Science.gov

Sample records for federal health initiative

  1. The federal health record gateway.

    PubMed

    Porter, Dennis

    2010-01-01

    The federal government can make federally held health data available to every American through a single, secure, recurring instance based portal on the emerging Nationwide Health Information Network (NHIN). The Federal Health Record Gateway (FHR Gateway) supports the President's initiatives for patient-centered health by enhancing transparency of government-held clinical and health claims data. PMID:20397336

  2. A Personal Perspective on the Initial Federal Health-Based Regulation to Remove Lead from Gasoline

    PubMed Central

    Bridbord, Kenneth; Hanson, David

    2009-01-01

    Objective This article describes the personal experience and perspective of the authors, who had primary responsibility for drafting the initial health-based regulation limiting lead content of gasoline during the early 1970s while employed by the U.S. Environmental Protection Agency (EPA). Data source Information used by the U.S. EPA in developing the initial health-based regulation limiting lead content of gasoline in December 1973 and studies documenting the impact of that and subsequent actions. Data extraction Among the lessons learned from this experience is the importance of having input from independent scientists to the regulatory decision-making process. This also demonstrates the critical role of independent peer-reviewed research, such as that supported by the National Institutes of Health, as well as research conducted by scientists from the Centers for Disease Control and Prevention, in delineating the consequences of lead exposure in the population. Data synthesis Removal of lead from gasoline in the United States has been described as one of the great public health achievements of the 20th century, but it almost did not happen. The experience of the authors in developing this regulation may be helpful to others involved in developing health-based regulatory policy in the future. Conclusion The initial U.S. EPA health-based regulation to remove lead from gasoline is clearly an example where science successfully affected public policy. The leadership of the U.S. EPA at that time deserves much credit for establishing an atmosphere in which this was possible. PMID:19672397

  3. Health Care Reform and the Federal Transformation Initiatives: Capitalizing on the Potential of Advanced Practice Psychiatric Nurses

    PubMed Central

    Hanrahan, Nancy P.; Delaney, Kathleen; Merwin, Elizabeth

    2012-01-01

    In the last decade the US federal government proposed a transformation vision of mental health service delivery; patient-centered, evidence-based and recovery oriented treatment models. Health care reform brings additional expectations for innovation in mental/substance use service delivery, particularly the idea of creating systems where physical health, mental health and substance use treatment is fully integrated. Psychiatric nurses, as one of the four core US mental health professions, have the potential to play a significant role in the both the transformation initiative and health care reform vision. However, psychiatric nurses, particularly advanced practice psychiatric nurses, are an untapped resource due in part to significant state regulatory barriers that limit their scope of practice in many states. The purpose of this paper is to document what is currently known about advanced practice psychiatric nurses and discuss policy implications for tapping into the strengths of this workforce. Strategies for facilitating utilization of advanced practice psychiatric nurses discussed. PMID:21233135

  4. [The federal politics of basic sanitation and the initiatives of participation, mobilization, social control, health and environmental education].

    PubMed

    Moisés, Márcia; Kligerman, Débora Cynamon; Cohen, Simone Cynamon; Monteiro, Sandra Conceição Ferreira

    2010-08-01

    The purpose of this article is to accomplish a critical analysis of two governmental important programs in health and environmental education - Health Education and Social Mobilization Program (PESMS) and Environmental Education and Sanitation Social Mobilization Program (PEAMSS), aiming at stimulate participative educational actions and social mobilization in sanitation projects. The methodology was based on reading and analysis of documents and observation in Workshops, Meetings, Seminars, Conventions, Congresses and Interviews. The authors describe the process of Program creation - PESMS and PEAMSS. They promoted a reflection and thought about Participation, Mobilization, Social Control, Health Education and Environmental Education. They also made considerations about the difficulties, facilities, advances and challenges in the implantation and implementation of PESMS and PEAMSS in the fundament for the realization of the public services of basic sanitation. They conclude that the creation of conditions by means of initiatives of Participation, Mobilization, Social Control, Health Education and Environmental Education become necessary for the development of Federal Policies of Basic Sanitation. PMID:20802890

  5. Federal radiation initiatives wane in Reagan administration.

    PubMed

    Linton, O W

    1981-12-01

    A series of administrative initiatives undertaken by the Carter Administration in response to public concerns about harmful effects of exposures to ionizing radiation in various settings has been abandoned by the Reagan Administration. The decision to discard the Radiation Policy Council, the coordinating agency established in 1980, leaves the federal government with no overall focus or overall budget for radiation research and protection activities. The line agencies with direct radiation responsibilities, including the Department of Energy, Nuclear Regulatory Commission, Department of Defense, Food and Drug Administration's Bureau of Radiological Health, and Department of Labor, continue with somewhat contradictory and uncoordinated programs. PMID:6976109

  6. Russian Federation. Health system review.

    PubMed

    Popovich, Larisa; Potapchik, Elena; Shishkin, Sergey; Richardson, Erica; Vacroux, Alexandra; Mathivet, Benoit

    2011-01-01

    The HiT reviews are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. At independence from the Soviet Union in 1991, the Russian health system inherited an extensive, centralized Semashko system, but was quick to reform health financing by adopting a mandatory health insurance (MHI) model in 1993. MHI was introduced in order to open up an earmarked stream of funding for health care in the face of severe fiscal constraints. While the health system has evolved and changed significantly since the early 1990 s, the legacy of having been a highly centralized system focused on universal access to basic care remains. High energy prices on world markets have ensured greater macroeconomic stability, a budget surplus and improvements in living standards for most of the Russian population. However, despite an overall reduction in the poverty rate, there is a marked urban rural split and rural populations have worse health and poorer access to health services than urban populations. The increase in budgetary resources available to policy-makers have led to a number of recent federal-level health programmes that have focused on the delivery of services and increasing funding for priority areas including primary care provision in rural areas. Nevertheless, public health spending in the Russian Federation remains relatively low given the resources available. However, it is also clear that, even with the current level of financing, the performance of the health system could be improved. Provider payment mechanisms are the main obstacle to improving technical efficiency in

  7. Federal health services grants, 1985.

    PubMed

    Zwick, D I

    1986-01-01

    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. PMID:3094081

  8. Towards Meeting the Needs of Adolescents: An Assessment of Federally Funded Adolescent Health Programs and Initiatives within the Department of Health and Human Services

    ERIC Educational Resources Information Center

    Brindis, Claire; Hair, Elizabeth; Valderrama, L. Teresa; Cleveland, Kevin; Park, Jane; Cochran, Stephanie

    2005-01-01

    The overall goal of this project is to better understand the types of youth programs available that may influence the health measures presented in the U.S. Chartbook where American adolescents fare differently--sometimes better, sometimes worse--than their counterparts in other countries. In an effort to do so, the authors reviewed the existing…

  9. Catholic Health Initiatives at 10.

    PubMed

    Ross, Joyce M

    2007-01-01

    The summer of 2006 marked the 10th anniversary of the formation of Denver-based Catholic Health Initiatives (CHI). Formed in 1996 as the result of the merger of three Catholic health care systems, and soon joined by a fourth, the system integrated a diverse collection of health care facilities previously sponsored by 12 different religious congregations. It was the first Catholic health system to give laity a sponsorship role in its facilities. CHI's facilities are sponsored by a public juridic person (PJP), the Catholic Health Care Federation (CHCF). The same people who sit on the system's board also constitute CHCF. They are thus responsible for both governance and sponsorship. CHI was the first Catholic health care system to give laypersons a sponsorship role in its facilities. Establishing the PJP was a long and complex task. Eventually, the church determined that CHI's PJP should be pontifical, accountable to the Congregation for Institutes of Consecrated Life and Societies of Apostolic Life in Rome. CHCF in 1991 became the first PJP in health care in the United States. CHI's staff, led by its first president and chief executive officer, Patricia Cahill, quickly took steps to help the new system begin to coalesce, establishing a single, systemwide pension plan, debt policy, and so forth. Also challenging was the creation of a systemwide new culture. An essential step in the development of CHI's culture was the involvement of employees in the identification of its core values: reverence, integrity, compassion, and excellence, The creation of CHI's Mission and Ministry Fund also helped give the system an identity. This fund provides grants to programs that take an innovative approach to building healthy communities, a goal expressed in CHI's mission and vision statements. The people who created CHI and nurtured it during its first decade give it high marks for faithful adherence to its mission. Even so, they acknowledge that there is always more work to be done

  10. Internet 2 Health Sciences Initiative.

    ERIC Educational Resources Information Center

    Simco, Greg

    2003-01-01

    The Internet 2 (I2) health sciences initiative (I2HSI) involves the formulation of applications and supporting technologies, and guidelines for their use in the health sciences. Key elements of I2HSI include use of visualization, collaboration, medical informatics, telemedicine, and educational tools that support the health sciences. Specific…

  11. Federal Executives: Initial Reactions to Change.

    ERIC Educational Resources Information Center

    Lynn, Naomi B.; Vaden, Richard E.

    1980-01-01

    The main concern of those federal executives surveyed before implementation of the Civil Service Reform Act of 1978 was that the reform would introduce politics into the civil service. Those surveyed also were concerned about affirmative action, bureaucratic image, bonuses, cronyism, managerial power, pay, performance evaluations, and unions.…

  12. Federative coordination and decentralization: Brazilian experience in health.

    PubMed

    Viana, Ana Luiza d'Avila; Machado, Cristiani Vieira

    2009-01-01

    This article deals with intergovernmental relations in health within the 20 years of implantation of the Unified Health System (SUS), in the light of the historical course of Brazilian federalism and its implications to health. Initially, a theoretical-conceptual review was carried out on the topic of federalism, social welfare and federative coordination of health, considering the international debate and the historical analysis of the Brazilian case. Following, the article analyzes the federal performance in the intergovernmental coordination of national health policy during the period of implantation of SUS, based on a research about the role of the Brazilian Ministry of Health from 1990 to 2002, which involved documental analysis and interviews with federal officers and other players in national politics. It was observed that health policies registered, in the past 20 years, changes in five relevant aspects that characterize federalism: institutional arrangements and rules for decisions in the federal government; the set of players with territorial basis; legal arrangements to define responsibilities among government levels; intergovernmental tax arrangements; informal arrangements among governments - vertically and horizontally. PMID:19547780

  13. Federal government initiates National Practitioner Data Bank.

    PubMed

    Bodenhorn, K; Hardy-Havens, D

    1989-01-01

    The formulation of the data bank will require the exchange of data and merging of information from a number of sources. The development and the implementation of this computerized system will be the work of the UNISYS Corporation in concert with the Bureau of Health Professions' Office of Quality Assurance, a part of the Health Resources and Services Administration, HHS. The assurance of the quality of the data on each nurse--correct, up-to-date, etc.--is the responsibility of the parties reporting to the data bank. In addition, each and every pediatric nurse practitioner will need to become knowledgeable regarding the data base and periodically ascertain that the information regarding himself or herself is correct. As additional information is received on the process by which you can monitor the bank's data on you, it will be published. PMID:2724023

  14. Health Care Provider Initiative Strategic Plan

    ERIC Educational Resources Information Center

    National Environmental Education & Training Foundation, 2012

    2012-01-01

    This document lays out the strategy for achieving the goals and objectives of NEETF's "Health Care Provider Initiative." The goal of NEETF's "Health Care Provider Initiative" is to incorporate environmental health into health professionals' education and practice in order to improve health care and public health, with a special emphasis on…

  15. Area Health Education Centers: A Directory of Federal, State, Local and Private Decentralized Health Professional Education Programs. Health Manpower References.

    ERIC Educational Resources Information Center

    Pagan (C. E.) Associates, Inc., Baltimore, MD.

    This Area Health Education Centers (AHEC) directory catalogues the Federal, State, local, and private decentralized professional health education programs initiated in direct response to the recommendations of the 1970 "Carnegie Commission Report of Higher Education and the Nation's Health." The introductory section briefly presents the history of…

  16. Federal Funding Sources for Public Job Creation Initiatives.

    ERIC Educational Resources Information Center

    Johnson, Clifford M.; Savner, Steve

    This overview on potential funding sources describes three major federal programs that can provide a financing base for public job creation initiatives serving hard-to-employ welfare recipients and non-custodial parents. Section I is an introduction. Section II focuses on the Temporary Assistance to Needy Families (TANF) block grant. Section III…

  17. Federal health information privacy cases from 2005.

    PubMed

    Herget, Greg

    2006-04-01

    The federal Personal Information Protection and Electronics Documents Act (PIPEDA) governs the collection, use and disclosure of personal information. PIPEDA is important legislation for people living with HIV/AIDS as it establishes rules for the handling of personal information, including personal health information. PIPEDA applies to personal information handled by commercial enterprises in the course of commercial activities throughout Canada, except in provinces that have significantly similar laws. Complaints under PIPEDA are heard by the Privacy Commissioner of Canada (PC). This article reviews the interpretation and application of PIPEDA in complaints related to health information decided in 2005. PMID:16805025

  18. State and federal regulatory initiatives: Pending or underway

    SciTech Connect

    Nosenchuck, N.H.

    1994-12-31

    The author discusses some of the present and future hazardous waste management regulatory initiatives and also presents some of his personal views on hazardous waste management. The primary federal statute governing the regulation of solid and hazardous wastes is the Resource Conservation and Recovery Act (RCRA). Subtitle C of RCRA, relating to hazardous waste management, has evolved into a command and control approach for hazardous waste generators and waste management facilities. The EPA, under RCRA, may authorize a state to administer and enforce a state hazardous waste program in lieu of the federal Subtitle C program.

  19. The Role of the Federal Government in Mental Health

    PubMed Central

    Newton, Patricia A.

    1982-01-01

    This paper reports a survey of public opinion regarding the role of the federal government in mental health. The impact of cuts in federal funding for mental health care is analyzed and discussed. PMID:7120445

  20. Public health assessment--Russian Federation, 1992.

    PubMed

    1992-02-14

    On December 25, 1991, the Russian Federation became an independent republic, and on January 2, 1992, restrictions on retail prices of most commodities were removed. From January 16 through February 6, a multidisciplinary team from the U.S. Food and Humanitarian Assistance Bureau (FHA) conducted an assessment of the needs for humanitarian and technical assistance, focusing on three regions in the southern Ural Mountains-Yekaterinburg, Perm, and Cheliabinsk-and three regions in south-central Siberia-Kusbas, Tomsk, and Novosibirsk. The FHA assessment included observations of health facilities, vaccine- and drug-storage centers, and disease-control programs; review of health data at central, regional, and district epidemiology stations; and collection of food-price and income data through interviews with administrative authorities and surveys of markets and private homes. This report summarizes findings from the assessment. PMID:1734228

  1. 42 CFR 405.2462 - Payment for rural health clinic and Federally qualified health center services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for rural health clinic and Federally... AND DISABLED Rural Health Clinic and Federally Qualified Health Center Services Payment for Rural Health Clinic and Federally Qualified Health Center Services § 405.2462 Payment for rural health...

  2. 42 CFR 405.2462 - Payment for rural health clinic and Federally qualified health center services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Payment for rural health clinic and Federally... AND DISABLED Rural Health Clinic and Federally Qualified Health Center Services Payment for Rural Health Clinic and Federally Qualified Health Center Services § 405.2462 Payment for rural health...

  3. Surgeon General's Family Health History Initiative

    MedlinePlus

    ... Versions Source Code The Surgeon General's Family Health History Initiative To help focus attention on the importance of family history, the Surgeon General, in cooperation with other agencies ...

  4. [Health insurance in the Russian Federation].

    PubMed

    Starodubov, V I; Semenov, V Iu

    1997-01-01

    The need to reform health care in Russia became evident in the late 1980s when due to socioeconomic crisis, the government could not cover the expenses connected with this field and put the up-to-date expensive technologies into life. The introduction of the compulsory health insurance system (CHIS) is aimed at: 1) obtaining an additional financial source for health care by making the goal-oriented stable rates of deductions from the wage fund; 2) protecting the Russian Federation citizens' rights to have free medical aid of the guaranteed scope; 3) enhancing the quality of medial care delivered to the population by introducing a mechanism of movement of funds paid for a patient; 4) paying for medical care in relation to the volume and quality of the work done by simultaneously controlling the stipulated use of funds. Three-year experience of CHIS in Russia has indicated that there is a real mechanism of reformation and government regulation of health care under the conditions of transition to the market, with the interests of the general population and medical personnel in mind. Obvious legal, organizational, technological, and psychological problems and disadvantages have been found at all management levels, which are an obstacle in the way of the reforms and which whip up social tension and call for prompt decisions. PMID:9213488

  5. Federal funding of health policy in Brazil: trends and challenges.

    PubMed

    Machado, Cristiani Vieira; Lima, Luciana Dias de; Andrade, Carla Lourenço Tavares de

    2014-01-01

    The article analyzes Federal funding of health policy in Brazil in the 2000s, focusing on the Ministry of Health's budget implementation. Federal spending on health was less unstable between 2000 and 2002 and has expanded since 2006. However, it fluctuated as a share of both the Gross Domestic Product and Gross National Revenue. Federal intergovernmental transfers increased, exceeding 70% in 2007. Meanwhile, the proportion of Federal investments remained low, varying from 3.4% to 6.3%. The highest absolute amount of spending was on specialized outpatient and hospital care. The decade showed a proportionally greater increase in spending on pharmaceutical care. The growing allocation of Federal funds to States in the North and Northeast, especially for primary care and epidemiological surveillance, failed to offset the sharp regional inequalities in per capita Federal spending. The main characteristics of health funding limit Federal health policy governance and pose several challenges for the Brazilian Unified National Health System. PMID:24627025

  6. Review Of Internet Health Information Quality Initiatives

    PubMed Central

    Dzenowagis, Joan

    2001-01-01

    Background The massive growth of health information on the Internet; the global nature of the Internet; the seismic shift taking place in the relationships of various actors in this arena, and the absence of real protection from harm for citizens who use the Internet for health purposes are seen to be real problems. One response to many of these problems has been the burgeoning output of codes of conduct by numerous organizations trying to address quality of health information. Objectives Review the major self-regulatory initiatives in the English-speaking world to develop quality and ethical standards for health information on the Internet. Compare and analyze the approaches taken by the different initiatives. Clarify the issues around the development and enforcement of standards. Methods Quality initiatives selected meet one or more of the following criteria: Self-regulatory. A reasonable constituency. Diversity (eg, of philosophy, approach and process)-to achieve balance and wide representation, and to illustrate and compare different approaches. Historic value. A wider reach than a national audience, except when its reach is a significant sector of the Internet health information industry. The initiatives were compared in 3 ways: (1) Analysis and comparison of: key concepts, mechanism, or approach. Analysis of: the obligations that a provider has to meet to comply with the given initiative, the intended beneficiaries of that initiative, and the burdens imposed on different actors. These burdens are described in terms of their effect on the long-term sustainability and maintenance of the initiative by its developers. Analysis of the enforcement mechanisms. (2) Analysis and comparison by type of sponsoring organization, the reach of the initiative, and the sources of funding of the initiative or the sponsoring organization. (3) How the various initiatives fall under 1 of 3 key mechanisms and comparison of the advantages and disadvantages of these key mechanisms

  7. Public and private health initiatives in Kansas.

    PubMed

    Fonner, E

    1998-01-01

    This article summarizes several health initiatives in Kansas that are being forwarded by way of public/private partnerships. Consensus is being shaped on the standardization of health data and use of actionable indicators. Statewide public health improvement planning is also being pursued. A group of large employers and state agencies are creating a basis for group purchasing, consumer assessments of health plans, and coordinated public policy formulation. PMID:9718510

  8. 75 FR 76615 - Federal Employees Health Benefits Program Miscellaneous Changes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-09

    ... and 892 RIN 3206-AL95 Federal Employees Health Benefits Program Miscellaneous Changes AGENCY: U.S...) is issuing a final regulation to provide for continuation of Federal Employees Health Benefits (FEHB... meaning of the PRA. The Office of Personnel Management (OPM) therefore is revising a health...

  9. Health Policy Formulation on a Federal Level, Process and Substance.

    ERIC Educational Resources Information Center

    Stambler, Moses

    Factors which influence the federal government's policy toward health care include cost, technology, social values, federalism, interest group politics, increased federal involvement, and the current utilitarian attitude toward research. The interaction of these factors results in a complex process of policy formation. For example, when the…

  10. Federally funded CMHCs: the effects of period of initial funding and hospital affiliation.

    PubMed

    Leaf, P J; Brown, R L; Manderscheid, R W; Bass, R D

    1985-01-01

    Previous research on federally funded community mental health centers has largely failed to recognize fundamental differences among different types of centers. Here we show that such basic factors as the arrangement for providing inpatient services and the period of initial federal funding have large effects on the development and organization of a center. Although the centers joining the federal program from 1965-1970 are the largest, those facilities funded between 1971-1975 are generally smaller than those funded later. The arrangement for providing inpatient services has an important effect on staffing. This work suggests the national norms may not be the most useful data for evaluating past performance or planning the future of a specific center. PMID:3935368

  11. Federal Data Bases for Health Education Research.

    ERIC Educational Resources Information Center

    Wilson, Ronald; Iverson, Donald

    1982-01-01

    Described are some of the national health related databases which are useful in conducting health education research. Among areas covered by the projects are hypertension, myocardial infarction, neighborhood health centers, alcoholism, and over the counter drugs. (CJ)

  12. Federating Clinical Data from Six Pediatric Hospitals: Process and Initial Results from the PHIS+ Consortium

    PubMed Central

    Narus, Scott P.; Srivastava, Rajendu; Gouripeddi, Ramkiran; Livne, Oren E.; Mo, Peter; Bickel, Jonathan P.; de Regt, David; Hales, Joseph W.; Kirkendall, Eric; Stepanek, Richard L.; Toth, Jamie; Keren, Ron

    2011-01-01

    Integrating clinical data with administrative data across disparate electronic medical record systems will help improve the internal and external validity of comparative effectiveness research. The Pediatric Health Information System (PHIS) currently collects administrative information from 43 pediatric hospital members of the Child Health Corporation of America (CHCA). Members of the Pediatric Research in Inpatient Settings (PRIS) network have partnered with CHCA and the University of Utah Biomedical Informatics Core to create an enhanced version of PHIS that includes clinical data. A specialized version of a data federation architecture from the University of Utah (“FURTHeR”) is being developed to integrate the clinical data from the member hospitals into a common repository (“PHIS+”) that is joined with the existing administrative data. We report here on our process for the first phase of federating lab data, and present initial results. PMID:22195159

  13. Swiss popular initiative for a single health insurer… once again!

    PubMed

    De Pietro, Carlo; Crivelli, Luca

    2015-07-01

    The article describes a recent Swiss popular initiative, aiming to replace the current system of statutory health insurance run by 61 competing private insurers with a new system run by a single public insurer. Despite the rejection of the initiative by 62% of voters in late September 2014, the campaign and ballot results are interesting because they show the importance of (effective) public communication in shaping the outcome of a popular ballot. The relevance of the Swiss case goes beyond the peculiarities of its federalism and direct democracy and might be useful for other countries debating the pros and cons of national unitary health insurance systems versus models using multiple insurers. After this electoral ballot, the project to establish a public sickness fund in Switzerland seems definitely stopped, at least for the next decade. Insurers, who opposed the initiative, have effectively fed the "fear of change" of the population and have stressed the good outcomes of the Swiss healthcare system. However, the political pressure favoured by the popular initiative opened a "windows of opportunity" and led the federal Parliament to pass a stricter regulation of health insurers, improving in this way the current system. PMID:26004844

  14. 75 FR 20314 - Federal Employees Health Benefits Program; Miscellaneous Changes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-19

    ... economic impact on a substantial number of small entities because the regulation only affects health... MANAGEMENT 5 CFR Parts 890 and 892 RIN 3206-AL95 Federal Employees Health Benefits Program; Miscellaneous... Health Benefits (FEHB) coverage for certain former Senate Restaurant employees who transferred...

  15. 77 FR 46425 - Federal Advisory Committee; Defense Health Board Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-03

    ... of the Secretary Federal Advisory Committee; Defense Health Board Meeting AGENCY: Department of... Defense Health Board (DHB) is announced. DATES: August 21, 2012 7:00 a.m.-4:00 p.m. (Administrative... Bader, Director, Defense Health Board, 7700 Arlington Boulevard, Suite 5101, Falls Church, VA...

  16. 78 FR 17232 - Meeting of the Global Justice Information Sharing Initiative Federal Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-20

    ... of Justice Programs Meeting of the Global Justice Information Sharing Initiative Federal Advisory... announcement of a meeting of the Global Justice Information Sharing Initiative (Global) Federal Advisory Committee (GAC) to discuss the Global Initiative, as described at www.it.ojp.gov/global . DATES: The...

  17. 77 FR 58412 - Meeting of the Global Justice Information Sharing Initiative Federal Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-20

    ... of Justice Programs Meeting of the Global Justice Information Sharing Initiative Federal Advisory... announcement of a meeting of the Global Justice Information Sharing Initiative (Global) Federal Advisory Committee (GAC) to discuss the Global Initiative, as described at www.it.ojp.gov/global . DATES: The...

  18. The federal environmental health workforce in the United States.

    PubMed Central

    Sexton, K; Perlin, S A

    1990-01-01

    This paper summarizes existing data on the size and composition of the federal environmental health workforce, delineates the major categories of activities carried out by its members, identifies current and emerging issues that are likely to affect workforce activities, and makes qualitative inferences about future trends and directions. Findings suggest that there is a current and future need for more and better qualified professionals in the federal environmental health workforce. PMID:2368849

  19. School Crime and Student Rights: "Surprises" from a Federal Initiative.

    ERIC Educational Resources Information Center

    Tremper, Charles R.

    1987-01-01

    A federal project introduced law enforcement and community development techniques in three urban school districts. The study found school safety and respect for students' procedural rights to be compatible. It may be possible to incorporate the techniques of the project into more promising approaches to school crime and student misbehavior.…

  20. Electronic Initiatives of the Federal Depository Library Program.

    ERIC Educational Resources Information Center

    Farrell, Maggie Parhamovich; And Others

    1996-01-01

    Examines the role of the Federal Depository Library Program (FDLP) as it changes from dissemination of primarily print government publications to an expanded program including distribution of and access to electronic government information. Topics include a World Wide Web interface, the Government Information Locator Service (GILS), and possible…

  1. Supports for community-based mental health care: an optimistic review of federal legislation.

    PubMed

    Bentley, K J

    1994-11-01

    For the past 50 years, federal legislation has been a key force in shaping the delivery of public mental health services. This article describes and summarizes recent relevant federal legislative initiatives and analyzes their potential in providing support, either explicit or implicit, for community-based mental health care for adults in the United States. These legislative mandates and options can be a source of optimism and ammunition for advocates and change agents as they continue to work vigorously to improve the mental health services system. PMID:7813967

  2. 75 FR 17700 - Energy Efficient Building Systems Regional Innovation Cluster Initiative-Joint Federal Funding...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-07

    ... Efficient Building Systems Regional Innovation Cluster Initiative--Joint Federal Funding Opportunity... Efficient Building Systems Regional Innovation Cluster Initiative. A single proposal submitted by a... innovation cluster focused on innovation in energy efficient building technologies and systems design....

  3. Civil Wrongs: Federal Equity Initiative Promotes Paperwork, Not Equality

    ERIC Educational Resources Information Center

    Melnick, R. Shep

    2016-01-01

    In October 2014, U.S. secretary of education Arne Duncan announced the Obama administration's new "education equity initiative," explaining that the president could not "continue to wait" for Congress to act "on behalf of vulnerable children." The centerpiece of this initiative was a 37-page "Dear Colleague"…

  4. Managing Evaluation in a Federal Public Health Setting

    ERIC Educational Resources Information Center

    Schooley, Michael W.

