-type group occupies an...
Ferguson, E. B.; Humbert, P.; Long, I. D.; Tipton, D. A.
Comprehensive occupational health services are provided to approximately 17,000 workers at the Kennedy Space Center and an additional 6000 on Cape Canaveral Air Force Station. These areas cover about 120,000 acres encompassing part of the Merritt Island Wild Life Refuge and wetlands which are the habitat of numerous endangered and protected species of wildlife. The services provided at the Kennedy Space Center optimally assure a safe and healthy working environment for the employees engaged in the preparation and launching of this country's Space Shuttle and other important space exploration programs.
Medina, Carmen; Salvador, Xavier; Faixedas, M Teresa; Gallo, Pedro
The purpose of this article is disclose services utilization patterns among the Catalan population with particular emphasis on primary care, specialised care, hospital care and emergency care. A number of logistic regression models were used to explain the utilization of the various types of services. Variables in the analysis included self-perceived need, lifestyles, and sociodemographic variables. Separate analyses were performed for male, female, adults, and children as well as for the general population. Women use all types of services more often than men. Children and people over 64 are more frequent users of primary care. Primary care is also associated to lower socioeconomic conditions. Young adults and the migrant population in general are found to be under users of services, except of emergency care services. The use of specialised care is associated to the better-off, to those with university level education attainment, individual private insurance, and those living in the city of Barcelona. Hospital care is largely associated to need variables. The use of health services is explained by self-perceived need as well as by demographic, socioeconomic and geographical factors. Copyright © 2011 Elsevier España S.L. All rights reserved.
health services: out-patient curative care for sick children, routine childhood vaccination services (EPI), and routine growth monitoring services. Figure 1: Percentage of facilities offering all three basic child vaccination services by facility type, Ethiopia. Figure 2: Percentage of facilities providing basic child health services, ...
Knobeloch, Lynda; Gorski, Patrick; Christenson, Megan; Anderson, Henry
Between July 1, 2007, and December 31, 2010, Wisconsin health departments tested nearly 4,000 rural drinking water supplies for coliform bacteria, nitrate, fluoride, and 13 metals as part of a state-funded program that provides assistance to low-income families. The authors' review of laboratory findings found that 47% of these wells had an exceedance of one or more health-based water quality standards. Test results for iron and coliform bacteria exceeded safe limits in 21% and 18% of these wells, respectively. In addition, 10% of the water samples from these wells were high in nitrate and 11% had an elevated result for aluminum, arsenic, lead, manganese, or strontium. The high percentage of unsafe test results emphasizes the importance of water quality monitoring to the health of nearly one million families including 300,000 Wisconsin children whose drinking water comes from a privately owned well.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency... Services Administration, HHS. ACTION: Notice. SUMMARY: In compliance with the requirement for opportunity... Reduction Act of 1995), the Health Resources and Services Administration (HRSA) announces plans to submit an...
Full Text Available Objectives: No research data exists on forensic psychiatric service provision in the Eastern Cape, Republic of South Africa. The objective of this research was to assess current forensic psychiatric service provision and utilisation rates at Fort England Hospital. This is important in improving and strengthening the service. A related objective was to develop a model for a provincial prison mental health service. Methodology: This study is a situational analysis of an existing forensic psychiatric service in the Eastern Cape. The design of the study was cross sectional. An audit questionnaire was utilised to collate quantitative data, which was submitted to Fort England Hospital, Grahamstown. A proposed prison mental health service was developed utilising prevalence rates of mental illness among prisoners to calculate bed and staff requirements for an ambulatory and in-patient service. Results: During the study period a total of 403 remand detainees were admitted to the forensic psychiatry division of Fort England Hospital. The average length of stay was 494 days and the bed utilisation rate was determined at 203.54%. We estimate that to provide a provincial prison mental health service to treat psychotic illnesses and major depression the province requires a 52 bedded facility and a total staff complement of approximately 31. Conclusions: Forensic psychiatric services include the assessment, management and treatment of mentally disordered persons in conflict with the law and prisoners requiring psychiatric assessments. The Eastern Cape Province does not have plans or policies to assess and manage mentally ill offenders, resulting in an increased load on available services. We recommend that an inter-departmental task team, which includes Health, Justice and Constitutional Development and Correctional Services, should be established in the province, to develop a strategy to assist in the development of an effective and efficient forensic
Layde, Molly M; Remington, Patrick L
Despite recent declines in teen birth rates, teenage pregnancy remains an important public health problem in Wisconsin with significant social, economic, and health-related effects. Compare and contrast teen birth rate trends by race, ethnicity, and county in Wisconsin. Teen (ages 15-19 years) birth rates (per 1000 teenage females) in Wisconsin from 2001-2010 were compared by racelethnicity and county of residence using data from the Wisconsin Interactive Statistics on Health. Teen birth rates in Wisconsin have declined by 20% over the past decade, from 35.5/1000 teens in 2001 to 28.3/1000 teens in 2010-a relative decline of 20.3%. However, trends vary by race, with declines among blacks (-33%) and whites (-26%) and increases among American Indians (+21%) and Hispanics (+30%). Minority teen birth rates continue to be 3 to 5 times greater than birth rates among whites. Rates varied even more by county, with an over 14-fold difference between Ozaukee County (7.8/1000) and Menominee County (114.2). Despite recent declines, teen pregnancy continues to be an important public health problem in Wisconsin. Pregnancy prevention programs should be targeted toward the populations and counties with the highest rates.
Kerbl, Reinhold; Ziniel, Georg; Winkler, Petra; Habl, Claudia; Püspök, Rudolf; Waldhauser, Franz
We describe child health care in Austria, a small country in Central Europe with a population of about 9 million inhabitants of whom approximately 1.7 million are children and adolescents under the age of 20 years. For children and adolescents, few health care indicators are available. Pediatric and adolescent health provision, such as overall health provision, follows a complex system with responsibilities shared by the Ministry of Health, 19 social insurance funds, provinces, and other key players. Several institutions are affiliated with or cooperate with the Ministry of Health to assure quality control. The Austrian public health care system is financed through a combination of income-based social insurance payments and taxes. Pediatric primary health care in Austria involves the services of general pediatricians and general practitioners. Secondary care is mostly provided by the 43 children's hospitals; tertiary care is (particularly) provided in 4 state university hospitals and 1 private university hospital. The training program of residents takes 6 years and is completed by a final examination. Every year, this training program is completed by about 60 residents. Copyright © 2016 Elsevier Inc. All rights reserved.
Jung, Mary-Louise; Loria, Karla
Mary-Louise Jung1, Karla Loria11Division of Industrial Marketing, e-Commerce and Logistics, Lulea University of Technology, SwedenObjective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health.Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of...
Touzet, Rodolfo; Pittaluga, Roberto R.
The implementation of a Quality system is an indispensable requirement to assure the protection and the radiological safety, especially in those facilities where the potential risks are important. One of the 'general conclusions' of the Conference of Malaga (to achieve the RPP) is also the implementation of quality systems. Lamentably the great majority of the Services of Health in the world, more than 95 %, has not nowadays any formal quality system but only any elements what can be named a 'natural quality system' that includes protocols of work, records of several processes, certified of training of the personnel and diverse practices that are realized in systematic form but that not always are documented. Most health services do not have the necessary means available to adhere quickly to international standards. At the same time the health services do not have either qualified or trained personnel to lead a certification or accreditation project and most of them do not have the resources available to hire external consultants, especially the public hospitals. The scenario described represents a challenge for the Regulatory Authorities who must determine 'how to ensure that installations comply with an acceptable standard of quality without it placing an impossible strain on their budget?' Due to these circumstances a 'Basic Guide' has developed for the implementation of a quality system in every Health Service that takes the elements as a foundation of the standard ISO - 9000:2000 and the standard for systems management GSR-3 of the IAEA. The criteria and the methodologies are showed in the presentation. (author)
This is an empirical study of 7 communities among the O-kun Yoruba of Ijumu, Kogi State, Nigeria. The general objective of the study was to investigate the prioritizing pattern of the various Primary Health Care services (PHC) in the study area. Data for the study were generated mainly through multi-stage sampling ...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National... Committee on Rural Health and Human Services, Health Resources and Services Administration, Parklawn..., and administration of health and human services in rural areas. Agenda: Wednesday morning, September 4...
Personal air samples were analyzed for carbon disulfide, ethylene dibromide, carbon tetrachloride, and grain dust at grain elevators. The survey was requested by a representative of Local 118 of the American Federation of Grain Millers to evaluate exposures to grain fumigants and dust among workers at the two sites. All concentrations of carbon disulfide, carbon tetrachloride, and ethylene dibromide were below the detection limit. Grain-dust concentrations ranged from 0.34 to 38 milligrams per cubic meter (mg/m/sup 3/). The American Conference of Governmental Industrial Hygienists threshold limit value for airborne grain dust is 4 mg/m/sup 3/. Short-term sampling for the fumigants was performed; however, the results were inconclusive. The author concludes that a health hazard due to overexposure to grain dust exists at the grain elevators. Recommendations were made.
McGinnis, Sandra; Moore, Jean
Objective To examine the size and characteristics of the health services research (HSR) workforce; the job satisfaction, job security, and future plans reported by the workforce; and the future of the HSR workforce supply. Data Sources (1) AcademyHealth active and lapsed members since 2000 and annual research meeting presenters and interest group participants; (2) principal investigators of research projects listed in the HSRProj database; and (3) authors of articles published in two HSR journals. Study Design Data on investigators conducting HSR in selected venues were collected and compared in order to identify the percentage of the HSR workforce represented in the “core” versus related disciplines and to investigate the extent to which the “core” researchers publish, present, or participate in disciplinary venues. Principal Findings The field appears to have grown dramatically since 1995, from an estimated 5,000 health services researchers to an estimated 11,596 in 2007. This is a broad workforce characterized by various levels of involvement in the field. Some researchers self-identify with the field of HSR, while others are associated primarily with venues related to specific disciplines. Many researchers who identify with HSR also publish in venues related to multiple other disciplines. Conclusions The field may face future challenges related to demographic change, such as an aging workforce and an increased need for diversity. International collaboration appears common, and in the future the field may need to be defined internationally rather than nationally. At the same time, there are also many indications that HSR is a good field to work in. Health services researchers reported high levels of satisfaction with their profession and current employer, as well as little desire to change jobs and little concern about job security. PMID:20459584
McGinnis, Sandra; Moore, Jean
To examine the size and characteristics of the health services research (HSR) workforce; the job satisfaction, job security, and future plans reported by the workforce; and the future of the HSR workforce supply. (1) AcademyHealth active and lapsed members since 2000 and annual research meeting presenters and interest group participants; (2) principal investigators of research projects listed in the HSRProj database; and (3) authors of articles published in two HSR journals. Data on investigators conducting HSR in selected venues were collected and compared in order to identify the percentage of the HSR workforce represented in the "core" versus related disciplines and to investigate the extent to which the "core" researchers publish, present, or participate in disciplinary venues. The field appears to have grown dramatically since 1995, from an estimated 5,000 health services researchers to an estimated 11,596 in 2007. This is a broad workforce characterized by various levels of involvement in the field. Some researchers self-identify with the field of HSR, while others are associated primarily with venues related to specific disciplines. Many researchers who identify with HSR also publish in venues related to multiple other disciplines. The field may face future challenges related to demographic change, such as an aging workforce and an increased need for diversity. International collaboration appears common, and in the future the field may need to be defined internationally rather than nationally. At the same time, there are also many indications that HSR is a good field to work in. Health services researchers reported high levels of satisfaction with their profession and current employer, as well as little desire to change jobs and little concern about job security.
Gofin, Rosa; Donchin, Milka
Although School Health Services (SHS) are an efficient way of providing health care to children and adolescents, in recent years they have been curtailed in Israel. To study parents' and teachers' knowledge about the content of SHS, their use and importance, and their preferred way of delivering these services. From December 2006 - January 2007, teachers (n=304) of 2nd-12th-grade pupils and the pupils' parents (n=808) in state schools of the Hebrew education system (both secular and religious) were interviewed by phone. Parents were located by random dialing (response rate 63%), and the teachers from a Ministry of Education list (response rate 70%). About 70% of parents and teachers knew that SHS provide immunizations; 70% and 80% respectively, reported they provided first aid. Only 8% of the parents and 13% of the teachers reported that a nurse came at least three days a week to the school and most of them preferred that the nurse should come every day. Most respondents said that the SHS did important work. About a third of parents and 40% of teachers preferred that all health care services be provided in the schools by doctor and nurse; 40% of parents and teachers wanted the nurse to provide counseling and that the rest of SHS content be provided by the regular primary health care providers; 20% of parents and 14% of teachers preferred other options. Parents and teachers rate SHS as important and are prepared to consider alternatives for their delivery. This should be considered when re-organizing the SHS.
Full Text Available OBJECTIVES: To reveal the equity of health workforce distribution in urban community health service (CHS, and to provide evidence for further development of community health service in China. METHODS: A community-based, cross-sectional study was conducted in China from September to December 2011. In the study, 190 CHS centers were selected from 10 provinces of China via stratified multistage cluster sampling. Human resources profiles and basic characteristics of each CHS centers were collected. Lorenz curves and Gini Coefficient were used to measure the inequality in the distribution of health workforce in community health service centers by population size and geographical area. Wilcoxon rank test for paired samples was used to analyze the differences in equity between different health indicators. RESULTS: On average, there were 7.37 health workers, including 3.25 doctors and 2.32 nurses per 10,000 population ratio. Significant differences were found in all indicators across the samples, while Beijing, Shandong and Zhejiang ranked the highest among these provinces. The Gini coefficients for health workers, doctors and nurses per 10,000 population ratio were 0.39, 0.44, and 0.48, respectively. The equity of doctors per 10,000 population ratio (G = 0.39 was better than that of doctors per square kilometer (G = 0.44 (P = 0.005. Among the total 6,573 health workers, 1,755(26.7% had undergraduate degree or above, 2,722(41.4%had junior college degree and 215(3.3% had high school education. Significant inequity was found in the distribution of workers with undergraduate degree or above (G = 0.52, which was worse than that of health works per 10000 population (P<0.001. CONCLUSIONS: Health workforce inequity was found in this study, especially in quality and geographic distribution. These findings suggest a need for more innovative policies to improve health equity in Chinese urban CHS centers.
husband's level of educational were found to be ... Conclusion: In order to increase utilization of mother health care services and improve maternal health care utilization services ..... and the corresponding estimates of the 95% confidence intervals.
U.S. Department of Health & Human Services — The National Mental Health Services Survey (N-MHSS) is an annual survey designed to collect statistical information on the numbers and characteristics of all known...
Wilkinson, Shelley A; Duncan, Leyanne; Barrett, Catherine; Turnbull, Robin; McCray, Sally
Allied health professionals (AHPs) in maternity and neonatology services are essential for quality care and outcomes, reflected in the minimum service delivery requirements in the Queensland Health clinical services capability framework (CSCF). However, allied health (AH) capacity across the Southern Queensland Health Service Districts (SQHSD) is not known. The aim of this project was to redress this knowledge gap to inform ongoing service planning and delivery. Maternity and neonatal AH clinicians in all birthing facilities in SQHSD were surveyed between October and December 2011 to investigate AHP staffing, practices and models of care. The professions surveyed included dietitians, occupational therapists, physiotherapists, psychologists, social workers and speech pathologists. Results were grouped per question, with stratification by CSCF and/or profession. Fifty-five valid surveys from the 16 facilities were received. All professions were represented. Gaps in maternity AH services were identified. Awareness and use of evidence-based practices were more likely to be reported where higher full-time equivalents (FTE) were allocated. Very low staffing levels have been recorded in all Maternity and Neonatology Services AHPs in the SQHSD. Gaps exist between actual and recommended CSCF staffing standards across all levels and professions. The results indicate that profession-specific support networks for AHPs have positive effects in the spreading of information, and continued promotion, support and involvement in these profession-specific networks is suggested for all facilities.
Introduction: The patient's view as a recipient of health care service is rarely taken into consideration in assessing the quality of healthcare service delivery in many developing countries. The views and opinions of patients on the quality of service, coupled with their satisfaction with health care services can assist ...
Rosenthal, Beth Spenciner; Wilson, William Cody
The authors present and empirically test a multivariate model of the use of mental health counseling services. Use of such services by 1st-year college students is directly a result of need for these services and willingness to use them. Beliefs about mental health services and demographic characteristics are not directly related to use, but…
Nelson, H Wayne
This article examines the causes and accelerants of dysfunctional health service conflict and how it emerges from the health system's core hierarchical structures, specialized roles, participant psychodynamics, culture, and values. This article sets out to answer whether health care conflict is more widespread and intense than in other settings and if it is, why? To this end, health care power, gender, and educational status gaps are examined with an eye to how they undermine open communication, teamwork, and collaborative forms of conflict and spark a range of dysfunctions, including a pervasive culture of fear; the deny-and-defend lawsuit response; widespread patterns of hierarchical, generational, and lateral bullying; overly avoidant conflict styles among non-elite groups; and a range of other behaviors that lead to numerous human resource problems, including burnout, higher staff turnover, increased errors, poor employee citizenship behavior, patient dissatisfaction, increased patient complaints, and lawsuits. Bad patient outcomes include decreased compliance and increased morbidity and mortality. Health care managers must understand the root causes of these problems to treat them at the source and implement solutions that avoid negative conflict spirals that undermine organizational morale and efficiency.
Palinkas, Lawrence A.
Qualitative and mixed methods play a prominent role in mental health services research. However, the standards for their use are not always evident, especially for those not trained in such methods. This paper reviews the rationale and common approaches to using qualitative and mixed methods in mental health services and implementation research based on a review of the papers included in this special series along with representative examples from the literature. Qualitative methods are used to provide a “thick description” or depth of understanding to complement breadth of understanding afforded by quantitative methods, elicit the perspective of those being studied, explore issues that have not been well studied, develop conceptual theories or test hypotheses, or evaluate the process of a phenomenon or intervention. Qualitative methods adhere to many of the same principles of scientific rigor as quantitative methods, but often differ with respect to study design, data collection and data analysis strategies. For instance, participants for qualitative studies are usually sampled purposefully rather than at random and the design usually reflects an iterative process alternating between data collection and analysis. The most common techniques for data collection are individual semi-structured interviews, focus groups, document reviews, and participant observation. Strategies for analysis are usually inductive, based on principles of grounded theory or phenomenology. Qualitative methods are also used in combination with quantitative methods in mixed method designs for convergence, complementarity, expansion, development, and sampling. Rigorously applied qualitative methods offer great potential in contributing to the scientific foundation of mental health services research. PMID:25350675
Examines forces motivating reform in mental health services, suggesting that mental health practitioners and researchers have relied on traditional and apparently unsuccessful methods (with little or no scientific support) to ensure service quality and effectiveness; debunking six myths about mental health services; and suggesting that…
Vernon, Mary E.; Bryan, Gloria; Hunt, Pete; Allensworth, Diane; Bradley, Beverly
Discusses school health services, adolescent immunization, current school immunization practices, and support for school-based immunization programs. Children and adolescents can receive preventive health services, including immunizations and monitoring of immunization levels. Expanding school health services could improve the immunization levels…
... services. The center operator shall provide a health program, including basic medical, dental, and mental health services, for all students from admission until termination from the Job Corps. The program shall... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Health care and services. 638.510 Section 638...
... 19 Customs Duties 1 2010-04-01 2010-04-01 false Public Health Service requirements. 4.70 Section 4... THE TREASURY VESSELS IN FOREIGN AND DOMESTIC TRADES Foreign Clearances § 4.70 Public Health Service... Public Health Service. [T.D. 00-4, 65 FR 2874, Jan. 19, 2000] ...
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Public Health Service. 3... Pension, Compensation, and Dependency and Indemnity Compensation Retirement § 3.753 Public Health Service... of the Public Health Service, who was receiving disability compensation on December 31, 1956, as...
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Mental health services... Outpatient Treatment § 17.98 Mental health services. (a) Following the death of a veteran, bereavement... mental health services in connection with treatment of the veteran under 38 U.S.C. 1710, 1712, 1712A...
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 ...
Schonbrun, Yael Chatav; Whisman, Mark A.
Objective: This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method: The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for…
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency..., Public Law 104-13), the Health Resources and Services Administration (HRSA) publishes periodic summaries... Administration (HRSA) plans to conduct a survey of the National Practitioner Data Bank and the Healthcare...
West, R T; Howard, F H
A study to determine the impact that the Area Health Education Center type of programs may have on health science libraries was conducted by the Extramural Programs, National Library of Medicine, in conjunction with a contract awarded by the Bureau of Health Manpower, Health Resources Administration, to develop an inventory of the AHEC type of projects in the United States. Specific study tasks included a review of these programs as they relate to library and information activities, on-site surveys on the programs to define their needs for library services and information, and a categorization of library activities. A major finding was that health science libraries and information services are generally not included in AHEC program planning and development, although information and information exchange is a fundamental part of the AHEC type of programs. This study suggests that library inadequacies are basically the result of this planning failure and of a lack of financial resources; however, many other factors may be contributory. The design and value of library activities for these programs needs explication.
Behr, Joshua G; Diaz, Rafael; Akpinar-Elci, Muge
The management and treatment of adult asthma has been associated with utilization of health services. First, to investigate the likelihood of health service utilization, including primary care, emergency department, and hospital stays, among persons diagnosed with an asthma condition relative to those that do not have an asthma condition. Second, to examine the likelihood of poor physical health among asthma respondents relative to those that do not have an asthma condition. Third, to demonstrate that these relationships vary with frequency of utilization. Fourth, to discuss the magnitude of differences in frequent utilization between asthma and non-asthma respondents. Data is derived from a random, stratified sampling of Hampton Roads adults, 18 years and older (n = 1678). Study participants are interviewed to identify asthma diagnosis, access to primary care, frequency of emergency department utilization, hospital admissions, and days of poor physical health. Odds-ratios establish relationships with the covariates on the outcome variable. Those with asthma are found more likely (OR 1.50, 95% CI 1.05-2.15) to report poor physical health relative to non-asthma study participants. Further, asthma respondents are found more likely (OR 4.23, 95% CI 1.56-11.69) to frequently utilize primary care that may be associated with the management of the condition and are also more likely to utilize treatment services, such as the emergency department (OR 1.87, 95% CI 1.32-2.65) and hospitalization (OR 2.21, 95% CI 1.39-3.50), associated with acute and episodic care. Further, it is a novel finding that these likelihoods increase with frequency of utilization for emergency department visits and hospital stays. Continuity in care and better management of the diseases may result in less demand for emergency department services and hospitalization. Health care systems need to recognize that asthma patients are increasingly more likely to be characterized as frequent utilizers of
... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service, Scientific Merit... management, and nursing research. Applications are reviewed for scientific and technical merit, mission... Advisory Committee Act, 5 U.S.C. App. 2, that the Health Services Research and Development Service (HSR&D...
... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Scientific Merit...-463 (Federal Advisory Committee Act) that various subcommittees of the Health Services Research and Development Service Scientific Merit Review Board will meet on August 28-30, 2012, at the Boston Omni Parker...
... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Scientific Merit...-463 (Federal Advisory Committee Act) that various subcommittees of the Health Services Research and Development Service Scientific Merit Review Board will meet on March 6-8, 2012, at the Hilton New Orleans...
Gmelin, Theresa; Raible, Claire A; Dick, Rebecca; Kukke, Surabhi; Miller, Elizabeth
This study assessed the feasibility of integrating reproductive health services into intimate partner violence/sexual violence (IPV/SV) programs. After a training for victim service agencies on integration of health services, we conducted semistructured interviews with IPV/SV program leadership. Leadership reported advocates were more likely to recognize the need to refer clients to health services, and revealed challenges operationalizing partnerships with health care centers. Training to integrate basic health assessment into victim services may be one way to address women's urgent health needs. Formal partnership agreements, protocols to facilitate referrals, and opportunities to cross-train are needed to nurture these cross-sector collaborations.
Moon, O R
Early in the 1970s the Korean government recognized the necessity of Health Services Research (HSR). The law of the Korea Health Development Institute was promulgated in 1975, and a contribution from the Republic was combined with an Agency for International Development loan to field test low-cost health service strategies. A program to deploy Community Health Practitioners (CHPs), similar to family nurse practitioners or Medex has been demonstrated to be effective. The CHP training program grew from 9 in 1980 to 1343 in 1984. CHP's main functions are curative, preventive, educative, and administrative. They are selected registered nurses and/or midwives, where possible from serviced communities. They are trained in 24 weeks, including 12 weeks of clinical practice, in an anticipated recruiting post. CHPs help train village health volunteers (VHVs), who are literate women chosen by their communities. They work closely with the CHPs as a liaison with the village and in information gathering. An HSR orientation workshop held in Chuncheon in 1980, discussed role, policy, status, finance components, information systems, behavioral and manpower components, staff training, protocols for project development, HSR in the future and evaluation of the conference. In 1980, a National Workshop on Biomedical Research Methodology was also held, with World Health Organization and Korean consultants. Training of junior scientists would include introduction to scientific method, statement of problems, quantitative study technics, research proposals, and interpretation of results. The Korean Institute of Public Health sponsored a 1982 experts forum on the health care system, medical facilities, organizational management, financing and medical security, and health behavioral aspects. Training of trainers and lower level field workers, orientation of program managers, researchers, and communities themselves should all be training priorities. In future, CHPs should be refresher
Killaspy, Helen; Marston, Louise; Omar, Rumana Z; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; King, Michael
Current health policy assumes better quality services lead to better outcomes. To investigate the relationship between quality of mental health rehabilitation services in England, local deprivation, service user characteristics and clinical outcomes. Standardised tools were used to assess the quality of mental health rehabilitation units and service users' autonomy, quality of life, experiences of care and ratings of the therapeutic milieu. Multiple level modelling investigated relationships between service quality, service user characteristics and outcomes. A total of 52/60 (87%) National Health Service trusts participated, comprising 133 units and 739 service users. All aspects of service quality were positively associated with service users' autonomy, experiences of care and therapeutic milieu, but there was no association with quality of life. Quality of care is linked to better clinical outcomes in people with complex and longer-term mental health problems. Thus, investing in quality is likely to show real clinical gains.
... is divided into nine sections, namely organisational structure; education, training and research; mental health service provision; highly specialised services; community mental health services; forensic mental health services; mental health and the private sector; pharmaceutical services; and summary of recommendations.
Hemmings, Colin; Bouras, Nick; Craig, Tom
Services for people with Intellectual Disability (ID) and coexisting mental health problems remain undeveloped; research into their effectiveness has been lacking. Three linked recent studies in the UK have provided evidence on essential service provision from staff, service users and carers. Interfaces with mainstream mental health services were seen as problematic: the area of crisis response was seen as a particular problem. Further services’ research is needed, focusing on service components rather than whole service configurations. There was not support for establishing more intensive mental health services for people with ID only. The way forward is in developing new ways of co-working with staff in “mainstream” mental health services. Mental health of ID staff might often be best situated directly within these services. PMID:25158137
Mental Health Services in South Africa: Scaling up and future directions. ... African Journal of Psychiatry ... Abstract. “No health without mental health” has become a rallying call for the World Health Organization and numerous service providers, training institutions, health researchers, and advocacy groups around the world.