    2009-01-01

    The author, a federal manager who leads development and maintenance of evaluation for specific public health programs at the Centers for Disease Control and Prevention, tells the story of developing an evaluation unit in the Office on Smoking and Health. Lessons about managing evaluation, including his practices and related principles, are…

  5. Finding Funding: A Guide to Federal Sources for Workforce Development Initiatives. Finding Funding Series

    ERIC Educational Resources Information Center

    Relave, Nannette

    2005-01-01

    This guide provides an overview of strategies for gaining access to and using federal funds, as well as a catalog of 87 funding sources that can potentially support workforce development initiatives for adults and youth. It is intended to help program developers, policy makers, and initiative leaders identify federal funding sources to support…

  6. Designing Work, Family & Health Organizational Change Initiatives.

    PubMed

    Kossek, Ellen Ernst; Hammer, Leslie B; Kelly, Erin L; Moen, Phyllis

    2014-01-01

    For decades, leaders and scholars have been advocating change efforts to improve work-life relationships. Yet most initiatives have lacked rigor and not been developed using scientific principles. This has created an evidence gap for employer support of work and personal life as a win-win for productivity and employees' well-being. This paper examines the approach used by the U.S. Work Family Health Network (WFRN) to develop an innovative workplace intervention to improve employee and family health. The change initiative was designed to reduce organizationally based work-family conflict in two contrasting contexts representative of major segments of today's U.S. workforce: health care employees and informational technology professionals. The WFRN Intervention (called STAR) had three theoretically based change elements. They were: 1) increase job control over work time and schedule; 2) increase supervisor social support for family and job effectiveness; and 3) improve organizational culture and job design processes to foster results orientation. Seven practical lessons for developing work-life interventions emerged from this groundbreaking endeavor. PMID:24683279

  7. Designing Work, Family & Health Organizational Change Initiatives

    PubMed Central

    Hammer, Leslie B.; Kelly, Erin L.; Moen, Phyllis

    2014-01-01

    Executive Summary For decades, leaders and scholars have been advocating change efforts to improve work-life relationships. Yet most initiatives have lacked rigor and not been developed using scientific principles. This has created an evidence gap for employer support of work and personal life as a win–win for productivity and employees’ well-being. This paper examines the approach used by the U.S. Work Family Health Network (WFRN) to develop an innovative workplace intervention to improve employee and family health. The change initiative was designed to reduce organizationally based work-family conflict in two contrasting contexts representative of major segments of today’s U.S. workforce: health care employees and informational technology professionals. The WFRN Intervention (called STAR) had three theoretically based change elements. They were: 1) increase job control over work time and schedule; 2) increase supervisor social support for family and job effectiveness; and 3) improve organizational culture and job design processes to foster results orientation. Seven practical lessons for developing work-life interventions emerged from this groundbreaking endeavor. PMID:24683279

  8. 78 FR 68865 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-15

    ... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Announcement of FACOSH meeting. SUMMARY: The Federal Advisory Council on Occupational Safety and Health (FACOSH)...

  9. 76 FR 39902 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-07

    ... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Request for nominations to serve on the Federal Advisory Council on Occupational Safety and Health (FACOSH). SUMMARY:...

  10. Federal Funding for Health Security in FY2015

    PubMed Central

    Sell, Tara Kirk; Watson, Matthew

    2014-01-01

    Previous articles in this series have provided funding information for federal civilian biodefense programs and programs focused on radiological and nuclear preparedness and consequence management. This year the authors have expanded the focus of the analysis to US federal funding for health security. This article provides proposed funding amounts for FY2015, estimated amounts for FY2014, and actual amounts for FY2010 through FY2013 in 5 domains critical to health security: biodefense programs, radiological and nuclear programs, chemical programs, pandemic influenza and emerging infectious disease programs, and multiple-hazard and preparedness programs. PMID:24988432

  11. Federal funding for health security in FY2015.

    PubMed

    Boddie, Crystal; Sell, Tara Kirk; Watson, Matthew

    2014-01-01

    Previous articles in this series have provided funding information for federal civilian biodefense programs and programs focused on radiological and nuclear preparedness and consequence management. This year the authors have expanded the focus of the analysis to US federal funding for health security. This article provides proposed funding amounts for FY2015, estimated amounts for FY2014, and actual amounts for FY2010 through FY2013 in 5 domains critical to health security: biodefense programs, radiological and nuclear programs, chemical programs, pandemic influenza and emerging infectious disease programs, and multiple-hazard and preparedness programs. PMID:24988432

  12. Standards for Teaching about the Federal Reserve System: An Initiative by Two Federal Reserve Banks

    ERIC Educational Resources Information Center

    Bosshardt, William D.; Grimes, Paul W.; Suiter, Mary C.

    2011-01-01

    In the fall of 2008, the Federal Reserve Banks of Atlanta and St. Louis began a systematic evaluation of their economic and personal finance educational outreach programs. Both banks were interested in developing tools to assess the success of their existing economic and financial education programs. However, before any assessment could begin, a…

  13. [Congressional amendments to the Brazilian Federal health budget].

    PubMed

    Baptista, Tatiana Wargas de Faria; Machado, Cristiani Vieira; Lima, Luciana Dias de; Garcia, Marcia; Andrade, Carla Lourenço Tavares de; Gerassi, Camila Duarte

    2012-12-01

    The public budget in Brazil has undergone significant changes since enactment of the 1988 Federal Constitution. Mechanisms for integration of planning activities and budget execution have been created, and Legislative participation in budgeting has increased. Congressional amendments appeared in this context. The article discusses the participation of Congressional amendments in the Federal health budget from 1997 to 2006, combining elements for discussion of funding mechanisms and health planning. Such amendments played a significant role in the budget process, accounting for over half of health funds in some years. The North was the region of Brazil that received most resources resulting from Congressional amendments, suggesting the need for further studies on the relationship between the amendments' enforcement and political party coalitions. The article concludes that the amendments cannot be understood solely as a funding mechanism, but mainly as a political instrument, and that they are not necessarily subject to health planning logic. PMID:23288060

  14. 75 FR 64731 - Request for Information (RFI) for Consumer Health Initiative To Develop Collaborations That...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-20

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES Request for Information (RFI) for Consumer Health Initiative To Develop Collaborations That Produce Evidence-Based Informatics Resources and Products\\1\\ \\1\\ Products include interventions, services, technology tools, and systems....

  15. [A federal project of Integrated Health Care in cardiology].

    PubMed

    Beyrle, B

    2006-01-01

    This paper reports in detail on a project of Integrated Health Care in cardiology at the federal level in Germany. Information on the structure of the contract, the participants, the agreed claiming of benefits and provision of services are provided as well as relevant figures and contact data. PMID:16598581

  16. [The judicialization of health in the Federal District of Brazil].

    PubMed

    Diniz, Debora; Machado, Teresa Robichez de Carvalho; Penalva, Janaina

    2014-02-01

    This paper seeks to analyze the Judiciary's approach with respect to demands for the judicialization of the right to health by means of a case study of civil lawsuits for access to health care in Brazil's Federal District. Judicialization of the right to health signifies the judicialization of various of the health services provided. This is a descriptive and exploratory case study that covers the Federal District and uses mixed techniques to gather and analyze data. This study analyzed 385 lawsuits (87% of the total number of cases of judicialization of health for the period from 2005 to 2010 that reached the Appellate court). The results indicate that the most judicialized service is access to intensive care unit, followed by drugs and health care. Almost all lawsuits are filed by public defenders, with medical prescriptions and recommendations from the public health service. The results of this study challenge some dominant themes in the national debate, particularly the claim that judicialization is a phenomenon of the elites and that the services judicialized are drugs. The study does not seek to make generalizations, but highlights the fact that the phenomenon of judicialization of health has different aspects encompassed under the same concept. PMID:24863835

  17. Biased selection in the Federal Employees Health Benefits Program.

    PubMed

    Price, J R; Mays, J W

    1985-01-01

    The existence of biased selection in health insurance markets has long been assumed by economic theorists as well as seen between classes of health plans. In this paper, we use a model of the premium rate that takes into consideration the effects of moral hazard to make empirical estimates of the extent of selection in the Federal Employees Health Benefits Program. We find that biased selection has raised the premium of the Blue Cross Plan high-option coverage by 21% and lowered the premium of the low-option coverage by 29%, both relative to premiums that would have been charged in the absence of selection. PMID:2933333

  18. Health care cost containment in the Federal Republic of Germany

    PubMed Central

    Schneider, Markus

    1991-01-01

    Since 1977, cost containment has been an integral part of health policy in the Federal Republic of Germany. The common goal of the cost-containment acts was to bring the growth of health care expenditures in line with growth of wages and salaries of sickness fund members. The Health Care Reform Act of 1989 is the most recent manifestation of this policy. The main features of the numerous cost-containment acts are described in this article, and the effects of cost containment on supply and demand are analyzed. PMID:10113614

  19. 49 CFR Appendix B to Part 209 - Federal Railroad Administration Guidelines for Initial Hazardous Materials Assessments

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Federal Railroad Administration Guidelines for Initial Hazardous Materials Assessments B Appendix B to Part 209 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD SAFETY ENFORCEMENT PROCEDURES Pt. 209, App....

  20. 49 CFR Appendix B to Part 209 - Federal Railroad Administration Guidelines for Initial Hazardous Materials Assessments

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Federal Railroad Administration Guidelines for Initial Hazardous Materials Assessments B Appendix B to Part 209 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD SAFETY ENFORCEMENT PROCEDURES Pt. 209, App....

  1. Research, Policy, and the Federal Role in Prevention Initiatives for Children.

    ERIC Educational Resources Information Center

    Ripple, Carol H.; Zigler, Edward

    2003-01-01

    Reviews five federal policy-based initiatives for children and families (Project Head Start; lead poisoning prevention; Medicaid; Special Supplemental Program for Women, Infants, and Children; and Earned Income Tax Credit), discussing aspects of federal prevention program design, implementation, policy, and research. (Contains references.) (SM)

  2. 76 FR 65318 - ``100,000 Strong'' Initiative Federal Advisory Committee: Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-20

    ...The Bureau of East Asian and Pacific Affairs of the Department of State hereby gives notice of a public meeting of the ``100,000 Strong'' Initiative Federal Advisory Committee. The ``100,000 Strong'' Federal Advisory Committee, composed of prominent China experts and leaders in business, academic, and non-profit organizations, serves a critical advisory role in achieving the Administration's......

  3. 77 FR 32712 - The “100,000 Strong” Initiative Federal Advisory Committee: Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-01

    ...The Bureau of East Asian and Pacific Affairs of the Department of State hereby gives notice of a public meeting of the ``100,000 Strong'' Initiative Federal Advisory Committee. The ``100,000 Strong'' Federal Advisory Committee, composed of prominent China experts and leaders in business, academic, and non-profit organizations, serves a critical advisory role in achieving the Obama......

  4. The New Knowledge Environment: Quality Initiatives in Health Sciences Libraries.

    ERIC Educational Resources Information Center

    Nagle, Ellen

    1996-01-01

    Reviews changes in health sciences libraries, including the evolving role of health sciences librarians, education and training of health sciences librarians, rethinking reference services, impact on quality health care, improving the value of information, virtual libraries, National Library of Medicine initiatives, and quality initiatives. (LRW)

  5. Evaluating the federal role in financing health-related research.

    PubMed

    Garber, A M; Romer, P M

    1996-11-12

    This paper considers the appropriate role for government in the support of scientific and technological progress in health care; the information the federal government needs to make well-informed decisions about its role; and the ways that federal policy toward research and development should respond to scientific advances, technology trends, and changes in the political and social environment. The principal justification for government support of research rests upon economic characteristics that lead private markets to provide inappropriate levels of research support or to supply inappropriate quantities of the products that result from research. The federal government has two basic tools for dealing with these problems: direct subsidies for research and strengthened property rights that can increase the revenues that companies receive for the products that result from research. In the coming years, the delivery system for health care will continue to undergo dramatic changes, new research opportunities will emerge at a rapid pace, and the pressure to limit discretionary federal spending will intensify. These forces make it increasingly important to improve the measurement of the costs and benefits of research and to recognize the tradeoffs among alternative policies for promoting innovation in health care. PMID:8917484

  6. Evaluating the federal role in financing health-related research

    PubMed Central

    Garber, Alan M.; Romer, Paul M.

    1996-01-01

    This paper considers the appropriate role for government in the support of scientific and technological progress in health care; the information the federal government needs to make well-informed decisions about its role; and the ways that federal policy toward research and development should respond to scientific advances, technology trends, and changes in the political and social environment. The principal justification for government support of research rests upon economic characteristics that lead private markets to provide inappropriate levels of research support or to supply inappropriate quantities of the products that result from research. The federal government has two basic tools for dealing with these problems: direct subsidies for research and strengthened property rights that can increase the revenues that companies receive for the products that result from research. In the coming years, the delivery system for health care will continue to undergo dramatic changes, new research opportunities will emerge at a rapid pace, and the pressure to limit discretionary federal spending will intensify. These forces make it increasingly important to improve the measurement of the costs and benefits of research and to recognize the tradeoffs among alternative policies for promoting innovation in health care. PMID:8917484

  7. 76 FR 28816 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-18

    ... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Announcement of meeting and member appointment. SUMMARY: The Federal Advisory Council on Occupational Safety and......

  8. 75 FR 62147 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-07

    ... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Announcement of meeting and member appointments. SUMMARY: The Federal Advisory Council on Occupational Safety and...

  9. New York State Health Foundation grant helps health centers win federal expansion funds.

    PubMed

    Sandman, David; Cozine, Maureen

    2012-11-01

    With approximately 1.2 million New Yorkers poised to gain health insurance coverage as a result of federal health reform, demand for primary care services is likely to increase greatly. The Affordable Care Act includes $11 billion in funding to enhance primary care access at community health centers. Recognizing a need and an opportunity, in August 2010 the New York State Health Foundation made a grant of nearly $400,000 to the Community Health Care Association of New York State to work with twelve health centers to develop successful proposals for obtaining and using these federal funds. Ultimately, eleven of the twelve sites are expected to receive $25.6 million in federal grants over a five-year period-a sixty-four-fold return on the foundation's investment. This article describes the strategy for investing in community health centers; identifies key project activities, challenges, and lessons; and highlights its next steps for strengthening primary care. PMID:23129688

  10. Effect of Federal programs on health sciences libraries.

    PubMed

    Palmer, R A

    1987-01-01

    The radical changes and improvements in health sciences libraries during the last quarter century have been primarily achieved through the leadership of the National Library of Medicine (NLM) in the application of technology and in the creation of a biomedical communications network. This article describes principal programs and activities of the National Library of Medicine and their effects on health sciences libraries: the Medical Literature Analysis and Retrieval System (MEDLARS), implementation of the Medical Library Assistance Act (MLAA), and defense of "fair use" of copyrighted material. The article briefly summarizes more recent Federal activities which directly affect access to and dissemination of health information and concludes with a summary of problems for which solutions must be found if health sciences libraries are to be prepared to meet the future. It is clear from comparing the programs described with current government attitudes that, although the Federal government has promoted advancement in the dissemination of biomedical information in the past, this trend is reversing, and Federal funding to libraries is decreasing while the cost of accessing information is increasing. PMID:10301370

  11. Federal Public Health Service: In Retrospect and Prospects.

    PubMed

    Kolbe, Lloyd J

    2016-10-01

    In this article, I offer a retrospective case study about my early, short-term work within the U.S. Office of the Assistant Secretary for Health and then my later, longer-term work within the U.S. Centers for Disease Control and Prevention, where I endeavored for two decades largely to help our nation's schools improve health and associated education outcomes. First, for context, I briefly portray the nature of our related political and public health systems. I then frame this retrospective by illustrating how my serial employment within other public health system organizations led to, and then resulted from, my work within these two federal public health agencies. To represent the many talented individuals in each organization with whom I had the good fortune to work, I name only one in each organization. I then characterize how these individuals and organizations progressively shaped my work and career. I conclude by speculating about prospects for academic institutions to more purposefully prepare students and faculty to work within federal government public health agencies. PMID:27585459

  12. Stroke findings in the Women's Health Initiative.

    PubMed

    Wassertheil-Smoller, Sylvia; Kaplan, Robert C; Salazar, Christian R

    2014-11-01

    The Women's Health Initiative (WHI) clinical trials of estrogen with or without progestin versus placebo in 27,341 postmenopausal women are the largest randomized, placebo-controlled, double-blind clinical trials to look at the effect of hormone therapy on the outcomes of stroke, dementia, and cognition. Data from a parallel prospective observational study of 93,676 women examine biomarkers and risk factors associated with stroke. We summarize the results of 29 published articles in the WHI with stroke or cognition as outcomes of interest. Estrogen alone or in combination with progestin resulted in approximately 50% excess risk of ischemic stroke and in a 76% excess risk of dementia in women 65 years or older. Other risk factors for stroke identified in the WHI were panic attacks, depression, use of antidepressants (particularly selective serotonin reuptake inhibitors for hemorrhagic but not ischemic stroke), high triglycerides, low walking speed, long sleep duration, certain inflammatory factors, and systolic blood pressure variability. Hormone therapy has adverse effects on the brain as manifested by higher risks of stroke and dementia. Additional risk factors for stroke identified in WHI should be followed up to determine if reversing them would result in lower stroke rates. PMID:25321421

  13. Health expectancy in the Russian Federation: a new perspective on the health divide in Europe.

    PubMed Central

    Andreev, Evgueni M.; McKee, Martin; Shkolnikov, Vladimir M.

    2003-01-01

    OBJECTIVES: To compare life expectancy and healthy life expectancy in the Russian Federation and in countries of Eastern and Western Europe. METHODS: WHO mortality data and data on self-reported health from the World Values Survey and the Russian Longitudinal Monitoring Survey were used to compare the above three regions. Life expectancy was calculated using Sullivan's method, with years of life lived divided into healthy and unhealthy. The gap in healthy life expectancy between the Russian Federation and Western Europe was examined by decomposing the difference by gender and age. FINDINGS: The probability of remaining alive and healthy declines faster in the Russian Federation than in Western Europe, with the gap between Eastern Europe and the Russian Federation widening at older ages. In the Russian Federation, this rapid decline is due mainly to the high probability of death or of poor health for men and women, respectively. CONCLUSIONS: There is a large toll of premature male mortality in the Russian Federation but there also appears to be a substantial burden of ill-health among women. As in other countries, the responses of men and women to adversity differ, leading to premature death in men but survival in a poor state of health in women. Epidemiological studies including objective measures of health would help policy-makers to estimate more precisely the scale and nature of this problem. Policy-makers must recognize that health expectancy in the Russian Federation is reduced in both men and women. PMID:14758403

  14. 76 FR 13226 - Meeting of the Department of Justice Global Justice Information Sharing Initiative Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-10

    ... of Justice Programs Meeting of the Department of Justice Global Justice Information Sharing... meeting. SUMMARY: This is an announcement of a meeting of the Department of Justice (DOJ) Global Justice Information Sharing Initiative (Global) Federal Advisory Committee (GAC) to discuss the Global Initiative,...

  15. 77 FR 18266 - Meeting of the Department of Justice Global Justice Information Sharing Initiative Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-27

    ... of Justice Programs Meeting of the Department of Justice Global Justice Information Sharing... meeting. SUMMARY: This is an announcement of a meeting of the Department of Justice (DOJ) Global Justice Information Sharing Initiative (Global) Federal Advisory Committee (GAC) to discuss the Global Initiative,...

  16. Federal employees health benefits program: debarment--OPM. Final rule.

    PubMed

    1994-10-11

    The Office of Personnel Management (OPM) is issuing final regulations to incorporate into regulations the statutory requirement that carriers in the Federal Employees Health Benefits (FEHB) Program may not deny claims for services or supplies due to the debarment of the providers who supplied them if the claimants could not have known that the provider was debarred. The purpose of these regulations is to comply with the provision of law that requires OPM to prescribe regulations on this issue. PMID:10137652

  17. The Future of Psychiatric Collaboration in Federally Qualified Health Centers.

    PubMed

    Kaliebe, Kristopher E

    2016-08-01

    Federally qualified health centers (FQHCs) provide comprehensive care to underserved and disadvantaged populations. FQHCs now comprise the largest primary care network in the United States. Currently, many FQHCs provide limited access to psychiatric services; and when such services are available, most use traditional on-site psychiatric clinics. The author reviews the rationale for increasing access to behavioral health care in FQHCs by adopting collaborative models of care, describes challenges to adopting these models in FQHCs, and discusses ways to increase the primary care team's ability to support patient self-care and family functioning. PMID:27032666

  18. [Use of routine data from statutory health insurances for federal health monitoring purposes].

    PubMed

    Ohlmeier, C; Frick, J; Prütz, F; Lampert, T; Ziese, T; Mikolajczyk, R; Garbe, E

    2014-04-01

    Federal health monitoring deals with the state of health and the health-related behavior of populations and is used to inform politics. To date, the routine data from statutory health insurances (SHI) have rarely been used for federal health monitoring purposes. SHI routine data enable analyses of disease frequency, risk factors, the course of the disease, the utilization of medical services, and mortality rates. The advantages offered by SHI routine data regarding federal health monitoring are the intersectoral perspective and the nearly complete absence of recall and selection bias in the respective population. Further, the large sample sizes and the continuous collection of the data allow reliable descriptions of the state of health of the insurants, even in cases of multiple stratification. These advantages have to be weighed against disadvantages linked to the claims nature of the data and the high administrative hurdles when requesting the use of SHI routine data. Particularly in view of the improved availability of data from all SHI insurants for research institutions in the context of the "health-care structure law", SHI routine data are an interesting data source for federal health monitoring purposes. PMID:24658676

  19. Registration requirements within the German Federal Health Office.

    PubMed

    Lingk, W

    1985-02-01

    Public health authorities responsible for consumer protection in connection with the use of chemical products are faced with several conflicting requirements. In addition to the primary requirements of protecting human health and assessing the balance between benefits and risks, the authorities are faced with the need to identify appropriate tests, to avoid unnecessary testing in experimental animals, to adapt existing test guidelines in the light of new technological and scientific developments and to make optimal use of the facilities and expertise available. Among the measures being taken by the German Federal Health Office to resolve these difficulties, particularly in connection with the testing of chemicals for skin and eye irritancy, are the evaluation of alternatives to animal tests, the encouragement of more effective screening and use of existing test results, promotion of the international exchange of test data, and support for proposed changes in the use of the Draize test. PMID:4040061

  20. Federated querying architecture with clinical & translational health IT application.

    PubMed

    Livne, Oren E; Schultz, N Dustin; Narus, Scott P

    2011-10-01

    We present a software architecture that federates data from multiple heterogeneous health informatics data sources owned by multiple organizations. The architecture builds upon state-of-the-art open-source Java and XML frameworks in innovative ways. It consists of (a) federated query engine, which manages federated queries and result set aggregation via a patient identification service; and (b) data source facades, which translate the physical data models into a common model on-the-fly and handle large result set streaming. System modules are connected via reusable Apache Camel integration routes and deployed to an OSGi enterprise service bus. We present an application of our architecture that allows users to construct queries via the i2b2 web front-end, and federates patient data from the University of Utah Enterprise Data Warehouse and the Utah Population database. Our system can be easily adopted, extended and integrated with existing SOA Healthcare and HL7 frameworks such as i2b2 and caGrid. PMID:21537849

  1. Federalism and health policy: the intergovernmental committees in Brazil

    PubMed Central

    Machado, Cristiani Vieira; de Lima, Luciana Dias; Viana, Ana Luiza d'Ávila; de Oliveira, Roberta Gondim; Iozzi, Fabíola Lana; de Albuquerque, Mariana Vercesi; Scatena, João Henrique Gurtler; Mello, Guilherme Arantes; Pereira, Adelyne Maria Mendes; Coelho, Ana Paula Santana

    2014-01-01

    OBJECTIVE To analyze the dynamics of operation of the Bipartite Committees in health care in the Brazilian states. METHODS The research included visits to 24 states, direct observation, document analysis, and performance of semi-structured interviews with state and local leaders. The characterization of each committee was performed between 2007 and 2010, and four dimensions were considered: (i) level of institutionality, classified as advanced, intermediate, or incipient; (ii) agenda of intergovernmental negotiations, classified as diversified/restricted, adapted/not adapted to the reality of each state, and shared/unshared between the state and municipalities; (iii) political processes, considering the character and scope of intergovernmental relations; and (iv) capacity of operation, assessed as high, moderate, or low. RESULTS Ten committees had advanced level of institutionality. The agenda of the negotiations was diversified in all states, and most of them were adapted to the state reality. However, one-third of the committees showed power inequalities between the government levels. Cooperative and interactive intergovernmental relations predominated in 54.0% of the states. The level of institutionality, scope of negotiations, and political processes influenced Bipartite Committees’ ability to formulate policies and coordinate health care at the federal level. Bipartite Committees with a high capacity of operation predominated in the South and Southeast regions, while those with a low capacity of operations predominated in the North and Northeast. CONCLUSIONS The regional differences in operation among Bipartite Interagency Committees suggest the influence of historical-structural variables (socioeconomic development, geographic barriers, characteristics of the health care system) in their capacity of intergovernmental health care management. However, structural problems can be overcome in some states through institutional and political changes. The creation

  2. Health Promoting Schools: Initiatives in Africa

    ERIC Educational Resources Information Center

    Macnab, Andrew J.; Stewart, Donald; Gagnon, Faith A.

    2014-01-01

    Purpose: The purpose of this paper is to describe the rationale for and potential of World Health Organization (WHO) health promoting schools (HPS) in Africa. Design/Methodology/Approach: Overview of the related literature and presentations at the 2011 Stellenbosch international colloquium on HPS relating to sub-Saharan Africa. Findings: Schools…

  3. Health quality initiative promoted by large employers.

    PubMed

    Fine, Allan

    2004-01-01

    The goal of Care Focused Purchasing is to create a scorecard of providers and physicians enabling health care consumers to make better decisions. The employer group is united around the belief that current health plan designs and cost-sharing strategies are short-sighted. They are looking for additional companies to join this organization. PMID:15702565

  4. Health effects of the Federal Bureau of Prisons tobacco ban

    PubMed Central

    2012-01-01

    Background Tobacco smoking remains the leading cause of preventable death in America, claiming 450,000 lives annually. Chronic Obstructive Pulmonary Disease, caused by smoking in the vast majority of cases, became the third leading cause of death in the U.S. in 2008. The burden of asthma, often exacerbated by tobacco exposure, has widespread clinical and public health impact. Despite this considerable harm, we know relatively little about the natural history of lung disease and respiratory impairment in adults, especially after smoking cessation. Methods/Design Our paper describes the design and rationale for using the 2004 Federal Bureau of Prisons tobacco ban to obtain insights into the natural history of respiratory diseases in adult men and women of different races/ethnicities who are imprisoned in federal medical facilities. We have developed a longitudinal study of new prison arrivals, with data to be collected from each participant over the course of several years, through the use of standardized questionnaires, medical chart reviews, lung function tests, six-minute walk tests, and stored serum for the analysis of present and future biomarkers. Our endpoints include illness exacerbations, medication and health services utilization, lung function, serum biomarkers, and participants’ experience with their health and nicotine addiction. Discussion We believe the proposed longitudinal study will make a substantial contribution to the understanding and treatment of respiratory disease and tobacco addiction. PMID:23067295

  5. Recent health policy initiatives in Nordic countries

    PubMed Central

    Saltman, Richard B.