A series of tornadoes ripped through the Upper Midwest region of the United States in the evening of June 7, 2007. At least five different tornadoes touched down in Wisconsin, according to the Associated Press, one of which tore through the Bear Paw Resort in northern Wisconsin. Despite dropping as much as fifteen centimeters (six inches) of rain in some places and baseball-size hail in others, authorities were reporting no deaths attributable to the storm system, and only a smattering of injuries, but considerable property damage in some areas. When the MODIS instrument on NASA's Terra satellite observed the area on June 9, 2007, the track torn through the woods by one of the tornadoes stands out quite clearly. This photo-like image uses data collected by MODIS in the normal human vision range to give a familiar natural-looking appearance. The landscape is largely a checkerboard of farms, towns, roads, and cities. The pale land is predominantly farmland where crops have not fully grown in yet. Dark blue shows the winding path of rivers and lakes dotting the landscape. The large blue lake on the east (right) side of the image is Lake Michigan. Towns and cities, including the city of Green Bay, are gray. To the north side, farmland gives way to dark green as land use shifts from agriculture to the Menominee Indian Reservation and Nicolet National Forest. The diagonal slash through the dark green forested land shows the tornado track. Bare land was revealed where the tornado tore down trees or stripped vegetation off the branches. The high-resolution image provided above is at MODIS' full spatial resolution (level of detail) of 250 meters per pixel. The MODIS Rapid Response System provides this image at additional resolutions.
Rezola, J G; Santolaya, J; Orduna, J; Dehesa, F
The Bilbao School Health Service was created at the beginning of the century with the aim of preventing transmittable diseases among children as well as improving nutrition. At that time such services were established in many other countries. Since then, according to evolving societal changes and emerging needs, the Service has reoriented its scope and structure towards the Health Promotion scheme. Current tasks include health screening examinations and hygiene surveillance as well as preventive and health education programmes.
Clewley, Derek; Rhon, Dan; Flynn, Tim; Koppenhaver, Shane; Cook, Chad
Physical therapists' familiarity, perceptions, and beliefs about health services utilization and health seeking behaviour have not been previously assessed. The purposes of this study were to identify physical therapists' characteristics related to familiarity of health services utilization and health seeking behaviour, and to assess what health seeking behaviour factors providers felt were related to health services utilization. We administered a survey based on the Andersen behavioural model of health services utilization to physical therapists using social media campaigns and email between March and June of 2017. In addition to descriptive statistics, we performed binomial logistic regression analysis. We asked respondents to rate familiarity with health services utilization and health seeking behaviour and collected additional characteristic variables. Physical therapists are more familiar with health services utilization than health seeking behaviour. Those who are familiar with either construct tend to be those who assess for health services utilization, use health services utilization for a prognosis, and believe that health seeking behaviour is measurable. Physical therapists rated need and enabling factors as having more influence on health services utilization than predisposing and health belief factors. Physical therapists are generally familiar with health services utilization and health seeking behaviour; however, there appears to be a disconnect between what is familiar, what is perceived to be important, and what can be assessed for both health services utilization and health seeking behaviour. Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. All rights reserved.
Dabiri, O M
Nigerians did not readily accept family planning when Family Health Services (FHS) began in 1988. FHS has made much headway in training, IEC (information, education, and communication), and constituency building and advocacy. Its staff have identified obstacles to implementation, especially program sustainability and management structure. Key limits to sustainability of IEC efforts were inadequately trained personnel and inability of trained personnel to apply what they learned at work stations. The Federal Ministry and Social Services' role in the FHS project was not clearly defined. Some private sector factors contributing to a confused management structure were inadequate method mix, high contraceptive cost, poor monitoring of quality of care, and no coordination of family planning training with the public factor. FHS has since decided to focus its efforts on increasing the demand for and availability of modern contraceptives and improving the quality of family planning services of both the public and private sectors. FHS hopes that accomplishing these activities will reduce fertility, morbidity, and mortality. Strategic plans include a regional focus, quality of care, a variety of methods offered, intensification, hospital and clinics, a management information system, contraceptive logistics, distribution regulations, and addressing social, cultural, and behavioral factors. To effectively implement the strategy, USAID and the Federal Ministry held a workshop in 1993 to effect full integration of Nigerian experience in the 2nd phase of the project (FHS II). Participants reviewed the strengths and weaknesses of the first phase and agreed on implementation. For example, nongovernmental organizations should implement FHS II. FHS II includes training, IEC, and commodities/logistics.
Integrating reproductive and child health and HIV services in Tanzania: Implication to policy, systems and services. ... Experts around the world recognize the central role of Sexual and Reproductive Health (SRH) services in preventing HIV infection. Evidence suggests that improving access to contraception for women to ...
Despite the interest in service quality, little research has been reported in South Africa on health and fitness service quality. The study adopted a conceptual framework for identifying factors that influence fitness service quality in commercial health and fitness centres in South Africa. A structured questionnaire containing 59 ...
Ackerman, Ashley M.; Wantz, Richard A.; Firmin, Michael W; Poindexter, Dawn C.; Pujara, Amita L.
Undergraduate perceptions of the overall effectiveness of six types of mental health service providers (MHSPs) were obtained with a survey. Although many mental health services are available to consumers in the United States, research has indicated that these services are underutilized. Perceptions have been linked to therapeutic outcomes and may…
Satisfaction with outpatient health services at. Jimma Hospital, South West Ethiopia. Lemessa Oljira, Solomon Gebre-Selassie. Abstract. Background: The opinions of users about the health care services and the degree of their satisfaction may indicate the efficiency of the services. Objective: To assess consumer satisfaction ...
Mickenautsch, S.; Hof, M.A. van 't; Frencken, J.E.F.M.
OBJECTIVES: To describe the provision of restorative care and dental operators' opinion about their conditions of service in a South African provincial oral health service system. DESIGN: Assessment of oral health service over a four-month period. SETTING: Gauteng Province, South Africa. SUBJECTS:
Larson, Satu; Chapman, Susan; Spetz, Joanne; Brindis, Claire D
Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities. Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if research was related to childhood trauma's effects, mental health care disparities, SBHC mental health services, or SBHC impact on academic achievement. Eight studies show a significant risk of mental health disorders and poor academic achievement when exposed to childhood trauma. Seven studies found significant disparities in pediatric mental health care in the US. Nine studies reviewed SBHC mental health service access, utilization, quality, funding, and impact on school achievement. Exposure to chronic childhood trauma negatively impacts school achievement when mediated by mental health disorders. Disparities are common in pediatric mental health care in the United States. SBHC mental health services have some showed evidence of their ability to reduce, though not eradicate, mental health care disparities. © 2017, American School Health Association.
Bisognano, Joseph J. [University of Wisconsin-Madison; Bissen, M. [University of Wisconsin-Madison; Bosch, R. [University of Wisconsin-Madison; Efremov, M. [University of Wisconsin-Madison; Eisert, D. [University of Wisconsin-Madison; Fisher, M. [University of Wisconsin-Madison; Green, M. [University of Wisconsin-Madison; Jacobs, K. [University of Wisconsin-Madison; Keil, R. [University of Wisconsin-Madison; Kleman, K. [University of Wisconsin-Madison; Rogers, G. [University of Wisconsin-Madison; Severson, M. [University of Wisconsin-Madison; Yavuz, D. D. [University of Wisconsin-Madison; Legg, Robert A. [JLAB; Bachimanchi, Ramakrishna [JLAB; Hovater, J. Curtis [JLAB; Plawski, Tomasz [JLAB; Powers, Thomas J. [JLAB
The University of Wisconsin has completed fabrication and commissioning of a low frequency (199.6 MHz) superconducting electron gun based on a quarter wave resonator (QWR) cavity. Its concept was optimized to be the source for a CW free electron laser facility. The gun design includes active tuning and a high temperature superconducting solenoid. We will report on the status of the Wisconsin SRF electron gun program, including commissioning experience and first beam measurements.
Charles H. Perry
Results of the 2000-2004 annual inventory of Wisconsin show about 16.0 million acres of forest land, more than 22.1 billion cubic feet of live volume on forest land, and nearly 593 million dry tons of all live aboveground tree biomass on timberland. Populations of jack pine budworm are increasing, and it remains a significant pest in Wisconsin forests. A complete...
Objective: The objectives of this study are to assess the availability of child health services and how often these services are ... for sick children, routine childhood vaccination services (EPI), and routine growth monitoring services) as a package. Seventy three .... Data cleaning and analysis: Data was cleaned by checking of ...
Grove, A L; Meredith, J O; Macintyre, M; Angelis, J; Neailey, K
This paper presents the findings of a 13-month lean implementation in National Health Service (NHS) primary care health visiting services from May 2008 to June 2009. Lean was chosen for this study because of its reported success in other healthcare organisations. Value-stream mapping was utilised to map out essential tasks for the participating health visiting service. Stakeholder mapping was conducted to determine the links between all relevant stakeholders. Waste processes were then identified through discussions with these stakeholders, and a redesigned future state process map was produced. Quantitative data were provided through a 10-day time-and-motion study of a selected number of staff within the service. This was analysed to provide an indication of waste activity that could be removed from the system following planned improvements. The value-stream map demonstrated that there were 67 processes in the original health visiting service studied. Analysis revealed that 65% of these processes were waste and could be removed in the redesigned process map. The baseline time-and-motion data demonstrate that clinical staff performed on average 15% waste activities, and the administrative support staff performed 46% waste activities. Opportunities for significant waste reduction have been identified during the study using the lean tools of value-stream mapping and a time-and-motion study. These opportunities include simplification of standard tasks, reduction in paperwork and standardisation of processes. Successful implementation of these improvements will free up resources within the organisation which can be redirected towards providing better direct care to patients.
Full Text Available Abstract Background There is evidence for higher morbidity among prison inmates than in the general population. Despite this, patient satisfaction with the prison health services is scarcely investigated. The aim of the present study was to investigate patient satisfaction with prison health services in Norway and to analyze possible patient and service effects. Methods The survey took part in 29 prisons in the southern and central part of Norway, representing 62% of the total prison capacity in Norway. A total of 1,150 prison inmates with prison health services experiences completed a satisfaction questionnaire (90% response rate. The patients' satisfaction was measured on a 12-item index. Multilevel analyses were used to analyze both patient and service characteristics as predictors of satisfaction. Results The study revealed high levels of dissatisfaction with prison health services. There were substantial differences between services, with between-service-variance accounting for 9% of the total variance. Satisfaction was significantly associated with a senior staff member's evaluation of the health services possessing adequate resources and the quality of drug abuse treatment. At the patient level, satisfaction was significantly associated with older age, frequent consultations and better self-perceived health. Conclusion Prison inmates' satisfaction with the health services provided are low compared with patient satisfaction measured in other health areas. The substantial differences observed between services - even when adjusting for several known factors associated with patient satisfaction - indicate a potential for quality improvement.
Bjørngaard, Johan Håkon; Rustad, Ase-Bente; Kjelsberg, Ellen
There is evidence for higher morbidity among prison inmates than in the general population. Despite this, patient satisfaction with the prison health services is scarcely investigated. The aim of the present study was to investigate patient satisfaction with prison health services in Norway and to analyze possible patient and service effects. The survey took part in 29 prisons in the southern and central part of Norway, representing 62% of the total prison capacity in Norway. A total of 1,150 prison inmates with prison health services experiences completed a satisfaction questionnaire (90% response rate). The patients' satisfaction was measured on a 12-item index. Multilevel analyses were used to analyze both patient and service characteristics as predictors of satisfaction. The study revealed high levels of dissatisfaction with prison health services. There were substantial differences between services, with between-service-variance accounting for 9% of the total variance. Satisfaction was significantly associated with a senior staff member's evaluation of the health services possessing adequate resources and the quality of drug abuse treatment. At the patient level, satisfaction was significantly associated with older age, frequent consultations and better self-perceived health. Prison inmates' satisfaction with the health services provided are low compared with patient satisfaction measured in other health areas. The substantial differences observed between services - even when adjusting for several known factors associated with patient satisfaction - indicate a potential for quality improvement.
Conclusion: This study brings to the fore the fact that most government employees and their dependants in Abakaliki have difficulties in accessing quality health care services via paying for them out-of-pocket. Keywords: Health services, payment, constraints, government employees. African Health Sciences 2011; 11(3): 481 ...
Cuffe, Kendra M; Leichliter, Jami S; Gift, Thomas L
State and local health department STD programs provide several partner services to reduce disease transmission. Budget cuts and temporary staff reassignments for public health emergencies may affect the provision of partner services. Determining the impact of staffing reductions on STD rates and public health response should be further assessed.
democratic control, current initiatives to restruc- ture health services ... Z, a Union responsibility' had the Public Health Bill of. 1919 been passed .... public health'. It recommended the establishment of a government medical service for blacks which incorporat- ed all mission hospitals, and the training of fully quali- fied black ...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Services Act; Delegation of Authority Notice is hereby given that I have delegated to the Director, Office of Public Health Preparedness and Response (OPHPR), with authority to redelegate, the authority to...
distance to health facility and partner's educational level as to whether they influenced utilization of formal maternal health services in Zambezi district. The aim of the study was to determine major social demographic factors affecting utilization of maternal health services among women 15 to 49 years in Zambezi district.
Background: Community mental health services (CMHS) are a central objective of the National Mental Health Policy Framework and Strategic Plan. Three core components are described: residential facilities, day care and outpatient services. Primary mental health care with specialist support is required according to an ...
information that can be utilized by programs designed to increase demand for health services. (Afr J Reprod Health 2017; 21:. 96-108). Keywords: Maternal health, family planning, demand-side, Northern Nigeria, literature review. Résumé. La demande et l'utilisation des services de santé des femmes dans le nord du ...
An analysis of the origins and outcome of the Gluckman Commission is relevant to the current health service debate in South Africa. Fundamental to the report's recommendations was the establishment of a unitary health service responsible for all health care functions within the Union of South Africa. On this proposal ...
Federal Laboratory Consortium — The Tri-Service Center for Oral Health Studies (TSCOHS), a service of the Postgraduate Dental College, is chartered by the Department of Defense TRICARE Management...
Despite fiscal stress, public confidence in the National Health Service (NHS) remains strong; privatisation has not hollowed out the service. But if long term challenges are to be overcome, pragmatism not rhetoric should be the guide PMID:26340494
Carlos Arturo Meza Carvajalino
Full Text Available This document studies the theoretical foundations, the different controversies regarding the health service and the conceptions adopted from the hypotheses related to the market efficiency in the provision of a public service and the consequent market failures. The author thinks that when the health public service was delegated to the market in Colombia they originated failures in the competition, externalities, preference goods and services, asymmetry and redistribution, among the most relevant ones.
Polsa, Pia; Fuxiang, Wei; Sääksjärvi, Maria; Shuyuan, Pei
Several service quality studies show how cultural features may influence the way service quality is perceived. However, few studies specifically describe culture's influence on health service quality. Also, there are few studies that take into account patients' health service quality perceptions. This article seeks to present a first step to fill these gaps by examining patients' cultural values and their health service quality assessments. The study draws on published work and applies its ideas to Chinese healthcare settings. Data consist of hospital service perceptions in the People's Republic of China (PRC), a society that is socially, economically and culturally undergoing major changes. In total, 96 patients were surveyed. Data relationships were tested using partial least square (PLS) analysis. Findings show that Chinese patients' cultural values and their health service assessments are related and that the cultural values themselves seem to be changing. Additionally, further analyses provided interesting results pointing to which cultural values influenced service quality perceptions. The strongest service quality predictor was power distance. The sample is relatively small and collected from only one major hospital in China. Therefore, future research should extend the sample size and scope. Follow-up research could also include cross-cultural investigations of perceived health service quality to substantiate cultural influences on health service quality perceptions. In line with similar research in other contexts, the study confirms that power distance has a significant relationship with service quality perceptions. The study contributes to existing health service literature by offering patients' views on health service quality and by describing relationships between health service perceptions and cultural values--the study's main contribution.
Larson, Satu; Chapman, Susan; Spetz, Joanne; Brindis, Claire D.
Background: Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers…
The primary aim of the present study was to consider health care service quality from the patients' perspective, specifically through the patient's eyes. A narrative analysis was performed on 300 patient stories. This rigorous analysis of patient stories is designed to identify and describe health care service quality through patients' eyes in an authentic and accurate, experiential manner. The findings show that there are variant and complex ways that patients experience health care service quality. Patient stories offer an authentic view of the complex ways that patients experience health care service quality. Narrative analysis is a useful tool to identify and describe how patients experience health care service quality. Patients experience health care service quality in complex and varying ways.
Full Text Available One of the most important components of health promotion is community participation. The importance of community participation in health care was raised by the Alma-Ata Declaration in 1978. According to the Alma-Ata Declaration community participation should be ensured by planning, organization, implementation and supervision of health services at the highest levels. Nowadays, community participation is distanced from the definition in the Alma-Ata Declaration. Citizens cannot take part in the decision making process and community financing has been mentioned as a part of the community participation in health services. Community participation in the health sector in Turkey was initially regulated by the Law on the Socialization of Health Services (No. 224 published in 1961. Unfortunately, this regulation has not been put widely into practice. Community participation is regulated as a contribution to the financing of health services (prescription fee, surcharge, inpatient bed fee, etc. by the Health Transformation Program (HTP. With HTP, the user fee for health services applies only for medical examinations provided by the Social Security Institution has increased to 2.132 billion TL in 2012 from 466 million TL in 2009. User fees in the health services only for medical examinations increased over the years and in the ratio of household health expenditures exceeded 18% for 2012. The Health Transformation Program should be discussed because of a structure that does not allow for community participation.Keywords: Community participation, health services, community financing, Turkey
Vellar, Lucia; Mastroianni, Fiorina; Lambert, Kelly
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
This paper explores the relationship between trade in health services, its liberalization, and Africa‟s health system with particular focus on Africa. Using a sample of African countries, a regression model link, health outcomes to health inputs and health policy variables were estimated to cover two separate periods- the pre- ...
Allevi, Liliana; Salvi, Giovanni; Ruggeri, Mirella
To start a process of Continuous Quality Improvement (CQI) in an Italian Community Mental Health Service by using a quality assurance questionnaire in a self audit exercise. The questionnaire was administered to 14 key workers and clinical managers with different roles and seniority. One senior manager's evaluation was used as a benchmark for all the others. Changes were introduced in the service practice according to what emerged from the evaluation. Meetings were scheduled to monitor those changes and renew the CQI process. There was a wide difference in the key workers' answers. Overall, the senior manager's evaluation was on the 60th percentile of the distribution of the other evaluations. Those areas that required prompt intervention were risk management, personnel development, and CQI. The CQI process was followed up for one year: some interventions were carried out to change the practice of the service. A self audit exercise in Community Mental Health Services was both feasible and useful. The CQI process was easier to start than to carry on over the long term.
Lazarus, I R
With or without federal health care reform to impact the delivery of health care services in the U.S., hospitals must commit to service marketing and strategic alliances as a fundamental business strategy. Service marketing not only differentiates the provider, but with the proper programs in place, it may actually facilitate the formation of strategic alliances. The combination of these strategies will be particularly effective in preparing for any health care policy change.
Okunseri, Christopher; Okunseri, Elaye; Garcia, Raul I; Gonzalez, Cesar; Visotcky, Alexis; Szabo, Aniko
In September 2006, Wisconsin Medicaid changed its policy to allow nondentists to become certified Medicaid providers and to bill for sealants in public health settings. This study examined changes in patterns of dental sealant utilization in first molars of Wisconsin Medicaid enrollees associated with a policy change. The Electronic Data Systems of Medicaid Evaluation and Decision Support for Wisconsin from 2001 to 2009. Retrospective claims data analysis of Wisconsin Dental Medicaid for children aged 6-16 years. A total of 479,847 children followed up for 1,441,300 person-years with 64,546 visits were analyzed. The rate of visits for sealants by dentists increased significantly from 3 percent per year prepolicy to 11 percent per year postpolicy, and that of nondentists increased from 18 percent per year to 20 percent after the policy change, but this was not significant. Non-Hispanic blacks had the lowest visit rates for sealant application by dentists and nondentists pre- and postpolicy periods. The Wisconsin Medicaid policy change was associated with increased rates of visits for dental sealant placement by dentists. The rate of visits with sealant placements by nondentists increased at the same rate pre- and postpolicy change. © Health Research and Educational Trust.
Noh, Normah Awang; Wahab, Haris Abd; Bakar Ah, Siti Hajar Abu; Islam, M Rezaul
The objective of this study was to know the status of the foreign workers' access to public health services in Malaysia based on their utilization pattern. The utilization pattern covered a number of areas, such as frequency of using health services, status of using health services, choice and types of health institutions, and cost of health treatment. The study was conducted on six government hospitals in the Klang Valley area in Kuala Lumpur, Malaysia. Data were collected from 600 foreign patients working in the country, using an interview method with a structured questionnaire. The results showed that the foreign workers' access to public health services was very low. The findings would be an important guideline to formulate an effective health service policy for the foreign workers in Malaysia.
Hu, Li; Zhang, Wen-sheng
To study the case of Wisconsin as the top ginseng state in United States which has come through four developing steps: beginning, stagnating, flourishing and now, downturn. The current situation of the ginseng industry in Wisconsin was briefly introduced, the federal and state management on ginseng cultivation and export, the organization of Ginseng Board of Wisconsin and their marketing style based on the field investigation and data collected from USDA and Wisconsin state. The advantages and disadvantages of Wisconsin ginseng industry were analyzed in order to provide some suggestions for Chinese medicine industry. Chinese ginseng industry should learn the organization system from Wisconsin.
Full Text Available Although Christian Health Services have a proud history of healing and compassion especially in developing countries, their future is affected by secular changes in the financing and provision of health care services. However, the nature of life as it is evolving in modern society promises a need for the capacity to deal with increasing dynamics, complexity and uncertainty. In these circumstances the potential capacity of Christians in their institutions and churches to provide Unconditional Reliability suggests a new opportunity. The components of Unconditional Reliability and how they affect the portfolio of Christian Health Services is explained. Effective Christian Health Services will require appropriate analysis of their portfolios.
Vlad, R.S.; Petersen, P.E.
Attitudes, dental status, socioeconomic factors, oral health care, production of oral health, health status, quality of life......Attitudes, dental status, socioeconomic factors, oral health care, production of oral health, health status, quality of life...
. Until 1990 all governmental health authorities and. NGOs functioned independently of each other with little co-ordination, co-operation or communication. Since then, a few steps forward on the road to a district health service have been taken.
Proctor, S R; Wright, G H
To generate thought and discussion regarding the application of key features of generic services which may influence management and marketing decisions in health care. Health care, as many other services provides benefits to the consumer, the quality of which is largely dependent on the interpersonal element of the service delivery. Services now dominate the UK economy, and consumer participation in service delivery is as important in health care as in services in the private sector. There is now an established body of research on the nature of services and the particular management and marketing challenges posed by service provision. The application of general management concepts and tools to the public services is an area of current debate. The paper firstly discusses key features of services and their application to health care contexts. Secondly, a discussion of strategic classifications of services seeks to identify common themes which exist across the diverse service sector. Nursing and midwifery managers have much to gain from understanding the use of services management frameworks, and have scope for much creativity in adapting generic frameworks for their own areas of practice.
Agampodi Thilini C
Full Text Available Abstract Background Adolescent health needs, behaviours and expectations are unique and routine health care services are not well geared to provide these services. The purpose of this study was to explore the perceived reproductive health problems, health seeking behaviors, knowledge about available services and barriers to reach services among a group of adolescents in Sri Lanka in order to improve reproductive health service delivery. Methods This qualitative study was conducted in a semi urban setting in Sri Lanka. A convenient sample of 32 adolescents between 17–19 years of age participated in four focus group discussions. Participants were selected from four midwife areas. A pre-tested focus group guide was used for data collection. Male and female facilitators conducted discussions separately with young males and females. All tape-recorded data was fully transcribed and thematic analysis was done. Results Psychological distresses due to various reasons and problems regarding menstrual cycle and masturbation were reported as the commonest health problems. Knowledge on existing services was very poor and boys were totally unaware of youth health services available through the public health system. On reproductive Health Matters, girls mainly sought help from friends whereas boys did not want to discuss their problems with anyone. Lack of availability of services was pointed out as the most important barrier in reaching the adolescent needs. Lack of access to reproductive health knowledge was an important reason for poor self-confidence among adolescents to discuss these matters. Lack of confidentiality, youth friendliness and accessibility of available services were other barriers discussed. Adolescents were happy to accept available services through public clinics and other health infrastructure for their services rather than other organizations. A demand was made for separate youth friendly services through medical practitioners
Horgan, C M
A two-part model is used to examine the demand for ambulatory mental health services in the specialty sector. In the first equation, the probability of having a mental health visit is estimated. In the second part of the model, variations in levels of use expressed in terms of visits and expenditures are examined in turn, with each of these equations conditional on positive utilization of mental health services. In the second part of the model, users are additionally grouped into those with and without out-of-pocket payment for services. This specification accounts for special characteristics regarding the utilization of ambulatory mental health services: (1) a large part of the population does not use these services; (2) of those who use services, the distribution of use is highly skewed; and (3) a large number of users have zero out-of-pocket expenditures. Cost-sharing does indeed matter in the demand for ambulatory mental health services from specialty providers; however, the decision to use mental health services is affected by the level of cost-sharing to a lesser degree than is the decision regarding the level of use of services. The results also show that price is only one of several important factors in determining the demand for services. The lack of significance of family income and of being female is notable. Evidence is presented for the existence of bandwagon effects. The importance of Medicaid in the probability of use equations is noted. PMID:3721874
Improving high quality, equitable maternal health services in Malawi (IMCHA). Malawi has high rates of maternal mortality despite concerted efforts to increase the rate of births at health facilities. In response, the Ministry of Health implemented a Standards-Based Management and Recognition for Reproductive Health ...
(129) of the women received delivery services while. 48.3 percent (193) received postnatal care services. In the logistic regression model, reduced income level was associated with decreased use of antenatal care (OR=0.1, P<0.05). In assisted delivery, increased .... seeking health care services such as transport to be a.
Shearn, P.; Ford, Norma J.; Murphy, R. G.
Objective: The objective of this article is to identify the profile of service users of an occupational health (OH) support service and establish areas of need, and to gather client feedback on the experience of participating in the support service and perceived outcomes and the impact of the advice received. Design and Setting: We carried out…
Conclusion: The male attendance to RH services together with their female partners' in rural Shinyanga .... infection, other than HIV (Table. 2). Table 2: Awareness of men on various the reproductive health services. Service. Response. Frequency. (N) = 204. Percentage (%). FP .... Knowing our status was important to both.
Martin, Robyn M; Ridley, Sophie C; Gillieatt, Sue J
Contemporary mental health policies require family inclusion in the design, implementation and evaluation of services. This scoping review considers the factors in mental health practice which either mediate or promote family inclusion. A wide range of factors are reported to obstruct family inclusion, while a smaller number of studies report that meaningful family inclusion rests on a partnership approach which values the input of families and services users. When it comes to family inclusion, there is a gap between policy and service delivery practice. Changes in service delivery attitudes, values and culture are necessary to meaningfully and systematically include families and service users.
Full Text Available The infusion of information communication technology (ICT into health services is emerging as an active area of research. It has several advantages but perhaps the most important one is providing medical benefits to one and all irrespective of geographic boundaries in a cost effective manner, providing global expertise and holistic services, in a time bound manner. This paper provides a systematic review of technological growth in eHealth services. The present study reviews and analyzes the role of four important technologies, namely, satellite, internet, mobile, and cloud for providing health services.
Lang, Y C
1. The first step of a successful Employee Health Service integration is to have a plan supported by management. The plan must be presented to the employees prior to implementation in a "user friendly" manner. 2. Prior to computerization of employee health records, a record order system must be developed to prevent duplication and to enhance organization. 3. Consistency of services offered must be maintained. Each employee must have the opportunity to receive the same service. Complexity of services will determine the site of delivery. 4. Integration is a new and challenging development for the health care field. Flexibility and brainstorming are necessary in an attempt to meet both employee and employer needs.
Background: The quality of health services has been known to be grossly deficient in developing countries, but only few studies were carried out to document the deficiencies in a systematic manner. Objective: To assess the quality of reproductive health services in rural settings with emphasis on the structural aspect.
Utilization of Maternal Health Services in Urban and Rural Communities of Anambra State, Nigeria. ... CONCLUSION: Measures to improve maternal health service utilization especially in rural areas should not only address the issue of access to care, but also improvement in quality of care and women empowerment.
Background: Since the establishment of free HIV/AIDS care and treatment services in Tanzania a lot of research has been done to assess how health care providers discharge their duties in these clinics. Little research however has been done regarding satisfaction of HIV patients with free health care services provided.
Maternal health service utilization in urban slums of selected towns in Ethiopia: Qualitative study. ... Reasons were found to be attributed to individual characteristics, perceived capacities of health facilities and friendliness of service providers and socio-cultural factors including socially sanctioned expectations at community ...
This study aims to identify reasons why urban women fail to use available maternal health services in selected urban ... addresses individual, institutional and socio-cultural factors in tandem to improve maternal health service utilization in urban setting. .... were transcribed to local language and were later translated into ...
Harding, April; Preker, Alexander S
... hospitals play a critical role in ensuring delivery of health services, less is known about how to improve the efficiency and quality of care provided. Much can be learned in this respect from the experiences of hospital reforms initiated during the 1990s. Innovations in Health Service Delivery: The Corporatization of Public Hospitals is an a...
Background: Health services for the elderly are very crucial for these people have unique diseases which need special attention and treatment. Objectives: To study the awareness , acceptability and utilization of health services by the elderly people at Tandale Dispensary, Kinondoni Municipality, Dar es Salaam. Methods: ...
Results: There are shortfalls in the provision of mental health care including insufficient numbers of mental health professionals, aging infrastructure, widespread stigma, inadequate funding and an inequitable geographical distribution of services. Conclusion: Community-based services need to be delivered in the primary ...
Aim: To determine awareness and perception of oral health services and their influence on the utilization of oral health services. Subjects and Methods: A total of 353 simple randomly selected pupils aged 11-20 years at Chifubu secondary school in Ndola participated in the study. Data was collected using structured close ...
Background. Europe and North America have low rates of mental health service use despite high rates of mental disorder. Little is known about mental health service use among South Africans. Design. A nationally representative survey of 4 351 adults. Twelve-month DSM-IV (Diagnostic and Statistical Manual, 4th edition) ...
Objective: This survey was aimed to assess service availability and readiness for diabetes health care. Methods: The data ... Of the facilities that offer service for diabetes, 12 % of them had guidelines for diagnosis and management of diabetes at the .... public, and 45 % were private for-profit health facilities. More than six in ...
... within Lagos metropolis was conducted using a 28-item questionnaire to obtain information about the socio-demographic characteristics, knowledge about the locations of Primary Health Care (PHC) services, type of services received, perceived quality, reasons for choice and sources of alternative maternal health care.
Westerholm, Peter; Hasle, Peter; Fortuin, Rick
A discussion of the possibilities for professionals from the occupational health service to act as external agents of change in introducing preventive activities in enterprises.......A discussion of the possibilities for professionals from the occupational health service to act as external agents of change in introducing preventive activities in enterprises....
or 4% were due to diabetes. In Ethiopia, data on the preparedness of health facilities to cope with the rising epidemic of diabetes are insufficient. Objective: This survey was aimed to assess service availability and readiness for diabetes health care. Methods: The data used in this study is part of the 2014 Ethiopian service ...
Erickson, Chris D.; Al-Timimi, Nada R.
This paper presents background information on the cultural sociopathology of the Arab American experience. It discusses how, in order to effectively deliver services, mental health workers need to be aware of their own biases. It explores ways to provide culturally relevant mental health services to Arab Americans. (JDM)
availability of services for neglected tropical diseases management at health facilities in Ethiopia. Method: The assessment is ... Conclusion and recommendation: Even though, the availability of service for neglected tropical disease in health facilities is ..... generous financial, logistics and technical support for the success of ...
Zwaanswijk, Marieke; Ende, J. van der; Verhaak, P.F.M.; Bensing, J.; Verhulst, F.C.
Objective: To determine the association of parent, family, and adolescent variables with adolescent mental health service need and utilization. Method: Correlates of adolescent mental health service utilization, self-perceived need and unmet need were investigated in a general population sample of
Harris, Jeffrey R; Hammerback, Kristen R; Hannon, Peggy A; McDowell, Julie; Katzman, Avi; Clegg-Thorp, Catherine; Gallagher, John
Small employers are underserved with workplace health promotion services, so we explored the potential for group purchasing of these services. We conducted semistructured telephone interviews of member organizations serving small employers, as well as workplace health promotion vendors, in Washington State. We interviewed 22 employer organizations (chambers of commerce, trade associations, and an insurance trust) and vendors (of fitness facilities, healthy vending machines, fresh produce delivery, weight management services, and tobacco cessation quitlines). Both cautiously supported the idea of group purchasing but felt that small employers' workplace health promotion demand must increase first. Vendors providing off-site services, for example, quitline, found group purchasing more feasible than vendors providing on-site services, for example, produce delivery. Employer member organizations are well-positioned to group purchase workplace health promotion services; vendors are receptive if there is potential profit.
Hansen, Kristian Schultz; Enemark, Ulrika; Foldspang, Anders
, 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours...... of substitute health services. By contrast, Morsø women compared to the rest of Viborg county reduced their use of GP services in terms of face-to-face visits (β = -0.08, P = 0.020), telephone consultations (β = -0.11, P = 0.007), home visits (β = -0.48, P = 0.009), and their inpatient hospital utilization (β...... = -0.12, P = 0.022) during the period when emergeny services were only available in the daytime. CONCLUSIONS: Emergency services at neighbouring hospitals (40 kilometres distance) were able to compensate, in part, for the decreased local emergency service provision. Concurrent changes in health care...
Anaf, Julia; Baum, Fran; Freeman, Toby; Labonte, Ron; Javanparast, Sara; Jolley, Gwyn; Lawless, Angela; Bentley, Michael
To examine case studies of good practice in intersectoral action for health as one part of evaluating comprehensive primary health care in six sites in South Australia and the Northern Territory. Interviews with primary health care workers, collaborating agency staff and service users (Total N=33); augmented by relevant documents from the services and collaborating partners. The value of intersectoral action for health and the importance of partner relationships to primary health care services were both strongly endorsed. Factors facilitating intersectoral action included sufficient human and financial resources, diverse backgrounds and skills and the personal rewards that sustain commitment. Key constraining factors were financial and time limitations, and a political and policy context which has become less supportive of intersectoral action; including changes to primary health care. While intersectoral action is an effective way for primary health care services to address social determinants of health, commitment to social justice and to adopting a social view of health are constrained by a broader health service now largely reinforcing a biomedical model. Effective organisational practices and policies are needed to address social determinants of health in primary health care and to provide a supportive context for workers engaging in intersectoral action. © 2014 Public Health Association of Australia.
Rubio, Encarnación; Comín, Magdalena; Montón, Gema; Martínez, Tomás; Magallón, Rosa
To describe the use of health and social services, and to analyze the influence of functional capacity for Instrumental Activities of Daily Living (IADL) and other factors in their use. Cross-sectional study in a non-institutionalized population older than 64 years old in a basic rural health area of Zaragoza. use of different health and social services. Main independent variable: functional capacity for IADL according to the Lawton-Brody. Confounding variables: sociodemographic, physical exercise, comorbidity, self-perceived health, walking aids, social resources and economic resources (OARS-MAFQ). The relationship between the use of services and functional capacity for IADL was assessed using crude OR (ORC) and adjusted (adjusted OR) with CI95% by means of multivariate logistic regression models. The use of social and health services increased with age and worse functional capacity for IADL. The increased use of health services was related with bad stage of health, limited social and economic resources, physical inactivity and female. The increased use of home help services was related with limited social resources, low education level and male. Regular physical activity and using walking aids were associated with greater participation in recreational activities. The probability of using social and health services increased in older people with impaired functional capacity for IADL. The specific use of them changed according to differences in health, demographic and contextual features. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.
Bjørngaard, Johan; Rustad, Åse-Bente; Kjelsberg, Ellen
Background: There is evidence for higher morbidity among prison inmates than in the general population. Despite this, patient satisfaction with the prison health services is scarcely investigated. The aim of the present study was to investigate patient satisfaction with prison health services in Norway and to analyze possible patient and service effects. Methods: The survey took part in 29 prisons in the southern and central part of Norway, representing 62% of the total prison capac...
Arunanondchai, Jutamas; Fink, Carsten
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.
... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Scientific Merit... Research and Development Service Scientific Merit Review Board will meet on February 13-14, 2013, at the... research. Applications are reviewed for scientific and technical merit. Recommendations regarding funding...
Result: The results showed that 38.5 percent (154) of the women received antenatal care, 32.3 percent (129) of the women received delivery services while 48.3 percent (193) received postnatal care services. In the logistic regression model, reduced income level was associated with decreased use of antenatal care ...
... testing of new methods of health care delivery and management, and nursing research. Applications are... Research and Development Officer. On August 30, the subcommittees on Nursing Research Initiatives and... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Merit Review Board...
Schenker, Yael; Arnold, Robert M; London, Alex John
Advertising by health care institutions has increased steadily in recent years. While direct-to-consumer prescription drug advertising is subject to unique oversight by the Federal Drug Administration, advertisements for health care services are regulated by the Federal Trade Commission and treated no differently from advertisements for consumer goods. In this article, we argue that decisions about pursuing health care services are distinguished by informational asymmetries, high stakes, and patient vulnerabilities, grounding fiduciary responsibilities on the part of health care providers and health care institutions. Using examples, we illustrate how common advertising techniques may mislead patients and compromise fiduciary relationships, thereby posing ethical risks to patients, providers, health care institutions, and society. We conclude by proposing that these risks justify new standards for advertising when considered as part of the moral obligation of health care institutions and suggest that mechanisms currently in place to regulate advertising for prescription pharmaceuticals should be applied to advertising for health care services more broadly.
Dee, Cheryl R
Two years after the initial 2002 study, a greater number of academic health science libraries are offering digital reference chat services, and this number appears poised to grow in the coming years. This 2004 follow-up study found that 36 (27%) of the academic health science libraries examined provide digital chat reference services; this was an approximately 6% increase over the 25 libraries (21%) located in 2002. Trends in digital reference services in academic health science libraries were derived from the exploration of academic health science library Web sites and from digital correspondence with academic health science library personnel using e-mail and chat. This article presents an overview of the current state of digital reference service in academic health science libraries.
This article examines the consequences of a "population-as-crisis" theme on the institutional configuration and resource endowments of health care services in an integrated Ministry of Health and Population Control in Bangladesh. The Ministry's focus on women as child bearers and its emphasis on sterilization supported by incentives has contradictory consequences as women become vulnerable to a limited health service and incentives encourage a focus on meeting sterilization targets. Both undermine people's access to and use of primary health care services. Findings from three studies, undertaken between 1978 and 1983, support the argument that despite international concern with preventive and promotive primary health care, simultaneous support for and emphasis on population control inhibits meeting the goals of a broad-based rural primary health care service.
Allen, Jennifer D; Mars, Dana R; Tom, Laura; Apollon, Guy; Hilaire, Dany; Iralien, Gerald; Cloutier, Lindsay B; Sheets, Margaret M; Zamor, Riché
Understanding the factors that influence health beliefs, attitudes, and service use among Haitians in the United States is increasingly important for this growing population. We undertook a qualitative analysis to explore the factors related to cancer screening and utilization of health services among Haitians in Boston. Key informant interviews (n=42) and nine focus groups (n=78) revealed that Haitians experience unique barriers to health services. These include language barriers, unfamiliarity with preventive care, confidentiality concerns, mistrust and stigma concerning Western medicine, and a preference for natural remedies. Results suggest that many Haitians could benefit from health system navigation assistance, and highlight the need for comprehensive, rather than disease-focused programs, to decrease stigma and increase programmatic reach. Faith-based organizations, social service agencies, and Haitian media were identified as promising channels for disseminating health information. Leveraging positive cultural traditions and existing communication networks could increase the impact of Haitian health initiatives.
Willoughby, Jessica Fitts; Muldrow, Adrienne
Objectives: Text message-based interventions may provide sexual health information to young people through a number of service types, from sending information on a regularly scheduled timeline, to providing an automated menu, to allowing young people to connect directly with health educators. While such service types exist, it is not clear which…
Bains, Ranbir Mangat; Diallo, Ana F.
Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…
Baker, Dian L.; Hebbeler, Kathleen; Davis-Alldritt, Linda; Anderson, Lori S.; Knauer, Heather
Children with special health care needs (CSHCN) are at risk for school failure when their health needs are not met. Current studies have identified a strong connection between school success and health. This study attempted to determine (a) how schools meet the direct service health needs of children and (b) who provides those services. The study…
Fox, Amanda; Gardner, Glenn; Osborne, Sonya
Health service managers and policy makers are increasingly concerned about the sustainability of innovations implemented in health care settings. The increasing demand on health services requires that innovations are both effective and sustainable; however, research in this field is limited, with multiple disciplines, approaches and paradigms influencing the field. These variations prevent a cohesive approach, and therefore the accumulation of research findings, in the development of a body of knowledge. The purpose of this paper is to provide a thorough examination of the research findings and provide an appropriate theoretical framework to examine sustainability of health service innovation. This paper presents an integrative review of the literature available in relation to sustainability of health service innovation and provides the development of a theoretical framework based on integration and synthesis of the literature. A theoretical framework serves to guide research, determine variables, influence data analysis and is central to the quest for ongoing knowledge development. This research outlines the sustainability of innovation framework; a theoretical framework suitable for examining the sustainability of health service innovation. If left unaddressed, health services research will continue in an ad hoc manner, preventing full utilisation of outcomes, recommendations and knowledge for effective provision of health services. The sustainability of innovation theoretical framework provides an operational basis upon which reliable future research can be conducted.
Ruotsalainen, Pekka; Blobel, Bernd
Trust is a social code and glue between persons and organizations in any business domain including health. pHealth is a complex concept that is built around health service providers, individuals and artefacts such as sensors, mobile devices, networks, computers, and software applications. It has many stakeholders such as organizations, persons, patients, customers, and tele-operators. pHealth services are increasingly offered in insecure information space, and used over organizational, geographical and jurisdictional borders. This all means that trust is an essential requirement for successful pHealth services. To make pHealth a successful business, organizations offering pHealth services should establish inter-organizational trust and trusted relationship between their customers. Before starting to use services, the pHealth user should have a possibility to define how much it trusts on the service provider and on the surrounding information infrastructure. The authors' analysis show that trust models used in today's health care and e-commerce are insufficient for networked pHealth. Calculated trust as proposed by the authors is stronger than the predefined dispositional trust model currently used in health care, other's recommendations used in e-commerce and risk assessment. Until now, caused by the lack of business incentive, lack of regulatory and political pressure, pHealth providers have not demonstrated meaningful interest in moving from the current unsatisfactory situation to trust calculation by making information necessary for this methodology available. To make pHealth successful, a combination of legal, political, organizational, technological and educational efforts is needed to initiate the paradigm change and start the era of trust-based pHealth services.
Lambert, David; Agger, Marc S.
This article examines geographic differences in the use of mental health services among Aid to Families with Dependent Children (AFDC)-eligible Medicaid beneficiaries in Maine. Findings indicate that rural AFDC beneficiaries have significantly lower utilization of mental health services than urban beneficiaries. Specialty mental health providers account for the majority of ambulatory visits for both rural and urban beneficiaries. However, rural beneficiaries rely more on primary-care provider...
Caruana, Erin L; Kuys, Suzanne S; Brauer, Sandra G
To determine current Australian allied health rehabilitation weekend service provision and to identify perceived barriers to and facilitators of weekend service provision. Senior physiotherapists from Australian rehabilitation units completed an online cross-sectional survey exploring current service provision, staffing, perceived outcomes, and barriers and facilitators to weekend service provision. A total of 179 (83%) eligible units responded, with 94 facilities (53%) providing weekend therapy. A Saturday service was the most common (97%) with the most frequent service providers being physiotherapists (90%). Rehabilitation weekend service was perceived to increase patient/family satisfaction (66%) and achieve faster goal attainment (55%). Common barriers were budgetary restraints (66%) and staffing availability (54%), with facilitators including organisational support (76%), staff availability (62%) and staff support (61%). Despite increasing evidence of effectiveness, only half of Australian rehabilitation facilities provide weekend services. Further efforts are required to translate evidence from clinical trials into feasible service delivery models. © 2018 AJA Inc.
Higgins, A; Maguire, G; Watts, M; Creaner, M; McCann, E; Rani, S; Alexander, J
In recent years, there is an ever increasing call to involve people who use mental health services in the development, delivery and evaluation of education programmes. Within Ireland, there is very little evidence of the degree of service user involvement in the educational preparation of mental health practitioners. This paper presents the findings on service user involvement in the education and training of professionals working in mental health services in Ireland. Findings from this study indicate that in the vast majority of courses curricula are planned and delivered without consultation or input from service users. Currently the scope of service user involvement is on teaching, with little involvement in curriculum development, student assessment and student selection. However, there is evidence that this is changing, with many respondents indicating an eagerness to move this agenda forward. © 2011 Blackwell Publishing.
Guerrero, Erick G; Aarons, Gregory A; Palinkas, Lawrence A
We examined factors associated with readiness to coordinate mental health, public health, and HIV testing among community-based addiction health services programs. We analyzed client and program data collected in 2011 from publicly funded addiction health services treatment programs in Los Angeles County, California. We analyzed a sample of 14 379 clients nested in 104 programs by using logistic regressions examining odds of service coordination with mental health and public health providers. We conducted a separate analysis to examine the percentage of clients receiving HIV testing in each program. Motivational readiness and organizational climate for change were associated with higher odds of coordination with mental health and public health services. Programs with professional accreditation had higher odds of coordinating with mental health services, whereas programs receiving public funding and methadone and residential programs (compared with outpatient) had a higher percentage of clients receiving coordinated HIV testing. These findings provide an evidentiary base for the role of motivational readiness, organizational climate, and external regulation and funding in improving the capacity of addiction health services programs to develop integrated care.
Madsen, Trine; Andersen, Søren Bo; Karstoft, Karen-Inge
BACKGROUND: Investigating the use of mental health services by combat veterans can help illuminate utilization and unmet needs of this population. The aims of this study were to estimate the use of mental health services and to examine how such use is associated with self-reported symptoms...... the Danish registers. RESULTS: The prevalence of PTSD symptoms increased over time, and almost 10% of the sample reported high levels of PTSD symptoms 2.5 years postdeployment. Overall, 37% of the soldiers utilized mental health services; 6% utilized psychiatric services, and 12.4% redeemed a prescription...... for psychiatric medicine. Approximately one-third received psychotherapy at the Military Psychological Division. In those reporting high PTSD symptomatology, 83% utilized 1 or more types of mental health service. At predeployment and homecoming, high PTSD symptomatology was significantly (P
Ana Carla Borghi
Full Text Available OBJECTIVEDescribing how Kaingang seniors and their primary caregivers experience access to public health services.METHODA qualitative study guided by ethnography, conducted with 28 elderly and 19 caregivers. Data were collected between November 2010 and February 2013 through interviews and participative observation analyzed by ethnography.RESULTSThe study revealed the benefits and difficulties of the elderly access to health services, the facility to obtain health care resources such as appointments, medications and routine procedures, and the difficulties such as special assistance service problems and delays in the dispatching process between reference services.CONCLUSIONThe importance of knowing and understanding the cultural specificities of the group in order to offer greater opportunities for the elderly access to health services was reinforced.
Rogers, Bonnie; Kono, Keiko; Marziale, Maria Helena Palucci; Peurala, Marjatta; Radford, Jennifer; Staun, Julie
Access to occupational health services for primary prevention and control of work-related injuries and illnesses by the global workforce is limited (World Health Organization [WHO], 2013). From the WHO survey of 121 (61%) participating countries, only one-third of the responding countries provided occupational health services to more than 30% of their workers (2013). How services are provided in these countries is dependent on legal requirements and regulations, population, workforce characteristics, and culture, as well as an understanding of the impact of workplace hazards and worker health needs. Around the world, many occupational health services are provided by occupational health nurses independently or in collaboration with other disciplines' professionals. These services may be health protection, health promotion, or both, and are designed to reduce health risks, support productivity, improve workers' quality of life, and be cost-effective. Rantanen (2004) stated that basic occupational health services must increase rather than decline, especially as work becomes more complex; workforces become more dynamic and mobile, creating new models of work-places; and jobs become more precarious and temporary. To better understand occupational health services provided by occupational health nurses globally and how decisions are made to provide these services, this study examined the scope of services provided by a sample of participating occupational health nurses from various countries. Copyright 2014, SLACK Incorporated.
Mohammad Javad Akbarian Bafghi
Full Text Available Background: Hospitals, in extreme competition, have accepted principles of marketing designed for industrial goods and customers. One of the important factors in health services marketing is the type of services. Organizations, including health centers, require meeting the clients' needs in order to survive and try to promote the way of providing services effectively. The present study aims to identify effective components in providing clinical services in hospitals. Methods: This was a practical and cross-sectional study. Data were collected using a questionnaire completed through random sampling after confirming the validity and reliability. Data were analyzed by SPSS 21 and Lisrel 8.50 using descriptive statistics and factor analysis. Results: The results of this study indicated that nine components had the highest impact on providing health services. Confirmatory factor analysis showed that the quality of providing services in the hospital, offering distinctive services compared with other hospitals, and considering quality of service beyond the patient's expectation had the greatest impact on marketing services in the hospital. Conclusion: Providing quality and distinctive services beyond the patient's expectation enables hospitals to improve their marketing activities and, beside higher level of patient satisfaction, develop their clinical services market share.
Wilson, Eric J [National Renewable Energy Laboratory (NREL), Golden, CO (United States)
Energy used by Wisconsin single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.
John S. Jr. Spencer; W. Brad Smith; Jerold T. Hahn; Gerhard K. Raile
The fourth inventory of the timber resource of Wisconsin shows that growing-stock volume increased from 11.2 to 15.5 billion cubic feet between 1968 and 1983, and area of timberland increased from 14.5 to 14.8 million acres. Presented are analysis and statistics on forest area and timber volume, growth, mortality, removals, and projections.
John S. Vissage; Gery J. Brand; Manfred E. Mielke
Results of the 2001 annual inventory of Wisconsin show about 15.8 million acres of forest land, more than 21.6 billion cubic feet of live volume on forest land, and nearly 584 million dry tons of all live aboveground tree biomass on timberland. Gypsy moth, forest tent caterpillar, twolined chestnut borer, bronze birch borer, ash yellows, and white pine blister rust...
Million, Laura; Henken, Rob; Dickman, Anneliese
In metro Milwaukee, as a part of the WIRED Initiative, the Regional Workforce Alliance (RWA)--a collaboration of organizations representing workforce development, economic development and education across southeast Wisconsin--has established the framework for pursuing the local talent dividend goal and a regional strategy for increasing…
This copiously illustrated document is designed to be a field quide to birds of prey that are common to Wisconsin, as well as to some that enter the state occasionally. An introduction discusses birds of prey with regard to migration patterns, the relationship between common names and the attitudes of people toward certain birds, and natural signs…
R Srinivasa Murthy
Full Text Available Development of mental health care for the total population is a challenge in all countries. Common challenges are accessibility, acceptability, affordability and stigma. There has been a progress in shifting the location of mental health services from jails, to asylums, to psychiatric hospitals, to general hospitals to community care facilities over the last three hundred years. Developing mental health services presents both universal and local challenges. There are advantages in collaboration across countries. Past efforts have taken advantage of collaboration to develop innovative approaches to care, tools for measuring impact of services, training methodology and evaluation of impact of interventions. Collaboration allows for bringing together wide ranging experiences and expertise, increase the size of the populations and understand the differences that influence development of mental health care. World Health Organization has pioneered collaborative projects in the past. The development of mhGAP Guidelines for non-specialists in recent times illustrates the value of collaboration. World Psychiatric Association promoted fighting stigma by bringing together over 20 countries. Grand Challenges Canada initiative is another example in this field. India has contributed to development of mental health services by focusing the importance of family in mental health care, integration of mental health with general health care, demonstrating the effectiveness of community care, revitalizing the traditional practices like yoga/meditation and presenting a different approach to psychotherapy. International collaboration for developing mental health services presents a win-win situation for all the partners and should be utilized to a greater extent.
Sebai, Zohair A.; Milaat, Waleed A.; Al-Zulaibani, Abdulmohsen A.
Health services in Saudi Arabia have developed enormously over the last two decades, as evidenced by the availability of health facilities throughout all parts of the vast Kingdom. The Saudi Ministry of Health (MOH) provides over 60% of these services while the rest are shared among other government agencies and the private sector. A series of development plans in Saudi Arabia have established the infra-structure for the expansion of curative services all over the country. Rapid development in medical education and the training of future Saudi health manpower have also taken place. Future challenges facing the Saudi health system are to be addressed in order to achieve the ambitious goals set by the most recent health development plan. These include the optimum utilization of current health resources with competent health managerial skills, the search for alternative means of financing these services, the maintenance of a balance between curative and preventive services, the expansion of training Saudi health manpower to meet the increasing demand, and the implementation of a comprehensive primary health care program. PMID:23008647
[households with pregnant mothers who did not received ANC from a health facility] in Butajira Rural Health Program site of Meskan and ... maternal health services, only place of residence (being an urban (X2=9.96, p<0.01)), average annual income level of more than 1000 ... poverty, race, rural residence, urbanization and.
“No health without mental health” has become a rallying call for the World Health Organization and numerous service providers, training institutions, health researchers, and advocacy groups around the world. It is timely to consider the implications of this call for South Africa. We review key evidence regarding the burden ...
Background: Expanding coverage, strengthening of, and increasing access and utilization of maternal health services is one of the key components of Nigeria's Primary Health Care (PHC) efforts , which was started in 1986. A descriptive study ... Journal of Community Medicine & Primary Health Care Vol.16(2) 2004: 47-54 ...
Mohan, C. I.; Bishai, D.; Kumar, S.; ten Asbroek, G.; Niessen, L.
Nepal. To assess the impact of community mobilization and health worker training on tuberculosis (TB) health services utilization. Questionnaire. The Japan International Cooperation Agency and the Nepal Ministry of Health launched a set of interventions to increase awareness and availability of
maternal health service utilization. Among the several investments to reduce maternal mortality, bridging potential delay to reach health facility in time is just one. Establishment of maternal waiting homes is considered the best solution to ensure timely intervention by keeping women at risk around health facility before their ...