    1992-01-01

    Health care systems in Sweden, Finland, and Denmark are in the midst of substantial organizational reconfiguration. Although retaining their tax-based single source financing arrangements, they have begun experiments that introduce a limited measure of competitive behavior in the delivery of health services. The emphasis has been on restructuring public operated hospitals and health centers into various forms of public firms, rather than on the privatization of ownership of institutions. If successful, the reforms will enable these Nordic countries to combine their existing macroeconomic controls with enhanced microeconomic efficiency, effectiveness, and responsiveness to patients. PMID:10122003

  6. Women's Health Initiative (WHI) Background and Overview

    MedlinePlus

    ... disease, cancer and osteoporosis. A Community Prevention Study (CPS), a 5-year cooperative venture with CDC, was ... a multi-disciplinary approach. The purpose of the CPS was to develop community-based public health interventions ...

  7. 42 CFR 405.2469 - Federally Qualified Health Centers supplemental payments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Federally Qualified Health Centers supplemental payments. 405.2469 Section 405.2469 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED...

  8. 20 CFR 726.203 - Federal Coal Mine Health and Safety Act endorsement.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Federal Coal Mine Health and Safety Act... LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR COAL MINE OPERATOR'S INSURANCE Insurance Contracts § 726.203 Federal Coal Mine Health and Safety...

  9. 20 CFR 726.203 - Federal Coal Mine Health and Safety Act endorsement.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Federal Coal Mine Health and Safety Act... OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR COAL MINE OPERATOR'S INSURANCE Insurance Contracts § 726.203 Federal Coal Mine Health...

  10. 76 FR 17419 - Federal Health IT Strategic Plan: 2011-2015 Open Comment Period

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-29

    ... HUMAN SERVICES Federal Health IT Strategic Plan: 2011-2015 Open Comment Period AGENCY: Office of the... the Federal Health IT Strategic Plan (developed June 3, 2008) in consultation with other appropriate... the Federal Health IT Strategic Plan is open through Friday, April 22 at 11:59 p.m. (Eastern)....

  11. Health Impact Assessment, Physical Activity and Federal Lands Trail Policy

    PubMed Central

    Davis, Sally M.; Cruz, Theresa H.; Kozoll, Richard L.

    2016-01-01

    Objectives The objectives of this paper are to describe the application of Health Impact Assessment (HIA) to inform trail decisions affecting a rural, under-resourced community and propose the routine integration of HIAs to enhance NEPA environmental assessments and environmental impact statements for trail decisions on federal lands. Methods Screening, scoping, assessment, recommendations, reporting, monitoring and evaluation are being used to examine the health impact of trail location and design. Results HIA recommendations are being integrated into the public lands National Environmental Protection Act process for planning access to a new segment of the Continental Divide National Scenic Trail. Potential users from a nearby rural New Mexico community and a region of almost one million may benefit from this HIA-informed planning. Conclusions HIA can be integrated into the policy and decision-making process for trails on public lands.

  12. Finding Funding: A Guide to Federal Sources for Asset-Building Initiatives. Finding Funding Series

    ERIC Educational Resources Information Center

    Lind, Christianne; Relave, Nanette; Schmid, William; Terzaghi, Damon

    2009-01-01

    This guide outlines strategies for financing asset-building initiatives and provides information on 71 federal funding sources that can be used to support a range of activities and services. It includes well-known sources of funding for asset building, for example, the Assets for Independence Demonstration Program and the Family Self-Sufficiency…

  13. 77 FR 11798 - Federal Housing Administration (FHA) Risk Management Initiatives: Revised Seller Concessions...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-28

    ... URBAN DEVELOPMENT 24 CFR Chapter II Federal Housing Administration (FHA) Risk Management Initiatives... Counsel, HUD. ACTION: Correction. SUMMARY: On February 23, 2012 (77 FR 10695), HUD published a request for... methods for submitting public comments. All submissions must refer to the docket number (FR-5572-N-01)...

  14. Education Reform: Federal Initiatives and National Mandates, 1963-1993. Occasional Paper 1993-3.

    ERIC Educational Resources Information Center

    Levitan, Sar A.; Gallo, Frank

    The federal government initiated educational reform measures in the United States long before the subject became a matter of national concern. In recent decades, reform has focused on helping children whose special needs were neglected by the school system. Evidence shows that these efforts have improved services to neglected groups, but without…

  15. The Ready to Teach Program: A Federal Initiative in Support of Online Courses for Teachers

    ERIC Educational Resources Information Center

    Gill, Wanda E.

    2011-01-01

    The report, "The Ready to Teach Program: A Federal Initiative in Support of Online Courses for Teachers", describes the history of the Ready to Teach Program and its role as one of the solutions to the national need to increase the performance of teachers through professional development. The report describes selected findings from the Eisenhower…

  16. Physical Restraint Initiation in Nursing Homes and Subsequent Resident Health

    ERIC Educational Resources Information Center

    Engberg, John; Castle, Nicholas G.; McCaffrey, Daniel

    2008-01-01

    Purpose: It is widely believed that physical restraint use causes mental and physical health decline in nursing home residents. Yet few studies exist showing an association between restraint initiation and health decline. In this research, we examined whether physical restraint initiation is associated with subsequent lower physical or mental…

  17. Mental health and substance abuse insurance parity for federal employees: how did health plans respond?

    PubMed

    Barry, Colleen L; Ridgely, M Susan

    2008-01-01

    A fundamental concern with competitive health insurance markets is that they will not supply efficient levels of coverage for treatment of costly, chronic, and predictable illnesses, such as mental illness. Since the inception of employer-based health insurance, coverage for mental health services has been offered on a more limited basis than coverage for general medical services. While mental health advocates view insurance limits as evidence of discrimination, adverse selection and moral hazard can also explain these differences in coverage. The intent of parity regulation is to equalize private insurance coverage for mental and physical illness (an equity concern) and to eliminate wasteful forms of competition due to adverse selection (an efficiency concern). In 2001, a presidential directive requiring comprehensive parity was implemented in the Federal Employees Health Benefits (FEHB) Program. In this study, we examine how health plans responded to the parity directive. Results show that in comparison with a set of unaffected health plans, federal employee plans were significantly more likely to augment managed care through contracts with managed behavioral health "carve-out" firms after parity. This finding helps to explain the absence of an effect of the FEHB Program directive on total spending, and is relevant to the policy debate in Congress over federal parity. PMID:18478666

  18. 42 CFR 440.365 - Coverage of rural health clinic and federally qualified health center (FQHC) services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Coverage of rural health clinic and federally... clinic and federally qualified health center (FQHC) services. If a State provides benchmark or benchmark... otherwise, to rural health clinic services and FQHC services as defined in subparagraphs (B) and (C)...

  19. 42 CFR 440.365 - Coverage of rural health clinic and federally qualified health center (FQHC) services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Coverage of rural health clinic and federally... clinic and federally qualified health center (FQHC) services. If a State provides benchmark or benchmark... otherwise, to rural health clinic services and FQHC services as defined in subparagraphs (B) and (C)...

  20. Integrated Mission Simulation (IMSim): Multiphase Initialization Design with Late Joiners, Rejoiners and Federation Save & Restore

    NASA Technical Reports Server (NTRS)

    Dexter, Daniel E.; Varesic, Tony E.

    2015-01-01

    This document describes the design of the Integrated Mission Simulation (IMSim) federate multiphase initialization process. The main goal of multiphase initialization is to allow for data interdependencies during the federate initialization process. IMSim uses the High Level Architecture (HLA) IEEE 1516 [1] to provide the communication and coordination between the distributed parts of the simulation. They are implemented using the Runtime Infrastructure (RTI) from Pitch Technologies AB. This document assumes a basic understanding of IEEE 1516 HLA, and C++ programming. In addition, there are several subtle points in working with IEEE 1516 and the Pitch RTI that need to be understood, which are covered in Appendix A. Please note the C++ code samples shown in this document are for the IEEE 1516-2000 standard.

  1. 78 FR 54923 - Federal Advisory Council on Occupational Safety and Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-06

    ... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Request for nominations to serve on the Federal Advisory Council on Occupational Safety and Health (FACOSH). SUMMARY: The Assistant Secretary...

  2. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Exclusion or suspension under a Federal or State..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health...

  3. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Exclusion or suspension under a Federal or State..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health...

  4. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Exclusion or suspension under a Federal or State..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health...

  5. 45 CFR 60.15 - Reporting exclusions from participation in Federal or state health care programs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... or state health care programs. 60.15 Section 60.15 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... exclusions from participation in Federal or state health care programs. (a) Who must report. Federal Government agencies and state law and fraud enforcement agencies must report health care...

  6. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Exclusion or suspension under a Federal or State..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health...

  7. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Exclusion or suspension under a Federal or State..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health...

  8. 42 CFR 137.302 - Are Federal funds available to cover start-up costs associated with initial Tribal assumption of...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Are Federal funds available to cover start-up costs... funds available to cover start-up costs associated with initial Tribal assumption of environmental responsibilities? (a) Yes, start-up costs are available as provided in section 508(c) of the Act . During...

  9. 76 FR 71077 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-16

    ... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Announcement of... advise the Secretary of Labor (Secretary) on all matters relating to the occupational safety and...

  10. Children and U.S. federal policy on health and health care: seen but not heard.

    PubMed

    Flores, Glenn; Lesley, Bruce

    2014-12-01

    Children account for 73.5 million Americans (24%), but 8% of federal expenditures. Data on health and health care indicate that child well-being in the United States has been in decline since the most recent recession. Childhood poverty has reached its highest level in 20 years, 1 in 4 children lives in a food-insecure household, 7 million children lack health insurance, a child is abused or neglected every 47 seconds, and 1 in 3 children is overweight or obese. Five children are killed daily by firearms, 1 in 5 experiences a mental disorder, racial/ethnic disparities continue to be extensive and pervasive, and major sequester cuts and underfunding of pediatric research have damaged our global leadership in biomedical research and hobbled economic growth. In this analysis, we identify 10 urgent priorities for the health and health care of US children, including poverty, food insufficiency, lack of health insurance, child abuse and neglect, overweight and obesity, firearm deaths and injuries, mental health, racial/ethnic disparities, immigration, and research. Overwhelming, bipartisan support by voters exists for enhancing our nation's investments in children's health and well-being. Federal policy action steps are proposed to successfully address these priorities and ensure a healthy, productive future for US children and the nation. PMID:25329439

  11. Measuring the impact and outcomes of maternal child health federal programs.

    PubMed

    Taylor, Yhenneko J; Nies, Mary A

    2013-07-01

    Improving maternal and child health is a key objective of the United Nations' Millennium Development Goals and the Healthy People goals for improving the health of Americans. Government initiatives are important particularly for reducing disparities that affect disadvantaged populations. Head Start, Healthy Start, WIC and Medicaid are four federal programs that target disparities in maternal and child health outcomes. This paper reviews recent evaluations of these programs to identify outcomes assessed and opportunities for further evaluation of these programs. We conducted a review of recent evaluation studies assessing the impact of four maternal and child health programs on a health or healthcare outcome. Sources for published literature included the PubMed, Academic Search Complete, CINAHL and PsycInfo databases. Titles and abstracts of studies were examined to determine if they met inclusion criteria. Included studies were categorized by type of outcome examined. Twenty peer-reviewed studies published between January 2006 and June 2011 met inclusion criteria. The majority of studies examined infant outcomes (11), followed by breastfeeding/nutrition (4), maternal health (3), and unintended pregnancy (2). Measures used were consistent across studies; however, findings on the impact of programs were mixed reflecting differences in selection of comparison group, data source and statistical methods. The impact of maternal and child health programs may vary by setting and population served, but inconclusive findings remain. Health service researchers can build upon current evaluations to increase our understanding of what works, help target resources, and improve evaluation of programs in the future. PMID:22729661

  12. DOE-HUD Initiative on Energy Efficiency in Housing: A federal partnership. Program summary report

    SciTech Connect

    Brinch, J.

    1996-06-01

    One of the primary goals of the US Department of Housing and urban Development (HUD) is the expansion of home ownership and affordable housing opportunities. Recognizing that energy efficiency is a key component in an affordable housing strategy, HUD and the US Department of Energy (DOE) created the DOE-HUD Initiative on Energy Efficiency in Housing. The DOE-HUD Initiative was designed to share the results of DOE research with housing providers throughout the nation, to reduce energy costs in federally-subsidized dwelling units and improve their affordability and comfort. This Program Summary Report provides an overview of the DOE-HUD Initiative and detailed project descriptions of the twenty-seven projects carried out with Initiative funding.

  13. Higher education initiatives for disaster and emergency health in iran.

    PubMed

    Ardalan, Ali; Mesdaghinia, Alireza; Masoumi, Gholamreza; Holakouie Naieni, Kourosh; Ahmadnezhad, Elham

    2013-01-01

    Iran's health system is expanding the disaster and emergency higher education programs over the country to enhance the capacity of human resources for effective and efficient disaster mitigation, preparedness, response and recovery. In this article we present an overview about the initiatives and progress of disaster and emergency health higher education in Iran. Following the Bam earthquake, in collaboration with the Ministry of Health & Medical Education and National Institute of Health Research, School of Public Health at the Tehran University of Medical Sciences, Iran took the initiative to develop a Master of Public Health (MPH) with disaster concentration in 2006, a PhD in disaster and emergency health in 2011, and a well constructed certificate course in 2008 entitled Disaster Health Management and Risk Reduction (DHMR). Iran, Kerman and Shahid Beheshti Universities of Medical Sciences and University of Social Welfare and Rehabilitation are other academia that joined this initiative. Regarding the importance of programs evaluation, we have planned for a comprehensive evaluation of MPH and DHMR programs in 2013-4 and the Accreditation and Evaluation Board of Disaster & Emergency Health, based in MOH&ME, is responsible for evaluation of the PhD program in 3-5 years from initiation. PMID:23967432

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

    PubMed

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

    2005-01-01

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

  15. 78 FR 30337 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-22

    ...The Federal Advisory Council on Occupational Safety and Health (FACOSH) will meet on June 6, 2013, in Washington, DC. This Federal Register notice also announces the appointment of seven individuals to serve on...

  16. Federal Government Health, Education, and Welfare Programs of Assistance to American Indians Residing on Federal Reservations (Including Table of Contents and Index).

    ERIC Educational Resources Information Center

    Langone, Stephen A.

    Federal health, education, and welfare programs for 1970 benefiting American Indians residing on Federal reservations are listed. The report is divided into 3 sections: (1) Federal Indian programs aimed at improving or providing Indian health services, tribal management services, housing, higher education, and conservation; (2) Federal programs…

  17. 75 FR 10629 - Federal Advisory Council on Occupational Safety and Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-08

    ... Occupational Safety and Health Programs), 41 CFR part 102-3, and Secretary of Labor's Order 5-2007 (72 FR 31160... Labor Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and...; ] DEPARTMENT OF LABOR Occupational Safety and Health Administration Federal Advisory Council on......

  18. 76 FR 60535 - Federal Advisory Council on Occupational Safety and Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-29

    ... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Reopening of the record and extension of... submitting nominations for membership on the Federal Advisory Council on Occupational Safety and...

  19. 77 FR 42417 - Federal Employees Health Benefits Program Coverage for Certain Firefighters

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-19

    ... 3206-AM66 Federal Employees Health Benefits Program Coverage for Certain Firefighters AGENCY: Office of... (OPM) is issuing an interim final rule to amend the Federal Employees Health Benefits Program (FEHB... health benefits plan under the FEHB. DATES: This rule is effective July 17, 2012. OPM must...

  20. DOE-HUD initiative on energy efficiency in housing: A federal partnership

    SciTech Connect

    Brinch, J.; Ternes, M.; Myers, M.

    1996-07-01

    A five-year initiative between the US Department of Energy (DOE) and the US Department of Housing and Urban Development (HUD) demonstrated the feasibility of improving the energy efficiency of publicly-assisted housing. Twenty-seven projects and activities undertaken during 1990--95 involved research and field demonstrations, institutional and administrative changes to HUD policies and procedures, innovative financing and leveraging of federal dollars with non-federal money, and education, training, and technical assistance. With most of the 27 projects and activities completed, the two departments have initiated a five-year deployment effort, the DOE-Energy Partnerships for Affordable Homes, to achieve energy and water savings in public and assisted housing on a large scale throughout the country. A Clearinghouse for Energy Efficiency in Public and Assisted Housing managed by the National Center for Appropriate Technology (NCAT), will offer hands-on energy assistance to housing providers to complement DOE`s assistance. This paper presents the findings of the DOE-HUD Initiative, with primary attention paid to those projects which successfully integrated energy efficiency into private and public single and multifamily housing. The paper includes examples of the publications, case-study reports, exhibits and videotapes developed during the course of the Initiative. Information on the new DOE Energy Partnerships and on the NCAT Clearinghouse is also presented. New Partnership projects with the Atlanta and Chicago Housing Authorities describe the technical assistance envisioned under the Partnership.

  1. Health-systems efficiency in the Russian Federation: tuberculosis control.

    PubMed Central

    Floyd, Katherine; Hutubessy, Raymond; Samyshkin, Yevgeniy; Korobitsyn, Alexei; Fedorin, Ivan; Volchenkov, Gregory; Kazeonny, Boris; Coker, Richard; Drobniewski, Francis; Jakubowiak, Wieslaw; Shilova, Margarita; Atun, Rifat A.

    2006-01-01

    OBJECTIVE: To conduct a comprehensive assessment of the case-mix of patients admitted to tuberculosis hospitals and the reasons for their admission in four Russian regions: Ivanovo, Orel, Samara and Vladimir. We also sought to quantify the extent to which efficiency could be improved by reducing hospitalization rates and re-profiling hospital beds available in the tuberculosis-control system. METHODS: We used a standard questionnaire to determine how beds were being used and who was using the beds in tuberculosis facilities in four Russian regions. Data were collected to determine how 4306 tuberculosis beds were utilized as well as on the socioeconomic and demographic indicators, clinical parameters and reasons for hospitalization for 3352 patients. FINDINGS: Of the 3352 patients surveyed about 70% were male; the average age was 40; and rates of unemployment, disability and alcohol misuse were high. About one-third of beds were occupied by smear-positive or culture-positive tuberculosis patients; 20% were occupied by tuberculosis patients who were smear-negative and/or culture-negative; 20% were occupied by patients who no longer had tuberculosis; and 20% were unoccupied. If clinical and public health admission criteria were applied then < 50% of admissions would be justified and < 50% of the current number of beds would be required. Up to 85% of admissions and beds were deemed to be necessary when social problems and poor access to outpatient care were considered along with clinical and public health admission criteria. CONCLUSION: Much of the Russian Federation's large tuberculosis hospital infrastructure is unnecessary when clinical and public health criteria are used, but the large hospital infrastructure within the tuberculosis-control system has an important social support function. Improving the efficiency of the system will require the reform of health-system norms and regulations as they relate to resource allocation and clinical care and implementation of

  2. Knowledge and Behavioral Effects in Cardiovascular Health: Community Health Worker Health Disparities Initiative, 2007–2010

    PubMed Central

    Hurtado, Margarita; Yang, Manshu; Evensen, Christian; Windham, Amy; Ortiz, Gloria; Tracy, Rachel; Ivy, Edward Donnell

    2014-01-01

    Introduction Cardiovascular disease is the leading cause of death in the United States, and disparities in cardiovascular health exist among African Americans, American Indians, Hispanics, and Filipinos. The Community Health Worker Health Disparities Initiative of the National Heart, Lung, and Blood Institute (NHLBI) includes culturally tailored curricula taught by community health workers (CHWs) to improve knowledge and heart-healthy behaviors in these racial/ethnic groups. Methods We used data from 1,004 community participants in a 10-session curriculum taught by CHWs at 15 sites to evaluate the NHLBI’s health disparities initiative by using a 1-group pretest–posttest design. The curriculum addressed identification and management of cardiovascular disease risk factors. We used linear mixed effects and generalized linear mixed effects models to examine results. Results Average participant age was 48; 75% were female, 50% were Hispanic, 35% were African American, 8% were Filipino, and 7% were American Indian. Twenty-three percent reported a history of diabetes, and 37% reported a family history of heart disease. Correct pretest to posttest knowledge scores increased from 48% to 74% for heart healthy knowledge. The percentage of participants at the action or maintenance stage of behavior change increased from 41% to 85%. Conclusion Using the CHW model to implement community education with culturally tailored curricula may improve heart health knowledge and behaviors among minorities. Further studies should examine the influence of such programs on clinical risk factors for cardiovascular disease. PMID:24524426

  3. 42 CFR 422.527 - Agreements with Federally qualified health centers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Application Procedures and Contracts for Medicare Advantage Organizations § 422.527 Agreements with Federally qualified health...

  4. Insurance Continuity and Human Papillomavirus Vaccine Uptake in Oregon and California Federally Qualified Health Centers

    PubMed Central

    Carlson, Matthew; Lapidus, Jodi; Heintzman, John; Bailey, Steffani; DeVoe, Jennifer

    2014-01-01

    Objectives. We examined the association between insurance continuity and human papillomavirus (HPV) vaccine uptake in a network of federally qualified health clinics (FQHCs). Methods. We analyzed retrospective electronic health record data for females, aged 9–26 years in 2008 through 2010. Based on electronic health record insurance coverage information, patients were categorized by percent of time insured during the study period (0%, 1%–32%, 33%–65%, 66%–99%, or 100%). We used bilevel multivariable Poisson regression to compare vaccine-initiation prevalence between insurance groups, stratified by race/ethnicity and age. We also examined vaccine series completion among initiators who had at least 12 months to complete all 3 doses. Results. Significant interactions were observed between insurance category, age, and race/ethnicity. Juxtaposed with their continuously insured peers, patients were less likely to initiate the HPV vaccine if they were insured for less than 66% of the study period, aged 13 years or older, and identified as a racial/ethnic minority. Insurance coverage was not associated with vaccine series completion. Conclusions. Disparities in vaccine uptake by insurance status were present in the FQHCs studied here, despite the fact that HPV vaccines are available to many patients regardless of ability to pay. PMID:25033154

  5. National Public Opinion on School Health Education: Implications for the Health Care Reform Initiatives.

    ERIC Educational Resources Information Center

    Torabi, Mohammad R.; Crowe, James W.

    1995-01-01

    This study investigated national public opinion on school health education and the implications for health-care reform initiatives. Telephone surveys of 1,005 adults nationwide indicated that the public at large believes in the importance of health education to reduce health problems among children, considering it the responsibility of parents and…

  6. A Student-Led Health Education Initiative Addressing Health Disparities in a Chinatown Community

    PubMed Central

    Lee, Benjamin J.; So, Chunkit; Chiu, Brandon G.; Polisetty, Radhika; Quiñones-Boex, Ana; Liu, Hong

    2015-01-01

    Together with community advocates, professional student organizations can help improve access to health care and sustain services to address the health disparities of a community in need. This paper examines the health concerns of an underserved Chinese community and introduces a student-led health education initiative that fosters service learning and student leadership. The initiative was recognized by the American Association of Colleges of Pharmacy (AACP) and received the 2012-2013 Student Community Engaged Service Award. PMID:26839422

  7. A Student-Led Health Education Initiative Addressing Health Disparities in a Chinatown Community.

    PubMed

    Lee, Benjamin J; Wang, Sheila K; So, Chunkit; Chiu, Brandon G; Wang, Wesley Y; Polisetty, Radhika; Quiñones-Boex, Ana; Liu, Hong

    2015-11-25

    Together with community advocates, professional student organizations can help improve access to health care and sustain services to address the health disparities of a community in need. This paper examines the health concerns of an underserved Chinese community and introduces a student-led health education initiative that fosters service learning and student leadership. The initiative was recognized by the American Association of Colleges of Pharmacy (AACP) and received the 2012-2013 Student Community Engaged Service Award. PMID:26839422

  8. 42 CFR 422.316 - Special rules for payments to Federally qualified health centers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Payments to Medicare Advantage Organizations § 422.316 Special rules for payments to Federally qualified health...

  9. Fostering innovation, advancing patient safety: the kidney health initiative.

    PubMed

    Archdeacon, Patrick; Shaffer, Rachel N; Winkelmayer, Wolfgang C; Falk, Ronald J; Roy-Chaudhury, Prabir

    2013-09-01

    To respond to the serious and underrecognized epidemic of kidney disease in the United States, the US Food and Drug Administration and the American Society of Nephrology have founded the Kidney Health Initiative-a public-private partnership designed to create a collaborative environment in which the US Food and Drug Administration and the greater kidney community can interact to optimize the evaluation of drugs, devices, biologics, and food products. The Kidney Health Initiative will bring together all the necessary stakeholders, including patients, regulators, industry, health care providers, academics, and other governmental agencies, to improve patient safety and foster innovation. This initiative is intended to enable the kidney community as a whole to provide the right drug, device, or biologic for administration to the right patient at the right time by fostering partnerships that will facilitate development and delivery of those products and addressing challenges that currently impede these goals. PMID:23744001

  10. Competencies for public health finance: an initial assessment and recommendations.

    PubMed

    Gillespie, Kathleen N; Kurz, Richard S; McBride, Timothy; Schmitz, Homer H

    2004-01-01

    The purpose of the study in this article was to identify The needs of public health managers with regard to public health finance. A survey of public health practitioners regarding competencies was conducted and a review of course offerings in finance among schools of public health was performed. Most public health practitioners surveyed believe that a broad array of management competencies are required to administer the finances of a public health facility or department. Respondents added 35 competencies to those initially given to them for review. Most added competencies that were more specific than the original competencies or could be viewed as subpoints of the original competencies. Many schools offered no courses specifically addressing public health care finance, with a few offering at most only one public health finance course. All schools offered at least one corporate finance course, and the majority offered two or more courses. We conclude with a number of recommendations for education and competency development, suggesting several next steps that can advance the field of public health's understanding of what managers need to master in public health finance to effectively function as public health managers. PMID:15552772

  11. 45 CFR 61.10 - Reporting exclusions from participation in Federal or State health care programs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Reporting exclusions from participation in Federal... exclusions from participation in Federal or State health care programs. (a) Who must report. Federal and... individual, personal identifiers, including: (i) Name; (ii) Social Security Number (or ITIN); (iii)...

  12. 45 CFR 60.15 - Reporting exclusions from participation in Federal or state health care programs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Reporting exclusions from participation in Federal... exclusions from participation in Federal or state health care programs. (a) Who must report. Federal..., including: (i) Name, (ii) Social Security Number (or ITIN) (state law and fraud enforcement agencies...

  13. 45 CFR 61.10 - Reporting exclusions from participation in Federal or State health care programs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Reporting exclusions from participation in Federal... exclusions from participation in Federal or State health care programs. (a) Who must report. Federal and... individual, personal identifiers, including: (i) Name; (ii) Social Security Number (or ITIN); (iii)...

  14. 76 FR 38281 - Federal Employees Health Benefits Program: New Premium Rating Method for Most Community Rated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-29

    ... appeared in the Federal Register of June 23, 2011 (76 FR 36857). The document amends the Federal Employees... groups (SSSGs). DATES: The interim final rule published on Thursday, June 23, 2011 at 76 FR 36857 is.... Federal Employees Health Benefits Program: New Premium Rating Method for Most Community Rated...

  15. 45 CFR 61.10 - Reporting exclusions from participation in Federal or State health care programs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Reporting exclusions from participation in Federal... exclusions from participation in Federal or State health care programs. (a) Who must report. Federal and... individual, personal identifiers, including: (i) Name; (ii) Social Security Number (or ITIN); (iii)...

  16. 45 CFR 156.330 - Changes of ownership of issuers of Qualified Health Plans in Federally-facilitated Exchanges.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES Federally-Facilitated...

  17. 20 CFR 726.203 - Federal Coal Mine Health and Safety Act endorsement.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Federal Coal Mine Health and Safety Act endorsement. 726.203 Section 726.203 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG...

  18. 20 CFR 726.203 - Federal Coal Mine Health and Safety Act endorsement.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Federal Coal Mine Health and Safety Act endorsement. 726.203 Section 726.203 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG...

  19. 20 CFR 726.203 - Federal Coal Mine Health and Safety Act endorsement.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Federal Coal Mine Health and Safety Act endorsement. 726.203 Section 726.203 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG...

  20. Perspectives on the Federal Government and Health Information: Patterns, Impact, Expectations.

    ERIC Educational Resources Information Center

    Lunin, Lois F.; And Others

    1987-01-01

    Nine articles examine patterns of federal health information services including: the current Administration's policy; the history of the National Library of Medicine; Federal Health Information Clearinghouses and other unique projects; the Center for the Utilization of Technology; marketing trends at the Government Printing Office; and…

  1. Regulation for the enforcement of federal health care provider conscience protection laws. Final rule.

    PubMed

    2011-02-23

    The Department of Health and Human Services issues this final rule which provides that enforcement of the federal statutory health care provider conscience protections will be handled by the Department's Office for Civil Rights, in conjunction with the Department's funding components. This Final Rule rescinds, in part, and revises, the December 19, 2008 Final Rule entitled "Ensuring That Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory Policies or Practices in Violation of Federal Law" (the "2008 Final Rule"). Neither the 2008 final rule, nor this final rule, alters the statutory protections for individuals and health care entities under the federal health care provider conscience protection statutes, including the Church Amendments, Section 245 of the Public Health Service Act, and the Weldon Amendment. These federal statutory health care provider conscience protections remain in effect. PMID:21351680

  2. Increasing the practice of health promotion initiatives by licensed premises.

    PubMed

    Wiggers, J; Considine, R; Hazell, T; Haile, M; Rees, M; Daly, J

    2001-06-01

    Licensees of all licensed premises in the Hunter Region of New South Wales, Australia, were offered free services to encourage adoption of health promotion initiatives relating to responsible service of alcohol, environmental tobacco smoke, healthy food choices, breast and cervical cancer prevention, and the prevention of HIV/AIDS. A total of 239 premises participated in the follow-up survey. Increases in prevalence ranged between 11% and 59% for alcohol-related initiatives. The prevalence of smoke-free areas and healthy food choices increased from 32% to 65% and 42% to 96%, respectively, and the provision of cancer prevention information increased from 3% to 59%. Licensed premises represent a particularly challenging sector for health promotion practitioners to work in. The results of this study suggest that the adoption of health promotion initiatives by licensed premises can be increased. A considerable opportunity therefore exists for health promotion practitioners to become more actively involved in facilitating the adoption of such initiatives in this setting. PMID:11380053

  3. Sierra Health Foundation's Positive Youth Justice Initiative. Briefing Paper

    ERIC Educational Resources Information Center

    Sierra Health Foundation, 2012

    2012-01-01

    In December 2011, the Sierra Health Foundation board of directors approved a framework for a new youth development initiative. The framework built upon the foundation's recently concluded REACH Youth Development Program and incorporated findings and recommendations from the highly regarded "Healthy Youth/Healthy Regions" and "Renewing Juvenile…

  4. Fostering Innovation, Advancing Patient Safety: The Kidney Health Initiative

    PubMed Central

    Archdeacon, Patrick; Winkelmayer, Wolfgang C.; Falk, Ronald J.; Roy-Chaudhury, Prabir

    2013-01-01

    Summary To respond to the serious and underrecognized epidemic of kidney disease in the United States, the US Food and Drug Administration and the American Society of Nephrology have founded the Kidney Health Initiative—a public–private partnership designed to create a collaborative environment in which the US Food and Drug Administration and the greater kidney community can interact to optimize the evaluation of drugs, devices, biologics, and food products. The Kidney Health Initiative will bring together all the necessary stakeholders, including patients, regulators, industry, health care providers, academics, and other governmental agencies, to improve patient safety and foster innovation. This initiative is intended to enable the kidney community as a whole to provide the right drug, device, or biologic for administration to the right patient at the right time by fostering partnerships that will facilitate development and delivery of those products and addressing challenges that currently impede these goals. PMID:23744001

  5. Mobile phone health risk policy in Germany: the role of the federal government and the Federal Office for Radiation Protection.

    PubMed

    Schweikardt, Christoph; Gross, Dominik

    2012-01-01

    In order to establish a regulatory framework for a given technology important to society, the government must make decisions in the face of existing unknowingness. In the last decade, health risks originating from electromagnetic fields of mobile telecommunication transmitting stations and devices have become a regulation policy issue in Germany. This article investigates the role of the government and the Federal Office for Radiation Protection in regard to policy-making by analysing publications and Federal Parliament reports, hearings and debates. The government and Federal Parliament perceived the research situation in 2001 as insufficient in the absence of hard evidence for health impairment. Against this background, the government struck a compromise with mobile telecommunication network operators, who did not want to integrate stricter limit values for transmission stations as precautionary measures. The network operators' voluntary self-commitment included financing half the budget of the German Mobile Telecommunication Research Programme (2002-2008) under the lead management of the Federal Office for Radiation Protection, which concluded that it was not required to change the position taken in 2001. The results of this programme provided the basis to continue the agreement of that year. With regard to health issues and all the other interests involved, this agreement was an acceptable and remarkably stable compromise. PMID:21923562

  6. Meeting the needs of people with AIDS: local initiatives and Federal support.

    PubMed Central

    Sundwall, D N; Bailey, D

    1988-01-01

    The Health Resources and Services Administration (HRSA), one of the seven agencies of the Public Health Service, is working to meet some of the resource and patient service needs engendered by the epidemic of acquired immune deficiency syndrome (AIDS). Those actions derived from, and support the continuation, expansion, and replication of, initiatives at the community and State levels. HRSA is carrying out many of the recommendations of the Intragovernmental Task Force on AIDS Health Care Delivery by enhancing the AIDS training of health care personnel in prevention, diagnosis, and care and by counseling and encouraging the expansion of facilities outside hospitals to care for AIDS patients. The agency, through its pediatric AIDS demonstration projects, is working on models for the care of children with HIV infections. The needs of AIDS patients are being addressed through a drug therapy reimbursement program; demonstration grants to 13 projects to promote coordinated, integrated systems of care in the community; and grants for the development of intermediate and long-term care facilities for patients. Ten regional education and training centers, funded in 1987 and 1988, will increase the supply of health care providers prepared to diagnose and treat persons with HIV infections. Programs will be conducted for several thousand providers over the next 3 years, using such modalities as televised programs and train-the-trainer courses. The centers will also offer support and referral services for providers. PMID:3131821

  7. Exploring Australian health promotion and environmental sustainability initiatives.

    PubMed

    Patrick, Rebecca; Kingsley, Jonathan

    2016-04-01

    Issue addressed Health promotion practitioners have important roles in applying ecosystem approaches to health and actively promoting environmental sustainability within community-level practice. The present study identified the nature and scope of health promotion activities across Australia that tackle environmental sustainability. Methods A mixed-method approach was used, with 82 participants undertaking a quantitative survey and 11 undertaking a qualitative interview. Purposeful sampling strategies were used to recruit practitioners who were delivering community-level health promotion and sustainability programs in Australia. The data were analysed thematically and interpretation was guided by the principles of triangulation. Results Study participants were at various stages of linking health promotion and environmental sustainability. Initiatives focused on healthy and sustainable food, active transport, energy efficiency, contact with nature and capacity building. Conclusion Capacity building approaches were perceived as essential to strengthening this field of practice. Healthy and sustainable food and active transport were suitable platforms for simultaneously promoting community health and sustainability. There was potential for expansion of programs that emphasise contact with nature and energy issues, as well as interventions that emphasise systems thinking and interdisciplinary approaches. So what? It was promising that Australian health promotion programs have started to address complexity rather than single issues, as evidenced by explicit engagement with environmental sustainability. However, more effort is required to enable a shift towards ecosystem approaches to health. PMID:26650394

  8. Women's health education initiatives: why have they stalled?

    PubMed

    Henrich, Janet B

    2004-04-01

    Since the U.S. Congress first requested an assessment of women's health content in medical school curricula ten years ago, surveys indicate at least a two-fold increase in the number of schools with a women's health curriculum and no change in the number that offer a women's health clinical elective or rotation. Despite a marked increase in the number of schools with an office or program responsible for integration of women's health and gender-specific content into curricula, change has been modest. Reasons for this slow progress include uncertainty about the domain of women's health and what should be included in a curriculum, a lack of practical guidelines for implementation, and institutional resistance to change. The dominant factors that will influence future curriculum development are the increasing scientific knowledge base on sex and gender differences and the emerging scientific field of sex-based biology, both of which have potential to benefit the health of women. Evidence-based data on significant sex and gender differences will provide compelling reasons for schools to integrate this information into curricula, and new educational initiatives must further develop educational models to help implement change. As women's health becomes synonymous with the term "sex and gender differences," the challenge to schools is to address equally in their curricula those unique aspects of women's health that were part of the original intent of the congressional mandate. PMID:15044158

  9. Effectiveness of health and wellness initiatives for seniors.

    PubMed

    Coberley, Carter; Rula, Elizabeth Y; Pope, James E

    2011-02-01

    Given the increasing prevalence of obesity and lifestyle-related chronic diseases in the United States and abroad, senior wellness initiatives have emerged as a means to stem the troubling trends that threaten the well-being and the economy of many nations. Seniors are an important demographic for such programs because this age group is growing, both as a proportion of the overall population and as a contributor to health care cost escalation. The goal of senior wellness programs is to improve the overall health of seniors through a variety of approaches, including increased physical activity, better nutrition, smoking cessation, and support of other healthy behaviors. Outcome metrics of particular interest are the effects of participation in these programs on health care utilization and expenditures. This review describes several studies that demonstrate reduced inpatient admissions and health care costs, as well as improved health-related quality of life as a direct result of participation in large-scale senior wellness programs. Programs that effectively engage seniors in, and change behavior as a direct result of, participation provide strong evidence that health improvements and decreased health care expenditures can be achieved. However, solutions to the challenges of broader enrollment and sustained participation in these programs would increase the impact of their outcomes and health-related benefits. PMID:21323620

  10. 78 FR 64873 - Federal Employees Health Benefits Program and Federal Employees Dental and Vision Insurance...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ... the Federal Register (77 FR 42914-42918) to expand coverage of children under the FEHB Program and... children up to age 26. The regulations also allow children of same-sex domestic partners living in states that do not allow same-sex couples to marry to be covered family members under the FEHB and the...

  11. Federal Program Encourages Health Service Innovations on Developmental Disabilities

    ERIC Educational Resources Information Center

    Nix, Mary P.

    2009-01-01

    There is always room for improvement in the delivery of health services. This article discusses the U.S. Agency for Healthcare Research and Quality's (AHRQ) Health Care Innovations Exchange (www.innovations.ahrq.gov), a comprehensive program that aims to increase awareness of innovative strategies to meet health service delivery challenges and…

  12. The Global Threat Reduction Initiative's Orphan Source Recovery Project in the Russian Federation

    SciTech Connect

    Russell, J. W.; Ahumada, A. D.; Blanchard, T. A.

    2012-06-04

    After 9/11, officials at the United States Department of Energy (DOE), National Nuclear Security Administration (NNSA) grew more concerned about radiological materials that were vulnerable to theft and illicit use around the world. The concern was that terrorists could combine stolen radiological materials with explosives to build and detonate a radiological dispersal device (RDD), more commonly known as a “dirty bomb.” In response to this and other terrorist threats, the DOE/NNSA formed what is now known as the Global Threat Reduction Initiative (GTRI) to consolidate and accelerate efforts to reduce and protect vulnerable nuclear and radiological materials located at civilian sites worldwide. Although a cooperative program was already underway in the Russian Federation to secure nuclear materials at a range of different facilities, thousands of sealed radioactive sources remained vulnerable at medical, research, and industrial sites. In response, GTRI began to focus efforts on addressing these materials. GTRI’s Russia Orphan Source Recovery Project, managed at the Nevada National Security Site’s North Las Vegas facility, was initiated in 2002. Throughout the life of the project, Joint Stock Company “Isotope” has served as the primary Russian subcontractor, and the organization has proven to be a successful partner. Since the first orphan source recovery of an industrial cobalt-60 irradiator with 647 curies (Ci) at an abandoned facility in Moscow in 2003, the GTRI Orphan Source Recovery Project in the Russian Federation has accomplished substantial levels of threat reduction. To date, GTRI has recovered and securely disposed of more than 5,100 sources totaling more that 628,000 Ci. This project serves as an extraordinary example of how international cooperation can be implemented by partners with mutual interests to achieve significant goals.

  13. The medicine and public health initiative ten years later.

    PubMed

    Beitsch, Leslie M; Brooks, Robert G; Glasser, Jay H; Coble, Yank D

    2005-08-01

    The Medicine and Public Health Initiative (MPHI) was created jointly 10 years ago by the American Medical Association and the American Public Health Association to bridge the nearly century-wide gulf between the respective disciplines. We review the history of MPHI and its growing significance in light of recent terrorism events. We report on current MPHI activities by examining three bellwether states-California, Florida, and Texas-as well as international sites. Upon its inception, MPHI was rapidly embraced and nationally disseminated. Sustainability 10 years later in the post-911 world requires renewed commitment by all collaborators. In order to meet the numerous health challenges facing our nation, from terrorism to chronic disease, and for MPHI to be successful, medicine and public health must work in tandem. PMID:16005812

  14. A common evaluation framework for the African Health Initiative

    PubMed Central

    2013-01-01

    Background The African Health Initiative includes highly diverse partnerships in five countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia), each of which is working to improve population health by strengthening health systems and to evaluate the results. One aim of the Initiative is to generate cross-site learning that can inform implementation in the five partnerships during the project period and identify lessons that may be generalizable to other countries in the region. Collaborators in the Initiative developed a common evaluation framework as a basis for this cross-site learning. Methods This paper describes the components of the framework; this includes the conceptual model, core metrics to be measured in all sites, and standard guidelines for reporting on the implementation of partnership activities and contextual factors that may affect implementation, or the results it produces. We also describe the systems that have been put in place for data management, data quality assessments, and cross-site analysis of results. Results and conclusions The conceptual model for the Initiative highlights points in the causal chain between health system strengthening activities and health impact where evidence produced by the partnerships can contribute to learning. This model represents an important advance over its predecessors by including contextual factors and implementation strength as potential determinants, and explicitly including equity as a component of both outcomes and impact. Specific measurement challenges include the prospective documentation of program implementation and contextual factors. Methodological issues addressed in the development of the framework include the aggregation of data collected using different methods and the challenge of evaluating a complex set of interventions being improved over time based on continuous monitoring and intermediate results. PMID:23819778

  15. Federal Information Policies: The Congressional Initiative. A Summary of Proceedings of the Annual Forum on Federal Information Policies (6th, Washington, D.C., March 22, 1989).

    ERIC Educational Resources Information Center

    Price, Douglas

    This booklet summarizes the proceedings of a forum--whose audience consisted of over 200 library and information managers, congressional staff members, and persons from the information industry and academic community--on the condition of federal information policies as they relate to the Congressional initiative. Among issues discussed are: (1)…

  16. Increasing health insurance coverage through an extended Federal Employees Health Benefits Program.

    PubMed

    Fuchs, B C

    2001-01-01

    The Federal Employees Health Benefits Program (FEHBP) could be combined with health insurance tax credits to extend coverage to the uninsured. An extended FEHBP, or "E-FEHBP," would be open to all individuals who were not covered through work or public programs and who also were eligible for the tax credits on the basis of income. E-FEHBP also would be open to employees of very small firms, regardless of their eligibility for tax credits. Most plans available to FEHBP participants would be required to offer enrollment to E-FEHBP participants, although premiums would be rated separately. High-risk individuals would be diverted to a separate high-risk pool, the cost of which would be subsidized by the federal government. E-FEHBP would be administered by the states, or if a state declined, by an entity that contracted with the Office of Personnel Management. While E-FEHBP would provide group insurance to people who otherwise could not get it, premiums could exceed the tax-credit amount and some people still might find the coverage unaffordable. PMID:11529514

  17. Bioterrorism and biological threats dominate federal health security research; other priorities get scant attention.

    PubMed

    Shelton, Shoshana R; Connor, Kathryn; Uscher-Pines, Lori; Pillemer, Francesca Matthews; Mullikin, James M; Kellermann, Arthur L

    2012-12-01

    The federal government plays a critical role in achieving national health security by providing strategic guidance and funding research to help prevent, respond to, mitigate, and recover from disasters, epidemics, and acts of terrorism. In this article we describe the first-ever inventory of nonclassified national health security-related research funded by civilian agencies of the federal government. Our analysis revealed that the US government's portfolio of health security research is currently weighted toward bioterrorism and emerging biological threats, laboratory methods, and development of biological countermeasures. Eight of ten other priorities identified in the Department of Health and Human Services' National Health Security Strategy-such as developing and maintaining a national health security workforce or incorporating recovery into planning and response-receive scant attention. We offer recommendations to better align federal spending with health security research priorities, including the creation of an interagency working group charged with minimizing research redundancy and filling persistent gaps in knowledge. PMID:23213160

  18. Federal Investments to Eliminate Racial/Ethnic Health-Care Disparities

    PubMed Central

    Freeman, William

    2014-01-01

    Health care is an important lever for moderating the effects of social determinants on health. We present a model that describes the relationships among social disadvantage, health-care disparities, and health disparities. Improving access to health care and enhancing patient-provider interaction are critical pathways for reducing disparities. Increasing the diversity of the public health and health-care workforces is an efficient strategy for reducing disparities because it impacts both access to care and patient-provider communication. Federal policy makers should continue interest in workforce diversity to optimize the health of all Americans. PMID:24385667

  19. 78 FR 34994 - Defense Health Board; Notice of Federal Advisory Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-11

    ... of the Secretary Defense Health Board; Notice of Federal Advisory Committee Meeting AGENCY... Health Board (DHB) meeting is announced. DATES: June 27, 2013 7:45 a.m.-9:00 a.m. (Administrative Working... Meeting.'') FOR FURTHER INFORMATION CONTACT: The Director of the Defense Health Board is Ms....

  20. 29 CFR 1960.19 - Other Federal agency standards affecting occupational safety and health.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

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

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  2. Federal Civil Rights Policy and Mental Health Treatment Access for Persons with Limited English Proficiency

    ERIC Educational Resources Information Center

    Snowden, Lonnie R.; Masland, Mary; Guerrero, Rachel

    2007-01-01

    As noted in the supplement to the U.S. Surgeon General's report on mental health (U.S. Department of Health and Human Services, 2001), overcoming language access barriers associated with limited English proficiency (LEP) should help to eliminate racial and ethnic disparities in mental health care access and quality. Federal policy requires…

  3. 76 FR 57674 - Defense Federal Acquisition Regulation Supplement; Award Fee Reduction or Denial for Health or...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-16

    ... Acquisition Regulation Supplement; Award Fee Reduction or Denial for Health or Safety Issues AGENCY: Defense... published in the Federal Register under DFARS Case 2009-D039, Award-Fee Reductions for Health and Safety... health or safety of Government personnel, and added as a fifth cause for reducing or denying a...

  4. A Statewide Common Elements Initiative for Children's Mental Health.

    PubMed

    Dorsey, Shannon; Berliner, Lucy; Lyon, Aaron R; Pullmann, Michael D; Murray, Laura K

    2016-04-01

    Many evidence-based treatments (EBTs) for child and adolescent mental health disorders have been developed, but few are available in public mental health settings. This paper describes initial implementation outcomes for a state-funded effort in Washington State to increase EBT availability, via a common elements training and consultation approach focused on four major problem areas (anxiety, posttraumatic stress disorder, depression, and behavioral problems). Clinicians (N = 180) reported significant improvement in their ability to assess and treat all problem areas at post-consultation. Clinicians from organizations with a supervisor-level "EBT champion" had higher baseline scores on a range of outcomes, but many differences disappeared at post-consultation. Outcomes suggest that a common elements initiative, which includes training and consultation, may positively impact clinician-level outcomes and that having "in-house" EBT expertise may provide additional benefits. PMID:25081231

  5. eHealth and mHealth initiatives in Bangladesh: A scoping study

    PubMed Central

    2014-01-01

    Background The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential. Methods This scoping study applies a combination of research tools to explore 26 eHealth and mHealth initiatives in Bangladesh. A screening matrix was developed by modifying the framework of Arksey & O’Malley, further complemented by case study and SWOT analysis to identify common traits among the selected interventions. The WHO health system building blocks approach was then used for thematic analysis of these traits. Results Findings suggest that most eHealth and mHealth initiatives have proliferated within the private sector, using mobile phones. The most common initiatives include tele-consultation, prescription and referral. While a minority of projects have a monitoring and evaluation framework, less than a quarter have undertaken evaluation. Most of the initiatives use a health management information system (HMIS) to monitor implementation. However, these do not provide for effective sharing of information and interconnectedness among the various actors. There are extremely few individuals with eHealth training in Bangladesh and there is a strong demand for capacity building and experience sharing, especially for implementation and policy making. There is also a lack of research evidence on how to design interventions to meet the needs of the population and on potential benefits. Conclusion This study concludes that Bangladesh needs considerable preparation and planning to sustain eHealth

  6. Making the connection: Federal efforts on climate change and health

    NASA Astrophysics Data System (ADS)

    Balbus, J. M.

    2014-12-01

    The 3rd National Climate Assessment highlights four key messages regarding the linkages between human health and climate change. There are many different ways in which climate change affects health, and some impacts are already being felt in the United States. People and places differ in their vulnerability to the health impacts of climate change. Adaptation measures are available for many health impacts in the US, but they may not be able to completely prevent impacts, especially if climate change becomes more severe in the future. And many measures undertaken to limit greenhouse gas emissions or increase resilience to climate impacts in other sectors have the potential to improve, or in some cases, harm, human health. This presentation will review the findings of the 3rd National Climate Assessment with regards to human health and describe ongoing and future efforts to more comprehensively assess the health impacts of climate change in the United States and provide information for helping to protect public health from climate impacts.

  7. The federal and Ontario budgets of 2012: what's in it for health equity?

    PubMed

    Ruckert, Arne

    2012-01-01

    Health equity has started to receive significant attention among Canadian policy-makers, with acknowledgement at both the federal and provincial levels of the importance of reducing health inequities. However, a challenging budget environment has led to a number of budget cutbacks in areas that are likely to negatively influence social determinants of health, such as housing, education, and social assistance. This article analyzes both the federal and Ontario budgets of 2012 and their potential impacts on and implications for health equity. Even though health care services have largely remained untouched in both budgets, the article argues that existing health inequities will be further amplified through the implementation of cutbacks in sectors other than health, given the importance of social determinants of health (SDH) for health equity outcomes. PMID:23617991

  8. Knowledge of Federal Regulations for Mental Health Research Involving Prisoners

    PubMed Central

    Johnson, Mark E.; Brems, Christiane; Bergman, Aaron L.; Mills, Michael E.; Eldridge, Gloria D.

    2014-01-01

    Background Given their vulnerability to coercion and exploitation, prisoners who participate in research are protected by Office for Human Research Protections (OHRP) regulations designed to ensure their safety and wellbeing. Knowledge of these regulations is essential for researchers who conduct and institutional review boards (IRBs) that oversee mental health research in correctional settings. Methods We explored depth of knowledge of OHRP regulations by surveying a nationwide sample of: (1) mental health researchers who have conducted research in correctional settings; (2) mental health researchers who have conducted research in non-correctional settings; (3) IRB members who have overseen mental health research in correctional settings; (4) IRB members who have overseen mental health research in in non-correctional settings; and (5) IRB prisoner representatives. Participants responded to a 10-item knowledge questionnaire based on OHRP regulations. Results 1,256 participants provided usable data (44.9% response rate). Results revealed limited knowledge of OHRP regulations, with a mean across groups of 44.1% correct answers. IRB Prisoner representatives, IRB members, and researchers with correctional experience demonstrated the highest levels of knowledge; however, even these participants were able to correctly answer only approximately 50% of the items. Conclusions Although awareness that prisoners are a protected population and that different regulatory procedures apply to research with them is likely to be universal among researchers and IRB members, our findings reveal limited mastery of the specific OHRP regulations that are essential knowledge for researchers who conduct and IRB members who oversee mental health research in correctional settings. Given well-documented health and healthcare disparities, prisoners could potentially benefit greatly from mental health research; increasing knowledge of the OHRP regulations among researchers and IRB members is a

  9. 77 FR 39743 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-05

    .... App, 2), Executive Order 12196 and 13511, Secretary of Labor's Order 1-2012 (77 FR 3912, 1/25/2012... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and...

  10. 77 FR 58174 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-19

    ... (77 FR 3912 (1/25/2012)). Signed at Washington, DC, on September 14, 2012. David Michaels, Assistant... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and...

  11. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... AFFAIRS MEDICAL Use of Department of Defense, Public Health Service Or Other Federal Hospitals § 17.50 Use of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to...

  12. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... AFFAIRS MEDICAL Use of Department of Defense, Public Health Service Or Other Federal Hospitals § 17.50 Use of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to...

  13. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... AFFAIRS MEDICAL Use of Department of Defense, Public Health Service Or Other Federal Hospitals § 17.50 Use of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to...

  14. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... AFFAIRS MEDICAL Use of Department of Defense, Public Health Service Or Other Federal Hospitals § 17.50 Use of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to...

  15. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... AFFAIRS MEDICAL Use of Department of Defense, Public Health Service Or Other Federal Hospitals § 17.50 Use of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to...

  16. 76 FR 22899 - Federal Health IT Strategic Plan: 2011-2015 Open Comment Period Extended Until Friday, May 6

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-25

    ... HUMAN SERVICES Federal Health IT Strategic Plan: 2011-2015 Open Comment Period Extended Until Friday...: Notice. SUMMARY: The Federal Health IT Strategic Plan: 2011-2015 (``the Plan'') ] was posted on the ONC... considered, you must submit your comment via the Federal Health IT Buzz Blog:...

  17. 75 FR 59237 - TRICARE Co-Pay Waiver at Captain James A. Lovell Federal Health Care Center Demonstration Project

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-27

    ... of the Secretary TRICARE Co-Pay Waiver at Captain James A. Lovell Federal Health Care Center... waiver at Captain James A. Lovell Federal Health Care Center demonstration project. SUMMARY: This notice... Captain James A. Lovell Federal Health Care (FHCC) Demonstration Project.'' Under this...

  18. 78 FR 27242 - Updated Special Advisory Bulletin on the Effect of Exclusion From Participation in Federal Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-09

    ... From Participation in Federal Health Care Programs AGENCY: Office of Inspector General (OIG), HHS... effect of exclusion from participation in Federal health care programs by OIG. The updated Special Advisory Bulletin describes the scope and effect of the legal prohibition on payment by Federal health...