Jan 16, 2013 ... Results: High cost of drugs (72.0%), non availability of essential drugs (54.8%), time spent waiting for treatment (67.2%), inadequate referral ... Key words: Health services, health workers, South West Nigeria, tertiary institution, utilization. Date of .... proper attitude by the health workers towards their patients.
Verbeek, J.; van Dijk, F.; Räsänen, K.; Piirainen, H.; Kankaanpää, E.; Hulshof, C.
To find answers in the literature to the questions if, why, and how consumer satisfaction with occupational health services (OHSs) should be measured. Publications about the concept of consumer satisfaction with health care and surveys of consumer satisfaction with occupational health care were
Grabert, John C.
This article describes the process of enhancing early childhood mental health awareness and skills in non-mental health staff. The author describes a pilot training model, conducted the U.S. Army's Early Intervention Services, that involved: (a) increasing early childhood mental health knowledge through reflective readings, (b) enhancing…
Results: The discussions revealed the following as barriers to maternal health service utilization: walking long distances to access health facilities, lack of midwives, lack of or insufficient items to be used during delivery, long stay and rude health personnel. Seeking help from Traditional Birth Attendants (TBAs) during ...
In Ghana, few studies have investigated the reproductive health needs of adolescent boys. The aim of this study was to find out sources of reproductive health information for boys and the reasons for their low/non use of public health services. Qualitative methods were used, including focus group discussions, ...
Patient satisfaction is an individual's state of being content with the care provided in the health system. It is important for reproductive health care providers to get feedback from women regarding satisfaction with reproductive health services. There is a dearth of knowledge about patient satisfaction in Malawi. Aim
Background: Rural women in developing countries, including Nigeria are faced with a number of health problems with very limited access to health care facilities. This study assessed the perception of women in rural areas on community health extension services in Ilorin, Kwara State. Methods: One hundred and twenty ...
Masopust, V; Rajman, K
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.
Gillette, Joyce L.; And Others
Five hundred college students who had used Kent State University's School Health Service were surveyed to determine patient satisfaction with health care services. Overall satisfaction with the services was high, and satisfaction was significantly influenced by patients' perceptions of practitioners' technical competence and by the adequacy of the…
Radloff, D; Blouin, A S; Larsen, L; Kripp, M E
When planning for growth and management efficiency across urban health systems, economic and market factors present significant service line challenges and opportunities. This article describes the evolutionary integration of emergency services in St John Health System, a large, religious-sponsored health care system located in Detroit, Michigan. Critical business elements, including the System's vision, mission, and economic context, are defined as the framework for site-specific and System-wide planning. The impact of managed care and market changes prompted St John's clinicians and executives to explore how integrating emergency services could create a competitive market advantage.
O'Hagan, Joshua; Persaud, David
Improving customer-service in health care organizations has been linked to better patient care, satisfied staff, a reduction in preventable medical errors, fewer malpractice lawsuits and improved revenue. However, it has been observed that there is sometimes a gap between the level of customer-service provided by health care organizations and their clients' expectations. This paper integrates, synthesizes and extends theory and practice from existing literature to provide health care organizations with strategies for closing this gap. Methods are also outlined for creating, implementing and evaluating an organizational plan for improving customer-service.
MacStravic, R S
Armed with valid information about what people expect, health care organizations can make commitments to current and prospective patients, thereby increasing their marketing success and improving patient satisfaction.
Regidor, Enrique; Sanz, Belén; Pascual, Cruz; Lostao, Lourdes; Sánchez, Elisabeth; Díaz Olalla, José Manuel
To compare health services utilization between the immigrant and indigenous populations in Spain. We used information provided by the following four health surveys carried out around 2005: Catalonia 2005; city of Madrid 2005, Canary Islands 2004 and the Autonomous Community of Valencia 2005. The health services studied were general practice, specialist services, emergency services, hospitalization, and two preventive services: pap smear test and mammography. In general, most health services were less frequently used by the immigrant population than by the Spanish population. The health services showing the least differences between the two populations were general practice and hospitalization, while the greatest differences were found in the use of specialist and preventive services. The most heterogeneous results were found in general practice and hospitalization, since some immigrant groups showed a relatively high frequency of use in some geographical areas and a relatively low frequency in other areas. The results of the present study reproduce those found in other studies carried out in countries with similar social and economic characteristics to Spain. Like previous results, the present results are difficult to explain. Future research should aim to use other study designs and to test hypotheses not put forward by the scientific community to date.
Lefkowitz, Ayla R F; Mannell, Jenevieve
Transgender youth often face difficulties when accessing sexual health services. However, few studies investigate health service providers' perceptions of transgender youth, and fewer focus on sexual health. To fill this gap, our study draws on social representations theory to examine sexual health service providers' perceptions of transgender youth and how this influences the provision of health services for this marginalised population in England. A thematic analysis of 20 semi-structured interviews with service providers, conducted between March and June 2014, resulted in five main themes centred on: binary representations of transgender; transgender as homosexuality; uncertain bodies; unstable mental states; and too young to know. Of the service providers interviewed, many understood transgender within a male/female binary, and perceived being transgender to be synonymous with being gay. There was confusion among service providers regarding transgender youths' sexual organs, and most of those interviewed saw transgender youth as mentally unstable and confused. Finally, many service providers perceived that transgender youth are too young to know that they are transgender and make decisions about their body. Some of these representations were potentially stigmatising and many conflicted with transgender youths' representations of themselves. Training by transgender people is recommended to help address these misunderstandings. © 2017 John Wiley & Sons Ltd.
Bobocea, L; Gheorghe, I R; Spiridon, St; Gheorghe, C M; Purcarea, V L
Applying marketing in health care services is presently an essential element for every manager or policy maker. In order to be successful, a health care organization has to identify an accurate measurement scale for defining service quality due to competitive pressure and cost values. The most widely employed scale in the services sector is SERVQUAL scale. In spite of being successfully adopted in fields such as brokerage and banking, experts concluded that the SERVQUAL scale should be modified depending on the specific context. Moreover, the SERVQUAL scale focused on the consumer's perspective regarding service quality. While service quality was measured with the help of SERVQUAL scale, other experts identified a structure-process-outcome design, which, they thought, would be more suitable for health care services. This approach highlights a different perspective on investigating the service quality, namely, the physician's perspective. Further, we believe that the Seven Prong Model for Improving Service Quality has been adopted in order to effectively measure the health care service in a Romanian context from a physician's perspective.
Kimerling, Rachel; Baumrind, Nikki
The Anderson behavioral model was used to investigate racial and ethnic disparities in access to specialty mental health services among women in California as well as factors that might account for such disparities. The study was a cross-sectional examination of a probability sample of 3,750 California women. The main indicators of access to services were perceived need, service seeking, and service use. Multivariate models were constructed that accounted for need and enabling and demographic variables. Significant racial and ethnic variations in access to specialty mental health services were observed. African-American, Hispanic, and Asian women were significantly less likely to use specialty mental health services than white women. Multivariate analyses showed that Hispanic and Asian women were less likely than white women to report perceived need, even after frequent mental distress had been taken into account. Among women with perceived need, African-American and Asian women were less likely than white women to seek mental health services after differences in insurance status had been taken into account. Among women who sought services, Hispanic women were less likely than white women to obtain services after adjustment for the effects of poverty. Need and enabling factors did not entirely account for the observed disparities in access to services. Additional research is needed to identify gender- and culture-specific models for access to mental health services in order to decrease disparities in access. Factors such as perceived need and decisions to seek services are important factors that should be emphasized in future studies.
Scholz, Brett; Gordon, Sarah; Happell, Brenda
Contemporary mental health policies call for greater involvement of mental health service consumers in all aspects and at all levels of service planning, delivery, and evaluation. The extent to which consumers are part of the decision-making function of mental health organizations varies. This systematic review synthesizes empirical and review studies published in peer-reviewed academic journals relating to consumers in leadership roles within mental health organizations. The Cochrane Library, Medline, and PsycINFO were searched for articles specifically analysing and discussing consumers' mental health service leadership. Each article was critically appraised against the inclusion criteria, with 36 articles included in the final review. The findings of the review highlight current understandings of organizational resources and structures in consumer-led organizations, determinants of leadership involvement, and how consumer leadership interacts with traditional mental health service provision. It appears that organizations might still be negotiating the balance between consumer leadership and traditional structures and systems. The majority of included studies represent research about consumer-run organizations, with consumer leadership in mainstream mental health organizations being less represented in the literature. Advocates of consumer leadership should focus more on emphasizing how such leadership itself can be a valuable resource for organizations and how this can be better articulated. This review highlights the current gaps in understandings of consumer leadership in mental health, including a need for more research exploring the benefits of consumer leadership for other consumers of services. © 2016 Australian College of Mental Health Nurses Inc.
Adolescent sexual and reproductive health access continues to dominate the development agenda since the historic 1994 Cairo Conference and becomes a huge public health concern for the increasing diverse of undocumented adolescents who have become an important component as irregular migration patterns and ...
Gurgel Jr., Garibaldi D.; Carvalho de Sousa, Islâandia M.; de Araujo Oliveira, Sydia Rosana
In 1990 the national health services in the United Kingdom and Sweden started to split up in internal markets with purchasers and providers. It was also the year when Brazil started to implement a national health service (SUS) inspired by the British national health service that aimed at principles......, and inequities have increased. The health sector reform in Brazil, on the other hand, contributed to great improvements in population health but never succeeded in changing the fact that more than half of health care spending was private. Demographic and epidemiological changes, with more elderly people having...... chronic disorders and very unequal comorbidities, bring the issue of integrality in the forefront in all 3 countries, and neither the public purchaser provider markets nor the 2-tier system in Brazil delivers on that front. It will demand political leadership and strategic planning with population...
Zaltman, G; Vertinsky, I
Focus is on social marketing in a health context, and attention is directed to the development of a psychosocial model of health-related behavior with emphasis on developing countries. Each component of the model is identified and defined, with some of the interactions among its components noted. There are both advantages and limitations to using the model in a social marketing context. The model's primary contribution at this stage of its development is in structuring and organizing diverse sources of knowledge and data. New relationships are suggested which were not previously considered in the literature. The relationship between risk-taking and perceived susceptibility is 1 example. The model also provides a basis for simulating health processes, providing a testing ground for health policies before their actual implementation. The model's perspective is uniquely appropriate for the development of social marketing strategies, and it promises to encompass health market behavior in various cultural settings.
Horney, Jennifer A; Bamrara, Sanjana; Macik, Maria Lazo; Shehane, Melissa
Although public health degree programs typically require practica and other field experiences, service-learning courses, with a focus on civic engagement and the application of classroom learning in real world settings, can go beyond these requirements and provide benefits to students and community-based practice partners. The goal of this paper is to assess potential benefits of service-learning programs for both graduate-level public health students and state and local public health agency partners. EpiAssist is a new service-learning program developed at the School of Public Health of the Texas A and M University Health Science Center, USA, in January 2015. EpiAssist was integrated into a new course, Methods in Field Epidemiology. The integration of service-learning was guided by a partnership with the Texas A and M Center for Teaching Excellence. State, regional, and local public health partners requested EpiAssist via email or telephone. A listserv was used to recruit student volunteers to meet requests. 54 of 86 registered EpiAssist students (63%) participated in at least one of ten service-learning and three training activities between January and June, 2015. Service-learning activities included questionnaire development, in-person and telephone data collection, and data analysis. Training topics for students included the Epi Info™ software, community assessment and communicable disease reporting. Students and partner organizations provided generally positive assessments of this service learning program through an online evaluation. Service-learning provides students with enhanced classroom learning through applied public health experience in state, regional and local health departments. These experiences provide both needed surge capacity to public health departments and valuable hands-on field experience to students.
O'Halloran, Paul; O'Connor, Nick
To report on the evaluation of publicly funded community mental health services in two New South Wales health districts. Qualitative and quantitative data from 28 publicly funded adult community mental health teams in two NSW health districts were gathered using structured interviews, benchmarking surveys, focus groups and online questionnaires. The community mental health services studied lacked a coherent strategic and recovery oriented framework or model of care for service delivery. There was evidence of poor role definition at the team level, resulting in duplication and inefficiency. There were inadequate staffing levels for stated objectives, a lack of training and continuing education in evidence based intervention, poor consumer and family participation in service design, and no development and monitoring of meaningful outcome measures. This review and benchmarking study highlights the need for mental health policy implementation to be further supported with: development of a service delivery framework outlining essential components of a specialist community mental health system; operational guidance to enable effective team specialisation in accordance with research; investment in practitioner training to support the development of evidence based practice; and processes to ensure effective consumer and carer participation in developing recovery oriented services. © The Royal Australian and New Zealand College of Psychiatrists 2015.
H. de Vries (Harwin); J.J. van de Klundert (Joris); A.P.M. Wagelmans (Albert)
markdownabstractProviding long distance truck drivers with adequate access to prevention, testing, and treatment services for HIV, Sexually Transmitted Infections (STIs), Tuberculosis (TB), and Malaria is suggested to be an extremely effective way to reduce the burden and the spread of these
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National... on Rural Health and Human Services, Health Resources and Services Administration, Parklawn Building..., development, and administration of health and human services in rural areas. Agenda: At 9:00 a.m. on June 18...
Tibaldi, Giuseppe; Munizza, Carmine; Pasian, Sherri; Johnson, Sonia; Salvador-Carulla, Luis; Zucchi, Serena; Cesano, Simona; Testa, Cristina; Scala, Elena; Pinciaroli, Luca
Since the 1978 Italian reform, an integrated network of community mental health services has been introduced. With few exceptions, research on determinants of mental health service use at the district level has focused on inpatient activities and social deprivation indicators. The European Psychiatric Care Assessment Team (EPCAT) standardized methodology allows for an evidence-based comparison of mental health systems between geographical areas. To compare service provision and utilization between local catchment areas; to explore quantitative relationships between residential and community service use and socio-demographic indicators at the ecological level. The European Socio-demographic Schedule (ESDS) was used to describe area characteristics, and the European Service Mapping Schedule (ESMS) to measure service provision and utilization in 18 catchment areas in Piedmont. Substantial variation in service use emerged. Acute hospital bed occupancy rates were lower in areas with more intensive community continuing care service users and with a smaller percentage of the population living alone. The non-acute hospital bed occupancy rate was directly related to the percentage of the population living alone or in overcrowded conditions, and to the level of mobile continuing care service users. Community continuing care service use was highest in areas with a larger percentage of the population living alone. Multiple regression models explained between 48 and 55% of the variation in inpatient and community service use between areas. Relationships based on ecological characteristics do not necessarily apply to the individual. This level of assessment, however, is necessary in evaluating mental health policy and service systems, and in allocating resources. The distribution of mental health care resources should be weighted in terms of indicators of social deprivation shown to be important predictors of both inpatient and community service use, as these are likely to be
Moore, Michele Johnson; Barr, Elissa; Wilson, Kristina; Griner, Stacey
Background: Numerous studies document support for sexuality education in the schools. However, there is a dearth of research assessing support for sexual health services offered through school-based health clinics (SBHCs). The purpose of this study was to assess voter support for offering 3 sexual health services (STI/HIV testing, STI/HIV…
Primary health care facility infrastructure and services and the nutritional status of children 0 to 71 months old and their caregivers attending these facilities in four rural districts in the Eastern Cape and KwaZulu-Natal provinces, South Africa.
... HIV/AIDS (29 items) Institute Announcements (104 items) Most Individuals Receive Health Services a Year Before Suicide ... made a medical visit within four weeks. The most common visit types included primary care and medical ...
Locke, Ben; Wallace, David; Brunner, Jon
This chapter provides a brief overview of the psychological issues facing today's college students, information about students receiving mental health services, and an evidence-based model describing the practice and functions of today's counseling centers.
Child health service provision in Ethiopia: Outpatient, growth monitoring and immunization. Theodros Getachew, Ibrahim Kedir, Abebe Bekele, Atkure Defar, Mekonnen Tadesse, Habtamu Teklie, Kassahun Amenu, Terefe Gelibo, Yibeltal Assefa, Amha Kebede, Agazi Ameha ...
Andrew M. Stoltman; Richard B. Rideout
In 2002, Wisconsin was part of two pilot projects in cooperation with the US Forest Service. The first was a street tree assessment, and the second was an urban FIA project. The data generated by these pilots changed the way that Wisconsin DNRsâ Urban Forestry Program conducts its business. Although there have been several urban FIA pilot projects throughout the U.S.,...
Secor-Turner, Molly A; Randall, Brandy A; Brennan, Alison L; Anderson, Melinda K; Gross, Dean A
The purpose of this study was to assess rural North Dakota adolescents' experiences in accessing adolescent-friendly health services and to examine the relationship between rural adolescents' communication with health care providers and risk behaviors. Data are from the Rural Adolescent Health Survey (RAHS), an anonymous survey of 14- to 19-year-olds (n = 322) attending secondary schools in four frontier counties of North Dakota. Descriptive statistics were used to assess participants' access to adolescent-friendly health services characterized as accessible, acceptable, and appropriate. Logistic regressions were used to examine whether participant-reported risk behaviors predicted communication with health care providers about individual health risk behaviors. Rural adolescents reported high access to acceptable primary health care services but low levels of effective health care services. Participant report of engaging in high-risk behaviors was associated with having received information from health care providers about the leading causes of morbidity and mortality. These findings reveal missed opportunities for primary care providers in rural settings to provide fundamental health promotion to adolescents. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Macharia, Peter M; Ouma, Paul O; Gogo, Ezekiel G; Snow, Robert W; Noor, Abdisalan M
At independence in 2011, South Sudan's health sector was almost non-existent. The first national health strategic plan aimed to achieve an integrated health facility network that would mean that 70% of the population were within 5 km of a health service provider. Publically available data on functioning and closed health facilities, population distribution, road networks, land use and elevation were used to compute the fraction of the population within 1 hour walking distance of the nearest public health facility offering curative services. This metric was summarised for each of the 78 counties in South Sudan and compared with simpler metrics of the proportion of the population within 5 km of a health facility. In 2016, it is estimated that there were 1747 public health facilities, out of which 294 were non-functional in part due to the on-going civil conflict. Access to a service provider was poor with only 25.7% of the population living within one-hour walking time to a facility and 28.6% of the population within 5 km. These metrics, when applied sub-nationally, identified the same high priority, most vulnerable counties. Simple metrics based upon population distribution and location of facilities might be as valuable as more complex models of health access, where attribute data on travel routes are imperfect or incomplete and sparse. Disparities exist in South Sudan among counties and those with the poorest health access should be targeted for priority expansion of clinical services.
Fenger, Morten Munthe; Mortensen, Erik Lykke; Poulsen, Stig Bernt
Background Psychotherapeutic treatment is associated with significant reduction of symptoms in patients, and it is generally assumed that treatment improves health and decreases the need for additional health care. The present study investigates the long-term changes in utilization of health care...... a long-term period psychotherapy patients increased their utilization of health care services with a factor 3 compared to a control group....
... 32 National Defense 5 2010-07-01 2010-07-01 false U.S. Public Health Service (USPHS), other than... FACILITIES Beneficiaries of Other Federal Agencies § 728.54 U.S. Public Health Service (USPHS), other than... 43 (Contract Health Service Purchase Order for Hospital Services Rendered) or HRSA form 64 (Purchase...
It has been noted that, within traditional regulatory frameworks for electric utilities, factors exist which discourage demand side management (DSM) and that there is a lack of positive incentives for DSM. Regulatory agencies should therefore make it possible for DSM measures to benefit from the same treatment as supply-side measures. The Wisconsin Public Service Commission (WPSC) has recognized this need and has adopted various measures accordingly. The need for efficiency incentives is described according to the particular experience of Wisconsin Electric concerning their recourse to a DSM incentive and according to new incentive models being tested in collaboration with other electricity suppliers in Wisconsin. The WPSC has concluded that the fact of considering the costs relating to DSM as expenses or capitalizing them within the rate base does not motivate the utility to promote DSM programs. The WPSC has thus decided to experiment with energy efficiency incentives in order to evaluate their eventual impact. The choice of the type of incentive had an objective of starting the process in an area where the lack of experience has created, from the regulatory point of view, a reticence on the part of utilities to engage in DSM programs. The WPSC has designed a variety of incentive models which have been adapted to each utility's own situation. Specific incentive programs developed for three Wisconsin utilities are reviewed
Hester, Lorraine; O'Doherty, Lorna Jane; Schnittger, Rebecca; Skelly, Niamh; O'Donnell, Muireann; Butterly, Lisa; Browne, Robert; Frorath, Charlotte; Morgan, Craig; McLoughlin, Declan M; Fearon, Paul
To develop a quality of care instrument that is grounded in the service user perspective and validate it in a mental health service. The instrument (SEQUenCE (SErvice user QUality of CarE)) was developed through analysis of focus group data and clinical practice guidelines, and refined through field-testing and psychometric analyses. All participants were attending an independent mental health service in Ireland. Participants had a diagnosis of bipolar affective disorder (BPAD) or a psychotic disorder. Twenty-nine service users participated in six focus group interviews. Seventy-one service users participated in field-testing: 10 judged the face validity of an initial 61-item instrument; 28 completed a revised 52-item instrument from which 12 items were removed following test-retest and convergent validity analyses; 33 completed the resulting 40-item instrument. Test-retest reliability, internal consistency and convergent validity of the instrument. The final instrument showed acceptable test-retest reliability at 5-7 days (r = 0.65; P Service Satisfaction Scale (r = 0.84, P service user perspective and suitable for routine use. It may serve as a useful tool in individual care planning, service evaluation and research. The instrument was developed and validated with service users with a diagnosis of either BPAD or a psychotic disorder; it does not yet have established external validity for other diagnostic groups. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.
... Infants. Learn More > Getting the Right Help for Opioid Dependence or Withdrawal The FTC, in partnership with SAMHSA, has developed ... to help those in need of treatment for opioid dependence or withdrawal. Learn More > Roadmap to Behavioral Health This new ...
This study describes health, functioning, and health care service use by medically complex technology-dependent children according to condition severity (moderately disabled, severely disabled, and vegetative state). Data were collected monthly for 5 months using the Pediatric Quality of Life Generic Core Module 4.0 Parent-Proxy Report. Health care service use measured the number of routine and acute care office visits (including primary and specialty physicians), emergency department visits, hospitalizations, nursing health care services, special therapies, medications, medical technology devices (MTDs), and assistive devices. Child physical health was different across the condition severity groups. The average age of the children was 10.1 years (SD, 6.2); the average number of medications used was 5.5 (SD, 3.7); the average number of MTDs used was 4.2 (SD, 2.9); and the average number of assistive devices used was 4.3 (SD, 2.7). Severely disabled and vegetative children were similar in age (older) and had a similar number of medications, MTDs, and assistive devices (greater) than moderately disabled children. The advanced practice nurse care coordinator role is necessary for the health and functioning of medically complex, technology-dependent children. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Objective. To review the anticipated changes in caesarean section (CS) rates following the restructuring of maternity health care services from regional to district level. Hypothesis. A change in provision of maternity services from regional to district level results in a decline in the CS rates. Method. A retrospective audit was ...
Moore, Gaye; Manias, Elizabeth; Gerdtz, Marie Frances
Homeless people face many challenges in accessing and utilising health services to obtain psychosocial supports offered in hospital and community settings. The complex nature of health issues is compounded by lack of accessibility to services and lack of appropriate and safe housing. To examine the perceptions and experiences of homeless people in relation to their health service needs as well as those of service providers involved with their care. A purposive sampling approach was undertaken with a thematic framework analysis of semi-structured interviews. Participants. Interviews were undertaken with 20 homeless people who accessed the emergency department in an acute hospital in Melbourne, Australia and 27 service providers involved in hospital and community care. Six key themes were identified from interviews: complexity of care needs, respect for homeless people and co-workers, engagement as a key strategy in continued care, lack of after-hour services, lack of appropriate accommodation and complexity of services. Findings revealed the complex and diverse nature of health concerns in homeless people. The demand on hospital services continues to increase and unless government policies take into consideration the psychosocial demands of the communities most vulnerable people efforts to divert hospital demand will continue to fail.
Health care consultation showed a majority of the people sought the services of modern medicine. In the first quintile 25.56 percent used modern medical services with an increasing trend to 55.96percent for the least poor or the fifth quintile. Although not as prevalent, it is important to note that both the non- poor and the ...
Background: As the world transits from the era of millennium development goals to that of sustainable development goals, an examination of the access to primary health care services in the previous era is germane to adequate planning and delivery of effective service in the emerging era. The objective of this study was ...
perceptions and needs of the community on maternal health service utilization. Methods. Qualitative data was obtained through focus group discussions with community ... policy makers, development partners, training institutions and service ..... Some women felt that it was more convenient and respectful to give birth at the ...
Lack of information about SRH, poor perceptions about SRH, feeling of shame, fear of being seen by others, restrictive cultural norms, lack of privacy, confidentiality and unavailability of services were deterring use of sexual and reproductive health services. Conclusions: Only a small proportion of young people used sexual ...
Background: One principal determinant of uptake and continued utilization of maternal health services is overall client satisfaction. The public and private sectors supply substantial portions of these services in developing countries, but face different challenges. This study aimed at determining the differences in the quality of ...
Mamdani, Masuma; Bangser, Maggie
Tanzania faces serious challenges to improving the health and well-being of its people. The Ministry of Health and its partners in government, the donor community and civil society have responded with concerted action, in many cases achieving significant gains. Services for prevention of mother-to child transmission of HIV are being expanded, a new protocol for malaria treatment is being implemented and evaluated, hundreds of service providers are now trained in life-saving skills for childbi...
Burt, A.K.; Bird, R.W.
The Health Physics, Safety and Medical Services Report for Harwell Laboratory for 1989 includes data on the monitoring of the working environment, personnel monitoring, radiological incidents, disposal of radioactive waste and protection of the public. Work on emergency planning, non-radiological health and safety, occupational hygiene, operations support is also discussed. Finally the medical services available and the medical examinations performed are described. (UK)
Nowadays, health services trade (otherwise called medical tourism) is becoming more and more popular (20% annual growth worldwide). Due to that, competition in the field is also increasing; thus, in order to stay competitive, one must understand medical tourists’ behaviour and act accordingly. With this in mind, the purpose of the research is to investigate consumer behaviour in medical tourism and analyse health service exports’ attractiveness in Lithuania. By using a case stu...
Hindall, S.M.; Borman, Ronald G.
This report describes the physical environment, availability, distribution, movement, quality, and use of water in the upper Wisconsin River basin as an aid in planning and water management. The report presents general information on the basin derived from data obtained from Federal, State, and local agencies, New field data were collected in areas where information was lacking. More detailed studies of problem areas may be required in the future, as water needs and related development increase.
Cuffe, Steven P.; Moore, Charity G.; McKeown, Robert
Objective: Describe the general health, comorbidities and health service use among U.S. children with ADHD. Method: The 2001 National Health Interview Survey (NHIS) contained the Strengths and Difficulties Questionnaire (SDQ; used to determine probable ADHD), data on medical problems, overall health, and health care utilization. Results: Asthma…
, retirement and brain drain to other countries mostly the UK, Saudi Arabia and South Africa. Training more health workers, training new but lower cadres of health workers not marketable to the outside world, improving the working conditions ...
... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... a provider of mental health services. (a) Except as provided in paragraph (b) of this section, if a... of mental health services, it may not disclose information from such records to the individual who is...
Costa, Ediná Alves; Araújo, Patrícia Sodré; Penaforte, Thais Rodrigues; Barreto, Joslene Lacerda; Guerra, Augusto Afonso; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Alvares, Juliana; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Leite, Silvana Nair
To identify and discuss the conceptions of pharmaceutical services in Brazilian Primary Health Care, according to different subjects. This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015), which is composed of an information survey in a representative sample of cities, stratified according to Brazilian regions, and a subsample of primary health care services. Municipal secretaries of health, those responsible for pharmaceutical services, and those responsible for medicine delivery in pharmacies/dispensing units of the selected services were interviewed. The questionnaires included one question about the understanding of the interviewee regarding pharmaceutical services. The content analysis technique was used to apprehend, in the statements, the meanings attributed to pharmaceutical services, which were subsequently classified into categories according to their main conceptions. Among the wide diversity of conceptions on pharmaceutical services (PS), we highlight the ones focused on 1) logistic control of medicines with activities concerning guidance or information on their use and 2) guidance or information to users on the use of medicine. The findings reveal a shifting tendency from a medicine-focused conception to one that considers the users and their needs as the final recipient of these actions. However, the lack of references to conceptions regarding care management and integrality point out the slowness of this change; after all, this is a social and historical process that comprises the production of meanings that transcend legal, logistic, and technical arrangements in pharmaceutical services. The diversity of conceptions expresses the several meanings attributed to pharmaceutical services; we also identified, in their reorientation process, a movement that reflects a gradual
Ediná Alves Costa
Full Text Available ABSTRACT OBJECTIVE To identify and discuss the conceptions of pharmaceutical services in Brazilian Primary Health Care, according to different subjects. METHODS This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015, which is composed of an information survey in a representative sample of cities, stratified according to Brazilian regions, and a subsample of primary health care services. Municipal secretaries of health, those responsible for pharmaceutical services, and those responsible for medicine delivery in pharmacies/dispensing units of the selected services were interviewed. The questionnaires included one question about the understanding of the interviewee regarding pharmaceutical services. The content analysis technique was used to apprehend, in the statements, the meanings attributed to pharmaceutical services, which were subsequently classified into categories according to their main conceptions. RESULTS Among the wide diversity of conceptions on pharmaceutical services (PS, we highlight the ones focused on 1 logistic control of medicines with activities concerning guidance or information on their use and 2 guidance or information to users on the use of medicine. The findings reveal a shifting tendency from a medicine-focused conception to one that considers the users and their needs as the final recipient of these actions. However, the lack of references to conceptions regarding care management and integrality point out the slowness of this change; after all, this is a social and historical process that comprises the production of meanings that transcend legal, logistic, and technical arrangements in pharmaceutical services. CONCLUSIONS The diversity of conceptions expresses the several meanings attributed to pharmaceutical services; we also identified
Papanikolaou, Vicky; Zygiaris, Sotiris
Abstract Context The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. Objective To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. Strategy SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. Results The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations. Discussion and conclusions This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. PMID:22296402
Background The Health Service Quality Scale is a multidimensional hierarchical scale that is based on interdisciplinary approach. This instrument was specifically created for measuring health service quality based on marketing and health care concepts. The aim of this study was to translate and culturally adapt the Health Service Quality Scale into Brazilian Portuguese and to assess the validity and reliability of the Brazilian Portuguese version of the instrument. Methods We conducted a cross-sectional, observational study, with public health system patients in a Brazilian university hospital. Validity was assessed using Pearson’s correlation coefficient to measure the strength of the association between the Brazilian Portuguese version of the instrument and the SERVQUAL scale. Internal consistency was evaluated using Cronbach’s alpha coefficient; the intraclass (ICC) and Pearson’s correlation coefficients were used for test-retest reliability. Results One hundred and sixteen consecutive postoperative patients completed the questionnaire. Pearson’s correlation coefficient for validity was 0.20. Cronbach's alpha for the first and second administrations of the final version of the instrument were 0.982 and 0.986, respectively. For test-retest reliability, Pearson’s correlation coefficient was 0.89 and ICC was 0.90. Conclusions The culturally adapted, Brazilian Portuguese version of the Health Service Quality Scale is a valid and reliable instrument to measure health service quality. PMID:23327598
Papanikolaou, Vicky; Zygiaris, Sotiris
The paper refers to the increased competition between health care providers and the need for patient-centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients' perceptions rather than expectations. THIS paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations-perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. © 2012 John Wiley & Sons Ltd.
Lam, Eddie T. C.; Zhang, James J.; Jensen, Barbara E.
This study was designed to develop the Service Quality Assessment Scale to evaluate the service quality of health-fitness clubs. Through a review of literature, field observations, interviews, modified application of the Delphi technique, and a pilot study, a preliminary scale with 46 items was formulated. The preliminary scale was administered to…
... management, and nursing research. Applications are reviewed for scientific and technical merit... subcommittee on Nursing Research Initiatives will convene from 8 a.m. to 2 p.m.; the subcommittee for pilot... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Merit Review Board...
... management, and nursing research. Applications are reviewed for scientific and technical merit... subcommittee on Nursing Research Initiative will convene from 8 a.m. to 2 p.m. and Career Development Award... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Merit Review Board...
Lee, Hyo Jung; Ju, Young Jun; Park, Eun-Cheol
Despite the positive effect of community-based mental health centers, the utilization of professional mental health services appears to be low. Therefore, we analyzed the relationship between regional recognition of mental health centers and utilization of professional mental health services. We used data from the Community Health Survey (2014) and e-provincial indicators. Only those living in Seoul, who responded that they were either feeling a lot of stress or depression, were included in the study. Multiple logistic regression analysis using generalized estimating equations was performed to examine both individual- and regional-level variables associated with utilization of professional mental health services. Among the 7338 participants who reported depression or stress, 646 (8.8%) had consulted a mental health professional for their symptoms. A higher recognition rate of mental health centers was associated with more utilization of professional mental health services (odds ratio [OR]=1.05, 95% confidence interval [CI]=1.03-1.07). Accessibility to professional mental health services could be improved depending on the general population's recognition and attitudes toward mental health centers. Therefore, health policy-makers need to plan appropriate strategies for changing the perception of mental health services and informing the public about both the benefits and functions of mental health centers. Copyright © 2017. Published by Elsevier B.V.
London, Andrew S.; Parker, Wendy M.
Objectives. This study examines differences in the relationship between veteran status and men's trajectories of health conditions, activities of daily living limitations, and self-rated health. Methods. We use data on 12,631 men drawn from the 1992–2006 waves of the Health and Retirement Study to estimate growth curve models that examine differences in health trajectories between nonveterans and veterans, veterans with and without wartime service, and war service veterans who served during World War II, Korea, Vietnam, and multiple wars. Results. The results indicate that veterans have better health at the mean age of 66.2 years, but experience greater age-related changes in health than nonveterans. Similarly, men who served during wartime have better health at the mean age, but more age-related changes in health than men who did not serve during wartime. Among war veterans, Vietnam veterans are in poorer health at the mean age, but they experience less substantial age-related health changes than men who served during previous wars. Discussion. Although veterans experience better health relative to nonveterans around retirement age, they have poorer health than nonveterans among the oldest old. These findings inform our understanding of the veteran–nonveteran health-mortality paradox found in previous research and suggest a health crossover among veterans and nonveterans in later life. PMID:20864570
Karbach, U; Stamer, M; Holmberg, C; Güthlin, C; Patzelt, C; Meyer, T
This is the second part of a 3-part discussion paper by the working group on "Qualitative Methods" in the German network of health services research (DNVF) that shall contribute to the development of a memorandum concerning qualitative health services research. It aims to depict the different types of qualitative research that are conducted in health services research in Germany. In addition, the authors present a specific set of qualitative data collection and analysis tools to demonstrate the potential of qualitative research for health services research. QUALITATIVE RESEARCH IN HEALTH SERVICES RESEARCH - AN OVERVIEW: To give an overview of the types of qualitative research conducted in German health services research, the abstracts of the 8th German Conference on Health Services Research were filtered to identify qualitative or mixed-methods studies. These were then analysed by looking at the context which was studied, who was studied, the aims of the studies, and what type of methods were used. Those methods that were mentioned most often for data collection and analysis are described in detail. QUALITATIVE RESEARCH AT THE CONFERENCE FOR HEALTH SERVICES RESEARCH 2009: Approximately a fifth of all abstracts (n=74) had a qualitative (n=47) or a mixed-methods approach combining quantitative and qualitative methods (n=27). Research aims included needs assessment (41%), survey development (36%), evaluation (22%), and theorizing (1%). Data collection mostly consisted of one-on-one interviews (n=45) and group discussions (n=29). Qualitative content analysis was named in 35 abstracts, 30 abstracts did not reference their method of analysis. In addition to a quantitative summary of the abstract findings, the diversity of fields addressed by qualitative methods is highlighted. Although drawing conclusions on the use of qualitative methods in German health services research from the analysis of conference abstracts is not possible, the overview we present demonstrates the
MacStravic, R S
Service marketing is the engineering of satisfaction, and the key to success is to identify and influence potential customers' expectations and then to fulfill those expectations. Patient satisfaction largely determines both a program's revenues and expenditures and the effectiveness of care received by patients. A program's ability to satisfy patients rests upon three basic elements: research, design, and communication. Research should be on two levels. The first is basic market assessment and analysis, and should reveal overall market potential by focusing on consumers' expectations, unmet needs, and level of satisfaction. From this stage of research, the organization should be able to identify current programs that are secure and stable, those which have significant growth potential, those which are threatened by competition, and those which have little future. This research also should indicate the potential for new programs and for new markets for existing programs. The second level of research focuses on a specific program (whether current or proposed) and is the basis for program design. The organization can tailor the program to consumers' expectations in everything from services provided to price of parking and other amenities. Research also provides a basis for communications. Not only can communications influence a potential customer to try a provider, but also care providers can use communications during and after the service experience to reinforce what might have been a casual decision. Ideally, all communication that occurs between patients and providers should serve marketing as well as diagnostic and therapeutic purposes. It can shape patients' expectations, reinforce satisfaction when those expectations have been fulfilled, and convey the provider's caring and concern.
Despite fiscal stress, public confidence in the National Health Service (NHS) remains strong; privatisation has not hollowed out the service. But if long term challenges are to be overcome, pragmatism not rhetoric should be the guide. © 2015 by Kerman University of Medical Sciences.
Deen, Tisha L.; Bridges, Ana J.; McGahan, Tara C.; Andrews, Arthur R., III
Purpose: Rural individuals utilize specialty mental health services (eg, psychiatrists, psychologists, counselors, and social workers) at lower rates than their urban counterparts. This study explores whether cognitive appraisals (ie, individual perceptions of need for services, outcome expectancies, and value of a positive therapeutic outcome) of…
A quasi-experimental study, participants were recruited through an advertisement calling for volunteer trainees who filled the self-administered Socio-demographic, Eysenck personality (short-form), took part in focus group discussions, then a knowledge pretest questionnaire. They were trained using a mental health peer ...
Bayes, Marjorie; Neill, T. Kerby
Issues of changing positions and roles for paraprofessionals are considered in the context of the hierarchical structure and process of mental health organizations. Discussion focuses on problems arising when paraprofessionals are promoted in the functional hierarchy while continuing to occupy the lowest level in the professional caste system.…
Psychotropic drug supply is limited and irregular. Families can buy newer antipsychotic drugs if they can afford them. Patients are not fed which is a major problem for those without families. Records and observations are minimal. There is no mental health legislation. The families carry out most of the care and family bonds ...
the lowest per capita income and a high rate of male migrancy. The Reproductive Health Transformation ... teenagers, one of whom said: 'A man will tell you in front of his friends when drunk that this and this happened. .... of choice for pain relief during labour in South Africa and which midwives are licensed to prescribe) is ...
Objective: To assess the determinants of conventional health care utilization among pastoralist communities in northeast Ethiopia. Methods: The study employed a cross-sectional household survey conducted using structured questionnaires administered among 276 mobile and 262 settled subjects within the pastoral area.
Hindall, S.M.; Flint, R.F.
Sediment in Wisconsin streams causes economic and engineering problems in water management and reduces the value of water for nearly all uses. Sediment produces problems such as reduced reservoir capacity, navigation hazards, increased cost of water treatment, property damage, temporary loss of farmland, destruction of feeding and nesting grounds of fish, and destruction of wildlife habitat. Sediment in water also reduces the aesthetic value of surface waters and is detrimental to the State's tourist and recreation industry.
This Site Specific Health and Safety Plan covers well servicing in support of the Environmental Restoration Contractor Groundwater Project. Well servicing is an important part of environmental restoration activities supporting several pump and treat facilities and assisting in evaluation and servicing of various groundwater wells throughout the Hanford Site. Remediation of contaminated groundwater is a major part of the ERC project. Well services tasks help enhance groundwater extraction/injection as well as maintain groundwater wells for sampling and other hydrologic testing and information gathering
% of the males visited for own health care. Overall, 57.1% of interviewee believed that the service they received was either good or very good. Satisfaction with health care was found to have a direct relationship with increase in age but has an ...
Poulymenopoulou, M; Papakonstantinou, D; Malamateniou, F; Vassilacopoulos, G
The increasingly large amount of data produced in healthcare (e.g. collected through health information systems such as electronic medical records - EMRs or collected through novel data sources such as personal health records - PHRs, social media, web resources) enable the creation of detailed records about people's health, sentiments and activities (e.g. physical activity, diet, sleep quality) that can be used in the public health area among others. However, despite the transformative potential of big data in public health surveillance there are several challenges in integrating big data. In this paper, the interoperability challenge is tackled and a semantic Extract Transform Load (ETL) service is proposed that seeks to semantically annotate big data to result into valuable data for analysis. This service is considered as part of a health analytics engine on the cloud that interacts with existing healthcare information exchange networks, like the Integrating the Healthcare Enterprise (IHE), PHRs, sensors, mobile applications, and other web resources to retrieve patient health, behavioral and daily activity data. The semantic ETL service aims at semantically integrating big data for use by analytic mechanisms. An illustrative implementation of the service on big data which is potentially relevant to human obesity, enables using appropriate analytic techniques (e.g. machine learning, text mining) that are expected to assist in identifying patterns and contributing factors (e.g. genetic background, social, environmental) for this social phenomenon and, hence, drive health policy changes and promote healthy behaviors where residents live, work, learn, shop and play.
... Resulting From a Section 610 Review) Substance Abuse and Mental Health Services Administration--Final Rule... Detoxification Treatment of Opiate Addiction (Section 0930-AA14 610 Review) Substance Abuse and Mental Health... Quarantine Regulations, Proposed Revision of 0920-AA14 HHS/CDC Animal Importation Regulations 125 Control of...
Although South Africa accepted the Convention on the Rights of the Child (CRC) in 1996 thereby committing itself to prioritisation of children, the implementation of school health services in South Africa has deteriorated to levels that contravene these rights. The promotion of health in schools requires a strong political ...
Objective: This review paper aims at demonstrating that mobile health services for HIV infection in resource-constrained countries may be particularly useful for HIV screening and treatment of HIV disease and associated co-morbidities, especially for people who have limited access to fixed health facilities, including remote ...
Herrador Cordoba, M.; Garcia Rotllan, J.
In Andalusia the contributions of radiological risks in the nuclear industry and of natural radiation are small and the same holds for medical applications of individuals and research. The performance models in radiation protection is monitored by the Andalusian Health Service through the public health institutions. This short communication describes the model and results obtained
The findings also indicate that although health facility delivery is high in the districts surveyed, only the well-to-do non-literate, urbanite women and the ... rural communities included the need to improve the quality of maternal and child health service through the supply of major logistic deficiencies, the need to provide ...
This publication identifies, discusses, and lists areas for further research for five ethical issues related to health services: 1) the right to health care; 2) death and euthanasia; 3) human experimentation; 4) genetic engineering; and, 5) abortion. Following a discussion of each issue is a selected annotated bibliography covering the years 1967…
Full Text Available Remote health monitoring and Health Relationship Management Services (HRMS can provide health care solutions for the elderly, the fastest-growing segment of the U.S. population. The year 2030 Problem questions whether enough resources and an operative service system will be available fourteen years from now when the elderly population will be greater than what it is today. One solution for reducing elder health care costs is home care, which is a preferable alternative to institutionalization. Many elderly have access to health services or outreach medical care, but do not use them due to lack of accessibility to safe transportation. The elderly often have problems with medication misuse stemming from the aging process, such as loss of memory, poor vision, and fixed-incomes. Seniors have dietary problems that weaken immune systems, leading to dehydration and other health issues. They also experience depression and loneliness from living alone or even with family members. The elderly who experience these problems can benefit from Health Relationship Management Services (HRMS, a new healthcare paradigm using remote health monitoring in the home.
Jun 24, 2005 ... The effect of restructuring of health care services on caesarean section rates. ARTICLE. Medical Research Council/ University of KwaZulu-Natal, Pregnancy Hypertension Research. Unit and Department of Obstetrics and Gynaecology, Nelson R Mandela School of Health. Sciences, University of ...
Whitley, Jessica; Gooderham, Suzanne
Worldwide, prevalence rates of students experiencing mental health difficulties are growing, with only one in five receiving treatment. The role of teachers in collaborative efforts both to identify and to provide effective services for these students is an essential one. However, scant research has explored the mental health literacy of…
Eighty different tests were offered by the health centres in various combinations. Twenty categories of suggestions were advanced by the respondents. Conclusion: There is a great shortage of manpower, equipment, chemicals and other supplies to provide adequate laboratory services in the health centres within the region ...
government became the main funding source for RH services (44.2%), partly reflecting government enhanced commitment to increase resources for maternal and child health, and due to exemption of pregnant women from paying for health care. Nevertheless, this commitment didn't last and the financing burden was borne ...
The State Ministry of Health is responsible for. • the National Tuberculosis Programme (NTP) in. Juba town (urban). The International Medical Corps (IMC) is. • responsible for the TB services in Kajo Keji. County (rural) and a. Ministry of Health, South Sudan, Field Epidemiology and. Laboratory Training Program, Kenya. b.
Background: Infant mortality rate in Nigeria is among the highest world-wide. Utilization of modern health care facilities during pregnancy and at delivery reduces infant mortality rate. We examined the relationship between Infant Mortality (IM) and Maternal Health Care Services Access Index (MHCI) in Nigeria. Methods: This ...
The purpose of this article is to show the relationship between women education, affordability of hospital delivery, availability of government health center and the use of reproductive health services among childbearing women in Akute Community of Ogun State, Nigeria. The article begins with a background of the ...
Objective: Approximately one in five children and adolescents (CA) suffer from mental disorders. This paper reports on the findings of a situational analysis of CA mental health policy and services in Ghana, Uganda, South Africa and Zambia. The findings are part of a 5 year study, the Mental Health and Poverty Project, ...
However, the presence of health facilities alone is not enough to guarantee use as other socioeconomic factors could influence access and utilization. This study assessed the community perceptions and factors affecting the utilization of health services in a rural community in Southern Nigeria. A descriptive cross-sectional ...
This paper reports on a study that examined the institutional dynamics affecting health service delivery at Jinja Regional Referral Hospital in Eastern Uganda. The institutional dynamics examined included the supply of essential medicines and other health supplies, physical infrastructure and the availability of medical ...
ABSTRACT. BACKGROUND: Infant mortality rate in Nigeria is among the highest world-wide. Utilization of modern health care facilities during pregnancy and at delivery reduces infant mortality rate. We examined the relationship between Infant Mortality (IM) and Maternal Health Care Services Access Index (MHCI) in.
Assessment of barriers to reproductive health service utilization among Bench Maji Zone Pastoralist Communities. ... PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN JOURNALS ... Background: The reproductive health (RH) needs and challenges in pastoralist area are different from elsewhere. People in this ...
commercial sex workers, house maids, and migrants were found to be reluctant in using maternal health services such ANC follow-up, ..... problem at all. For me and other women alike running to health facility because you are pregnant is not normal although there is continuous push from UHEPs”. (Housewife, Adama).
Seeking to understand patient perspectives is an important step in the efforts to improve the quality of health care. The purpose of this study was to examine patient satisfaction with primary health care (PHC) services. A purposive sample of 19136 patients aged 18 years and above was interviewed at 266 PHC clinics in ...
There was no doubt that the health services were culturally accessible in the sense that no complaints of racial discrimination were indicated. The clients did not have any problems to be nursed by health care providers of any cultural background. The issue of functional accessibility needs urgent attention to be in line with ...
Objective: Poor utilization of health facilities during delivery by pregnant mothers is still a major cause of maternal and childhood morbidity and mortality in Nigeria. The aim of this study was to determine the level of utilization of health care services by pregnant women during delivery in Gokana Local Government Area of ...
Health services have the functions to define community health problems, to identify unmet needs and survey the resources to meet them ... systems should rely on newer approaches of management as management-by-objectives, risk- management, and ..... planning what is to be done, organizing how things are to be done, ...
McGuire, James; Rosenheck, Robert A; Kasprow, Wesley J
This study compared client characteristics, service use, and health care costs of two groups of veterans who were contacted by outreach workers: a group of veterans who were contacted while incarcerated at the Los Angeles jail and a group of homeless veterans who were contacted in community settings. Between May 1, 1997, and October 1, 1999, a total of 1,676 veterans who were in jail and 6,560 community homeless veterans were assessed through a structured intake procedure that documented their demographic, clinical, and social adjustment characteristics. Data on the use and costs of health services during the year after outreach contact were obtained from national databases of the Department of Veterans Affairs (VA). Chi square and t tests were used for statistical comparisons. The veterans who were contacted in jail obtained higher scores on several measures of social stability (marital status and homelessness status) but had higher rates of unemployment. They had fewer medical problems but higher levels of psychiatric and substance use problems, although the rate of current substance use was lower among these veterans than among the community homeless veterans. One-year service access for the jailed veterans was half that of the community homeless veterans. No differences were observed in the intensity of use of mental health services among those who used services, but the jailed outreach clients used fewer residential, medical, and surgical services. Total health care expenditures for the veterans who received outreach contact in jail were $2,318 less, or 30 percent less, than for those who were contacted through community outreach. Specialized outreach services appear to be modestly effective in linking veterans who become incarcerated with VA health care services. Although it is clinically challenging to link this group with services, the fact that the rate of current substance use is lower during incarceration may provide a window of opportunity for
Treml, Kimberly B; McElroy, Jane A; Kaufman, Stephanie K; Remington, Patrick L; Wegner, Mark V
In 1989, experts in cancer prevention, early detection, and treatment met in Madison to set the public health agenda for cancer control. Part of the plan defined target percent change in cancer mortality rates to be met by the year 2000. During the 1990s, public health and health care professionals developed programs and policies to reach these goals. The purpose of this analysis is to evaluate Wisconsin's progress in reducing cancer mortality and success in meeting the year 2000 objectives. Wisconsin mortality data for 1984-1986 and 1999-2001 were obtained from the Centers for Disease Control and Prevention, CDC Wonder. Percent change was calculated between the 2 time periods and compared to the 2000 target percent change for all-site cancer and site specific cancer mortality. All-site cancer mortality decreased by 7% from 1984-1986 to 1999-2001 with a greater than 16% decline in age groups <65 years. Mortality from breast, colorectal, and cervical cancer each decreased by at least 25%. Lung cancer and malignant melanoma mortality rates increased by 5% and 17%, respectively. Among additionally analyzed cancers, mortality decreased in prostate, stomach, and childhood cancers and increased in liver cancer and non-Hodgkin's lymphoma. The results of the state's cancer control effort are mixed. The year 2000 objectives were met for breast and colorectal cancer. Progress was made in reducing mortality from cervical cancer and from all sites combined, but the other year 2000 objectives were not met. Mortality rates increased for lung cancer and malignant melanoma during the 15-year period.
Kluge, U.; Bogic, M.; Devillé, W.; Greacen, T.; Dauvrin, M.; Dias, S.; Gaddini, A.; Koitzsch Jensen, N.; Ioannidi-Kapolou, E.; Mertaniemi, R.; Puipcinós i Riera, R.; Sandhu, S.; Sarvary, A.; Soares, J.J.F.; Stankunas, M.; Straßmayr, C.; Welbel, M.; Heinz, A.; Priebe, S.
Background The number of immigrants using health services has increased across Europe. For assessing and improving the quality of care provided for immigrants, information is required on how many immigrants use services, what interpreting services are provided and whether staff members are from
Kluge, U.; Bogic, M.; Devillé, W.; Greacen, T.; Dauvrin, M.; Dias, S.; Gaddini, A.; Koitzsch Jensen, N.; Ioannidi-Kapolou, E.; Mertaniemi, R.; Puipcinos i Riera, R.; Sandhu, S.; Sarvary, A.; Soares, J.J.F.; Stankunas, M.; Straßmayr, C.; Welbel, M.; Heinz, A.; Priebe, S.
Background: The number of immigrants using health services has increased across Europe. For assessing and improving the quality of care provided for immigrants, information is required on how many immigrants use services, what interpreting services are provided and whether staff members are from
Campbell, Megan A; Hunt, Jennifer; Walker, David; Williams, Rodger
Aboriginal people continue to experience a disproportionately heavy burden of oral disease. A range of oral health services may be available to Aboriginal communities, including those provided by Aboriginal Community Controlled Health Services (ACCHSs). This study explored the oral health care experiences and activities of ACCHSs to inform policy and program decision making. Mixed methods, including an online survey and semi-structured interviews with senior ACCHS staff, were used. Areas of inquiry included perceived community need for oral health care, oral health care models, accessibility of other oral health services and barriers to providing oral health care. Twenty-nine NSW ACCHSs participated in the study. The activities of NSW ACCHSs in oral health care are diverse and reflect the localised approaches they take to delivering primary health care. ACCHSs commonly face barriers in delivering oral health care, as do Aboriginal communities in accessing other oral health services. NSW ACCHSs are important but under-acknowledged providers of a range of oral health services to Aboriginal communities and are well placed to provide this care as part of their comprehensive primary health care model. ACCHS roles in improving Aboriginal oral health would be strengthened by greater acknowledgement of their contributions and expertise and the development of transparent, long-term funding policies that respond to community need. © 2014 Public Health Association of Australia.
Full Text Available This study was designed to identify: (1 predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2 correlates associated with healthcare service utilization for mental health reasons among individuals with and without mental disorders respectively. Analyses comprised univariate, bivariate, and multiple regression analyses. Being male, having poor quality of life, possessing better self-perception of physical health, and suffering from major depressive episodes, panic disorder, social phobia, and emotional problems predicted healthcare service utilization for mental health reasons. Among individuals with mental disorders, needs factors (psychological distress, impulsiveness, emotional problems, victim of violence, and aggressive behavior and visits to healthcare professionals were associated with healthcare service utilization for mental health reasons. Among individuals without mental disorders, healthcare service utilization for mental health reasons is strongly associated with enabling factors such as social support, income, environmental variables, and self-perception of the neighborhood. Interventions facilitating social cohesion and social solidarity in neighborhood settings may reduce the need to seek help among individuals without mental disorders. Furthermore, in their capacity as frontline professionals, general practitioners should be more sensitive in preventing, detecting, and treating mental disorders in routine primary care.