  19. Coordinated Public Health Initiatives to Address Violence Against Women and Adolescents

    PubMed Central

    James, Lisa; Langhorne, Aleisha; Kelley, Marylouise

    2015-01-01

    Abstract Intimate partner violence (IPV) is a well-recognized public health problem. IPV affects women's physical and mental health through direct pathways, such as injury, and indirect pathways, such as a prolonged stress response that leads to chronic health problems. The influence of abuse can persist long after the violence has stopped and women of color are disproportionately impacted. Successfully addressing the complex issue of IPV requires multiple prevention efforts that target specific risk and protective factors across individual, interpersonal, institutional, community, and societal levels. This paper includes examples of community-based, state led and federally funded public health programs focused on IPV along this continuum. Two community-based efforts to increase access to mental health care for low income, women of color who had experienced IPV, Mindfulness-Based Stress Reduction, and a telehealth intervention are discussed. Core tenets of a patient-centered comprehensive approach to assessment and responses and strategies for supporting a statewide comprehensive response are described in Project Connect: A Coordinated Public Health Initiative to Prevent Violence Against Women. Project Connect provides technical assistance to grantees funded through the Violence Against Women Act's health title and involves developing, implementing, and evaluating new ways to identify, respond to, and prevent domestic and sexual violence and promote an improved public health response to abuse in states and Native health programs. Health care partnerships with domestic violence experts are critical in order to provide training, develop referral protocols, and to link IPV victims to advocacy services. Survivors need a comprehensive response that addresses their safety concerns and may require advocacy around housing or shelter, legal assistance, and safety planning. Gaps in research knowledge identified are health system readiness to respond to IPV victims in health

  20. Recommendations for evaluation of health care improvement initiatives.

    PubMed

    Parry, Gareth J; Carson-Stevens, Andrew; Luff, Donna F; McPherson, Marianne E; Goldmann, Donald A

    2013-01-01

    Intensive efforts are underway across the world to improve the quality of health care. It is important to use evaluation methods to identify improvement efforts that work well before they are replicated across a broad range of contexts. Evaluation methods need to provide an understanding of why an improvement initiative has or has not worked and how it can be improved in the future. However, improvement initiatives are complex, and evaluation is not always well aligned with the intent and maturity of the intervention, thus limiting the applicability of the results. We describe how initiatives can be grouped into 1 of 3 improvement phases-innovation, testing, and scale-up and spread-depending on the degree of belief in the associated interventions. We describe how many evaluation approaches often lead to a finding of no effect, consistent with what has been termed Rossi's Iron Law of Evaluation. Alternatively, we recommend that the guiding question of evaluation in health care improvement be, "How and in what contexts does a new model work or can be amended to work?" To answer this, we argue for the adoption of formative, theory-driven evaluation. Specifically, evaluations start by identifying a program theory that comprises execution and content theories. These theories should be revised as the initiative develops by applying a rapid-cycle evaluation approach, in which evaluation findings are fed back to the initiative leaders on a regular basis. We describe such evaluation strategies, accounting for the phase of improvement as well as the context and setting in which the improvement concept is being deployed. Finally, we challenge the improvement and evaluation communities to come together to refine the specific methods required so as to avoid the trap of Rossi's Iron Law. PMID:24268081

  1. Federating Clinical Data from Six Pediatric Hospitals: Process and Initial Results for Microbiology from the PHIS+ Consortium

    PubMed Central

    Gouripeddi, Ramkiran; Warner, Phillip B.; Mo, Peter; Levin, James E.; Srivastava, Rajendu; Shah, Samir S.; de Regt, David; Kirkendall, Eric; Bickel, Jonathan; Korgenski, E. Kent; Precourt, Michelle; Stepanek, Richard L.; Mitchell, Joyce A.; Narus, Scott P.; Keren, Ron

    2012-01-01

    Microbiology study results are necessary for conducting many comparative effectiveness research studies. Unlike core laboratory test results, microbiology results have a complex structure. Federating and integrating microbiology data from six disparate electronic medical record systems is challenging and requires a team of varied skills. The PHIS+ consortium which is partnership between members of the Pediatric Research in Inpatient Settings (PRIS) network, the Children’s Hospital Association and the University of Utah, have used “FURTHeR’ for federating laboratory data. We present our process and initial results for federating microbiology data from six pediatric hospitals. PMID:23304298

  2. The Arctic Human Health Initiative: a legacy of the International Polar Year 2007–2009

    PubMed Central

    Parkinson, Alan J.

    2013-01-01

    promotion; and promoting synergy and strategic direction of Arctic human health research and health promotion. Results As of 31 March, 2009, the official end of the IPY, AHHI represented a total of 38 proposals, including 21 individual Expressions of Intent (EoI), and 9 full proposals (FP), submitted to the IPY Joint Committee for review and approval from lead investigators from the US, Canada, Greenland, Norway, Finland, Sweden and the Russian Federation. In addition, there were 10 National Initiatives (NI-projects undertaken during IPY beyond the IPY Joint Committee review process). Individual project details can be viewed at www.arctichealth.org. The AHHI currently monitors the progress of 28 individual active human health projects in the following thematic areas: health network expansion (5 projects), infectious disease research (7 projects), environmental health research (7 projects), behavioral and mental health research (4 projects), and outreach education and communication (5 projects). Conclusions While some projects have been completed, others will continue well beyond the IPY. The IPY 2007–2008 represented a unique opportunity to further stimulate cooperation and coordination on Arctic health research and increase the awareness and visibility of Arctic regions. PMID:23971017

  3. Motherhood Preconceived: The Emergence of the Preconception Health and Health Care Initiative

    PubMed Central

    Waggoner, Miranda R.

    2013-01-01

    Since the 1980s, maternal and child health experts have sought to redefine maternity care to include the period prior to pregnancy, essentially by expanding the concept of prenatal care to encompass the time before conception. In 2004, the Centers for Disease Control and Prevention endorsed and promoted this new definition when it launched the Preconception Health and Health Care Initiative. In arguing that prenatal care was often too little too late, a group of maternal and child health experts in the United States attempted to spur improvements in population health and address systemic problems in health care access and health disparities. By changing the terms of pregnancy risk and by using maternalism as a social policy strategy, the preconception health and health care paradigm promoted an ethic of anticipatory motherhood and conflated women’s health with maternal health, sparking public debate about the potential social and clinical consequences of preconception care. This article tracks the construction of this policy idea and its ultimate potential utility in health and health policy discussions. PMID:23262764

  4. Federal Funding for Health Security in FY2016.

    PubMed

    Boddie, Crystal; Sell, Tara Kirk; Watson, Matthew

    2015-01-01

    This article assesses US government funding in 5 domains critical to strengthening health security: biodefense programs, radiological and nuclear programs, chemical programs, pandemic influenza and emerging infectious disease programs, and multiple-hazard and preparedness programs. This year's article also highlights the emergency funding appropriated in FY2015 to enable the international and domestic response to the Ebola outbreak in West Africa. PMID:26042863

  5. Federal Funding for Health Security in FY2016

    PubMed Central

    Sell, Tara Kirk; Watson, Matthew

    2015-01-01

    This article assesses US government funding in 5 domains critical to strengthening health security: biodefense programs, radiological and nuclear programs, chemical programs, pandemic influenza and emerging infectious disease programs, and multiple-hazard and preparedness programs. This year's article also highlights the emergency funding appropriated in FY2015 to enable the international and domestic response to the Ebola outbreak in West Africa. PMID:26042863

  6. Initiation of quality improvement activities in mental health services.

    PubMed

    Tobin, M; Chen, L

    1999-06-01

    In the public sector mental health service setting, accountability for quality has often been considered the responsibility of the individual clinician. This presents a particular challenge for introducing an organization-wide quality improvement culture in this setting. The introduction of a systemic view of quality may encounter resistance from individual clinicians reluctant to accept that some clinical autonomy must be subsumed within more standardized patterns of intervention and evaluation. Services must firstly tackle the issue of clinicians' readiness to embrace such a culture, which requires strong direction from the executive level. The area of recently diagnosed psychosis was selected in one public sector mental health service as a starting point for initiating the quality improvement culture. The eventual outcome for the organization has been a positive commitment to improvement, but the journey was long and hard. This paper describes the beginning of this ultimately rewarding journey. PMID:10408753

  7. Transdisciplinary Research and Evaluation for Community Health Initiatives

    PubMed Central

    Harper, Gary W.; Neubauer, Leah C.; Bangi, Audrey K.; Francisco, Vincent T.

    2010-01-01

    Transdisciplinary research and evaluation projects provide valuable opportunities to collaborate on interventions to improve the health and well-being of individuals and communities. Given team members’ diverse backgrounds and roles or responsibilities in such projects, members’ perspectives are significant in strengthening a project’s infrastructure and improving its organizational functioning. This article presents an evaluation mechanism that allows team members to express the successes and challenges incurred throughout their involvement in a multisite transdisciplinary research project. Furthermore, their feedback is used to promote future sustainability and growth. Guided by a framework known as organizational development, the evaluative process was conducted by a neutral entity, the Quality Assurance Team. A mixed-methods approach was utilized to garner feedback and clarify how the research project goals could be achieved more effectively and efficiently. The multiple benefits gained by those involved in this evaluation and implications for utilizing transdisciplinary research and evaluation teams for health initiatives are detailed. PMID:18936267

  8. What public health strategies are needed to reduce smoking initiation?

    PubMed

    Pierce, John P; White, Victoria M; Emery, Sherry L

    2012-03-01

    Smoking initiation is a key behaviour that determines the future health consequences of smoking in a society. There is a marked difference in smoking patterns around the world, driven by initiation rates. While a number of high-income countries have seen smoking prevalence decline markedly from peak, many low-income and middle-income countries appear to still be on an upward trend. Unlike cessation where changes are limited by nicotine dependence, rates of smoking initiation can change rapidly over a short time span. Interventions that can be effective in achieving this include increases in the price of tobacco products, mass media anti-smoking advertising, smoke-free policies, smoking curricula in schools, restrictions on marketing opportunities for the tobacco industry as well as social norms that lead to restrictions on adolescents' ability to purchase cigarettes. Comprehensive tobacco control programmes that aim to denormalise smoking behaviour in the community contain all of these interventions. Rapid reductions in smoking initiation in adolescents have been documented in two case studies of comprehensive tobacco control programmes in California and Australia. Consistent and inescapable messages from multiple sources appear to be key to success. However, the California experience indicates that the rapid decline in adolescent smoking will not continue if tobacco control expenditures and the relative price of cigarettes are reduced. These case studies provide strong additional evidence of the importance of countries implementing the provisions of the Framework Treaty on Tobacco Control. PMID:22345263

  9. Factors in health initiative success: learning from Nepal's newborn survival initiative.

    PubMed

    Smith, Stephanie L; Neupane, Shailes

    2011-02-01

    What shapes the level of political priority for alleviation of significant health problems in low-income countries? We investigate this question in the context of the significantly increasing political priority for newborn survival in Nepal since 2000. We use a process-tracing methodology to investigate causes of this shift, drawing on twenty-nine interviews with individuals close to newborn health policymaking in Nepal and extensive document analysis. Shifts in the political context (commitments to the child health MDG), the strength of concerned actors (emergence of collective action, leadership, resources) and the power of ideas (problem status, existence of contextually relevant solutions, agreement on these points) surrounding the issue have been instrumental in elevating priority for newborn survival, if not institutionalizing that priority to ensure long-term support. The findings highlight the significance of political fragmentation in war-torn areas for impeding priority generation. Additionally, theories of social construction provide important insights to the roles of ideas in shaping health initiative success. PMID:21195521

  10. Vocational Instructional Materials for Health Occupations Education Available from Federal Agencies.

    ERIC Educational Resources Information Center

    Northwest Regional Educational Lab., Portland, OR.

    This annotated bibliography lists curriculum materials for health occupations education which were produced by Federal agencies and are appropriate for these subject matter areas: (1) dentistry, (2) medical laboratory technology, (3) nursing, (4) rehabilitation, (5) radiology, (6) opthalmology, (7) environmental health, and (8) mental health…

  11. Basic Health Program; Federal Funding Methodology for Program Years 2017 and 2018. Final methodology.

    PubMed

    2016-02-29

    This document provides the methodology and data sources necessary to determine Federal payment amounts made in program years 2017 and 2018 to states that elect to establish a Basic Health Program under the Affordable Care Act to offer health benefits coverage to low-income individuals otherwise eligible to purchase coverage through Affordable Insurance Exchanges (hereinafter referred to as the Exchanges). PMID:26925486

  12. Federal spending on behavioral health accelerated during recession as individuals lost employer insurance.

    PubMed

    Levit, Katharine R; Mark, Tami L; Coffey, Rosanna M; Frankel, Sasha; Santora, Patricia; Vandivort-Warren, Rita; Malone, Kevin

    2013-05-01

    The 2007-09 recession had a dramatic effect on behavioral health spending, with the effect most prominent for private, state, and local payers. During the recession behavioral health spending increased at a 4.6 percent average annual rate, down from 6.1 percent in 2004-07. Average annual growth in private behavioral health spending during the recession slowed to 2.7 percent from 7.2 percent in 2004-07. State and local behavioral health spending showed negative average annual growth, -1.2 percent, during the recession, compared with 3.7 percent increases in 2004-07. In contrast, federal behavioral health spending growth accelerated to 11.1 percent during the recession, up from 7.2 percent in 2004-07. These behavioral health spending trends were driven largely by increased federal spending in Medicaid, declining private insurance enrollment, and severe state budget constraints. An increased federal Medicaid match reduced the state share of Medicaid spending, which prevented more drastic cuts in state-funded behavioral health programs during the recession. Federal Medicaid served as a critical safety net for people with behavioral health treatment needs during the recession. PMID:23650330

  13. Coordinating Canada's research response to global health challenges: the Global Health Research Initiative.

    PubMed

    Di Ruggiero, Erica; Zarowsky, Christina; Frank, John; Mhatre, Sharmila; Aslanyan, Garry; Perry, Alita; Previsich, Nick

    2006-01-01

    The Global Health Research Initiative (GHRI) involving the Canadian International Development Agency, the Canadian Institutes of Health Research, Health Canada and the International Development Research Centre seeks to coordinate Canada's research response to global health challenges. In light of numerous calls to action both nationally and internationally, an orientation to applied health policy and systems research, and to public health research and its application is required to redress global inequalities in wealth and health and to tackle well-documented constraints to achieving the United Nations Millennium Development Goals. Over the last four years, the GHRI has funded close to 70 research program development and pilot projects. However, longer-term investment is needed. The proposed dollars 100 million Teasdale-Corti Global Health Research Partnership Program is such a response, and is intended to support teams of researchers and research users to develop, test and implement innovative approaches to strengthening institutional capacity, especially in low- and middle-income countries; to generating knowledge and its effective application to improve the health of populations, especially those most vulnerable; and to strengthen health systems in those countries. While Canada stands poised to act, concerted leadership and resources are still required to support "research that matters" for health and development in low- and middle-income countries. PMID:16512323

  14. ONE Nano: NIEHS’s Strategic Initiative on the Health and Safety Effects of Engineered Nanomaterials

    PubMed Central

    Johnson, Anne F.; Balshaw, David M.; Garantziotis, Stavros; Walker, Nigel J.; Weis, Christopher; Nadadur, Srikanth S.; Birnbaum, Linda S.

    2013-01-01

    Background: The past decade has seen tremendous expansion in the production and application of engineered nanomaterials (ENMs). The unique properties that make ENMs useful in the marketplace also make their interactions with biological systems difficult to anticipate and critically important to explore. Currently, little is known about the health effects of human exposure to these materials. Objectives: As part of its role in supporting the National Nanotechnology Initiative, the National Institute of Environmental Health Sciences (NIEHS) has developed an integrated, strategic research program—“ONE Nano”—to increase our fundamental understanding of how ENMs interact with living systems, to develop predictive models for quantifying ENM exposure and assessing ENM health impacts, and to guide the design of second-generation ENMs to minimize adverse health effects. Discussion: The NIEHS’s research investments in ENM health and safety include extramural grants and grantee consortia, intramural research activities, and toxicological studies being conducted by the National Toxicology Program (NTP). These efforts have enhanced collaboration within the nanotechnology research community and produced toxicological profiles for selected ENMs, as well as improved methods and protocols for conducting in vitro and in vivo studies to assess ENM health effects. Conclusion: By drawing upon the strengths of the NIEHS’s intramural, extramural, and NTP programs and establishing productive partnerships with other institutes and agencies across the federal government, the NIEHS’s strategic ONE Nano program is working toward new advances to improve our understanding of the health impacts of engineered nanomaterials and support the goals of the National Nanotechnology Initiative. PMID:23407114

  15. Elementary and Secondary Education: Flexibility Initiatives Do Not Address Districts' Key Concerns about Federal Requirements. Report to Congressional Requesters.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. Health, Education, and Human Services Div.

    The Government Accounting Office (GAO) was asked to: (1) describe major federal requirements that affect school districts; (2) identify key issues school districts face in implementing these requirements; and (3) analyze the impact of the Department of Education's flexibility initiatives on school districts' ability to address these implementation…

  16. Policy succession: the case for federal health planning in the 1990's.

    PubMed

    Mueller, K J

    1993-01-01

    Direct federal involvement in local health planning ended in 1986 with the repeal of the Health Planning and Resources Development Act of 1974. This article argues that planning has remained an important element in state and local public health activities, and that it will re-emerge as a national effort. Theories of policy succession are used to derive conditions for policy renewal that are satisfied by the current policy environment for health planning. The need for planning is obvious when issues related to health care delivery in rural areas are considered, and there are strong advocates of the need for planning. PMID:10145800

  17. [The periodic health examination: from law to the directive of the German Federal Joint Committee (G-BA)].

    PubMed

    Perleth, Matthias; Matthias, Katja

    2014-01-01

    Since 1989 a periodic health examination beginning at the age of 35 for the early detection of "common diseases" (especially cardiovascular and kidney diseases as well as diabetes) by means of history-taking, physical examination, blood and urine tests and counselling has been available in Germany. Altogether, the respective directive of the Federal Joint Committee (G-BA) was revised six times, but a substantive change took place only once (i. e., the cancellation of uric acid, creatinine, and resting ECG in 1999). However, additional examinations (e.g., glaucoma screening) were not added to the health check after systematic assessments of the evidence were completed. In the mid-1990s, several evaluations were performed which showed that new diagnoses were established in a significant proportion of patients, and measures were initiated such as nutrition counselling. A patient-relevant benefit in terms of avoided adverse events (such as heart attacks) could, however, not be demonstrated due to methodological reasons. Criticism of the health examination is not new, in particular concerning the lack of evidence of benefit for the diagnostic procedures of the health examination. A draft law issued by the former Federal Government proposing an amendment to the health examination has recently been rejected in the Bundesrat (upper house of the German parliament). PMID:24889707

  18. Social Health Maintenance Organizations: assessing their initial experience.

    PubMed Central

    Newcomer, R; Harrington, C; Friedlob, A

    1990-01-01

    The Social/Health Maintenance Organization (S/HMO) is a four-site national demonstration. This program combines Medicare Part A and B coverage, with various extended and chronic care benefits, into an integrated health plan. The provision of these services extends both the traditional roles of HMOs and that of long-term care community-service case management systems. During the initial 30 months of operation the four S/HMOs shared financial risk with the Health Care Financing Administration. This article reports on this developmental period. During this phase the S/HMOs had lower-than-expected enrollment levels due in part to market competition, underfunding of marketing efforts, the limited geographic area served, and an inability to differentiate the S/HMO product from that of other Medicare HMOs. The S/HMOs were allowed to conduct health screening of applicants prior to enrolling them. The number of nursing home-certifiable enrollees was controlled through this mechanism, but waiting lists were never very long. Persons joining S/HMOs and other Medicare HMOs during this period were generally aware of the alternatives available. S/HMO enrollees favored the more extensive benefits; HMO enrollees considerations of cost. The S/HMOs compare both newly formed HMOs and established HMOs. On the basis of administrator cost, it is more efficient to add chronic care benefits to an HMO than to add an HMO component to a community care provider. All plans had expenses greater than their revenues during the start-up period, but they were generally able to keep service expenditures within planned levels. PMID:2116384

  19. The free health care initiative: how has it affected health workers in Sierra Leone?

    PubMed Central

    Witter, Sophie; Wurie, Haja; Bertone, Maria Paola

    2016-01-01

    There is an acknowledged gap in the literature on the impact of fee exemption policies on health staff, and, conversely, the implications of staffing for fee exemption. This article draws from five research tools used to analyse changing health worker policies and incentives in post-war Sierra Leone to document the effects of the Free Health Care Initiative (FHCI) of 2010 on health workers. Data were collected through document review (57 documents fully reviewed, published and grey); key informant interviews (23 with government, donors, NGO staff and consultants); analysis of human resource data held by the MoHS; in-depth interviews with health workers (23 doctors, nurses, mid-wives and community health officers); and a health worker survey (312 participants, including all main cadres). The article traces the HR reforms which were triggered by the FHCI and evidence of their effects, which include substantial increases in number and pay (particularly for higher cadres), as well as a reported reduction in absenteeism and attrition, and an increase (at least for some areas, where data is available) in outputs per health worker. The findings highlight how a flagship policy, combined with high profile support and financial and technical resources, can galvanize systemic changes. In this regard, the story of Sierra Leone differs from many countries introducing fee exemptions, where fee exemption has been a stand-alone programme, unconnected to wider health system reforms. The challenge will be sustaining the momentum and the attention to delivering results as the FHCI ceases to be an initiative and becomes just ‘business as normal’. The health system in Sierra Leone was fragile and conflict-affected prior to the FHCI and still faces significant challenges, both in human resources for health and more widely, as vividly evidenced by the current Ebola crisis. PMID:25797469

  20. The free health care initiative: how has it affected health workers in Sierra Leone?

    PubMed

    Witter, Sophie; Wurie, Haja; Bertone, Maria Paola

    2016-02-01

    There is an acknowledged gap in the literature on the impact of fee exemption policies on health staff, and, conversely, the implications of staffing for fee exemption. This article draws from five research tools used to analyse changing health worker policies and incentives in post-war Sierra Leone to document the effects of the Free Health Care Initiative (FHCI) of 2010 on health workers.Data were collected through document review (57 documents fully reviewed, published and grey); key informant interviews (23 with government, donors, NGO staff and consultants); analysis of human resource data held by the MoHS; in-depth interviews with health workers (23 doctors, nurses, mid-wives and community health officers); and a health worker survey (312 participants, including all main cadres). The article traces the HR reforms which were triggered by the FHCI and evidence of their effects, which include substantial increases in number and pay (particularly for higher cadres), as well as a reported reduction in absenteeism and attrition, and an increase (at least for some areas, where data is available) in outputs per health worker. The findings highlight how a flagship policy, combined with high profile support and financial and technical resources, can galvanize systemic changes. In this regard, the story of Sierra Leone differs from many countries introducing fee exemptions, where fee exemption has been a stand-alone programme, unconnected to wider health system reforms. The challenge will be sustaining the momentum and the attention to delivering results as the FHCI ceases to be an initiative and becomes just 'business as normal'. The health system in Sierra Leone was fragile and conflict-affected prior to the FHCI and still faces significant challenges, both in human resources for health and more widely, as vividly evidenced by the current Ebola crisis. PMID:25797469

  1. A Conceptual Framework for Allocation of Federally Stockpiled Ventilators During Large-Scale Public Health Emergencies.

    PubMed

    Zaza, Stephanie; Koonin, Lisa M; Ajao, Adebola; Nystrom, Scott V; Branson, Richard; Patel, Anita; Bray, Bruce; Iademarco, Michael F

    2016-01-01

    Some types of public health emergencies could result in large numbers of patients with respiratory failure who need mechanical ventilation. Federal public health planning has included needs assessment and stockpiling of ventilators. However, additional federal guidance is needed to assist states in further allocating federally supplied ventilators to individual hospitals to ensure that ventilators are shipped to facilities where they can best be used during an emergency. A major consideration in planning is a hospital's ability to absorb additional ventilators, based on available space and staff expertise. A simple pro rata plan that does not take these factors into account might result in suboptimal use or unused scarce resources. This article proposes a conceptual framework that identifies the steps in planning and an important gap in federal guidance regarding the distribution of stockpiled mechanical ventilators during an emergency. PMID:26828799

  2. Assessing regression to the mean effects in health care initiatives

    PubMed Central

    2013-01-01

    Background Interventions targeting individuals classified as “high-risk” have become common-place in health care. High-risk may represent outlier values on utilization, cost, or clinical measures. Typically, such individuals are invited to participate in an intervention intended to reduce their level of risk, and after a period of time, a follow-up measurement is taken. However, individuals initially identified by their outlier values will likely have lower values on re-measurement in the absence of an intervention. This statistical phenomenon is known as “regression to the mean” (RTM) and often leads to an inaccurate conclusion that the intervention caused the effect. Concerns about RTM are rarely raised in connection with most health care interventions, and it is uncommon to find evaluators who estimate its effect. This may be due to lack of awareness, cognitive biases that may cause people to systematically misinterpret RTM effects by creating (erroneous) explanations to account for it, or by design. Methods In this paper, the author fully describes the RTM phenomenon, and tests the accuracy of the traditional approach in calculating RTM assuming normality, using normally distributed data from a Monte Carlo simulation and skewed data from a control group in a pre-post evaluation of a health intervention. Confidence intervals are generated around the traditional RTM calculation to provide more insight into the potential magnitude of the bias introduced by RTM. Finally, suggestions are offered for designing interventions and evaluations to mitigate the effects of RTM. Results On multivariate normal data, the calculated RTM estimates are identical to true estimates. As expected, when using skewed data the calculated method underestimated the true RTM effect. Confidence intervals provide helpful guidance on the magnitude of the RTM effect. Conclusion Decision-makers should always consider RTM to be a viable explanation of the observed change in an outcome in

  3. The evolution of the federal funding policies for the public health surveillance component of Brazil's Unified Health System (SUS).

    PubMed

    Pinto, Vitor Laerte; Cerbino Neto, José; Penna, Gerson Oliveira

    2014-12-01

    Health surveillance (HS) is one of the key components of the Brazilian Unified Health System (SUS). This article describes recent changes in health surveillance funding models and the role these changes have had in the reorganization and decentralization of health actions. Federal law no. 8.080 of 1990 defined health surveillance as a fundamental pillar of the SUS, and an exclusive fund with equitable distribution criteria was created in the Basic Operational Norm of 1996 to pay for health surveillance actions. This step facilitated the decentralization of health care at the municipal level, giving local authorities autonomy to plan and provide services. The Health Pact of 2006 and its regulation under federal decree No. 3252 in 2009 bolstered the processes of decentralization, regionalization and integration of health care. Further changes in the basic concepts of health surveillance around the world and in the funding policies negotiated by different spheres of government in Brazil have been catalysts for the process of HS institutionalization in recent years. PMID:25388192

  4. A long and winding road: federally qualified health centers, community variation and prospects under reform.

    PubMed

    Katz, Aaron B; Felland, Laurie E; Hill, Ian; Stark, Lucy B

    2011-11-01

    Community health centers have evolved from fringe providers to mainstays of many local health care systems. Those designated as federally qualified health centers (FQHCs), in particular, have largely established themselves as key providers of comprehensive, efficient, high-quality primary care services to low-income people, especially Medicaid and uninsured patients. The Center for Studying Health System Change's (HSC's) site visits to 12 nationally representative metropolitan communities since 1996 document substantial growth in FQHC capacity, based on growing numbers of Medicaid enrollees and uninsured people, increased federal support, and improved managerial acumen. At the same time, FQHC development has varied considerably across communities because of several important factors, including local health system characteristics and financial and political support at federal, state and local levels. Some communities--Boston; Syracuse, N.Y.; Miami; and Seattle--have relatively extensive FQHC capacity for their Medicaid and uninsured populations, while other communities--Lansing, Mich.; northern New Jersey; Indianapolis; and Greenville, S.C.--fall in the middle. FQHC growth in Phoenix; Little Rock, Ark.; Cleveland; and Orange County, Calif.; has lagged in comparison. Today, FQHCs seem poised to play a key role in federal health care reform, including coverage expansions and the emphasis on primary care and medical homes. PMID:23155547

  5. Reaching for the Stars: A New NASA-National Federation of the Blind Initiative

    NASA Astrophysics Data System (ADS)

    Maynard, N. G.; Riccobono, M. A.

    2004-12-01

    The National Aeronautics and Space Administration (NASA) and the National Federation of the Blind (NFB) recently launched a unique new partnership which will inspire and empower blind youth to consider opportunities in science, technologies, engineering, and math related careers from which they have typically been excluded. This partnership presents a framework for successful cultivation of the next generation of scientists. By partnering with the NFB Jernigan Institute, a one of a kind research and training facility developed and directed by blind people, NASA has engaged the most powerful tool for tapping the potential of blind youth. By teaming NASA scientists and engineers with successful blind adults within a national organization, the NFB, this partnership has established an unparalleled pipeline of talent and imagination. The NASA/NFB partnership seeks to facilitate the means that will lead to increased science and technology employment opportunities for the blind, and particularly within NASA. The initiative is facilitating the development of education programs and products which will stimulate better educational opportunities and supports for blind youth in the STEM areas and better preparing them to enter the NASA employment path. In addition, the partnership brings the unique perspective of the blind to the continuing effort to develop improved space technologies, which may be applied for navigation and wayfinding, technologies for education and outreach, and technologies for improving access to information using nonvisual techniques. This presentation describes some of the activities accomplished in the first year of the partnership. Examples include the establishment of the first NFB Science Academy for Blind Youth which included two summer science camps supported by NASA. During the first camp session, twelve middle school age blind youth explored earth science concepts such as identification and characterization of soils, weather parameters, plants

  6. Federal expenditures on maternal and child health in the United States.

    PubMed

    Kenney, Mary Kay; Kogan, Michael D; Toomer, Stephanie; van Dyck, Peter C

    2012-02-01

    The goals of this study are to estimate federal maternal and child health (MCH) expenditures and identify their sources. This analysis is intended to provide a broad view of MCH funding appropriations and a basis for discussion of whether funds could be better utilized for the benefit of the population served. Data on federal maternal and child health expenditures for fiscal year (FY) 2006 were derived from examining federal legislation, department/agency budgets, and various web-based program documents posted by federal agencies. Based on selected criteria, we identified programs targeting children under 21 or pregnant/parenting women within the United States. The funding levels of agency programs for maternal and child health activities were determined and the programs briefly summarized. The identifiable funding for maternal and child health programs in FY 2006 approached $57.5 billion dollars. Funding sources for maternal and child health were concentrated within the U.S. Department of Health and Human Services, but spread across several different agencies within the department and in the Departments of Defense, Education, Agriculture, Housing and Urban Development, and the Environmental Protection Agency. Multiple agencies and offices often funded related activities, without evidence of a common underlying strategy. Federal maternal and child health funding mechanisms may lead to a fragmentation in maternal and child health activities. The funding and service delivery apparatus would benefit from an integrative MCH infrastructure approach to pediatric research, service delivery, and data collection/access that incorporates life-course and social/environmental determinants perspectives. PMID:21318294

  7. Derivation of proposed human health and wildlife bioaccumulation factors for the Great Lakes initiative. Draft report

    SciTech Connect

    Stephan, C.E.

    1993-03-01

    The publication is divided into two sections: Comparison of Proposed Human Health and Bioaccumulation Factors (HHBAFs) for the Great Lakes Initiative (GLI) and Derivation of Proposed Human Health and Wildlife Bioaccumulation Factors for the Great Lakes Initiative.

  8. Current initiatives in One Health: consolidating the One Health Global Network.

    PubMed

    Vandersmissen, A; Welburn, S C

    2014-08-01

    The Global Response to Avian Influenza has led to a longer-term One Health movement, which addresses risks, including zoonoses, at the human-animal- environment interface, and requires the development of innovative partnerships at the political, institutional and technical levels. One Health is a sustainable and rational option when the cumulative effects of health hazards on food and economic security are considered, but demands long-term financial investment. Projections of growth in the demand for livestock production and consumption in Asia and Africa also call for effective One Health responses. However, an effective response also requires validated evidence of the socio-economic value that the One Health approach can provide. Implementing the One Health approach depends on forging strong links between human and animal health services, the environment and public policy. The authors present a list of some of the national and transnational partnerships established since 2006. Political support, good governance and effective policies and networks are crucial building blocks for One Health sustainability. The Global Response to Avian Influenza was initially established under the joint leadership of the European Union, the United States and the United Nations System Influenza Coordination Office. Since then it has supported numerous initiatives, including the World Health Organization (WHO)/Food and Agriculture Organization of the United Nations (FAO)/World Organisation for Animal Health (OIE) Global Early Warning System (GLEWS). Indeed, the Global Response to Avian Influenza paved the way for an unprecedented WHO/FAO/OIE tripartite partnership, which promoted the integration of foodborne, neglected zoonotic and tropical diseases within the One Health movement and led to the tripartite High-Level Technical Meeting of 2011 in Mexico. The One Health Global Network, which began as a proposition at an Expert Consultation in Winnipeg, Canada, in 2009, is now a reality

  9. The roles of federal legislation and evolving health care systems in promoting medical-dental collaboration.

    PubMed

    Edelstein, Burton L

    2014-01-01

    Recent federal health care legislation contains explicit and implicit drivers for medical-dental collaboration. These laws implicitly promote health care evolution through value-based financing, "big data" and health information technology, increased number of care providers and a more holistic approach. Additional changes--practice aggregation, consumerism and population health perspectives--may also influence dental care. While dentistry will likely lag behind medicine toward value-based and accountable care organizations, dentists will be affected by changing consumer expectations. PMID:25080685

  10. 78 FR 9890 - DoD Medicare-Eligible Retiree Health Care Board of Actuaries; Notice of Federal Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-12

    ... of the Secretary DoD Medicare-Eligible Retiree Health Care Board of Actuaries; Notice of Federal... that the following Federal Advisory Committee meeting of the DoD Medicare-Eligible Retiree Health Care... in the valuation of benefits under DoD retiree health care programs for...

  11. Firm's health going south. Federal authorities charge HealthSouth, leader Scrushy with 'massive accounting fraud,' systematic betrayal of investors.

    PubMed

    Romano, Michael

    2003-03-24

    HealthSouth and its chief executive Richard Scrushy, left, find themselves coping with a public relations nightmare after federal officials last week charged the rehabilitation giant with "massive accounting fraud" and a systematic betrayal of tens of thousands of investors. PMID:12687991

  12. Federal Farmworker Housing Standards and Regulations, Their Promise and Limitations, and Implications for Farmworker Health.

    PubMed

    Moss Joyner, Ann; George, Lance; Hall, Mary Lee; Jacobs, Ilene J; Kissam, E D; Latin, Shelley; Parnell, Allan; Ruiz, Virginia; Shadbeh, Nargess; Tobacman, Janet

    2015-11-01

    The housing available to most farmworkers is substandard and unacceptable in 21st-century America. The federal government established minimal occupational safety and health standards applicable to migrant farmworker labor camps decades ago, and some states have statutory schemes and regulations that set standards for farm labor camps and employee housing. Many of these federal and state regulations no longer reflect current employment and housing trends, and enforcement success varies greatly. These regulations implicitly recognize the connection between housing conditions and health, but do not effectively address that connection. This review describes the current state of farmworker housing, discusses laws and regulations pertaining to such housing, and highlights the literature on health risks associated with inadequate housing. We propose specific recommendations to strengthen enforcement and reduce the risks of substandard housing for the health of farmworkers and their families. PMID:26378154

  13. 42 CFR 137.302 - Are Federal funds available to cover start-up costs associated with initial Tribal assumption of...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Nepa Process § 137.302 Are Federal... Act if the Secretary does not receive a written notification of the nature and extent of the...

  14. 78 FR 49471 - Ferrosilicon From the Russian Federation and Venezuela: Initiation of Antidumping Duty...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-14

    ... antidumping duty (``AD'') petitions concerning imports of ferrosilicon from the Russian Federation (``Russia... Russia Petition'' and ``Supplement to Venezuela Petition''). On August 2, 2013, the Department spoke with... below. \\1\\ See ``Petitions for the Imposition of Antidumping Duties on Ferrosilicon from Russia...

  15. 76 FR 61384 - Notice of Initial Determination Revising the List of Products Requiring Federal Contractor...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-04

    ... Federal Register on June 16, 1999 (64 FR 32383). EO 13126 declared that it was ``the policy of the United... been mined, produced or manufactured with forced or indentured child labor (66 FR 5353). The Department..., which provide procedures for the maintenance, review and, as appropriate, revision of the List (66...

  16. 75 FR 78755 - Notice of Initial Determination Revising the List of Products Requiring Federal Contractor...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ... Executive Order No. 13126 (EO 13126), which was published in the Federal Register on June 16, 1999 (64 FR... forced or indentured child labor (66 FR 5353). The Department also published on January 18, 2001... maintenance, review, and as appropriate, revision of the List (66 FR 5351). The Procedural Guidelines...

  17. Title III: A Critically Important Federal Initiative Supporting Rural Community Colleges. Policy Paper.

    ERIC Educational Resources Information Center

    Katsinas, Stephen G.; Opp, Ronald D.

    Title III, the Strengthening Institutions Program, is one of the most important federal programs for rural community colleges. Created by the Higher Education Act of 1965, Title III provides institutional aid to qualified colleges and universities that serve large numbers of first-generation, low-income students and students from groups…

  18. Federally Qualified Health Center Use Among Dual Eligibles: Rates Of Hospitalizations And Emergency Department Visits

    PubMed Central

    Wright, Brad; Potter, Andrew J.; Trivedi, Amal

    2016-01-01

    People who are eligible for both Medicare and Medicaid, known as “dual eligibles,” disproportionately are members of racial or ethnic minority groups. They face barriers accessing primary care, which in turn increase the risk of potentially preventable hospitalizations and emergency department (ED) visits for ambulatory care–sensitive conditions. Federally qualified health centers provide services known to address barriers to primary care. We analyzed 2008–10 Medicare data for elderly and nonelderly disabled dual eligibles residing in Primary Care Service Areas with nearby federally qualified health centers. Among our findings: There were fewer hospitalizations for ambulatory care–sensitive conditions among blacks and Hispanics who used these health centers than among their counterparts who did not use them (16 percent and 13 percent fewer, respectively). Use of the health centers was also associated with 3 percent and 12 percent fewer hospitalizations for ambulatory care–sensitive conditions among nonelderly disabled blacks and Hispanics, respectively. These findings suggest that federally qualified health centers can reduce disparities in preventable hospitalizations for some dual eligibles. However, further efforts are needed to reduce preventable ED visits among dual eligibles receiving care in the health centers. PMID:26153309

  19. Global health initiative investments and health systems strengthening: a content analysis of global fund investments

    PubMed Central

    2013-01-01

    Background Millions of dollars are invested annually under the umbrella of national health systems strengthening. Global health initiatives provide funding for low- and middle-income countries through disease-oriented programmes while maintaining that the interventions simultaneously strengthen systems. However, it is as yet unclear which, and to what extent, system-level interventions are being funded by these initiatives, nor is it clear how much funding they allocate to disease-specific activities – through conventional ‘vertical-programming’ approach. Such funding can be channelled to one or more of the health system building blocks while targeting disease(s) or explicitly to system-wide activities. Methods We operationalized the World Health Organization health system framework of the six building blocks to conduct a detailed assessment of Global Fund health system investments. Our application of this framework framework provides a comprehensive quantification of system-level interventions. We applied this systematically to a random subset of 52 of the 139 grants funded in Round 8 of the Global Fund to Fight AIDS, Tuberculosis and Malaria (totalling approximately US$1 billion). Results According to the analysis, 37% (US$ 362 million) of the Global Fund Round 8 funding was allocated to health systems strengthening. Of that, 38% (US$ 139 million) was for generic system-level interventions, rather than disease-specific system support. Around 82% of health systems strengthening funding (US$ 296 million) was allocated to service delivery, human resources, and medicines & technology, and within each of these to two to three interventions. Governance, financing, and information building blocks received relatively low funding. Conclusions This study shows that a substantial portion of Global Fund’s Round 8 funds was devoted to health systems strengthening. Dramatic skewing among the health system building blocks suggests opportunities for more balanced

  20. The Medical Education Partnership Initiative: PEPFAR's effort to boost health worker education to strengthen health systems.

    PubMed

    Mullan, Fitzhugh; Frehywot, Seble; Omaswa, Francis; Sewankambo, Nelson; Talib, Zohray; Chen, Candice; Kiarie, James; Kiguli-Malwadde, Elsie

    2012-07-01

    The early success of the President's Emergency Plan for AIDS Relief (PEPFAR) in delivering antiretroviral medications in poor countries unmasked the reality that many lacked sufficient health workers to dispense the drugs effectively. The 2008 reauthorization of PEPFAR embraced this challenge and committed to supporting the education and training of thousands of new health workers. In 2010 the program, with financial support from the US National Institutes of Health and administrative support from the Health Resources and Services Administration, launched the Medical Education Partnership Initiative to fund thirteen African medical schools and a US university. The US university would serve as a coordinating center to improve the quantity, quality, and retention of the schools' graduates. The program was not limited to training in the delivery of services for patients with HIV/AIDS. Rather, it was based on the principle that investment in medical education and retention would lead to health system strengthening overall. Although results are limited at this stage, this article reviews the opportunities and challenges of the first year of this major transnational medical education initiative and considers directions for future efforts and reforms, national governmental roles, and the sustainability of the program over time. PMID:22778346

  1. Uncertainties of Federal Child Health Policies: Impact in Two States; NCHSR Research Digest Series.

    ERIC Educational Resources Information Center

    Foltz, Anne-Marie

    This report assesses the impact of federal child health policy under Titles V and XIX of the Social Security Act upon the states of Connecticut and Vermont for the years 1935 to 1975, and analyzes the reasons for the discrepancy between policy intent and state execution. Two simultaneous approaches are used for data analysis: a cross sectional…

  2. 77 FR 65676 - Federal Advisory Committee; Defense Health Board (DHB) Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-30

    ...Pursuant to the Federal Advisory Committee Act of 1972 (5 U.S.C., Appendix as amended), the Sunshine in the Government Act of 1976 (5 U.S.C. 552b, as amended), and 41 CFR 102-3.150, and in accordance with section 10(a)(2) of Public Law, a Defense Health Board (DHB) meeting is...

  3. Clinical Perspectives on Colorectal Cancer Screening at Latino-Serving Federally Qualified Health Centers

    ERIC Educational Resources Information Center

    Coronado, Gloria D.; Petrik, Amanda F.; Spofford, Mark; Talbot, Jocelyn; Do, Huyen Hoai; Taylor, Victoria M.

    2015-01-01

    Purpose: Colorectal cancer is the second most common cause of cancer death in the United States, and rates of screening for colorectal cancer are low. We sought to gather the perceptions of clinic personnel at Latino-serving Federally Qualified Health Centers (operating 17 clinics) about barriers to utilization of screening services for colorectal…

  4. 77 FR 67743 - Federal Employees Health Benefits Program Coverage for Certain Intermittent Employees

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-14

    ... Benefits program (FEHBP) to temporary firefighters and fire protection personnel. 77 FR 42417. In addition... types of emergency response services to enroll in a health benefits plan under this part. In granting... Federal Emergency Management Agency (FEMA) to apply to OPM for authorization to offer FEHBP coverage...

  5. Vocational Instructional Materials for Allied Health Education Available from Federal Agencies.

    ERIC Educational Resources Information Center

    Hill, Carol L., Comp.

    This listing of federally produced curriculum and instructional materials for allied health education is one of eight annotated bibliographies that provide information for vocational educators at the secondary, postsecondary, and adult levels. Introductory information given includes a description of how to use the listing and sources and ordering…

  6. 78 FR 48151 - Defense Health Board; Notice of Federal Advisory Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-07

    ...Pursuant to the Federal Advisory Committee Act of 1972 (5 U.S.C., Appendix, as amended), the Government in the Sunshine Act of 1976 (5 U.S.C. 552b, as amended), and 41 CFR Sec. 102-3.150, a Defense Health Board (DHB) meeting is...

  7. A Political History of Federal Mental Health and Addiction Insurance Parity

    PubMed Central

    Barry, Colleen L; Huskamp, Haiden A; Goldman, Howard H

    2010-01-01

    Context: This article chronicles the political history of efforts by the U.S. Congress to enact a law requiring “parity” for mental health and addiction benefits and medical/surgical benefits in private health insurance. The goal of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity (MHPAE) Act of 2008 is to eliminate differences in insurance coverage for behavioral health. Mental health and addiction treatment advocates have long viewed parity as a means of increasing fairness in the insurance market, whereas employers and insurers have opposed it because of concerns about its cost. The passage of this law is viewed as a legislative success by both consumer and provider advocates and the employer and insurance groups that fought against it for decades. Methods: Twenty-nine structured interviews were conducted with key informants in the federal parity debate, including members of Congress and their staff; lobbyists for consumer, provider, employer, and insurance groups; and other key contacts. Historical documentation, academic research on the effects of parity regulations, and public comment letters submitted to the U.S. Departments of Labor, Health and Human Services, and Treasury before the release of federal guidance also were examined. Findings: Three factors were instrumental to the passage of this law: the emergence of new evidence regarding the costs of parity, personal experience with mental illness and addiction, and the political strategies adopted by congressional champions in the Senate and House of Representatives. Conclusions: Challenges to implementing the federal parity policy warrant further consideration. This law raises new questions about the future direction of federal policymaking on behavioral health. PMID:20860577

  8. New thoughts about estrogen therapy from the Women's Health Initiative.

    PubMed

    Ko, Marcia Gene

    2008-09-01

    Since the introduction of hormone replacement therapy (HRT) in 1942, the availability of scientific information regarding the physiologic action of estrogen alone and in combination with progesterone has grown substantially. The specific physiology of changes in endogenous estrogen as a causal factor in bone loss that occurs as the result of menopause is now better understood. Accumulating evidence regarding the benefit of estrogen in protecting against bone loss at the time of menopause made it the first choice for prevention and treatment of osteoporosis, until the findings of the Women's Health Initiative (WHI) were announced in 2002. Fortunately, the availability of multiple alternative agents for prevention and treatment of osteoporosis in menopausal women has provided clinicians with other options. There remain a small number of patients who cannot tolerate or afford these alternative therapies. Recent publications resulting from the WHI should be understood by practicing physicians who are faced with this dilemma and may need to consider HRT in treating patients with osteoporosis. PMID:18752772

  9. [Will health promotion remain a utopia in a fragmented political system? The case of the Wallonia-Brussels Federation].

    PubMed

    Bantuelle, Martine

    2013-01-01

    In the French Community of Belgium (the Wallonia-Brussels Federation), the changing political landscape and the various laws relating to the roles of the federal state, communities and regions introduced since 1980 have had a significant impact on health policy. Since then, there have been significant developments in health education services and activities. In 1997, a government decree was issued to promote the concept of health promotion, to reform the existing system and to define policy priorities as part of a new five-year plan (1998-2003). Significant progress was made during this period as a result of the development of a global approach extending beyond the mere analysis of risk factors. The second five-year plan (2004-2008), aimed at combining preventive medicine and health promotion, resulted in the involvement of a wider range of actors and greater cross-sector collaboration. However, the sheer number of decision-making levels has been a major obstacle to popular participation and consultation. If the question of social and cultural accessibility is not seriously addressed, the focus on preventive medicine programs may prove to be detrimental to the development of an effective health promotion framework. The disconnect between the political vision and the reality of practice has had an adverse impact on health promotion. Health promotion professionals have repeatedly called for a third five-year plan involving all ministers and aimed at developing a cross-sector approach, at addressing the determinants of health, at promoting the active participation of local communities and at reducing social health inequalities. The concerns of health promotion practitioners were further exacerbated by the introduction of an external assessment process initiated by the Ministry of Health in 2010. The current concerns over the future of the Belgian state, the economic crisis and the impact of spending cuts have increased the sense of uncertainty. The upcoming elections

  10. Cooperative Russian Federation -United States Near-Earth Object (NEO) Observation Initiative

    NASA Astrophysics Data System (ADS)

    Schnelzer, Garry; Marshall, James; Bottke, William; Andrews, John

    On February 15, 2013, an asteroid exploded in the atmosphere near Chelyabinsk, Russia, causing significant damage and concern. Following the Chelyabinsk event, scientists and government leaders in the Russian Federation and United States have highlighted the need for collaborative efforts to quantify and characterize the potential threat from a Near Earth Objects (NEO). This paper will explore the possibility of a collaborative Russian Federation - United States program to perform a survey mission and create mechanisms and protocols for sharing of data relating to NEO threats to our planet. The joint collaboration would focus on identifying capability improvements for NEO observations using current or future space-based and/or ground-based assets of the two countries. Another part of the effort would include improvements in Bolide reporting, to include the “real-time” characterization of a NEO entry.

  11. Politics and the erosion of federal scientific capacity: restoring scientific integrity to public health science.

    PubMed

    Rest, Kathleen M; Halpern, Michael H

    2007-11-01

    Our nation's health and prosperity are based on a foundation of independent scientific discovery. Yet in recent years, political interference in federal government science has become widespread, threatening this legacy. We explore the ways science has been misused, the attempts to measure the pervasiveness of this problem, and the effects on our long-term capacity to meet today's most complex public health challenges. Good government and a functioning democracy require public policy decisions to be informed by independent science. The scientific and public health communities must speak out to defend taxpayer-funded science from political interference. Encouragingly, both the scientific community and Congress are exploring ways to restore scientific integrity to federal policymaking. PMID:17901422

  12. [Memorandum on sustainable reinforcement of prevention and health promotion: challenges at the federal, state and local level].

    PubMed

    Walter, U; Nöcker, G; Pawils, S; Robra, B-P; Trojan, A; Franz, M; Grossmann, B; Schmidt, T-A; Lehmann, H; Bauer, U; Göpel, E; Janz, A; Kuhn, J; Naegele, G; Müller-Kohlenberg, H; Plaumann, M; Stender, K-P; Stolzenberg, R; Süß, W; Trenker, M; Wanek, V; Wildner, M

    2015-05-01

    Research-based evidence and practice-based experience are core requirements for the effective implementation of preventive interventions. The knowledge gained in the Prevention Research Funding Initiative of the German Federal Ministry of Education and Research (2004-2013) was therefore amalgamated, reflected and consolidated in the Cooperation for Sustainable Prevention Research (KNP) meta-project. In annual strategy meetings, researchers and practitioners from the field and other experts developed 3 memoranda providing recommendations for the further development of research and practice in the field of prevention and health promotion. Memorandum III is primarily aimed at decision-makers in politics and administration at the federal, state and local level, in civil society and in the workplace. Its recommendations show that structuring efforts are urgently needed to achieve sustainable policy, particularly in the fields of health, education, employment and social affairs. Memorandum III brings together the knowledge extracted and problems identified in research projects. More so than its 2 predecessors, Memorandum III abstracts knowledge from the individual projects and attempts to derive guidance for action and decision-making, as shown by the 7 recommendations that appear to useful for consensus-building in practice and research. Value judgments are inevitable. Prevention and health promotion are an investment in the future: of social health, social capital and social peace. Improvement of the framework conditions is needed to achieve the harmonized awareness and the sustained effectiveness of these structure-building efforts in different policy areas, spheres of life, fields of action, and groups of actors. This includes the implementation of an overall national strategy as well as the expansion of sources of funding, extension of the legal framework, overarching coordination, and the establishment of a National Center of Excellence to develop and safeguard

  13. 78 FR 57178 - Meeting of the Global Justice Information Sharing Initiative Federal Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-17

    ... Committee (GAC) to discuss the Global Initiative, as described at www.it.ojp.gov/global . DATES: The meeting... Global information sharing concept. It will advise the Assistant Attorney General, OJP; the...

  14. 78 FR 24220 - Submission for OMB Review; 30-Day Comment Request: Women's Health Initiative Observational Study

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-24

    ... Next of kin 936 1 .6/60 92 Physician/Office Staff 17 1 5/60 1 * Annual burden is placed on health care... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Submission for OMB Review; 30-Day Comment Request:...

  15. Mental Health and Substance Abuse Insurance Parity for Federal Employees: How Did Health Plans Respond?

    ERIC Educational Resources Information Center

    Barry, Colleen L.; Ridgely, M. Susan

    2008-01-01

    A fundamental concern with competitive health insurance markets is that they will not supply efficient levels of coverage for treatment of costly, chronic, and predictable illnesses, such as mental illness. Since the inception of employer-based health insurance, coverage for mental health services has been offered on a more limited basis than…

  16. Impact of global health governance on country health systems: the case of HIV initiatives in Nigeria

    PubMed Central

    Chima, Charles Chikodili; Homedes, Nuria

    2015-01-01

    Background Three global health initiatives (GHIs) – the US President’s Emergency Plan for AIDS Relief, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank Multi–Country HIV/AIDS Program – finance most HIV services in Nigeria. Critics assert that GHIs burden fragile health systems in resource–poor countries and that health system limitations in these countries constrain the achievement of the objectives of GHIs. This study analyzed interactions between HIV GHIs and the Nigerian Health System and explored how the impact of the GHIs could be optimized. Methods A country case study was conducted using qualitative methods, including: semi–structured interviews, direct observation, and archival review. Semi–structured interviews were held with key informants selected to reach a broad range of stakeholders including policymakers, program managers, service providers, representatives of donor agencies and their implementing partners; the WHO country office in Nigeria; independent consultants; and civil society organizations involved in HIV work. The fieldwork was conducted between June and August 2013. Findings HIV GHIs have had a mixed impact on the health system. They have enhanced availability of and access to HIV services, improved quality of services, and strengthened health information systems and the role of non–state actors in health care. On the negative end, HIV donor funding has increased dependency on foreign aid, widened disparities in access to HIV services, done little to address the sustainability of the services, crowded out non–HIV health services, and led to the development of a parallel supply management system. They have also not invested significantly in the production of new health workers and have not addressed maldistribution problems, but have rather contributed to internal brain drain by luring health workers from the public sector to non–governmental organizations and have increased workload for

  17. NAVIGATING the Future Through the Past The Enduring Historical Legacy of Federal Children's Health Programs in the United States

    PubMed Central

    2012-01-01

    The United States excels at treating the most complex medical conditions, but our low-ranking health statistics (relative to other countries) do not match our high-end health care spending. One way to understand this paradox is to examine the history of federal children's health programs. In the 1800s, children's health advocates confronted social determinants of health to reduce infant mortality. Over the past 100 years, however, physicians have increasingly focused on individual doctor–patient encounters; public health professionals, meanwhile, have maintained a population health perspective but struggled with the politics of addressing root causes of disease. Political history and historical demography help explain some salient differences with European nations that date to the founding of federal children's health programs in the early 20th century. More recently, federal programs for children with intellectual disability illustrate technical advances in medicine, shifting children's health epidemiology, and the politics of public health policy. PMID:22897550

  18. Bring Hidden Hazards to the Publics Attention, Understanding, and Informed Decision by Coordinating Federal Education Initiatives

    NASA Astrophysics Data System (ADS)

    Niepold, F.; Karsten, J. L.; Wei, M.; Jadin, J.