Rae, John; Green, Bill
A model is proposed for supporting reflexivity in qualitative health research, informed by arguments from Bourdieu and Finlay. Bourdieu refers to mastering the subjective relation to the object at three levels-the overall social space, the field of specialists, and the scholastic universe. The model overlays Bourdieu's levels of objectivation with Finlay's three stages of research (pre-research, data collection, and data analysis). The intersections of these two ways of considering reflexivity, displayed as cells of a matrix, pose questions and offer prompts to productively challenge health researchers' reflexivity. Portraiture is used to show how these challenges and prompts can facilitate such reflexivity, as illustrated in a research project. © The Author(s) 2016.
This Annual Report provides the first comprehensive survey carried out on community CAMHS teams and includes preliminary data collected by The Health Research Board on the admission of young people under the age of 18 years to inpatient mental health facilities. As many measures in this report do not have historic comparators it provides a baseline foundation that will be built upon in subsequent years providing an indication of trends that cannot yet be drawn on the basis of this report. The next report will include day hospital, liaison and inpatient services. Subsequent reports will further extend the mapping of mental health services for young people.
Burt, A.K.; Bird, R.W.
A Health Physics and Medical Services report is presented for Harwell Laboratory for 1986. Health physics aspects covered include safety policy and organisation, monitoring results for the working environment and personnel, an analysis of radiological incidents and radioactive waste disposal, and protection of the public. Other non-radiological aspects of health and safety are briefly considered. The section on Medical Services contains details of the staffing, the types of medical examinations performed, the treatments received, work on the safety of asbestos and manmade mineral fibres and training and education programmes. (UK)
Oswald, Donald P.; Gilles, Donna L.; Cannady, Mariel S.; Wenzel, Donna B.; Willis, Janet H.; Bodurtha, Joann N.
Transition to adult services for children and youth with special health care needs (CYSHCN) has emerged as an important event in the life course of individuals with disabilities. Issues that interfere with efficient transition to adult health care include the perspectives of stakeholders, age limits on pediatric service, complexity of health conditions, a lack of experienced healthcare professionals in the adult arena, and health care financing for chronic and complex conditions. The purposes...
Natalya Vasilyevna Krivenko
Full Text Available In the article, the definitions of the concept organizational and economic changes in institution problems of changes in public health service, the purpose and issues of the management system of organizational and economic changes in the field are considered. The combined strategy of development and innovative changes in management is offered. The need of resource-saving technologies implementation is shown. Expediency of use of marketing tools in a management system of organizational and economic changes is considered the mechanism of improvement of planning and pricing in public health service is offered. The author’s model of management of organizational and economic changes in health services supporting achievement of medical, social, economic efficiency in Yekaterinburg's trauma care is presented. Strategy of traumatism prevention is determined on the basis of interdepartmental approach and territorial segmentation of health care market
Full Text Available One of heatlh policies implemented by the hospital is the minimum service standards (MSS. MSS is a benchmark of hospital service quality in providing services to the public. Talking about health service quality problem, it was found out as the field fact that the achievement of MSS indicator in General Hospital of Dr. H. Koesnadi Bondowoso, Indonesia in 2016 still did not fulfill target of standard hospital service (type B and minimum service standard (MSS of hospital. This fact shows that the quality of health services in general hospital of dr. H. Koesnadi Bondowoso is still low. So, this research aims to describe the policy implementation of minimum service standard and to analyze the obstacles in the implementation of MSS policy at general hospital of dr. H. Koesnadi Bondowoso. So, this research would discuss the policy implementation of minimum service standards by using Edward III concept as a tool to analyze it. This research employed qualitative research with phenomenological approach. The results showed that the implementation of MSS policy of dr. H. Koesnadi Bondowoso general hospital still did not run well. This was due to several factors such as communication, bureaucratic structure, sources, dispositions (attitude and leadership in sectoral ego control. Sectoral ego can be shaped from educational background of specialist doctors who still adhered seniority and lack of individual role of implementor in building interpersonal communication and conflict management.
Loeste de Arruda-Barbosa
Full Text Available Objective: To assess the evaluation of the users regarding the family health services and identify the main reasons that led them to seek such services. Methods: A descriptive study with qualitative approach, carried out in 5 Family Health Units with 25 users of theFamily Health Strategy (FHS of the city of Crato-CE, Brazil. The study took place from March to April 2009. Semi-structured interview was applied and recorded. We used thetechnique of thematic content analysis. Results: We found that the users of the FHS have great dissatisfaction, especially on the organization and access to health services, evaluating the family health as inefficient, although bringing care closer to the population, primarily through home visits. It was clear also that there is a search to the service mainly supported by curative vision and the acquisition of medicines. Conclusions: The subjects evaluate the organization and access to healthcare services as unsatisfactory, but value the actions, when there is a bond with the health team. However, there is still demand for health services, based on the search for medicines and medical consultation. Thus, it is necessary to improve services of the Family Health Strategy in Crato, with a view to ensure quality, accessibilityand greater resolution of health services.
Vinot, Anne-Laure; Rein, Lucile; Parigot, Chantal; Lambert, Fanny; Billon, Louise; Blanc, Myriam
Part of the health and social care landscape since 1998, health service access points (in French, permanences d'accès aux soins de santé) were set up in response to a health and social care problem. The objective is to help disadvantaged people integrate the healthcare pathway. The ultimate aim is to ensure everyone has access to the appropriate care at a fair price. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Storm, Marianne; Hausken, Kjell; Knudsen, Knud
For two decades, mental health services in Norway have focused on service user involvement. Despite this, there is little knowledge about how inpatient mental health services have promoted user involvement. To examine service providers' reports of service user involvement at the individual and departmental levels in Norwegian community mental health centres (CMHCs). One hundred and eighty six (186) inpatient service providers in five CMHCs filled out a questionnaire. Confirmatory factor analysis showed that service provider perceptions and awareness of service user involvement can be measured by three subscales: organizational user involvement; patient collaboration; and assisted patient involvement. Little user involvement was reported at the departmental level. Providers more often reported user involvement at the individual level. Providers in two of the CMHCs reported a somewhat higher degree of departmental-level user involvement. There were no significant differences across gender, age, leader position, profession and job tenure, though evening/night shift workers reported a lesser degree of user involvement. The results suggest that user involvement at the departmental level needs to be addressed in future efforts to promote user involvement in CMHCs.
Full Text Available Jane Burns, Emma Birrell Young and Well Cooperative Research Centre, Abbotsford, VIC, Australia Abstract: International studies have shown that the prevalence of mental illness, and the fundamental contribution it make to the overall disease burden, is greatest in children and young people. Despite this high burden, adolescents and young adults are the least likely population group to seek help or to access professional care for mental health problems. This issue is particularly problematic given that untreated, or poorly treated, mental disorders are associated with both short- and long-term functional impairment, including poorer education and employment opportunities, potential comorbidity, including drug and alcohol problems, and a greater risk for antisocial behavior, including violence and aggression. This cycle of poor mental health creates a significant burden for the young person, their family and friends, and society as a whole. Australia is enviably positioned to substantially enhance the well-being of young people, to improve their engagement with mental health services, and – ultimately – to improve mental health. High prevalence but potentially debilitating disorders, such as depression and anxiety, are targeted by the specialized youth mental health service, headspace: the National Youth Mental Health Foundation and a series of Early Psychosis Prevention and Intervention Centres, will provide early intervention specialist services for low prevalence, complex illnesses. Online services, such as ReachOut.com by Inspire Foundation, Youthbeyondblue, Kids Helpline, and Lifeline Australia, and evidence-based online interventions, such as MoodGYM, are also freely available, yet a major challenge still exists in ensuring that young people receive effective evidence-based care at the right time. This article describes Australian innovation in shaping a comprehensive youth mental health system, which is informed by an evidence
Globalization is a key challenge facing health policy-makers. A significant dimension of this is trade in health services. Traditionally, the flow of health services exports went from North to South, with patients travelling in the opposite direction. This situation is changing and a number of papers have discussed the growth of health services exports from Southern countries in its different dimensions. Less attention has been paid to assess the real scope of this trade at the global level and its potential impact at the local level. Given the rapid development of this area, there are little empirical data. This paper therefore first built an estimate of the global size and of the growth trend of international trade in health services since 1997, which is compared with several country-based studies. The second purpose of the paper is to demonstrate the significant economic impact of this trade at the local level for the exporting country. We consider the case of health providers in the South-Mediterranean region for which the demand potential, the economic effects and the consequence for the health system are presented. These issues lead to the overall conclusion that different policy options would be appropriate, in relation to the nature of the demand. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Lacey Bryant, Sue; Bingham, Helen; Carlyle, Ruth; Day, Alison; Ferguson, Linda; Stewart, David
This article is the fourth in a series on New Directions. The National Health Service is under pressure, challenged to meet the needs of an ageing population, whilst striving to improve standards and ensure decision making is underpinned by evidence. Health Education England is steering a new course for NHS library and knowledge services in England to ensure access to knowledge and evidence for all decision makers. Knowledge for Healthcare calls for service transformation, role redesign, greater coordination and collaboration. To meet user expectations, health libraries must achieve sustainable, affordable access to digital content. Traditional tasks will progressively become mechanised. Alongside supporting learners, NHS librarians and knowledge specialists will take a greater role as knowledge brokers, delivering business critical services. They will support the NHS workforce to signpost patients and the public to high-quality information. There is a need for greater efficiency and effectiveness through greater co-operation and service mergers. Evaluation of service quality will focus more on outcomes, less on counting. These changes require an agile workforce, fit for the future. There is a bright future in which librarians' expertise is used to mobilise evidence, manage and share knowledge, support patients, carers and families, optimise technology and social media and provide a keystone for improved patient care and safety. © 2018 Health Libraries Group.
Erika Balfour MD
Full Text Available From 2009 to 2015, the laboratories of the 19-hospital North Shore-LIJ Health System experienced 5 threatened interruptions in service and supported 2 regional health-care providers with threatened interruptions in their laboratory service. We report our strategies to maintain laboratory performance during these events, drawing upon the strengths of our integrated laboratory service line. Established in 2009, the laboratory service line has unified medical and administrative leadership and system-wide divisional structure, quality management, and standardization of operations and procedures. Among many benefits, this governance structure enabled the laboratories to respond to a series of unexpected events. Specifically, at our various service sites, the laboratories dealt with pandemic (2009, 2 floods (2010, 2012, 2 fires (2010, 2015, and laboratory floor subsidence (2013. We were also asked to provide support for a regional physician network facing abrupt loss of testing services from closure of another regional clinical laboratory (2010 and to intervene for a non-health system hospital threatened with closure owing to noncompliance of laboratory operations (2012. In all but a single instance, patient care was served without interruption in service. In the last instance, fire interrupted laboratory services for 30 minutes. We conclude that in a large integrated health system, threats to continuous laboratory operations are not infrequent when measured on an annual basis. While most threats are from external physical circumstances, some emanate from unexpected administrative events. A strong laboratory governance mechanism that includes unified medical and administrative leadership across the entirety of the laboratory service line enables successful responses to these threats.
This paper discusses the use of bilingual workers who do not have formal mental health training as mediators and providers of mental health care for refugees. The introduction provides a background discussion of the need for refugee mental health services, the characteristics of bilingual mental health workers, and the work places and expectations…
Results: There was no comprehensive mental health policy and legislation in Eritrea. Only 5% of the health services budget is allocated for mental health services. Mental health services is free of charge and were provided integrated with Primary Health Care services. Inadequate human resources and inadequate training ...
... provided in a non-hospital based health care facility or at a hospital; (ii) Inpatient hospital services, which must include but not be limited to, room and board, general nursing care, meals and special diets... hospital services must include short-term rehabilitation services and physical therapy, the provision of...
McDonald, James Ted; Conde, Heather
The rising cost of health care and changing demographic profiles have resulted in the relocation and redistribution of funding and services between rural and urban areas. Most econometric analyses of Canada's health service use include broad controls by province and rural/urban status, but relatively little econometric work has focused on geographical variation in health service use. Using the Canadian Community Health Survey 2.1, we examined determinants of various measures of health services use by Canadians aged 55 or older across a range of urban and rural areas of residence. Our regression analysis showed that older residents in rural areas made fewer visits to a general practitioner, to a specialist, and to a dentist relative to urban residents. All else being equal, there are no significant differences in hospital nights or in unmet healthcare needs. These differences are significant after controlling for demographic characteristics, socioeconomic status, private health insurance, and health status.
Forrester, Andrew; Exworthy, Tim; Olumoroti, Olumuyiwa; Sessay, Mohammed; Parrott, Janet; Spencer, Sarah-Jane; Whyte, Sean
In responding to high levels of psychiatric morbidity amongst prisoners and recognising earlier poor quality prison mental health care, prison mental health in-reach teams have been established in England and Wales over the last decade. They are mostly provided by the National Health Service (NHS), which provides the majority of UK healthcare services. Over the same period, the prison population has grown to record levels, such that prisons in England and Wales now contain almost 90,000 of the world's overall prison population of over 10 million people (roughly the size of Paris or Istanbul). This study provides an overview of mental health in-reach services in prisons in England and Wales, including variations between them, through a telephone survey of senior staff in all prisons and young offender institutions in England and Wales. 73% of prisons took part; of them 13% had no in-reach team at all (usually low security establishments) and the majority of services were run by NHS teams, usually according to a generic community mental health team (CMHT) model rather than other specialist models. Team size was unrelated to prison size. Each nurse covered around 500 prisoners, each doctor over 3700. Many provided few or no healthcare cells and 24-h psychiatric cover (including on-call cover) was uncommon. Despite developments in recent years, mental health in-reach services still fall short of community equivalence and there is wide variation in service arrangements that cannot be explained by prison size or function. The aim of community equivalence has not yet been reached in prison healthcare and a more sophisticated measure of service improvement and standardisation would now be useful to drive and monitor future development. Copyright © 2013 Elsevier Ltd. All rights reserved.
Shah, Tayyab Ikram; Bell, Scott; Wilson, Kathi
Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA) method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population), was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms) used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons). An integrated geocoding approach was used to establish PHC locations. The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs. The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood level. In
Meldrum, Rebecca; Ho, Hillary; Satur, Julie
People with a lived experience of mental illness are at a higher risk for developing oral diseases and having poorer oral health than the broader population. This paper explores the role of Australian community mental health services in supporting the prevention and management of poor oral health among people living with mental illness. Through focus groups and semi-structured interviews, participants identified the value of receiving oral health support within a community mental health setting, in particular the delivery of basic education, preventive strategies, assistance with making or attending appointments and obtaining priority access to oral health services. Engagement with Community Health Services and referrals generated through the priority access system were identified as key enablers to addressing oral health issues. This study provides new insight into the importance of undertaking an integrated approach to reducing the oral health disparities experienced by those living with mental illness.
This work presents a development approach for mixed reality systems in health care. Although health-care service costs account for 5-15% of GDP in developed countries the sector has been remarkably resistant to the introduction of technology-supported optimizations. Digitalization of data storing and processing in the form of electronic patient records (EPR) and hospital information systems (HIS) is a first necessary step. Contrary to typical business functions (e.g., accounting or CRM) a health-care service is characterized by a knowledge intensive decision process and usage of specialized devices ranging from stethoscopes to complex surgical systems. Mixed reality systems can help fill the gap between highly patient-specific health-care services that need a variety of technical resources on the one side and the streamlined process flow that typical process supporting information systems expect on the other side. To achieve this task, we present a development approach that includes an evaluation of existing tasks and processes within the health-care service and the information systems that currently support the service, as well as identification of decision paths and actions that can benefit from mixed reality systems. The result is a mixed reality system that allows a clinician to monitor the elements of the physical world and to blend them with virtual information provided by the systems. He or she can also plan and schedule treatments and operations in the digital world depending on status information from this mixed reality.
Level of health care and services in a tertiary health setting in Nigeria. ... responded to questions on the clinical, support and corporate services ... Also low were the level of medical and environmental research, informal relationship and security, but the management had a high level of social responsibility in form of ...
Yell, Mitchell; Smith, Carl; Katsiyannis, Antonis; Losinski, Mickey
In the past few years, the provision of mental health services in public schools has received considerable attention. When students with disabilities are eligible for special education and related services under the Individuals With Disabilities Education Act (IDEA), mental health services are required if such services are needed to provide…
In 2003 the Prostitution Reform Act (PRA) was passed in New Zealand which decriminalised all activities associated with sex work. To explore sex workers' utilisation of health services in New Zealand following decriminalisation of sex work and disclosure of their occupation to health professionals. A cross-sectional survey was carried out with 772 sex workers and in-depth interviews were carried out with 58 sex workers in New Zealand. Most sex workers have regular sexual health check-ups and most access their general practitioner (GP) for both general health needs (91.8%) and sexual health needs (41.3%). A quarter of the participants accessed a local sexual health centre for their sexual health needs and just over 15% accessed New Zealand Prostitutes' Collective's (NZPC's) Sexual Health Clinic. Little change was found in disclosure of occupation to health professionals following decriminalisation. Sex workers remain concerned about disclosing their occupation because of perceived stigma attached to their occupation. Most sex workers have regular sexual health check-ups and most access their GP for this service. However, because of on-going perceptions of stigmatisation many do not report their occupation to their GP which may mean that check-ups may not be comprehensive. For this reason, sexual health check-ups performed at NZPC may be preferable to check-ups elsewhere because disclosure of occupation is not an issue.
Blewett, Lynn A; Call, Kathleen Thiede; Turner, Joanna; Hest, Robert
Rich federal data resources provide essential data inputs for monitoring the health and health care of the US population and are essential for conducting health services policy research. The six household surveys we document in this article cover a broad array of health topics, including health insurance coverage (American Community Survey, Current Population Survey), health conditions and behaviors (National Health Interview Survey, Behavioral Risk Factor Surveillance System), health care utilization and spending (Medical Expenditure Panel Survey), and longitudinal data on public program participation (SIPP). New federal activities are linking federal surveys with administrative data to reduce duplication and response burden. In the private sector, vendors are aggregating data from medical records and claims to enhance our understanding of treatment, quality, and outcomes of medical care. Federal agencies must continue to innovate to meet the continuous challenges of scarce resources, pressures for more granular data, and new multimode data collection methodologies.
Full Text Available The W.H.O. (1982 estimates that the annual risk of infection with tuberculosis in most developing countries is in the order of 3 to 5%. Every year 4-million to 5-million highly infectious cases of tuberculosis occur in those countries, according to the WHO Technical Report No. 671. This report also states that case finding and chemotherapy, combined as one entity, must be considered to be the most powerful weapon in tuberculosis control. Since case finding in those countries depends principally on the examination of patients presenting with relevant symptoms to a health facility, it is recommended that all staff at such facilities should be properly trained and motivated to identify potential tuberculosis patients.
Gerlack, Letícia Farias; Karnikowski, Margô Gomes de Oliveira; Areda, Camila Alves; Galato, Dayani; Oliveira, Aline Gomes de; Álvares, Juliana; Leite, Silvana Nair; Costa, Ediná Alves; Guibu, Ione Aquemi; Soeiro, Orlando Mario; Costa, Karen Sarmento; Guerra, Augusto Afonso; Acurcio, Francisco de Assis
To identify limiting factors in the management of pharmaceutical services in the primary health care provided by the Brazilian Unified Health System (SUS). This study was based on the data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), and it was conducted by interviews with professionals responsible for pharmaceutical services in Brazilian cities, in 2015. To identify the management limiting factors, we considered the organizational, operational, and sustainability indicators of the management. For the analyses, we included the weights and structure of analysis plan for complex samples. The results were expressed by frequencies and measures of central tendency with 95% confidence interval, considering the Brazilian geographic regions. We identified the following limiting factors: lack of pharmaceutical services in the Municipal Health Secretariat organization chart (24%) and in the health plan (18%); lack of participation of managers in the Health Board and the absence of reference to this topic in the agenda of meetings (58.4%); lack of financial autonomy (61.5%) and lack of knowledge on the available values (81.7%); lack of adoption of operational procedures (about 50%) for selection, scheduling, and acquisition; and the fact that most professionals evaluate the organization of pharmaceutical services as good and great (58.8%), despite the worrisome indicators. Pharmaceutical services management is currently supported by a legal and political framework that should guide and contribute to improve the pharmaceutical services in the Brazilian Unified Health System primary health care. However, there is a mismatch between the goals established by these guidelines and what is actually happening.
Tham, Rachel; Humphreys, John S; Kinsman, Leigh; Buykx, Penny; Asaid, Adel; Tuohey, Kathy
Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. The evaluation framework aims to examine the health service over a six-year period in terms of: (a) Structural domains (health service performance; sustainability; and quality of care); (b) Process domains (health service utilisation and satisfaction); and (c) Outcome domains (health behaviours, health outcomes and community viability). Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how; what benefits have been realised and for whom; the level of
Full Text Available Abstract Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. Methods/Design The evaluation framework aims to examine the health service over a six-year period in terms of: (a Structural domains (health service performance; sustainability; and quality of care; (b Process domains (health service utilisation and satisfaction; and (c Outcome domains (health behaviours, health outcomes and community viability. Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. Discussion This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how
Full Text Available Los objetivos de este trabajo son tres: en primer lugar, se revisan las causas de las desigualdades sociales en salud incluyendo el papel que juegan los servicios sanitarios en las mismas; posteriormente se analiza la influencia de la financiación y la organización de los servicios sanitarios en las desigualdades y finalmente, se muestra un ejemplo de las desigualdades en la utilización de los servicios sanitarios en Cataluña, comunidad autónoma del Estado Español donde existe un Sistema Nacional de Salud. Se analizan las siguientes causas de las desigualdades en salud: los estilos de vida o conductas relacionadas con la salud, los servicios sanitarios, los factores materiales o estructurales, las desigualdades de renta y los factores políticos. Los servicios sanitarios no son los determinantes principales de la salud ni de las desigualdades en salud. Pero la existencia de servicios sanitarios adecuados es una necesidad fundamental y el acceso a los mismos debería ser un derecho de todas las personas sin distinciones sociales. Tanto la calidad como la cobertura de los servicios sanitarios son una parte integral de la definición del desarrollo en sí mismo y constituyen unos de los principales indicadores de bienestar social. Finalmente, se muestra un ejemplo sobre las desigualdades según clase social en la utilización de servicios sanitarios en Cataluña en 1994 y en 2002, desigualdades que son prácticamente inexistentes en el caso de los servicios sanitarios curativos, pero que se mantienen en los servicios preventivos.The objectives of this paper are three: first to review the causes of inequalities in health and the role played by health services; second, to analyze the influence of health care financing and the organization of health services on inequalities in health and to show an example of the study of inequalities in health services utilization in Catalonia, an autonomous community of Spain where a National Health System
Kaur, Manmeet; Prinja, Shankar; Singh, Pravin K; Kumar, Rajesh
In India, the process of decentralization of health services started taking shape in the mid-1990s. Systemic reforms envisaged delegation of administrative and financial responsibilities at district level for management of health-care institutions in 23 states of India in 1999. Subsequently, some of these reforms became part of the National Rural Health Mission (NRHM) launched in 2005. This study aims to document the process of decentralization in health services with special reference to the barriers and facilitating factors encountered during formulation and implementation of reform policies. Secondary data were reviewed, health facilities were observed, and semi-structured interviews of the key actors involved in decentralization were carried out in Haryana (India). Political and bureaucratic commitment to reforms was found to be the most important facilitating factor. Orientation training on decentralized administrative structures and performance-based resource distribution were the other important facilitators. Structural changes in administrative procedures led to improvement in the financial management system. Significant improvement in the public health infrastructure was observed. From 2004 to 2008, the state government increased the budget of health sector by nearly 60%. Frequent changes in the top administration at the state level hampered the decentralization process. Districts having a dynamic administrative leadership implemented decentralization more effectively than the rest. Decentralization of financial resources has improved the functioning of health services to some extent. Major policy decisions on decentralization of human resource management, increase in financial allocation, and greater involvement of community in decision-making are required.
Liang, Zhanming; Howard, Peter F; Leggat, Sandra; Bartram, Timothy
Purpose The importance of managerial competencies in monitoring and improving the performance of organisational leaders and managers is well accepted. Different processes have been used to identify and develop competency frameworks or models for healthcare managers around the world to meet different contextual needs. The purpose of the paper is to introduce a validated process in management competency identification and development applied in Australia - a process leading to a management competency framework with associated behavioural items that can be used to measure core management competencies of health service managers. Design/methodology/approach The management competency framework development study incorporated both qualitative and quantitative methods, implemented in four stages, including job description analysis, focus group discussions and online surveys. Findings The study confirmed that the four-stage process could identify management competencies and the framework developed is considered reliable and valid for developing a management competency assessment tool that can measure management competence amongst managers in health organisations. In addition, supervisors of health service managers could use the framework to distinguish perceived superior and average performers among managers in health organisations. Practical implications Developing the core competencies of health service managers is important for management performance improvement and talent management. The six core management competencies identified can be used to guide the design professional development activities for health service managers. Originality/value The validated management competency identification and development process can be applied in other countries and different industrial contexts to identify core management competency requirements.
Wiecha, J L; Dwyer, J T; Dunn-Strohecker, M
This review discusses nutrition and related health problems among homeless Americans, summarizes recent information, and identifies needs for services and future research. The nature of homelessness today provides a context for the discussion. Many homeless persons eat fewer meals per day, lack food more often, and are more likely to have inadequate diets and poorer nutritional status than housed U.S. populations. Yet many homeless people eligible for food stamps do not receive them. While public and private agencies provide nutritious food and meals for homeless persons, availability of the services to homeless persons is limited. Many homeless people lack appropriate health care, and certain nutrition-related health problems are prevalent among them. Compared with housed populations, alcoholism, anemia, and growth problems are more common among homeless persons, and pregnancy rates are higher. The risks vary among homeless persons for malnutrition, nutrition-related health problems, drug and alcohol abuse, and mental illness. For example, among homeless persons, fewer heads of families than single adults are substance abusers, and mental illness varies in prevalence among single men, single women, and parents in homeless families. Homeless persons need improved access to food, nutrition, and health services. More nutrition education needs to be available to them and to service providers. Use of representative samples and validation of self-reported nutrition and health data will help future investigators to clarify the relationships between the characteristics of the homeless and their nutritional status.
Graetz, V.; Rechel, B.; Groot, W.
, searching the databases Medline, Cinahl and Embase and covering the period from January 2009 to April 2016. The final number of articles included was 39. Areas of agreement: Utilization of accident and emergency services and hospitalizations were higher among migrants compared with non-migrants in most......Introduction: Our study reviewed the empirical evidence on the utilization of health care services by migrants in Europe, and on differences in health service utilization between migrants and non-migrants across European countries. Sources of data: A systematic literature review was performed...... countries for which evidence was available. In contrast, screening and outpatient visits for specialized care were generally used less often by migrants. Areas of controversy: Utilization of general practitioner services among migrants compared with non-migrants presents a diverging picture. Growing points...