    2010-12-01

    In the 2010 National Research Council’s America’s Climate Choices’ report on Informing Effective Decisions and Actions Related to Climate Change concluded; “Education and communication are among the most powerful tools the nation has to bring hidden hazards to public attention, understanding, and action.” They conclude that the “current and future students, the broader public, and policymakers need to understand the causes, consequences, and potential solutions to climate change, develop scientific thinking and problem-solving skills, and improve their ability to make informed decisions.” The U.S. Global Change Research Program (USGCRP) works to integrate the climate related activities of these different agencies, with oversight from the Office of Science and Technology Policy and other White House offices. USGCRP’s focus is now on evaluating optimal strategies for addressing climate change risks, improving coordination among the Federal agencies, engaging stakeholders (including national policy leaders and local resource managers) on the research results to all and improving public understanding and decision-making related to global change. Implicit to these activities is the need to educate the public about the science of climate change and its consequences, as well as coordinate Federal investments related to climate change education. In a broader sense, the implementation of the proposed Interagency Taskforce on Climate Change Communication and Education will serve the evolving USGCRP mandates around cross-cutting, thematic elements, as recommended by the National Research Council (NRC, 2009) and the U.S. Climate Change Science Program Revised Research Plan: An update to the 2003 Strategic Plan (USGCRP, 2008), to help the Federal government “capitalize on its investments and aid in the development of increased climate literacy for the Nation.” This session will update the participants on the work to date and the near term coordinated plans

  19. Optimism and diet quality in the Women's Health Initiative.

    PubMed

    Hingle, Melanie D; Wertheim, Betsy C; Tindle, Hilary A; Tinker, Lesley; Seguin, Rebecca A; Rosal, Milagros C; Thomson, Cynthia A

    2014-07-01

    Diet quality has not been well studied in relation to positive psychological traits. Our purpose was to investigate the relationship between optimism and diet quality in postmenopausal women enrolled in the Women's Health Initiative observational study (OS) and clinical trials (CTs), and to determine whether optimism was associated with diet change after a 1-year dietary intervention. Diet quality was scored with the Alternate Healthy Eating Index (AHEI) and optimism assessed with the Life Orientation Test-Revised. Baseline characteristics were compared across AHEI quintiles or optimism tertiles using regression models with each variable of interest as a function of quintiles or tertiles (OS, n=87,630; CT, n=65,360). Association between optimism and baseline AHEI and change in AHEI over 1 year were tested using multivariate linear regression (CT, n=13,645). Potential interaction between optimism and trial arm and demographic/lifestyle factors on AHEI change was tested using likelihood ratio test (CT intervention, n=13,645; CT control, n=20,242). Women reporting high AHEI were non-Hispanic white, educated, physically active, past or never smokers, hormone therapy users, had lower body mass index and waist circumference, and were less likely to have chronic conditions. In the CT intervention, higher optimism was associated with higher AHEI at baseline and with greater change over 1 year (P=0.001). Effect modification by intervention status was observed (P=0.014), whereas control participants with highest optimism achieved threefold greater AHEI increase compared with those with the lowest optimism. These data support a relationship between optimism and dietary quality score in postmenopausal women at baseline and over 1 year. PMID:24556429

  20. The sustainability of public health expenditures: evidence from the Canadian federation.

    PubMed

    Di Matteo, Livio

    2010-12-01

    The fiscal sustainability of government health expenditures is defined as the gap between growth rates of spending and measures of the resource base. The results show that over the period 1965-2008, real per capita Canadian provincial government health spending has grown at rates that exceed growth in basic measures of the resource base such as per capita gross domestic product (GDP), per capita federal transfers and per capita provincial government revenues. Forecasts of future spending to 2035 using determinant regression and growth rate extrapolation techniques show that Canadian provincial government health spending is projected to continue rising in the future and its share of provincial GDP will rise. While the amount spent on health is ultimately a public policy choice, provincial government health spending also cannot continue growing faster than the resource base indefinitely. PMID:20066461

  1. Teaching Medical Students about Health Literacy: 2 Chicago Initiatives

    ERIC Educational Resources Information Center

    Harper, William; Cook, Sandy; Makoul, Gregory

    2007-01-01

    Objective: To develop medical students' skills in interacting with individuals who have limited health literacy. Methods: Described are 2 novel approaches to health literacy curriculum design. Efforts at both schools have been implemented to improve medical student awareness of health literacy, as well as specific skills in clear communication and…

  2. The impact of global health initiatives on the health system in Angola.

    PubMed

    Craveiro, Isabel; Dussault, Gilles

    2016-04-01

    We assessed the impact of global health initiatives (GHIs) on the health care system of Angola, as a contribution to documenting how GHIs, such as the Global Fund, GAVI and PEPFAR, influence the planning and delivery of health services in low-income countries and how national systems respond. We collected the views of national and sub-national key informants through 42 semi-structured interviews between April 2009 and May 2011 (12 at the national level and 30 at the sub-national level). We used a snowball technique to identify respondents from government, donors and non-governmental organisations. GHIs stimulated the formulation of a health policy and of plans and strategies, but the country has yet to decide on its priorities for health. At the regional level, managers lack knowledge of how GHIs' function, but they assess the effects of external funds as positive as they increased training opportunities, and augment the number of workers engaged in HIV or other specific disease programmes. However, GHIs did not address the challenge of attraction and retention of qualified personnel in provinces. Since Angola is not entirely dependent on external funding, national strategic programmes and the interventions of GHIs co-habit well, in contrast to countries such as Mozambique, which heavily depend on external aid. PMID:26758687

  3. Protecting resources for primary health care under fiscal federalism: options for resource allocation.

    PubMed

    Okorafor, Okore A; Thomas, Stephen

    2007-11-01

    The introduction of fiscal federalism or decentralization of functions to lower levels of government is a reform not done primarily with health sector concerns. A major concern for the health sector is that devolution of expenditure responsibilities to sub-national levels of government can adversely affect the equitable distribution of financial resources across local jurisdictions. Since the adoption of fiscal federalism in South Africa, progress towards achieving a more equitable distribution of public sector health resources (financial) has slowed down considerably. This study attempts to identify appropriate resource allocation mechanisms under the current South African fiscal federal system that could be employed to promote equity in primary health care (PHC) allocations across provinces and districts. The study uses data from interviews with government officials involved in the budgeting and resource allocation process for PHC, literature on fiscal federalism and literature on international experience to inform analysis and recommendations. The results from the study identify historical incremental budgeting, weak managerial capacity at lower levels of government, poor accounting of PHC expenditure, and lack of protection for PHC funds as constraints to the realization of a more equitable distribution of PHC allocations. Based on interview data, no one resource allocation mechanism received unanimous support from stakeholders. However, the study highlights the particularly high level of autonomy enjoyed by provincial governments with regards to decision making for allocations to health and PHC services as the major constraint to achieving a more equitable distribution of PHC resources. The national government needs to have more involvement in decision making for resource allocation to PHC services if significant progress towards equity is to be achieved. PMID:18006526

  4. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... hospital care under 38 U.S.C. 1710 or 38 CFR 17.46. Use of Public or Private Hospitals ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public...

  5. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... hospital care under 38 U.S.C. 1710 or 38 CFR 17.46. Use of Public or Private Hospitals ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public...

  6. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... hospital care under 38 U.S.C. 1710 or 38 CFR 17.46. Use of Public or Private Hospitals ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public...

  7. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... hospital care under 38 U.S.C. 1710 or 38 CFR 17.46. Use of Public or Private Hospitals ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public...

  8. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... hospital care under 38 U.S.C. 1710 or 38 CFR 17.46. Use of Public or Private Hospitals ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public...

  9. 78 FR 8551 - Federal Housing Administration (FHA) Risk Management Initiatives: Changes to Maximum Loan-to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-06

    ...'s annual Fiscal Year 2012 report to Congress on the financial status of the FHA Mutual Mortgage... improve the health of the MMIF, while ensuring continued access to mortgage credit for American families... housing crisis, and the volume of FHA insurance increased rapidly during the housing crisis as...

  10. Expenditures in the health care system in Brazil: the participation of states and the Federal District in financing the health care system from 2002 to 2013

    PubMed Central

    de Deus Costa, Renata Maria; da Silva Barbosa, Rafael; Zucchi, Paola

    2015-01-01

    OBJECTIVE: To analyze the public expenditures of states on health care and the participation of states and the Federal District in financing the Unified Health System, better known by the acronym SUS. To develop the research, two targets were used: “to rescue expenses per government source (federal, state and municipal) during the period from 2002 to 2013” and “to rescue resource transfers from the federal SUS to the states and also to municipalities”. METHODS: This research is bibliographic, documentary and descriptive and used a quantitative approach. Data were extracted from the Information System Public Health Budget, and additional data were collected from the public managers of states, municipalities and the Federal District during the period from 2002 to 2013. Federal data from the Undersecretary of Planning and Budget (originally extracted from the Integrated System of Financial Administration of the Federal Government and available on the Budget Public Health System webpage) were also collected. RESULTS: The data revealed that during the same researched period, the Federal District has maintained the health care system budget, whereas states and municipalities have increased their budgets for the same spending. CONCLUSIONS: By analyzing the results, there is clearly a disparity regarding the investment expended by the entities of the Federation. Although municipalities and states have gradually increased their application of resources to health care, the federal state has maintained the same budget. These results reveal a bit of concern about public health funding. PMID:26017788

  11. Rainbows: a primary health care initiative for primary schools.

    PubMed

    Munns, Ailsa; Forde, Karen A; Krouzecky, Miriam; Shields, Linda

    2015-01-01

    Within the current Australian health system is the understanding of a need to change from the predominate biomedical model to incorporate a comprehensive primary health care centred approach, embracing the social contexts of health and wellbeing. Recent research investigated the benefits of the primary health care philosophy and strategies in relation to the Rainbows programme which addresses grief and loss in primary school aged students in Western Australia. A multidisciplinary collaboration between the Western Australian Departments of Health and Education enabled community school health nurse coordinators to train teacher facilitators in the implementation of Rainbows, enabling support for students and their parents. The results of this qualitative study indicate that all participants regard Rainbows as effective, with many perceived benefits to students and their families. PMID:26281402

  12. STOPPING DECEPTIVE HEALTH CLAIMS: THE NEED FOR A PRIVATE RIGHT OF ACTION UNDER FEDERAL LAW.

    PubMed

    Hoffmann, Diane; Schwartz, Jack

    2016-01-01

    This Article offers a thorough analysis of an important public health issue, namely how to confront the growing problem of deceptive claims regarding foods and dietary supplements, including increasingly prevalent but unverifiable claims. The authors call for the creation of a limited private right of action under the Federal Trade Commission (FTC) Act for deceptive health-related claims for these products. The proposal responds to the growing market for these products and the inadequacy of current laws and enforcement actions to prevent such claims. In crafting the limited private right of action, the authors attempt to enhance consumer protection without undermining federal agency primacy in enforcement. The Article ends with an appendix setting forth proposed language for a statutory amendment to the FTC Act incorporating the authors' proposal. PMID:27263263

  13. Federalism, the economic-industrial health care complex and high-cost pharmaceutical assistance in Brazil.

    PubMed

    da Fonseca, Elize Massard; Costa, Nilson do Rosario

    2015-04-01

    Brazil has a relevant, although relatively unknown, special medicines programme that distributes high-cost products, such as drugs needed for cancer treatments. In 2009, the purchase of these medicines became the responsibility of the Brazilian Federal Government. Until then, there were no clear norms regarding the responsibilities, in terms of the management/financing of these medicines, of the Brazilian Federal Government and of the states themselves. This qualitative study analyses the policy process needed to transfer this programme to the central government. The study examines the reports of the Tripartite Commission between 2000 and 2012, and in-depth interviews with eleven key informants were conducted. The study demonstrates that throughout the last decade, institutional changes have been made in regard to the federal management of these programmes (such as recentralisation of the purchasing of medicines). It concludes that these changes can be explained because of the efficiency of the coordinating mechanisms of the Federal Government. These findings reinforce the idea that the Ministry of Health is the main driver of public health policies, and it has opted for the recentralisation of activities as a result of the development project implicit in the agenda of the Industrial and Economic Heal. PMID:25923627

  14. Professional and educational initiatives, supports, and opportunities for advanced training in public health.

    PubMed

    Truong, Hoai-An; Patterson, Brooke Y

    2010-09-10

    The United States is facing a public health workforce shortage and pharmacists have the opportunity and obligation to address this challenge in health care. There have been initiatives and supports from within and beyond the profession for the pharmacist's role in public health. This article identifies existing professional and educational initiatives for the pharmacist's expanded role in public health, as well as postgraduate and other advanced educational opportunities in public health. Recommendations also are provided on how to further engage pharmacists in public health activities to alleviate the public health workforce challenge. PMID:21088727

  15. EHR adopters vs. non-adopters: Impacts of, barriers to, and federal initiatives for EHR adoption

    PubMed Central

    Jamoom, Eric W.; Patel, Vaishali; Furukawa, Michael F.; King, Jennifer

    2016-01-01

    While adoption of electronic health record (EHR) systems has grown rapidly, little is known about physicians’ perspectives on its adoption and use. Nationally representative survey data from 2011 are used to compare the perspectives of physicians who have adopted EHRs with those that have yet to do so across three key areas: the impact of EHRs on clinical care, practice efficiency and operations; barriers to EHR adoption; and factors that influence physicians to adopt EHRs. Despite significant differences in perspectives between adopters and non-adopters, the majority of physicians perceive that EHR use yields overall clinical benefits, more efficient practices and financial benefits. Purchase cost and productivity loss are the greatest barriers to EHR adoption among both adopters and non-adopters; although non-adopters have significantly higher rates of reporting these as barriers. Financial incentives and penalties, technical assistance, and the capability for electronic health information exchange are factors with the greatest influence on EHR adoption among all physicians. However, a substantially higher proportion of non-adopters regard various national health IT policies, and in particular, financial incentives or penalties as a major influence in their decision to adopt an EHR system. Contrasting these perspectives provides a window into how national policies have shaped adoption thus far; and how these policies may shape adoption in the near future. PMID:26250087

  16. Veterans Affairs Health System Enrollment and Health Care Utilization After the Affordable Care Act: Initial Insights.

    PubMed

    Silva, Abigail; Tarlov, Elizabeth; French, Dustin D; Huo, Zhiping; Martinez, Rachael N; Stroupe, Kevin T

    2016-05-01

    The Affordable Care Act (ACA) was signed into law in 2010 and its individual mandate and expanded health care coverage options were implemented in 2014. These provisions may affect Veterans Affairs (VA) enrollment and health care utilization. Using data from two VA regional networks, we examined recent patterns in the number of new VA enrollees and their primary care use. Trends were assessed by enrollment priority group (based on the veteran's severity of service-connected disabilities, exposures, and income level) and a state's Medicaid expansion status. Compared to the same time period in the previous year, the number of new enrollees from low-income priority groups was higher during the open enrollment period and the increase was sharper in Medicaid non-expansion states (25-42%) than in expansion states (20-32%). In addition, low-income patients with a copay requirement who enrolled in the VA during the ACA open enrollment had a lower average number of primary care visits than counterparts who had enrolled in prior time periods (1.73 versus 1.87, p < 0.0001). Although this study is an initial step, more research is required to better understand veterans' decision making and behavior in regard to health care coverage through the ACA and related impacts on VA and non-VA health care utilization and care coordination. PMID:27136655

  17. 75 FR 60089 - Federal Advisory Committee; Defense Health Board (DHB) Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-29

    ...Pursuant to the Federal Advisory Committee Act of 1972 (5 U.S.C., Appendix as amended), the Sunshine in the Government Act of 1976 (5 U.S.C. 552b, as amended), and 41 CFR 102-3.150, and in accordance with section 10(a)(2) of Public Law, DoD announces that the Defense Health Board (DHB) will meet November 1 and 2, 2010, in Arlington,...

  18. Inventory of Federal School Health Promotion Activities. Working Document. Interagency Meeting on Health Promotion through the Schools (March 24-25, 1983).

    ERIC Educational Resources Information Center

    Department of Health and Human Services, Washington, DC.

    A review was made of federal activity in school health promotion for the purpose of sharing information to use effectively existing federal activity, to prevent duplication of effort, and to increase interagency cooperation. Surveyed agencies submitted a statement regarding their missions in school health promotion and provided a list of current…

  19. Employment-Related Health Insurance: Federal Agencies' Roles in Meeting Data Needs

    PubMed Central

    Wiatrowski, William; Harvey, Holly; Levit, Katharine R.

    2002-01-01

    Employer-sponsored health insurance accounts for almost one-third of all health care spending. As health care cost growth accelerates affecting the availability of employer-sponsored insurance and depth of coverage, the importance of timely and accurate information for measuring and monitoring these changes and formulating policy options increases. Identifying a growing gap between the need for and availability of data to inform policy on employment-related health insurance issues, the Office of Management and Budget (OMB) established a committee of Federal agency representatives to evaluate and advise data collection efforts. This article reports on the committee's current efforts, focusing on evaluation of results from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) and the National Compensation Survey (NCS). PMID:12500352

  20. Employment-related health insurance: federal agencies' roles in meeting data needs.

    PubMed

    Wiatrowski, William; Harvey, Holly; Levit, Katharine R

    2002-01-01

    Employer-sponsored health insurance accounts for almost one-third of all health care spending. As health care cost growth accelerates affecting the availability of employer-sponsored insurance and depth of coverage, the importance of timely and accurate information for measuring and monitoring these changes and formulating policy options increases. Identifying a growing gap between the need for and availability of data to inform policy on employment-related health insurance issues, the Office of Management and Budget (OMB) established a committee of Federal agency representatives to evaluate and advise data collection efforts. This article reports on the committee's current efforts, focusing on evaluation of results from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) and the National Compensation Survey (NCS). PMID:12500352

  1. Licensed Practical Nurses in Occupational Health. An Initial Survey.

    ERIC Educational Resources Information Center

    Lee, Jane A.; And Others

    The study, conducted in 1971, assessed characteristics of licensed practical nurses (LPN's) who worked in occupational health nursing. The survey instrument, a questionnaire, was returned by 591 LPN's in occupational health and provided data related to: personal characteristics, work and setting, administrative and professional functioning,…

  2. Health Care of Incarcerated Youth: State Programs & Initiatives.

    ERIC Educational Resources Information Center

    Thompson, Linda S.; Sheahan, Paula M.

    This report presents the analysis and results of a survey of states' progress in meeting the goals and objectives of their state action plans on the health care of incarcerated youth. The survey questioned 48 juvenile justice professionals, health care professionals, and university faculty from across the nation concerning state progress toward…

  3. The Long Way From Government Open Data to Mobile Health Apps: Overcoming Institutional Barriers in the US Federal Government

    PubMed Central

    2014-01-01

    Background Government agencies in the United States are creating mobile health (mHealth) apps as part of recent policy changes initiated by the White House’s Digital Government Strategy. Objective The objective of the study was to understand the institutional and managerial barriers for the implementation of mHealth, as well as the resulting adoption pathways of mHealth. Methods This article is based on insights derived from qualitative interview data with 35 public managers in charge of promoting the reuse of open data through Challenge.gov, the platform created to run prizes, challenges, and the vetting and implementation of the winning and vendor-created apps. Results The process of designing apps follows three different pathways: (1) entrepreneurs start to see opportunities for mobile apps, and develop either in-house or contract out to already vetted Web design vendors; (2) a top-down policy mandates agencies to adopt at least two customer-facing mobile apps; and (3) the federal government uses a policy instrument called “Prizes and Challenges”, encouraging civic hackers to design health-related mobile apps using open government data from HealthData.gov, in combination with citizen needs. All pathways of the development process incur a set of major obstacles that have to be actively managed before agencies can promote mobile apps on their websites and app stores. Conclusions Beyond the cultural paradigm shift to design interactive apps and to open health-related data to the public, the managerial challenges include accessibility, interoperability, security, privacy, and legal concerns using interactive apps tracking citizen. PMID:25537314

  4. eHealth in Belgium, a new "secure" federal network: role of patients, health professions and social security services.

    PubMed

    France, Francis Roger

    2011-02-01

    eHealth platform is the official federal network in Belgium (created by law on 21 August 2008) devoted to a secure exchange of health data in many types of applications, such as health care purposes, simplification of administrative procedures and contribution to health policy. It implies a controlled access to decentralized databases and uses encrypted personal data. The national identification number has been chosen in order to authenticate the requester, the patient, and the receiver of information exchange. Authorizations have to be respected in order to obtain personal health data. Several questions are raised about its security: the lack of mandatory request for systematic journaling on accesses to the electronic patient record as well as the absence of explicit procedures for sanctions in case of unauthorized access, the new role of social security administration in managing security where a eHealth manager can be both judge and party (in the function of trusted third party for health data encryption and of a required lawyer for texts proposed by physicians to the Commission for the protection of private life). Another critic concerns the number of physicians in minority and the absence of patients' delegates in the eHealth Board. At a time when the patient is becoming a partner in the care team, should not he be the gate-keeper for the access to his own health record? How could networks help him to get the appropriate knowledge to contribute to care and to write his testament of life? Recent laws (on private life, patient rights and euthanasia) have contributed to a behavioural change in citizens and physician attitudes. Recommendations are made in order to improve the acceptability of eHealth platform. PMID:21035383

  5. Partnership for Implementation of Evidence-Based Mental Health Practices in Rural Federally Qualified Health Centers: Theory and Methods

    PubMed Central

    Hunt, Justin B.; Curran, Geoffrey; Kramer, Teresa; Mouden, Sip; Ward-Jones, Susan; Owen, Richard; Fortney, John

    2013-01-01

    Background Mental health and substance abuse are among the most commonly reported reasons for visits to Federally Qualified Health Centers (CHCs), yet only 6.5% of encounters are with on-site behavioral health specialists. Rural CHCs are significantly less likely to have on-site behavioral specialists than urban CHCs. Due to this lack of mental health specialists in rural areas, the most promising approach to improving mental health outcomes is to help rural primary care providers deliver evidence based practices (EBPs). Despite the scope of these problems, no research has developed an effective implementation strategy for facilitating the adoption of mental health EBPs for rural CHCs. Objectives To describe the conceptual components of an Implementation Partnership that focuses on the adaption and adoption of mental health EBPs by rural CHCs in Arkansas. Methods We present a conceptual model that integrates seven separate frameworks: 1) Jones and Wells’ Evidence-Based Community Partnership Model, 2) Kitson’s Promoting Action on Research Implementation in Health Services (PARiHS) implementation framework, 3) Sackett’s definition of evidence-based medicine, 4) Glisson’s organizational social context model, 5) Rubenstein’s Evidence-Based Quality Improvement (EBQI) facilitation process, 6) Glasgow’s RE-AIM evaluation approach, and 7) Naylor’s concept of shared decision making. Conclusions By integrating these frameworks into a meaningful conceptual model, we hope to develop a successful Implementation Partnership between an academic health center and small rural CHCs to improve mental health outcomes. Findings from this Implementation Partnership should have relevance to hundreds of clinics and millions of patients, and could help promote the sustained adoption of EBPs across rural America. PMID:22982852

  6. [Revision of the legal prescription requirements for strong opioids in the federal republic of Germany-an initiative of the German association for the study of pain.].

    PubMed

    Sorge, J

    1992-09-01

    In the Federal Republic of Germany, strict regulations complicate the prescription of strong opioids to patients suffering from severe pain. In summer 1991 the German Association for the Study of Pain launched an initiative directed at simplification of the prescription requirements for such analgesics and submitted the suggestions to the ministries responsible. In the meantime a draft bill has been presented by the Ministry of Health, with due consideration for the main recommendations. For example, substantial increases in the permitted quantities of the individual narcotic analgesics and the prescription periods are planned. Moreover, the prescriptions are to be simpler to make out and certain exemptions have been specified by law. Acceptance of the bill by the political committees and its realization are expected in autumn 1992. PMID:18415607

  7. Barriers to sustainable tuberculosis control in the Russian Federation health system.

    PubMed Central

    Atun, R. A.; Samyshkin, Y. A.; Drobniewski, F.; Skuratova, N. M.; Gusarova, G.; Kuznetsov, S. I.; Fedorin, I. M.; Coker, R. J.

    2005-01-01

    The Russian Federation has the eleventh highest tuberculosis burden in the world in terms of the total estimated number of new cases that occur each year. In 2003, 26% of the population was covered by the internationally recommended control strategy known as directly observed treatment (DOT) compared to an overall average of 61% among the 22 countries with the highest burden of tuberculosis. The Director-General of WHO has identified two necessary starting points for the scaling-up of interventions to control emerging infectious diseases. These are a comprehensive engagement with the health system and a strengthening of the health system. The success of programmes aimed at controlling infectious diseases is often determined by constraints posed by the health system. We analyse and evaluate the impact of the arrangements for delivering tuberculosis services in the Russian Federation, drawing on detailed analyses of barriers and incentives created by the organizational structures, and financing and provider-payment systems. We demonstrate that the systems offer few incentives to improve the efficiency of services or the effectiveness of tuberculosis control. Instead, the system encourages prolonged supervision through specialized outpatient departments in hospitals (known as dispensaries), multiple admissions to hospital and lengthy hospitalization. The implementation, and expansion and sustainability of WHO-approved methods of tuberculosis control in the Russian Federation are unlikely to be realized under the prevailing system of service delivery. This is because implementation does not take into account the wider context of the health system. In order for the control programme to be sustainable, the health system will need to be changed to enable services to be reconfigured so that incentives are created to reward improvements in efficiency and outcomes. PMID:15798846

  8. Initiating continuing improvement within Greenfield sites: A federal remanufacturing facility case study

    SciTech Connect

    Montgomery, J.C.; Paul, B.K.

    1992-09-01

    The setting for this study was a federal government remanufacturing depot, responsible for the replacement and overhaul of large wheeled vehicles. These vehicles include 2.5 and 5 ton trucks and their major subordinate component items such as engines, axles, and transmissions. At the time of the case study the depot was involved in the design and construction of a 400,000 square foot hard metal subordinate items remanufacturing facility. The purpose of the facility was to consolidate all existing subordinate item remanufacturing under one roof. Commodity items to be remanufactured within the facility included engines, transmissions, transfer cases, axles, differentials, power generators, and other components. From the onset, the concept of consolidating existing processes under one roof had posed a significant material handling problem. Digital simulation was used to analyze material flow patterns within the new facility. As a result it was determined that, without changing the existing flow of material between processes, significant choke points would form in the areas of shared-capacity resources such as cleaning and painting. It was estimated that these choke points, representing piles of work-in-process (WIP) inventory, would clog aisles and prevent forklifts from making essential deliveries. Thus, a strategy was needed for controlling the buildup of WIP inventory within the new facility. To accomplish this objective, a program was begun to certify the WIP inventory levels of each subordinate item commodity line within existing facilities prior to the move into the new facility. This program focused on training workers in new methods of inventory control, production control, and quality control needed to minimize the WIP levels required within the new facility.

  9. 78 FR 16685 - Indian Health Professions Preparatory, Indian Health Professions Pre-graduate, and Indian Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-18

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Indian Health Professions Preparatory, Indian Health Professions Pre-graduate, and Indian Health Professions Scholarship Programs Announcement Type: Initial. ]...