Continuous Quality Improvement (or Total Quality Management) is an approach to management originally used in manufacturing and now being applied in the health services. This article describes a model of Continuous Quality Improvement which has been used in NSW public and private hospitals. The model consists of Ten Key Elements. The first driving force of this model is 'defining quality in terms of customer expectations' of quality. The second driving force emphasises that 'quality improvement is a leadership issue'. Leaders are required to: coordinate staff participation in work process analysis; train staff in the customer service orientation; lead effective meetings and negotiate with both internal and external service partners. Increased staff motivation, quality improvement and reduction in running costs are seen to be the benefits of CQI for health service organisations.
Nemec, Patricia B; Swarbrick, Margaret; Legere, Lyn
This column describes the experience of prejudice and discrimination that some mental health service users encounter in their interactions with service providers and organizations. The intent of this column is to highlight potential action steps to address the negative beliefs and attitudes of service providers that contribute to prejudice and discrimination. This description draws from published material and the authors' experience. If the most effective approaches to reduce public prejudice and discrimination toward people diagnosed with a mental illness are education and contact, then those methods may be useful methods to help mental health service providers view and engage persons served from a strengths-based recovery and wellness orientation. (c) 2015 APA, all rights reserved).
Hernandez, Stephen H A; Morgan, Brenda J; Parshall, Mark B
The aim of this concept analysis is to clarify military service members' stigma associated with seeking mental health services (MHS). Since 2001, over 2 million military service members have been deployed for or assigned to support military operations. Many service members develop a mental health concern during or after a deployment. Although researchers have assessed perceptions of stigma associated with accessing MHS, defining stigma is difficult, and conceptual clarity regarding stigma is lagging behind studies focused on its effects. Stigma was explored using Walker and Avant's method of concept analysis. Thirty articles were found in the PsycARTICLES, PsycINFO, and PubMed databases and selected for inclusion and synthesis. Military service member stigma is a set of beliefs, based on the member's military and prior civilian enculturation, that seeking MHS would be discrediting or embarrassing, cause harm to career progression, or cause peers or superiors to have decreased confidence in the member's ability to perform assigned duties. Nurses are ideally suited and situated to play an important role in decreasing stigma inhibiting service members from seeking MHS. Healthcare providers and civilian and uniformed leaders must communicate the value of seeking MHS to ensure service members' health, unit readiness, and overall force preparedness. © 2016 Wiley Periodicals, Inc.
Peters, David H; Noor, Ayan Ahmed; Singh, Lakhwinder P; Kakar, Faizullah K; Hansen, Peter M; Burnham, Gilbert
The Ministry of Public Health (MOPH) in Afghanistan has developed a balanced scorecard (BSC) to regularly monitor the progress of its strategy to deliver a basic package of health services. Although frequently used in other health-care settings, this represents the first time that the BSC has been employed in a developing country. The BSC was designed via a collaborative process focusing on translating the vision and mission of the MOPH into 29 core indicators and benchmarks representing six different domains of health services, together with two composite measures of performance. In the absence of a routine health information system, the 2004 BSC for Afghanistan was derived from a stratified random sample of 617 health facilities, 5719 observations of patient-provider interactions, and interviews with 5597 patients, 1553 health workers, and 13,843 households. Nationally, health services were found to be reaching more of the poor than the less-poor population, and providing for more women than men, both key concerns of the government. However, serious deficiencies were found in five domains, and particularly in counselling patients, providing delivery care during childbirth, monitoring tuberculosis treatment, placing staff and equipment, and establishing functional village health councils. The BSC also identified wide variations in performance across provinces; no province performed better than the others across all domains. The innovative adaptation of the BSC in Afghanistan has provided a useful tool to summarize the multidimensional nature of health-services performance, and is enabling managers to benchmark performance and identify strengths and weaknesses in the Afghan context.
Detmer Don E
Full Text Available Abstract Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries. The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin
Supplemental health care activities are described in the context of the augmented product. The potential benefits of supplemental services to recipients and provider are discussed. The author describes a study that was the basis for (re)developing a supplemental maternity service. The implementation of the results in terms of changes in the marketing mix of this supplemental program is discussed. The effects of the marketing mix changes on program participation are presented.
Wakeley, P J; Marshall, S B; Foster, E C
In an increasingly information-based society, hospitals need a variety of information for multiple purposes--direct patient care, staff development and training, continuing education, patient and community education, and administrative decision support. Health science library and information services play a key role in providing broad-based information support within the hospital. This guide identifies resources that will help administrators plan information services that are appropriate to their needs.
among LGBT service members and improve unit cohesion. The military has always been a leader in understanding and implementing gender and racial... LGBT minority stressor scale Funding Support: 25% Name: Ian Holloway, PhD, MSW, MPH Project Role : Co-Principal Investigator Researcher...1 Award Number: W81XWH-15-1-0699 Title: Improving Acceptance, Integration, and Health Among LGBT Service Members Principal Investigators: Jeremy
Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.
Davidson, Fiona; Heffernan, Ed; Greenberg, David; Butler, Tony; Burgess, Philip
The aim of this paper is to describe the development and technical specifications of a framework and national key performance indicators (KPIs) for Australian mental health Court Liaison Services (CLSs) by the National Mental Health Court Liaison Performance Working Group (Working Group). Representatives from each Australian State and Territory were invited to form a Working Group. Through a series of national workshops and meetings, a framework and set of performance indicators were developed using a review of literature and expert opinion. A total of six KPIs for CLSs have been identified and a set of technical specifications have been formed. This paper describes the process and outcomes of a national collaboration to develop a framework and KPIs. The measures have been developed to support future benchmarking activities and to assist services to identify best practice in this area of mental health service delivery.
Full Text Available Health has become a dominant economic and political issue over the past years, where many nations experience rapid rises in health care spending. The main reason why the health care sector does not operate entirely in accordance with economic market principles is the fact that inequalities in health and access to health care are understood as the lack of humanity and justice. Health care demands might seem as quite inelastic, but because of the health insurance, it shows a certain degree of price, income, cross - price and time elasticity. The subject of this study was the demand for health services in the Republic of Serbia in order to assess the ability of the public sector to meet the demand for providing these services. The underlying assumption was that public health can not adequately meet the needs of citizens due to insufficient investment in the sector and inefficient allocation of resources. To confirm this assumption, basic characteristics of health care market and the factors affecting the supply and demand for health services were discussed. Based on the analysis of investment in the health sector, the existing capacity and organization of health services, our research has shown that the public health system in the Republic of Serbia is not able to adequately meet the demand for health services. In the current economic situation in the Republic of Serbia, which already spends a significant portion of its GDP on health, there is no realistic possibility of increased spending on public health care system, although it can be expected that there will be increasing demand for health services and increase of costs. The health sector is not, and does not have the ability to be a perfectly competitive market, and the questions of its financing, rational and efficient organization is extremely delicate. However, health care economists and experts in health economics should give a significantly higher contribution in organizing health sector
Pérez-Urdiales, Iratxe; Goicolea, Isabel
To determine the perception of health professionals working in alternative health centres on the barriers and facilitators in the access by immigrant women to general public health services and sexual and reproductive health in the Basque Country. Basque Country. Analysis of qualitative content based on 11 individual interviews. Health professionals working in alternative health centres of Primary Care and sexual and reproductive health. Data collection was performed between September and December 2015 in four alternative health centres. After transcription, the units of meaning, codes and categories were identified. Four categories emerged from the analysis, which represented how the characteristics of immigrant women (Tell me how you are and I will tell you how to access), the attitude of the administrative and health staff ("When they are already taken care of"), the functioning of the health system (Inflexible, passive and needs-responsive health system), and health policies ("If you do not meet the requirements, you do not go in. The law is the law") influence access to health services of immigrant women. This study shows that there are a considerable number of barriers and few facilitators to the access by immigrant women to public health and sexual and reproductive health services in the Basque Country. The alternative health centres were presented as favouring the improvement of the health of the immigrant population and in their access. Copyright © 2017. Publicado por Elsevier España, S.L.U.
Wouterse, Bram; Huisman, Martijn; Meijboom, Bert R; Deeg, Dorly J H; Polder, Johan J
The effect of population aging on future health services use depends on the relationship between longevity gains and health. Whether further gains in life expectancy will be paired by improvements in health is uncertain. We therefore analyze the effect of population ageing on health services use under different health scenarios. We focus on the possibly diverging trends between different dimensions of health and their effect on health services use. Using longitudinal data on health and health services use, a latent Markov model has been estimated that includes different dimensions of health. We use this model to perform a simulation study and analyze the health dynamics that drive the effect of population aging. We simulate three health scenarios on the relationship between longevity and health (expansion of morbidity, compression of morbidity, and the dynamic equilibrium scenario). We use the scenarios to predict costs of health services use in the Netherlands between 2010 and 2050. Hospital use is predicted to decline after 2040, whereas long-term care will continue to rise up to 2050. Considerable differences in expenditure growth rates between scenarios with the same life expectancy but different trends in health are found. Compression of morbidity generally leads to the lowest growth. The effect of additional life expectancy gains within the same health scenario is relatively small for hospital care, but considerable for long-term care. By comparing different health scenarios resulting in the same life expectancy, we show that health improvements do contain costs when they decrease morbidity but not mortality. This suggests that investing in healthy aging can contribute to containing health expenditure growth.
Fariña, Diana; Rodríguez, Susana; Erpen, Norma
Argentine's neonatal mortality rate represents 60% of infant mortality; implementation of strategies that improve quality of neonatal care is a priority. Traditionally, the training of health professionals is accomplished through scientific meetings with little capacity for exchange; in-service training incorporates the identification and resolution of problems joining the daily patient care. To describe the in-service training program (ISTP), to identify its strengths as strategies for quality of care improvement and to evaluate its impact in four different Argentine maternity services. health services research intervention study, not controlled, before and after evaluation. This program is a multidimensional strategy consisting in regular visits by a neonatologist and a nurse to health professionals in their own settings. Program stages: 1) service assessment and design of the action plan according to the priorities, 2) implementation, 3) consolidation and analysis through indicators. Greatest impact was found over equipment and human resources improvement; we also observed an improvement in management related aspects like organization and coordination of care. The reduction of preventable deaths varied between centers. The in-service training program is an effective tool with measurable quantitative and qualitative results with positive impact on the quality of care. Conjunctural factors and political will were determinant on the program's success, as it is commonly seen in the implementation of strategies that involve changing established structures.
Broad, Kathleen L; Sandhu, Vijay K; Sunderji, Nadiya; Charach, Alice
Adolescence and young adulthood is a vulnerable time during which young people experience many development milestones, as well as an increased incidence of mental illness. During this time, youth also transition between Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). This transition puts many youth at risk of disengagement from service use; however, our understanding of this transition from the perspective of youth is limited. This systematic review aims to provide a more comprehensive understanding of youth experiences of transition from CAMHS to AMHS, through a qualitative thematic synthesis of the extant literature in this area. Published and unpublished literature was searched using keywords targeting three subject areas: Transition, Age and Mental Health. Studies were included if they qualitatively explored the perceptions and experiences of youth who received mental health services in both CAMHS and AMHS. There were no limitations on diagnosis or age of youth. Studies examining youth with chronic physical health conditions were excluded. Eighteen studies, representing 14 datasets and the experiences of 253 unique service-users were included. Youth experiences of moving from CAMHS and AMHS are influenced by concurrent life transitions and their individual preferences regarding autonomy and independence. Youth identified preparation, flexible transition timing, individualized transition plans, and informational continuity as positive factors during transition. Youth also valued joint working and relational continuity between CAMHS and AMHS. Youth experience a dramatic culture shift between CAMHS and AMHS, which can be mitigated by individualized and flexible approaches to transition. Youth have valuable perspectives to guide the intelligent design of mental health services and their perspectives should be used to inform tools to evaluate and incorporate youth perspectives into transitional service improvement
Baker, Dian L; Hebbeler, Kathleen; Davis-Alldritt, Linda; Anderson, Lori S; Knauer, Heather
Children with special health care needs (CSHCN) are at risk for school failure when their health needs are not met. Current studies have identified a strong connection between school success and health. This study attempted to determine (a) how schools meet the direct service health needs of children and (b) who provides those services. The study used the following two methods: (a) analysis of administrative data from the California Basic Educational Data System and (b) a cross-sectional online survey of 446 practicing California school nurses. Only 43% of California's school districts employ school nurses. Unlicensed school personnel with a variety of unregulated training provide school health services. There is a lack of identification of CSHCN, and communication barriers impair the ability to deliver care. Study results indicate that California invests minimally in school health services. © The Author(s) 2015.
Full Text Available Background Decentralisation aims to bring services closer to the community and has been advocated in the health sector to improve quality, access and equity, and to empower local agencies, increase innovation and efficiency and bring healthcare and decision-making as close as possible to where people live and work. Fiji has attempted two approaches to decentralisation. The current approach reflects a model of deconcentration of outpatient services from the tertiary level hospital to the peripheral health centres in the Suva subdivision. Methods Using a modified decision space approach developed by Bossert, this study measures decision space created in five broad categories (finance, service organisation, human resources, access rules, and governance rules within the decentralised services. Results Fiji’s centrally managed historical-based allocation of financial resources and management of human resources resulted in no decision space for decentralised agents. Narrow decision space was created in the service organisation category where, with limited decision space created over access rules, Fiji has seen greater usage of its decentralised health centres. There remains limited decision space in governance. Conclusion The current wave of decentralisation reveals that, whilst the workload has shifted from the tertiary hospital to the peripheral health centres, it has been accompanied by limited transfer of administrative authority, suggesting that Fiji’s deconcentration reflects the transfer of workload only with decision-making in the five functional areas remaining largely centralised. As such, the benefits of decentralisation for users and providers are likely to be limited.
Mohammed, Jalal; North, Nicola; Ashton, Toni
Decentralisation aims to bring services closer to the community and has been advocated in the health sector to improve quality, access and equity, and to empower local agencies, increase innovation and efficiency and bring healthcare and decision-making as close as possible to where people live and work. Fiji has attempted two approaches to decentralisation. The current approach reflects a model of deconcentration of outpatient services from the tertiary level hospital to the peripheral health centres in the Suva subdivision. Using a modified decision space approach developed by Bossert, this study measures decision space created in five broad categories (finance, service organisation, human resources, access rules, and governance rules) within the decentralised services. Fiji's centrally managed historical-based allocation of financial resources and management of human resources resulted in no decision space for decentralised agents. Narrow decision space was created in the service organisation category where, with limited decision space created over access rules, Fiji has seen greater usage of its decentralised health centres. There remains limited decision space in governance. The current wave of decentralisation reveals that, whilst the workload has shifted from the tertiary hospital to the peripheral health centres, it has been accompanied by limited transfer of administrative authority, suggesting that Fiji's deconcentration reflects the transfer of workload only with decision-making in the five functional areas remaining largely centralised. As such, the benefits of decentralisation for users and providers are likely to be limited. © 2016 by Kerman University of Medical Sciences.
Buchwald, Cheryl A.
The U.S. Geological Survey (USGS) Wisconsin Water Science Center is responsible for presenting data collected or estimated for water withdrawals and diversions every 5 years to the National Water-Use Information Program (NWUIP). This program serves many purposes such as quantifying how much, where, and for what purpose water is used; tracking and documenting water-use trends and changes; and providing these data to other agencies to support hydrologic projects. In 2005, data at both the county and subbasin levels were compiled into the USGS national water-use database system; these data are published in a statewide summary report and a national circular. This publication, Water Use in Wisconsin, 2005, presents the water-use estimates for 2005; this publication also describes how these water-use data were determined (including assumptions used), limitations of using these data, and trends in water-use data presented to the NWUIP. Estimates of water use in Wisconsin indicate that about 8,608 million gallons per day (Mgal/d) were withdrawn during 2005. Of this amount, about 7,622 Mgal/d (89 percent) were from surface-water sources and about 986 Mgal/d (11 percent) were from ground-water sources. Surface water used for cooling at thermoelectric-power plants constituted the largest portion of daily use at 6,898 Mgal/d. Water provided by public-supply water utilities is the second largest use of water and totaled 552 Mgal/d. Public supply served approximately 71 percent of the estimated 2005 Wisconsin population of 5.54 million people; two counties - Milwaukee and Dane - accounted for more than one-third of the public-supply withdrawal. Industrial and irrigation were the next major water uses at 471 and 402 Mgal/d, respectively. Non-irrigational agricultural (livestock and aquaculture) accounted for approximately 155 Mgal/d and is similar to the combined withdrawal for the remaining water-use categories of domestic, commercial, and mining (131 Mgal/d). Data on water use
Dehlendorf, Christine; Weitz, Tracy
Minority and low SES women have persistently and disproportionately higher rates of abortion than White and higher SES women, yet have limited access to these services. The response of governmental health agencies to these disparities in abortion has focused solely on decreasing the number of abortions, without attention to access to needed health services. This commentary seeks to build an understanding of how access to abortion care is currently impeded for low-income women and women of color and calls for an end to that omission.
Jaruseviciene, L.; Valius, L.; Lazarus, J.V.
collaboration with mental health teams were a lack of GPs'confidence in their communication skills and ability to diagnose the most frequent mental disorders, prompt referral to mental health team specialists, low estimation of the prevalence of non-managed mental disorders, and location of mental health team......Background. General practitioners (GPs) often become the first point of care for mental health issues. Improved collaboration between GPs and mental health teams can make a GP's mental health services more efficient. Objective. The aim of this study was to assess the collaboration between GPs...... and mental health team members and determine predictors for better collaboration. Methods. In this cross-sectional study, a 41- item questionnaire was distributed to a random sample of 797 Lithuanian GPs. The purpose of this questionnaire was to obtain knowledge about current practices of GPs in providing...
Jaruseviciene, L.; Valius, L.; Lazarus, J.V.
Background. General practitioners (GPs) often become the first point of care for mental health issues. Improved collaboration between GPs and mental health teams can make a GP's mental health services more efficient. Objective. The aim of this study was to assess the collaboration between GPs...... and mental health team members and determine predictors for better collaboration. Methods. In this cross-sectional study, a 41- item questionnaire was distributed to a random sample of 797 Lithuanian GPs. The purpose of this questionnaire was to obtain knowledge about current practices of GPs in providing...... mental health care for patients as well as GPs' collaboration with metal health teams. Results. The response rate was 52.2%. GPs collaborated closest with psychiatrists: 30.7% of them reported that they discuss the mental health care of their patients with psychiatrists. Predictors of greater...
Patwardhan, Anjali; Patwardhan, Prakash
In the recent climate of consumerism and consumer focused care, health and social care needs to be more responsive than ever before. Consumer needs and preferences can be elicited with accepted validity and reliability only by strict methodological control, customerisation of the questionnaire and skilled interpretation. To construct, conduct, interpret and implement improved service provision, requires a trained work force and infrastructure. This article aims to appraise various aspects of consumer surveys and to assess their value as effective service improvement tools. The customer is the sole reason organisations exist. Consumer surveys are used worldwide as service and quality of care improvement tools by all types of service providers including health service providers. The article critically appraises the value of consumer surveys as service improvement tools in health services tool and its future applications. No one type of survey is the best or ideal. The key is the selection of the correct survey methodology, unique and customised for the particular type/aspect of care being evaluated. The method used should reflect the importance of the information required. Methodological rigor is essential for the effectiveness of consumer surveys as service improvement tools. Unfortunately so far there is no universal consensus on superiority of one particular methodology over another or any benefit of one specific methodology in a given situation. More training and some dedicated resource allocation is required to develop consumer surveys. More research is needed to develop specific survey methodology and evaluation techniques for improved validity and reliability of the surveys as service improvement tools. Measurement of consumer preferences/priorities, evaluation of services and key performance scores, is not easy. Consumer surveys seem impressive tools as they provide the customer a voice for change or modification. However, from a scientific point
Affleck, William; Carmichael, Victoria; Whitley, Rob
Numerous scholars have stated that there is a silent crisis in men's mental health. In this article, we aim to provide an overview of core issues in the field of men's mental health, including a discussion of key social determinants as well as implications for mental health services. Firstly, we review the basic epidemiology of mental disorders with a high incidence and prevalence in men, including suicide and substance use disorder. Secondly, we examine controversies around the low reported rates of depression in men, discussing possible measurement and reporting biases. Thirdly, we explore common risk factors and social determinants that may explain higher rates of certain mental health outcomes in men. This includes a discussion of 1) occupational and employment issues; 2) family issues and divorce; 3) adverse childhood experience; and 4) other life transitions, notably parenthood. Fourthly, we document and analyze low rates of mental health service utilization in men. This includes a consideration of the role of dominant notions of masculinity (such as stubbornness and self-reliance) in deterring service utilization. Fifthly, we note that some discourse on the role of masculinity contains much "victim blaming," often adopting a reproachful deficit-based model. We argue that this can deflect attention away from social determinants as well as issues within the mental health system, such as claims that it is "feminized" and unresponsive to men's needs. We conclude by calling for a multipronged public health-inspired approach to improve men's mental health, involving concerted action at the individual, health services, and societal levels.
Rr Dian Tristiana
Conclusion: Families whose members suffered from mental illness still experienced barriers in relation to mental health services even with universal health coverage. Improved mental health services are related to the health insurance coverage, affordability, availability of mental health services and stigma reduction in the health professionals and wide community.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Public Health... is September 1, 2011, to August 31, 2012. Authority: Section 330I(d)(2) of the Public Health Service... health care systems in California. FOR FURTHER INFORMATION CONTACT: Monica Cowan, Public Health Analyst...
to establish and verify the existing human health problems at the study area by focusing on respiratory tract related symptoms of .... the Selebi Phikwe area and the control site. (one each in sites two, four, five and six, two .... diseases, cardiac arrest, diabetes, heart disease, meningitis, pneumonia, tuberculosis, and stroke.
Haruna, Hussein; Mtoroki, Majaliwa; Gerendasy, Dan D; Detlefsen, Ellen G
The intention of the Government of Tanzania is to establish more health information resource canters in all health facilities. With this regard, health information science personnel are needed to provide adequate and accurate health information services. However, availability of these personnel remains to be a challenge because of their non-existence. To identify the current status and local impact of health sciences libraries and user perception of these libraries, as a prerequisite to the development of a competence-based curriculum for health information science training in Tanzania. A needs assessment was carried out using a convenience sample of local respondents, including librarians, trainers, academicians, students, health care providers, and patients and families, drawn from national, referral, regional, district hospitals, health training institutions, and universities from both government and nongovernment entities in Tanzania. A focus group approach was used to gather data from respondents. Results from this assessment revealed that health science libraries in Tanzania are faced with the challenges of insufficient infrastructure, old technology, limited facilities and furniture, inadequate and incompetent library staff, lack of health sciences librarians, outdated and insufficient resources, and low knowledge and use of information technologies by library clients. Most respondents would prefer to have both physical and electronic libraries, as well as librarians with specialized health information science skills, to cope with changing nature of the medical field. The findings obtained from this assessment are strong enough to guide the development of a curriculum and training strategy and an operational plan and training packages for health information professionals. The development of a training curriculum for health information science professionals will mean better health information service delivery for Tanzania. Copyright © 2016 Icahn School of
This article explores the relationship between the components of the services provided by complementary voluntary health insurance (CVHI), to which users ascribe different levels of importance. Research model that consists of four constructs (importance of quality service, additional coverage, price discounts of CVHI and insurance company reputation) and an indicator of the importance of insurance premium of CVHI was tested with structural equation modelling (SEM) on the sample of 300 Sloveni...
Service quality in health and recreational services represents a growing, yet currently understudied area in the service industry. Consequently, this study proposes an integrated model of health and fitness service quality and examines the relationship among service quality, satisfaction and loyalty. A thirty-nine item health ...
By 2035, the number of elderly residents in Wisconsin is expected to nearly double, and one in four drivers on Wisconsin roads will be elderly. According to national statistics, the elderly are more likely to be involved in crashes on a per-mile basi...
Major transformations in forms of governance of the liberal state have been wrought over the course of the last century, including the rise of neoliberalism and 'new public management.' Mental health too has witnessed change, with pharmacological treatment displacing residential care, a shift to community-based services, mainstreaming with general health care, and greater reliance on civil society institutions such as the family or markets. This article considers whether mental health law, and its court/tribunal 'gatekeepers' have kept pace with those changes. It argues that the focus of the liberal project needs to shift to measures which will better guarantee access to mental health services, and keep a more watchful eye on both 'hidden' coercion of people on community treatment orders, and passive neglect of human need.
Roese, Adriana; Gerhardt, Tatiana Engel
The organization of health services must respond to population demands resulting from complex social, individual and cultural factors. The objective of this study was to build the social-economic and demographic profile of the users to illustrate how to intermediate-complexity health services are used by mapping user flows in the southern region of the state of Rio Grande do Sul, Brazil. This was a descriptive and transversal study with 150 users. Statistic and spatial analyses were used. User flow analysis revealed dissonance between the Regionalization Master Health Plan and users' practice because the organization proposed by the State does not correspond to users' real needs of moving in the local space. An inevitable political engagement is evidenced on behalf of regionalization, and users' mobility and building therapeutic trajectories were considered as new challenges to be faced by public health.
Darbyshire, Philip; Muir-Cochrane, Eimear; Fereday, Jennifer; Jureidini, Jon; Drummond, Andrew
The present qualitative study describes and discusses the perspectives and experiences of young homeless people with mental health problems in relation to their interactions with health and social care services. Working in partnership with Streetlink, a supported accommodation assistance programme in Adelaide, Australia, the authors interviewed 10 homeless young people, aged from 16 to 24 years of age, who had experienced mental health problems. In-depth interviews elicited accounts of the best and worst of the participants' experiences of health and social care services. Access to services was not identified as being a significant problem in comparison with the participants' concerns regarding the quality of the services encountered. The central findings stress the importance of a respectful and supportive climate in relation to the qualities of service provision that the young people identified as valuable for their continuing treatment or consultation.
Doocy, Shannon; Lyles, Emily; Akhu-Zaheya, Laila; Burton, Ann; Burnham, Gilbert
The influx of Syrian refugees into Jordan presents an immense burden to the Jordanian health system. Changing lifestyles and aging populations are shifting the global disease burden towards increased non-infectious diseases including chronic conditions, co-morbidities, and injuries which are more complicated and costly to manage. The strain placed on health systems threatens the ability to ensure the health needs of both refugees and host country populations are adequately addressed. In light of the increasing challenges facing host governments and humanitarian actors to meet health needs of Syrian refugees and affected host communities, this study was undertaken to assess utilization of health services among Syrian refugees in non-camp settings. A survey of Syrian refugees in Jordan was undertaken in June 2014 to characterize health seeking behaviors and issues related to accessing care. A cluster design with probability proportional to size sampling was used to attain a nationally representative sample of 1550 non-camp Syrian refugee households. Differences in household characteristics by geographic region, facility type, and sector utilized were examined using chi-square and t-test methods. Care-seeking was high with 86.1 % of households reporting an adult sought medical care the last time it was needed. Approximately half (51.5 %) of services were sought from public sector facilities, 38.7 % in private facilities, and 9.8 % in charity/NGO facilities. Among adult care seekers, 87.4 % were prescribed medication during the most recent visit, 89.8 % of which obtained the medication. Overall, 51.8 % of households reported out-of-pocket expenditures for the consultation or medications at the most recent visit (mean US$39.9, median US$4.2). Despite high levels of care-seeking, cost was an important barrier to health service access for Syrian refugees in Jordan. The cessation of free access to health care since the time of the survey is likely to have worsened
Full Text Available Abstract Background India and the EU are currently negotiating a Trade and Investment Agreement which also covers services. This paper examines the opportunities for and constraints to India-EU relations in health services in the context of this agreement, focusing on the EU as a market for India's health services exports and collaboration. The paper provides an overview of key features of health services in the EU and India and their bearing on bilateral relations in this sector. Methods Twenty six semi-structured, in-person, and telephonic interviews were conducted in 2007-2008 in four Indian cities. The respondents included management and practitioners in a variety of healthcare establishments, health sector representatives in Indian industry associations, health sector officials in the Indian government, and official representatives of selected EU countries and the European Commission based in New Delhi. Secondary sources were used to supplement and corroborate these findings. Results The interviews revealed that India-EU relations in health services are currently very limited. However, several opportunity segments exist, namely: (i Telemedicine; (ii Clinical trials and research in India for EU-based pharmaceutical companies; (iii Medical transcriptions and back office support; (iv Medical value travel; and (v Collaborative ventures in medical education, research, training, staff deployment, and product development. However, various factors constrain India's exports to the EU. These include data protection regulations; recognition requirements; insurance portability restrictions; discriminatory conditions; and cultural, social, and perception-related barriers. The interviews also revealed several constraints in the Indian health care sector, including disparity in domestic standards and training, absence of clear guidelines and procedures, and inadequate infrastructure. Conclusions The paper concludes that although there are several
Background India and the EU are currently negotiating a Trade and Investment Agreement which also covers services. This paper examines the opportunities for and constraints to India-EU relations in health services in the context of this agreement, focusing on the EU as a market for India's health services exports and collaboration. The paper provides an overview of key features of health services in the EU and India and their bearing on bilateral relations in this sector. Methods Twenty six semi-structured, in-person, and telephonic interviews were conducted in 2007-2008 in four Indian cities. The respondents included management and practitioners in a variety of healthcare establishments, health sector representatives in Indian industry associations, health sector officials in the Indian government, and official representatives of selected EU countries and the European Commission based in New Delhi. Secondary sources were used to supplement and corroborate these findings. Results The interviews revealed that India-EU relations in health services are currently very limited. However, several opportunity segments exist, namely: (i) Telemedicine; (ii) Clinical trials and research in India for EU-based pharmaceutical companies; (iii) Medical transcriptions and back office support; (iv) Medical value travel; and (v) Collaborative ventures in medical education, research, training, staff deployment, and product development. However, various factors constrain India's exports to the EU. These include data protection regulations; recognition requirements; insurance portability restrictions; discriminatory conditions; and cultural, social, and perception-related barriers. The interviews also revealed several constraints in the Indian health care sector, including disparity in domestic standards and training, absence of clear guidelines and procedures, and inadequate infrastructure. Conclusions The paper concludes that although there are several promising areas for India
India and the EU are currently negotiating a Trade and Investment Agreement which also covers services. This paper examines the opportunities for and constraints to India-EU relations in health services in the context of this agreement, focusing on the EU as a market for India's health services exports and collaboration. The paper provides an overview of key features of health services in the EU and India and their bearing on bilateral relations in this sector. Twenty six semi-structured, in-person, and telephonic interviews were conducted in 2007-2008 in four Indian cities. The respondents included management and practitioners in a variety of healthcare establishments, health sector representatives in Indian industry associations, health sector officials in the Indian government, and official representatives of selected EU countries and the European Commission based in New Delhi. Secondary sources were used to supplement and corroborate these findings. The interviews revealed that India-EU relations in health services are currently very limited. However, several opportunity segments exist, namely: (i) Telemedicine; (ii) Clinical trials and research in India for EU-based pharmaceutical companies; (iii) Medical transcriptions and back office support; (iv) Medical value travel; and (v) Collaborative ventures in medical education, research, training, staff deployment, and product development. However, various factors constrain India's exports to the EU. These include data protection regulations; recognition requirements; insurance portability restrictions; discriminatory conditions; and cultural, social, and perception-related barriers. The interviews also revealed several constraints in the Indian health care sector, including disparity in domestic standards and training, absence of clear guidelines and procedures, and inadequate infrastructure. The paper concludes that although there are several promising areas for India-EU relations in health services, it will be
Gadkari, Abhijit S.; Mott, David A.; Kreling, David H.; Bonnarens, Joseph K.
Context: Higher prevalence of chronic diseases and reduced access to other health professionals in rural areas suggest that rural Medicare enrollees will benefit from pharmacist-provided drug therapy services (DTS). Purpose: The purpose of this study was to describe non-metropolitan community pharmacy sites in Wisconsin, the provision of DTS at…
Changes in patterns of delivery of mental health care over several decades are putting pressure on primary health and social care services to increase their involvement. Mental health policy in countries like the UK, Australia and New Zealand recognises the need for these services to make a greater contribution and calls for increased intersectoral collaboration. In Australia, most investment to date has focused on the development and integration of specialist mental health services and primary medical care, and evaluation research suggests some progress. Substantial inadequacies remain, however, in the comprehensiveness and continuity of care received by people affected by mental health problems, particularly in relation to social and psychosocial interventions. Very little research has examined the nature of the roles that non-medical primary health and social care services actually or potentially play in mental health care. Lack of information about these roles could have inhibited development of service improvement initiatives targeting these services. The present paper reports the results of an exploratory study that examined the mental health care roles of 41 diverse non-medical primary health and social care services in the state of Victoria, Australia. Data were collected in 2004 using a purposive sampling strategy. A novel method of surveying providers was employed whereby respondents within each agency worked as a group to complete a structured survey that collected quantitative and qualitative data simultaneously. This paper reports results of quantitative analyses including a tentative principal components analysis that examined the structure of roles. Non-medical primary health and social care services are currently performing a wide variety of mental health care roles and they aspire to increase their involvement in this work. However, these providers do not favour approaches involving selective targeting of clients with mental disorders.
Gwaikolo, Wilfred S; Kohrt, Brandon A; Cooper, Janice L
There are increasing efforts and attention focused on the delivery of mental health services in primary care in low resource settings (e.g., mental health Gap Action Programme, mhGAP). However, less attention is devoted to systematic approaches that identify and address barriers to the development and uptake of mental health services within primary care in low-resource settings. Our objective was to prepare for optimal uptake by identifying barriers in rural Liberia. The country's need for mental health services is compounded by a 14-year history of political violence and the largest Ebola virus disease outbreak in history. Both events have immediate and lasting mental health effects. A mixed-methods approach was employed, consisting of qualitative interviews with 22 key informants and six focus group discussions. Additional qualitative data as well as quantitative data were collected through semi-structured assessments of 19 rural primary care health facilities. Data were collected from March 2013 to March 2014. Potential barriers to development and uptake of mental health services included lack of mental health knowledge among primary health care staff; high workload for primary health care workers precluding addition of mental health responsibilities; lack of mental health drugs; poor physical infrastructure of health facilities including lack of space for confidential consultation; poor communication support including lack of electricity and mobile phone networks that prevent referrals and phone consultation with supervisors; absence of transportation for patients to facilitate referrals; negative attitudes and stigma towards people with severe mental disorders and their family members; and stigma against mental health workers. To develop and facilitate effective primary care mental health services in a post-conflict, low resource setting will require (1) addressing the knowledge and clinical skills gap in the primary care workforce; (2) improving physical
Rosano, Aldo; Dauvrin, Marie; Buttigieg, Sandra C; Ronda, Elena; Tafforeau, Jean; Dias, Sonia
Preventive health services (PHSs) form part of primary healthcare with the aim of screening to prevent disease. Migrants show significant differences in lifestyle, health beliefs and risk factors compared with the native populations. This can have a significant impact on migrants' access to health systems and participation in prevention programmes. Even in countries with widely accessible healthcare systems, migrants' access to PHSs may be difficult. The aim of the study was to compare access to preventive health services between migrants and native populations in five European Union (EU) countries. Information from Health Interview Surveys of Belgium, Italy, Malta, Portugal and Spain were used to analyse access to mammography, Pap smear tests, colorectal cancer screening and flu vaccination among migrants. The comparative risk of not accessing PHSs was calculated using a mixed-effects multilevel model, adjusting for potential confounding factors (sex, education and the presence of disability). Migrant status was defined according to citizenship, with a distinction made between EU and non-EU countries. Migrants, in particular those from non-EU countries, were found to have poorer access to PHSs. The overall risk of not reporting a screening test or a flu vaccination ranged from a minimum of 1.8 times (colorectal cancer screening), to a high of 4.4 times (flu vaccination) for migrants. The comparison among the five EU countries included in the study showed similarities, with particularly limited access recorded in Italy and in Belgium for non-EU migrants. The findings of this study are in accordance with evidence from the scientific literature. Poor organization of health services, in Italy, and lack of targeted health policies in Belgium may explain these findings. PHSs should be responsive to patient diversity, probably more so than other health services. There is a need for diversity-oriented, migrant-sensitive prevention. Policies oriented to removing
Wright, Nat M J; Hearty, Philippa; Harris, Linda; Burnell, Andrew; Pender, Sue; Oxnard, Chris; Charlesworth, George
Health-based social enterprises are spun out of the NHS, yet continue to provide NHS-funded services. With the spin-out, however, formal processes for research governance were lost. Patients have a right to take part in research, regardless of where they access healthcare. This paper discusses the barriers to social enterprises undertaking applied health research and makes recommendations to address the need for equivalence of governance processes with NHS trusts.
Wright, Nat M. J.; Hearty, Philippa; Harris, Linda; Burnell, Andrew; Pender, Sue; Oxnard, Chris; Charlesworth, George
Health-based social enterprises are spun out of the NHS, yet continue to provide NHS-funded services. With the spin-out, however, formal processes for research governance were lost. Patients have a right to take part in research, regardless of where they access healthcare. This paper discusses the barriers to social enterprises undertaking applied health research and makes recommendations to address the need for equivalence of governance processes with NHS trusts.
Karthikeyan, N; Sukanesh, R
A hospital is a health care organization providing patient treatment by expert physicians, surgeons and equipments. A report from a health care accreditation group says that miscommunication between patients and health care providers is the reason for the gap in providing emergency medical care to people in need. In developing countries, illiteracy is the major key root for deaths resulting from uncertain diseases constituting a serious public health problem. Mentally affected, differently abled and unconscious patients can't communicate about their medical history to the medical practitioners. Also, Medical practitioners can't edit or view DICOM images instantly. Our aim is to provide palm vein pattern recognition based medical record retrieval system, using cloud computing for the above mentioned people. Distributed computing technology is coming in the new forms as Grid computing and Cloud computing. These new forms are assured to bring Information Technology (IT) as a service. In this paper, we have described how these new forms of distributed computing will be helpful for modern health care industries. Cloud Computing is germinating its benefit to industrial sectors especially in medical scenarios. In Cloud Computing, IT-related capabilities and resources are provided as services, via the distributed computing on-demand. This paper is concerned with sprouting software as a service (SaaS) by means of Cloud computing with an aim to bring emergency health care sector in an umbrella with physical secured patient records. In framing the emergency healthcare treatment, the crucial thing considered necessary to decide about patients is their previous health conduct records. Thus a ubiquitous access to appropriate records is essential. Palm vein pattern recognition promises a secured patient record access. Likewise our paper reveals an efficient means to view, edit or transfer the DICOM images instantly which was a challenging task for medical practitioners in the
Studies have described the opportunities and challenges of applying service design techniques to health services, but empirical evidence on how such techniques can be implemented in the context of eHealth services is still lacking. This paper presents how a service design thinking approach can be applied for specification of an existing and new eHealth service by supporting evaluation of the current service and facilitating suggestions for the future service. We propose Service Journey Modelling Language and Service Journey Cards to engage stakeholders in the design of eHealth services.
Benko, Laura B
While other health systems have been steadily getting rid of the HMOs they launched in the 1980s and '90s, UW Health is buying one back. "We decided it was better for us to own the HMO independently than to have it operate within the WellPoint-Anthem framework," says Jane Barnett, left.
Costrell, Robert M.
Rising health insurance costs have been a source of fiscal distress for school districts. In this paper, I closely examine data from the National Compensation Survey (NCS) of the Bureau of Labor Statistics (BLS) to address a few basic questions: (1) Are district costs for teachers' health insurance higher, on average, than employer costs for…
... Animal and Plant Health Inspection Service Notice of Establishment of an Animal and Plant Health Inspection Service Stakeholder Registry AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION..., Acting Administrator, Animal and Plant Health Inspection Service. BILLING CODE 3410-34-P ...
... FEDERAL BUILDINGS AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.304 Type of occupational health services. The type of occupational health services made available to occupying agencies will be as... to limit the cost of an occupational health services program, the provision of inservice examinations...
... HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Mental Health... of meeting agenda, date change, and participant link change for the Substance Abuse and Mental Health Services Administration's (SAMHSA), Center for Mental Health Services National Advisory Council (CMHS NAC...
... 42 Public Health 1 2010-10-01 2010-10-01 false Establishment of contract health service delivery... Services § 136.22 Establishment of contract health service delivery areas. (a) In accordance with the..., contract health service delivery areas are established as follows: (1) The State of Alaska; (2) The State...
Blashki, Grant; Armstrong, Greg; Berry, Helen Louise; Weaver, Haylee J; Hanna, Elizabeth G; Bi, Peng; Harley, David; Spickett, Jeffery Thomas
Although the implications of climate change for public health continue to be elucidated, we still require much work to guide the development of a comprehensive strategy to underpin the adaptation of the health system. Adaptation will be an evolving process as impacts emerge. The authors aim is to focus on the responses of the Australian health system to health risks from climate change, and in particular how best to prepare health services for predicted health risks from heat waves, bushfires, infectious diseases, diminished air quality, and the mental health impacts of climate change. In addition, the authors aim to provide some general principles for health system adaptation to climate change that may be applicable beyond the Australian setting. They present some guiding principles for preparing health systems and also overview some specific preparatory activities in relation to personnel, infrastructure, and coordination. Increases in extreme weather-related events superimposed on health effects arising from a gradually changing climate will place additional burdens on the health system and challenge existing capacity. Key characteristics of a climate change-prepared health system are that it should be flexible, strategically allocated, and robust. Long-term planning will also require close collaboration with the nonhealth sectors as part of a nationwide adaptive response.
Mohammadi, Ali; Mohammadi, Jamshid
To assess quality of health services in Zanjan health centres based on clients' expectations and perceptions. The study was conducted by using service quality (SERVQUAL) scale on a sample of 300 females, clients of health care centres in the district of Zanjan, selected by cluster sampling. The results indicated that there were negative quality gaps at five SERVQUAL dimensions. The most and least negative quality gap mean scores were in reliability dimension (-2.1) and tangible (-1.13) respectively. There was statistically significant difference between clients' perceptions and expectations mean scores at all of the five service quality dimensions (P<0.001). The negative quality gap level in health service dimensions can be used as a guideline for redistribution of resources and managerial attempts to reduce quality gaps and improvement of health care quality.
Kanchanachitra, Churnrurtai; Lindelow, Magnus; Johnston, Timothy; Hanvoravongchai, Piya; Lorenzo, Fely Marilyn; Huong, Nguyen Lan; Wilopo, Siswanto Agus; dela Rosa, Jennifer Frances
In this paper, we address the issues of shortage and maldistribution of health personnel in southeast Asia in the context of the international trade in health services. Although there is no shortage of health workers in the region overall, when analysed separately, five low-income countries have some deficit. All countries in southeast Asia face problems of maldistribution of health workers, and rural areas are often understaffed. Despite a high capacity for medical and nursing training in both public and private facilities, there is weak coordination between production of health workers and capacity for employment. Regional experiences and policy responses to address these challenges can be used to inform future policy in the region and elsewhere. A distinctive feature of southeast Asia is its engagement in international trade in health services. Singapore and Malaysia import health workers to meet domestic demand and to provide services to international patients. Thailand attracts many foreign patients for health services. This situation has resulted in the so-called brain drain of highly specialised staff from public medical schools to the private hospitals. The Philippines and Indonesia are the main exporters of doctors and nurses in the region. Agreements about mutual recognition of professional qualifications for three groups of health workers under the Association of Southeast Asian Nations Framework Agreement on Services could result in increased movement within the region in the future. To ensure that vital human resources for health are available to meet the needs of the populations that they serve, migration management and retention strategies need to be integrated into ongoing efforts to strengthen health systems in southeast Asia. There is also a need for improved dialogue between the health and trade sectors on how to balance economic opportunities associated with trade in health services with domestic health needs and equity issues. Copyright © 2011
Brey, Rebecca A.; Clark, Susan E.; Wantz, Molly S.
The second National Health Education Standard states the importance of student demonstration of the ability to access valid health information and services. The teaching technique presented in this article provides an opportunity for children and adolescents to develop their health literacy and advocacy skills by contributing to a class resource…
Today, a substantial reorientation of the Public Health services in the Federal Republic of Germany is broadly seen necessary. Patterns of functional and organisational restructuring of Public Health services on the regional and the communal level are closely linked with concepts of prevention and health promotion. Hence, a number of agencies have already adopted new tasks and functions like comprehensive and transorganizational planning, coordination and evaluation as well as the establishment of new reporting systems. Presently, the transformation process from the bureaucratic mode of administering matters of health to a new Public Health orientation receives new impacts from the international "New Public Management" movement. Comparatively late, with the beginning of the 1990s, a growing number of German municipalities has introduced new concepts of administration. Local government administrations, of which the Public Health services are a part, follow the model of modern service organizations producing services in a more efficient, professionalized and consumer-oriented way. Specific elements of economising modernisation programmes like re-distribution of tasks, de-centralisation, extension of managerial capacities, setting of stimulating working conditions that provide employees with greater independence of action as well as career opportunities, are at the same time prerequisites for innovative strategies of health protection and coordination policies of Public Health services.
Cappelli, M; Esplen, M J; Wilson, B J; Dorval, M; Bottorff, J L; Ly, M; Carroll, J C; Allanson, J; Humphreys, E; Rayson, D
The purpose of this study was to examine the mental health needs of individuals at risk for adult onset hereditary disorder (AOHD) from the perspective of their genetic service providers, as it is unknown to what extent psychosocial services are required and being met. A mail-out survey was sent to 281 providers on the membership lists of the Canadian Association of Genetic Counsellors and the Canadian College of Medical Geneticists. The survey assessed psychosocial issues that were most commonly observed by geneticists, genetic counsellors (GCs), and nurses as well as availability and types of psychosocial services offered. Of the 129 respondents, half of genetic service providers reported observing signs of depression and anxiety, while 44% noted patients' concerns regarding relationships with family and friends. In terms of providing counselling to patients, as the level of psychological risk increased, confidence in dealing with these issues decreased. In addition, significantly more GCs reported that further training in psychosocial issues would be most beneficial to them if resources were available. As a feature of patient care, it is recommended that gene-based predictive testing include an integrative model of psychosocial services as well as training for genetic service providers in specific areas of AOHD mental health.
In 1997 the Forensic Mental Health Service (FMHS) in the. Western Cape had a total of 205 state patients in its database, most of whom were inpatients at Valkenberg and Lenteguer. Hospitals. Currently the database has just over 800 state patients. The number of state patients in the Western Cape has more than.
South Sudan Medical Journal. EDITORIAL. Conflict devastates health service delivery in. South Sudan ... Independence in July 2011 saw a huge improvement in healthcare delivery throughout the country. The opening of roads improved access to ... shortages of food and drugs. The trauma of war can also have devastating ...
Objectives: Provision of skilled health care during pregnancy, childbirth and the early postpartum period is an effective strategy to reduce maternal mortality. This study was done to determine and compare the utilization of antenatal and delivery services in an urban and rural area of Lagos State. Methods: A community ...
Barrêto, Anne Jaquelyne Roque; de Sá, Lenilde Duarte; Nogueira, Jordana de Almeida; Palha, Pedro Fredemir; Pinheiro, Patrícia Geórgia de Oliveira Diniz; de Farias, Nilma Maria Porto; Rodrigues, Débora Cezar de Souza; Villa, Tereza Cristina Scatena
The scope of this study was to analyze the discourse of managers regarding the relationship between the organization of the health services and tuberculosis care management in a city in the metropolitan region of João Pessoa, State of Pernambuco. Using qualitative research in the analytical field of the French line of Discourse Analysis, 16 health workers who worked as members of the management teams took part in the study. The transcribed testimonials were organized using Atlas.ti version 6.0 software. After detailed reading of the empirical material, an attempt was made to identify the paraphrasic, polyssemic and metaphoric processes in the discourses, which enabled identification of the following discourse formation: Organization of the health services and the relation with TB care management: theory and practice. In the discourse of the managers the fragmentation of the actions of control of tuberculosis, the lack of articulation between the services and sectors, the compliance of the specific activities for TB, as well as the lack of strategic planning for management of care of the disease are clearly revealed. In this respect, for the organization of the health services to be effective, it is necessary that tuberculosis be considered a priority and acknowledged as a social problem in the management agenda.
Bivariate analysis and logistic regression were conducted and a significance level of 5% was considered for interpretation. ... episode (OR=28.3), perceived transport cost (OR=3.6), perceived treatment cost (OR=0.15) and distance to the nearest health center or hospital ... delivery services (10). Lack of money may lead to.
Qureshi, Muhammad Imran; Rasli, Amran Md; Awan, Usama; Ma, Jian; Ali, Ghulam; Faridullah; Alam, Arif; Sajjad, Faiza; Zaman, Khalid
The objective of the study is to establish the link between air pollution, fossil fuel energy consumption, industrialization, alternative and nuclear energy, combustible renewable and wastes, urbanization, and resulting impact on health services in Malaysia. The study employed two-stage least square regression technique on the time series data from 1975 to 2012 to possibly minimize the problem of endogeniety in the health services model. The results in general show that air pollution and environmental indicators act as a strong contributor to influence Malaysian health services. Urbanization and nuclear energy consumption both significantly increases the life expectancy in Malaysia, while fertility rate decreases along with the increasing urbanization in a country. Fossil fuel energy consumption and industrialization both have an indirect relationship with the infant mortality rate, whereas, carbon dioxide emissions have a direct relationship with the sanitation facility in a country. The results conclude that balancing the air pollution, environment, and health services needs strong policy vistas on the end of the government officials.
Reinstitutionalization by stealth: The Forensic Mental Health Service is the new chronic system. S Kaliski. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/ajpsy.v16i1.2 · AJOL African Journals Online. HOW TO ...
A descriptive cross-sectional study was carried out in the Lagos Zone of the largest and oldest indigenous oil and gas company in Nigeria. The purpose was to compare the occupational health facilities and services in the Upstream and Downstream operations of the industry. Data was collected by key informant interviews ...
Results and conclusion. Social adjustment, community behaviour and psychiatric functioning were within reasonable limits compared with those reported for discharged patients in international studies. Functioning was found to be poor in a small minority. Patients expressed their satisfaction with the mental health service, ...
The history of the development of mental health services in Africa falls into four phases, firstly the pre-colonial phase, with care being under the traditional and spiritual healers, then the rise of asylums for mainly custodial confinement, followed by modern large asylum-like mental hospitals during and soon after the colo-.
The study investigated the effect of environmental health services on students' academic performance in secondary schools in Brass Local Government Area of Bayelsa State. The study adopted the descriptive survey design. The sample for the study comprised a total of 245 students and 59 teachers, amounting to 304 ...
Pointer, D D
One of six different strategies must be selected for a health service offering to provide consumers with distinctive value and achieve sustainable competitive advantage in a market or market segment. Decisions must be made regarding objectives sought, market segmentation, market scope, and the customer-value proposition that will be pursued.
Vergez-Larrouget, Claude; Roberton, Delphine; Schneider, Cindy; Reggad, Farid; Charrot, François; Cueff, Serge
The operational reserve is an essential component of the army health service thanks to the trained and experienced healthcare professionals. From a civilian background or with prior active duty, their technical and military skills enable them to provide medical support for all types of missions, both within France and abroad.
Nissen, Nina Konstantin; Madsen, Mette; Olsen Zwisler, Ann-Dorthe
systematically reviewed to clarify what the health services do for relatives of heart patients and to assess the effects of interventions. We searched Medline, EMBASE, PsycINFO, CINAHL database, CSA and the Cochrane Library from January 2000 to March 2006. RESULTS: Only six scientific articles reported...
in health service structures in Khayelitsha. There are many obstacles ... tem. It comprises first and foremost a well-defined population, living within a clearly delineated admini- strative and geographical area, whether urban or rural. It includes all ... tem and was intended as a solution to the housing needs of the blacks of the ...
The paper is aimed at examining the poverty profile of Nigeria and its consequences on access to health care services and human capital development in the country. It is a startling paradox that about two – thirds of Nigerians are poor despite living in a country with vast potential wealth. Apart from looking at the theoretical ...
Werff, Albert; Hirsch, Gary; Barnard, Keith
The Advanced Research Institute on "Health Services Systems" was held under the auspices of the NATO Special Programme Panel on Systems Science as a part of the NATO Science Committee's continuous effort to promote the advancement of science through international cooperation. A special word is said in this respect supra by Pro fessor Checkland, Chairman of the Systems Science Panel. The Advanced Research Institute (ARI) was organized for the purpose of bringing together senior scientists to seek a consensus on the assessment of the present state of knowledge on the specific topic of "health services systems" and to present views and recom mendations for future health services research directions, which should be of value to both the scientific community and the people in charge of reorienting health services. The conference was structured so as to permit the assembly of a variety of complementary viewpoints through intensive group discussions to be the basis of this final report. Invitees were selected fr...
The literature on public service delivery alternatives has to date been highly localized, sector specific and lacking in methodological consistency. This project seeks to analyze health, water and electricity delivery models in Africa, Asia and Latin America in order to identify and document successful alternatives to ...
de Vries, J.; Huijsman, R.
Purpose - This paper seeks to concentrate on the question whether any parallels can be found between the industrial sector and health care services with respect to the developments that have taken place in the area of Supply Chain Management. Starting from an analysis of existing literature, it is
Mental Health Services in South Africa: Taking stock. ... African Journal of Psychiatry ... At primary care level key challenges include- training and supervision of staff in the detection and management of common mental disorders, and the development of community-based psychosocial rehabilitation programmes for people ...
AJRH Managing Editor
Abstract. Youth report embarrassment, cost, and poor access as barriers to sexual and reproductive health (SRH) services. ..... Table 4: Percent of Respondents Reporting Perceived Barriers to HIV Testing, Abortion, and Contraception by. Gender, Age, Community and School Status. Perceived. Barrier. Boys Girls 11-16 yrs.
This paper attempted to identify whether access to reproductive health services partly explains use of modern contraception in Malawi. Recent changes in Malawi\\'s population policy have brought the state\\'s population ambitions into alignment with the consensus reached at the International Conference on Population and ...
In the wake of Nigeria's recent legislation against the prevalent corrupt and unhealthy practices among her citizenry, it has become important to examine the mental health status of the various social services couriers who are indeed the vendors of the new orientation. This paper therefore is a report of the level of ...
Challenges of monitoring reproductive health services: a case study of antenatal clinics in Kinondoni municipality, Dar Es Salaam. ... was descriptive cross sectional employing both qualitative and quantitative methods. The sample population included nurse-midwives who manage ANC clinics in Kinondoni Municipality.