  10. 75 FR 1384 - Indian Health Professions Preparatory, Indian Health Professions Pregraduate and Indian Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Indian Health Professions Preparatory, Indian Health Professions Pregraduate and Indian Health Professions Scholarship Programs Announcement Type: Initial. CFDA Numbers:...

  11. What does it take? How federal initiatives can support the implementation of evidence-based programs to improve outcomes for adolescents.

    PubMed

    Metz, Allison; Albers, Bianca

    2014-03-01

    Over the last 20 years, there has been a growing emphasis on developing and identifying evidence-based programs and practices for children and families and within the last decade an increasing number of federally funded initiatives have been dedicated to replicating and scaling evidence-based programs with the hope of achieving socially meaningful impact. However, only recently have efforts to promote high-fidelity implementation been given the attention needed to ensure evidence-based practices are used as intended and generate the outcomes they were designed to produce. In this article, we propose that the wide-scale implementation of evidence-based practices requires: (1) careful assessment and selection of the "what"; (2) a stage-based approach that provides adequate time and resources for planning and installation activities; (3) the co-creation of a visible infrastructure by a triad of key stakeholders including funders and policymakers, program developers, and implementing sites; and (4) the use of data to guide decision-making and foster curiosity into continuous improvement among grantees. Each of these strategies is explored in greater detail through the lens of the Teen Pregnancy Prevention (TPP) Program, a $100 million initiative overseen by the Office of Adolescent Health (OAH) in the U.S. Department of Health and Human Services. PMID:24560083

  12. Safe motherhood and newborn health: FIGO initiatives 2006-2010.

    PubMed

    Lalonde, André B; McMullen, Heather; Lee, Amanda C

    2009-08-01

    Through international partnerships, FIGO has been delivering safe motherhood and newborn health (SMNH) projects in a number of low-income countries. The projects aim to achieve the objectives set out in the ICPD Programme of Action and the Millennium Development Goals 4 and 5, which are related to child survival and maternal mortality. Each project is developed in response to the needs of the intervention region and can be organized around the following themes: provision of maternal and newborn health care services to underserved and hard-to-reach areas; improvement and provision of quality basic emergency obstetric care; establishment of functional clinical and perinatal audits; development of new maternal and newborn health care protocols; community education and sensitization to women's rights in sexual and reproductive health; and reducing the risk of unsafe abortion. PMID:19535074

  13. Student-Initiated Sexual Health Selective as a Curricular Tool

    PubMed Central

    Johnson, Katie; Rullo, Jordan; Faubion, Stephanie

    2015-01-01

    Introduction Patients’ sexual health functioning is important for physicians in all fields of medicine to consider; however, this topic is lacking from almost half of U.S. medical school curricula. Aims This study aims to develop, implement, and assess the feasibility of a preliminary sexual health curriculum for medical students. Methods This Sexual Health Selective (SHS) was developed and implemented by a student and faculty champion for first year medical students. Its design incorporated a number of the guiding principles and recommendations from the 2012 Summit on Medical School Education in Sexual Health. Main Outcome Measures Feasibility was measured by limited-efficacy testing and participant acceptability of the SHS. Limited-efficacy testing was accomplished by conducting descriptive comparisons of responses to a sexual health attitudes and knowledge survey. These responses were compared between (i) participants vs. nonparticipants prior to the SHS, (ii) participants immediately after vs. participants prior to the SHS, (iii) participants 3 months after vs. participants prior to the SHS, and (iv) participants 3 months after vs. participants immediately after the SHS. Participant acceptability was assessed by asking qualitatively and quantitatively whether students enjoyed the SHS, found it beneficial to their learning, and would recommend it to their classmates. Results Immediately after the SHS and 3 months later, participants reported increased comfort and open-mindedness in their attitudes toward sexual health and demonstrated an increase in accurate knowledge about sexual health issues compared with baseline. Objective follow-up also revealed that most participants enjoyed the SHS, found it beneficial to their learning, and would recommend it to their classmates. Conclusions The 1-week SHS was successfully implemented through the teamwork of a medical student and faculty champion. It resulted in more accurate knowledge and more open attitudes toward

  14. SU-E-T-544: A Radiation Oncology-Specific Multi-Institutional Federated Database: Initial Implementation

    SciTech Connect

    Hendrickson, K; Phillips, M; Fishburn, M; Evans, K; Banerian, S; Mayr, N; Wong, J; McNutt, T; Moore, J; Robertson, S

    2014-06-01

    Purpose: To implement a common database structure and user-friendly web-browser based data collection tools across several medical institutions to better support evidence-based clinical decision making and comparative effectiveness research through shared outcomes data. Methods: A consortium of four academic medical centers agreed to implement a federated database, known as Oncospace. Initial implementation has addressed issues of differences between institutions in workflow and types and breadth of structured information captured. This requires coordination of data collection from departmental oncology information systems (OIS), treatment planning systems, and hospital electronic medical records in order to include as much as possible the multi-disciplinary clinical data associated with a patients care. Results: The original database schema was well-designed and required only minor changes to meet institution-specific data requirements. Mobile browser interfaces for data entry and review for both the OIS and the Oncospace database were tailored for the workflow of individual institutions. Federation of database queries--the ultimate goal of the project--was tested using artificial patient data. The tests serve as proof-of-principle that the system as a whole--from data collection and entry to providing responses to research queries of the federated database--was viable. The resolution of inter-institutional use of patient data for research is still not completed. Conclusions: The migration from unstructured data mainly in the form of notes and documents to searchable, structured data is difficult. Making the transition requires cooperation of many groups within the department and can be greatly facilitated by using the structured data to improve clinical processes and workflow. The original database schema design is critical to providing enough flexibility for multi-institutional use to improve each institution s ability to study outcomes, determine best practices

  15. Recent federal initiatives to promote unconventional gas: High octane delivery of just hot air?

    SciTech Connect

    Griff, M.T.

    1995-10-01

    This paper provides an overview of recent initiatives of the United States which promote greater use of natural gas and unconventional gas as one part of this nations`s larger response to the global warming threat. Measurable increases in greenhouse gas concentrations since the beginning of the industrial revolution have led to the belief in the existence of a global warming problem. The international community has responded to the global warming threat with the United Nations Framework Convention on Climate Change which is directed toward the stabilization of greenhouse gases in the atmosphere. The Climate Change Action Plan is the Clinton Administration`s detailed response to the global warming threat. It is designed to return United States emissions of greenhouse gases to their 1990 levels by the year 2000. The Action Plan targets all greenhouse gases and emphasizes energy efficiency. Significant regulatory reformation designed to increase the efficiency of the natural gas industry has already occurred and will be continued. Recovery of methane emissions from landfills will be encouraged through indentification of suitable sites and use of existing technology and development of new technology. Recovery of methane from coal mining operations will be promoted by targeting 50 of the gassiest mines in the United States. Even if the Action Plan is fully implemented. legitimate questions arise as to whether its goals will be achieved as a result of funding shortfalls.

  16. A comparative performance scorecard for federally funded community health centers in North Carolina.

    PubMed

    Radford, Andrea; Pink, George; Ricketts, Thomas

    2007-01-01

    To make informed management decisions, healthcare executives must have timely and useful information about the performance of their organizations. A review of the methods used by the Health Resources and Services Administration's Bureau of Primary Health Care to evaluate the performance of community health centers (CHCs) revealed a lack of such information. This information gap motivated the development of a comparative performance scorecard for the federally funded CHCs in North Carolina. The scorecard includes 19 indicators in four performance dimensions (access to care, financial performance, human resources, and utilization and productivity). A survey of participating CHC executive directors showed that the comparative performance scorecard is a useful tool for managing and evaluating the performance of CHCs. PMID:17288115

  17. Considering health insurance: how do dialysis initiates with Medicaid coverage differ from persons without Medicaid coverage?

    PubMed Central

    Wetmore, James B.; Rigler, Sally K.; Mahnken, Jonathan D.; Mukhopadhyay, Purna; Shireman, Theresa I.

    2010-01-01

    Background. Type of health insurance is an important mediator of medical outcomes in the United States. Medicaid, a jointly sponsored Federal/State programme, is designed to serve medically needy individuals. How these patients differ from non-Medicaid-enrolled incident dialysis patients and how these differences have changed over time have not been systematically examined. Methods. Using data from the United States Renal Data System, we identified individuals initiating dialysis from 1995 to 2004 and categorized their health insurance status. Longitudinal trends in demographic, risk behaviour, functional, comorbidity, laboratory and dialysis modality factors, as reported on the Medical Evidence Form (CMS-2728), were examined in all insurance groups. Polychotomous logistic regression was used to estimate adjusted generalized ratios (AGRs) for these factors by insurance status, with Medicaid as the referent insurance group. Results. Overall, males constitute a growing percentage of both Medicaid and non-Medicaid patients, but in contrast to other insurance groups, Medicaid has a higher proportion of females. Non-Caucasians also constitute a higher proportion of Medicaid patients than non-Medicaid patients. Body mass index increased in all groups over time, and all groups witnessed a significant decrease in initiation on peritoneal dialysis. Polychotomous regression showed generally lower AGRs for minorities, risk behaviours and functional status, and higher AGRs for males, employment and self-care dialysis, for non-Medicaid insurance relative to Medicaid. Conclusions. While many broad parallel trends are evident in both Medicaid and non-Medicaid incident dialysis patients, many important differences between these groups exist. These findings could have important implications for policy planners, providers and payers. PMID:19736241

  18. The inequity of the Swiss health care system financing from a federal state perspective

    PubMed Central

    2014-01-01

    Introduction Previous studies have shown that Swiss health-care financing is particularly regressive. However, as it has been emphasized in the 2011 OECD Review of the Swiss Health System, the inter cantonal variations of income-related inequities are still broadly unexplored. The present paper aims to fill this gap by analyzing the differences in the level of equity of health-care system financing across cantons and its evolution over time using household data. Methods Following the methodology proposed by Wagstaff et al. (JHE 11:361–387, 1992) we use the Kakwani index as a summary measure of regressivity and we compute it for each canton and for each of the sources that have a role in financing the health care system. We graphed concentration curves and performed relative dominance tests, which utilize the full distribution of expenditures. The microdata come from the Swiss Household Income and Expenditure Survey (SHIES) based on a sample of the Swiss population (about 3500 households per year), for the years 1998 - 2005. Results The empirical evidence confirms that the health-care financing in Switzerland has remained regressive since the major reform of 1996 and shows that the variations in equity across cantons are quite significant: the difference between the most and the least regressive canton is about the same as between two extremely different financing systems like the US and Sweden. There is no evidence, instead, of a clear evolution over time of regressivity. Conclusions The significant variation in equity across cantons can be explained by fiscal federalism and the related autonomy in the design of tax and social policies. In particular, the results highlight that earmarked subsidies, the policy adopted to smooth the regressivity of the premiums, appear to be not enough; in the practice of federal states the combination of allowances with mandatory community-rated health insurance premiums might lead to a modest outcome in terms of equity. PMID

  19. 75 FR 6360 - Federal Advisory Committee; DoD Medicare-Eligible Retiree Health Care Board of Actuaries

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-09

    ... of the Secretary Federal Advisory Committee; DoD Medicare-Eligible Retiree Health Care Board of... that the DoD Medicare-Eligible Retiree Health Care Board of Actuaries will meet on August 18, 2010... used in the valuation of benefits under DoD retiree health care programs for...

  20. Policy initiation and political levers in health policy: lessons from Ghana’s health insurance

    PubMed Central

    2012-01-01

    Background Understanding the health policy formulation process over the years has focused on the content of policy to the neglect of context. This had led to several policy initiatives having a still birth or ineffective policy choices with sub-optimal outcomes when implemented. Sometimes, the difficulty has been finding congruence between different values and interests of the various stakeholders. How can policy initiators leverage the various subtle mechanisms that various players draw on to leverage their interests during policy formulation. This paper attempts to conceptualise these levers of policy formulation to enhance an understanding of this field of work based on lived experience. Methodology This is a qualitative participant observation case study based on retrospective recollection of the policy process and political levers involved in developing the Ghana National Health Insurance Scheme. The study uses a four-concept framework which is agenda setting, symbols manipulation, constituency preservation and coalition building to capture the various issues, negotiations and nuanced approaches used in arriving at desired outcomes. Results Technical experts, civil society, academicians and politicians all had significant influence on setting the health insurance agenda. Each of these various stakeholders carefully engaged in ways that preserved their constituency interests through explicit manoeuvres and subtle engagements. Where proposals lend themselves to various interpretations, stakeholders were quick to latch on the contentious issues to preserve their constituency and will manipulate the symbols that arise from the proposals to their advantage. Where interests are contested and the price of losing out will leave government worse off which will favour its political opponent, it will push for divergent interests outside parliamentary politics through intense negotiations to build coalitions so a particular policy may pass. Conclusions This paper has

  1. Federal Enactment of Healthy Homes Legislation in the United States to Improve Public Health

    PubMed Central

    Ferguson, Alesia Coralie; Yates, Christopher

    2016-01-01

    Not all homes across America are “healthy” homes. This contributes to the poor health of Americans and exacerbates existing health conditions costing millions each year in health-care cost. Newer research is being conducted into strategies to alleviate biological, chemical, and physical hazards in the home, and various programs exist to assist the homeowner in making improvements in the quality of their home. Not every homeowner or renter nationwide or within community localities has access to these strategies or programs that could potentially improve their home environment and therefore the health of their family. The objective of this article is to propose elements of a policy to address this inconsistency and variation. This proposal centers around the federal enactment of a national policy demanding that each state implements a healthy homes program tailored to fit their specific state housing and health needs. Members of Congress from States that have successfully implemented healthy home programs should champion this policy. Organizations that recognize the impact of housing on health should support the development of a national healthy homes strategy. This article will discuss the need, outcomes, stakeholders, and minimum requirements of such a policy. PMID:27047913

  2. Identifying emergent social networks at a federally qualified health center-based farmers' market.

    PubMed

    Alia, Kassandra A; Freedman, Darcy A; Brandt, Heather M; Browne, Teri

    2014-06-01

    Identifying potential mechanisms connecting farmers' market interventions with health, economic, and community outcomes could inform strategies for addressing health disparities. The present study used social network theory to guide the in-depth examination of naturally occurring social interactions at a farmers' market located at a federally qualified health center located in a rural, low-income community. Trained observers recorded 61 observation logs at the market over 18 weeks. Thematic analysis revealed a range of actors and nonhuman facilitators instrumental to the farmers' market context. These actors connected with one another for communication and relationship development, economic and financial exchange, education, resource sharing, community ownership of the farmers' market, and conflict resolution. These interactions provided opportunities for social networks to develop among attendees, which may have facilitated the acquisition of social supports related to improved health, economic and community outcomes. Results provide insight into the role social networks may play in mediating the relationship between a farmers' market intervention and individual benefits. Findings also contribute to defining the typology of social networks, which may further disentangle the complex relationships between social networks and health outcomes. Future research should identify strategies for purposefully targeting social networks as a way to reduce diet-related health disparities. PMID:24352510

  3. Federal Enactment of Healthy Homes Legislation in the United States to Improve Public Health.

    PubMed

    Ferguson, Alesia Coralie; Yates, Christopher

    2016-01-01

    Not all homes across America are "healthy" homes. This contributes to the poor health of Americans and exacerbates existing health conditions costing millions each year in health-care cost. Newer research is being conducted into strategies to alleviate biological, chemical, and physical hazards in the home, and various programs exist to assist the homeowner in making improvements in the quality of their home. Not every homeowner or renter nationwide or within community localities has access to these strategies or programs that could potentially improve their home environment and therefore the health of their family. The objective of this article is to propose elements of a policy to address this inconsistency and variation. This proposal centers around the federal enactment of a national policy demanding that each state implements a healthy homes program tailored to fit their specific state housing and health needs. Members of Congress from States that have successfully implemented healthy home programs should champion this policy. Organizations that recognize the impact of housing on health should support the development of a national healthy homes strategy. This article will discuss the need, outcomes, stakeholders, and minimum requirements of such a policy. PMID:27047913

  4. Elementary and Secondary Education: Flexibility Initiatives Do Not Address Districts' Key Concerns about Federal Requirement. Testimony before the Committee on Education and the Workforce, House of Representatives.

    ERIC Educational Resources Information Center

    Fagnoni, Cynthia M.

    This testimony about how federal requirements affect local school districts focuses on three major issues: (1) the major federal requirements that affect school districts; (2) the issues school districts face in implementing these requirements; and (3) recent initiatives by the Congress and the Department of Education (DOE) to provide flexibility…

  5. UNICEF and New Initiatives in Child Health and Development.

    ERIC Educational Resources Information Center

    Nyi, Nyi

    The four sections of this paper outline changes in UNICEF programs from their inception in 1946 to recent initiatives circa 1983. The first section delineates shifts in program emphasis, showing how the organization's focus has moved from meeting the emergency needs of post-World War II European children toward addressing the long-term needs of…

  6. Adolescents Initiating Cannabis Use: Cultural Opposition or Poor Mental Health?

    ERIC Educational Resources Information Center

    Pedersen, Willy

    1990-01-01

    Investigated possible links between normative and political opposition, mental health, and the use of cannabis in prospective longitudinal study of Norwegian adolescents (n=1,311). Findings indicated that the group that experimented with cannabis was mainly characterized by political and normative "oppositional" engagement, but heavy users also…

  7. Private and Public Initiatives: Working Together for Health and Education.

    ERIC Educational Resources Information Center

    Gaag, Jacques van der

    The World Bank helps countries to arrive at whatever combination of public and private control is best for their particular economic circumstances. This booklet describes that work and summarizes examples of private-sector involvement in health and education provision in the developing world today. The examples also illustrate what the World Bank…

  8. Breckinridge Project, initial effort. Report VII, Volume 4. Safety and health plan

    SciTech Connect

    1982-01-01

    The Safety and Health Plan recognizes the potential hazards associated with the Project and has been developed specifically to respond to these risks in a positive manner. Prevention, the primary objective of the Plan, starts with building safety controls into the process design and continues through engineering, construction, start-up, and operation of the Project facilities and equipment. Compliance with applicable federal, state, and local health and safety laws, regulations, and codes throughout all Project phases is required and assured. The Plan requires that each major Project phase be thoroughly reviewed and analyzed to determine that those provisions required to assure the safety and health of all employees and the public, and to prevent property and equipment losses, have been provided. The Plan requires followup on those items or situations where corrective action needs were identified to assure that the action was taken and is effective. Emphasis is placed on loss prevention. Exhibit 1 provides a breakdown of Ashland Synthetic Fuels, Inc.'s (ASFI's) Loss Prevention Program. The Plan recognizes that the varied nature of the work is such as to require the services of skilled, trained, and responsible personnel who are aware of the hazards and know that the work can be done safely, if done correctly. Good operating practice is likewise safe operating practice. Training is provided to familiarize personnel with good operational practice, the general sequence of activities, reporting requirements, and above all, the concept that each step in the operating procedures must be successfully concluded before the following step can be safely initiated. The Plan provides for periodic review and evaluation of all safety and loss prevention activities at the plant and departmental levels.

  9. [Immunization and equity in the Regional Initiative of the Mesoamerican Health Initiative].

    PubMed

    Franco-Paredes, Carlos; Hernández-Ramos, Isabel; Santos-Preciado, José Ignacio

    2011-01-01

    National immunization rates indicate high vaccine coverage in Mesoamerica, but there is growing evidence that the most vulnerable groups are not being reached by immunization programs. Therefore, there is likely low effective vaccine coverage in the region, leading to persistent and growing health inequity. The planning phase of this project was from June to December 2009. The project will be conducted in the target populations which includes children under five, pregnant women, and women of child-bearing age from the most vulnerable populations within countries of the Mesoamerican region, as indicated geographically by a low human development index (HDI) and/or high prevalence of poverty at the municipal level and through the use of participatory methods to define poverty and vulnerability in local contexts. We defined three lines of action for vaccine-preventable disease interventions: 1) pilot projects to fill gaps in knowledge; 2) strengthening immunization policy; and 3) implementation of evidence-based practices. Health system strengthening through health equity is the central regional objective of the immunization workgroup. We hope to have a transformational impact on health systems so as to improve effective coverage, including vaccine and other integrated primary healthcare services. PMID:22344377

  10. [Families of incarcerated women, health promotion and access to social policies in the Federal District, Brazil].

    PubMed

    Pereira, Éverton Luís

    2016-06-01

    This paper assesses the options for accessing public policies available to families of women incarcerated in the female penitentiary of Brazil's Federal District. It seeks to contribute to the construction of health promotion strategies for the female population living in the prison system. Some of the claims were revealed in the national comprehensive healthcare policy for individuals in the prison system, especially those that acknowledge the importance of intersectoral actions and relationship networks to promote health. Data are presented from research conducted at the penitentiary in 2014 that used qualitative methodology by means of participant observation and semi-structured interviews with family members of women incarcerated in the Federal District. It was detected that attention must be paid to the different types of relationship that exist between incarcerated women and their families, and especially to the allegations of exhaustion and difficulty of access to public policies. A more in-depth survey into how this population organizes itself could assist in the development of public policies to promote health and overcome social vulnerability. PMID:27383346

  11. The Untold Story: Examining Ontario's Community Health Centres' Initiatives to Address Upstream Determinants of Health

    PubMed Central

    Collins, Patricia A.; Resendes, Sarah J.; Dunn, James R.

    2014-01-01

    Background: Unlike traditional primary care centres, part of the Community Health Centre (CHC) mandate is to address upstream health determinants. In Ontario, CHCs refer to these activities as Community Initiatives (CIs); yet, little is known about how CIs operate. The objective of this study was to examine the scope, resource requirements, partnerships, successes and challenges among selected Ontario CIs. Methods: We conducted qualitative interviews with 10 CHC staff members representing 11 CIs across Ontario. CIs were identified through an online inventory, recruited by e-mail and interviewed between March and June 2011. Results: Most CIs aim to increase community participation, while addressing social isolation and poverty. They draw minimal financial resources from their CHC, and employ highly skilled staff to support implementation. Most enlist support from various partners, and use numerous methods for community engagement. Successes include improved community relations, increased opportunities for education and employment and rewarding partnerships, while insufficient funding was a commonly identified challenge. Conclusions: Despite minimal attention from researchers and funders, our findings suggest that CIs play key capacity-building roles in vulnerable communities across Ontario, and warrant further investigation. PMID:25410693

  12. The physician quality reporting initiative--a gateway to pay for performance: what every health care professional should know.

    PubMed

    Stulberg, Jonah

    2008-01-01

    The Physician Quality Reporting Initiative (PQRI) is a pay-for-reporting (P4R) program sponsored by the Centers for Medicare & Medicaid Services open to all health care providers that treat Medicare patients. This P4R initiative provides financial incentives for participation and unlike most pay-for-performance (P4P) programs, there are no penalties for poor performance. PQRI therefore offers Medicare providers nationwide a low-risk opportunity to gain experience with reporting procedures likely to be incorporated into P4P reimbursement schemes. The 74 measures used during the first reporting period are applicable to both generalist and specialist providers and open participation in PQRI to a much broader audience compared with previous federal initiatives. Also in contrast to programs that measure hospital or group quality and reimburse for services at the health system level, measurement and reimbursement in PQRI directly affects individual Medicare providers. The combination of provider-level measurement and reimbursement and efforts to assess care delivered by both generalist and specialist Medicare providers highlights how this P4R initiative is truly a gateway to a P4P reimbursement system. Participation in the PQRI program provides useful experience to Medicare providers and their staff in preparing for future initiatives that try to tie quality to reimbursement. PMID:18204372

  13. 78 FR 71676 - Submission for Review: 3206-0201, Federal Employees Health Benefits (FEHB) Open Season Express...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-29

    ...The Retirement Services, Office of Personnel Management (OPM) offers the general public and other Federal agencies the opportunity to comment on a revised information collection request (ICR) 3206-0201, Federal Employees Health Benefits (FEHB) Open Season Express Interactive Voice Response (IVR) System and the Open Season Web site, Open Season Online. As required by the Paperwork Reduction Act......

  14. The role of the Federal Trade Commission in advertising health products and services.

    PubMed

    Daynard, Matthew

    2006-01-01

    The Federal Trade Commission plays a unique role in enforcing well-established standards ensuring that consumers can make informed purchase and use decisions about health-related products and services based on truthful, nonmisleading advertising claims. Deceptive and unfair practices are defined. The importance of the "net impression" that ads convey to consumers and the need for substantiation of objective, factual claims is explained. The FTC uses its enforcement powers and consumer and industry outreach to create a climate for preventing misleading advertising. PMID:16696500

  15. The role of the Federal Trade Commission in advertising health products and services.

    PubMed

    Daynard, Matthew

    2004-01-01

    The Federal Trade Commission plays a unique role in enforcing well-established standards ensuring that consumers can make informed purchase and use decisions about health-related products and services based on truthful, non-misleading advertising claims while encouraging competition. Deceptive and unfair practices are defined. The importance of the "net impression" that ads convey to consumers and the need for substantiation of objective, factual claims is explained. The FTC uses its enforcement powers and consumer and industry outreach to create a climate for preventing misleading advertising. PMID:15347100

  16. Patients' perceptions of colorectal cancer screening tests and preparatory education in federally qualified health centers.

    PubMed

    Gwede, Clement K; Koskan, Alexis M; Quinn, Gwendolyn P; Davis, Stacy N; Ealey, Jamila; Abdulla, Rania; Vadaparampil, Susan T; Elliott, Gloria; Lopez, Diana; Shibata, David; Roetzheim, Richard G; Meade, Cathy D

    2015-06-01

    This study explored federally qualified health center (FQHC) patients' perceptions about colorectal cancer screening (CRCS) tests, including immunochemical fecal occult blood tests (iFOBT), as well as preferences for receiving in-clinic education about CRCS. Eight mixed gender focus groups were conducted with 53 patients. Findings centered on three thematic factors: (1) motivators and impediments to CRCS, (2) test-specific preferences and receptivity to iFOBTs, and (3) preferences for entertaining and engaging plain language materials. Results informed the development of educational priming materials to increase CRCS using iFOBT in FQHCs. PMID:25249181

  17. Federally-Assisted Healthcare Coverage among Male State Prisoners with Chronic Health Problems

    PubMed Central

    Rosen, David L.; Grodensky, Catherine A.; Holley, Tara K.

    2016-01-01

    Prisoners have higher rates of chronic diseases such as substance dependence, mental health conditions and infectious disease, as compared to the general population. We projected the number of male state prisoners with a chronic health condition who at release would be eligible or ineligible for healthcare coverage under the Affordable Care Act (ACA). We used ACA income guidelines in conjunction with reported pre-arrest social security benefits and income from a nationally representative sample of prisoners to estimate the number eligible for healthcare coverage at release. There were 643,290 US male prisoners aged 18–64 with a chronic health condition. At release, 73% in Medicaid-expansion states would qualify for Medicaid or tax credits. In non-expansion states, 54% would qualify for tax credits, but 22% (n = 69,827) had incomes of ≤ 100% the federal poverty limit and thus would be ineligible for ACA-mediated healthcare coverage. These prisoners comprise 11% of all male prisoners with a chronic condition. The ACA was projected to provide coverage to most male state prisoners with a chronic health condition; however, roughly 70,000 fall in the “coverage gap” and may require non-routine care at emergency departments. Mechanisms are needed to secure coverage for this at risk group and address barriers to routine utilization of health services. PMID:27479089

  18. Federal Parity In The Evolving Mental Health And Addiction Care Landscape.

    PubMed

    Barry, Colleen L; Goldman, Howard H; Huskamp, Haiden A

    2016-06-01

    The intent of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 is to eliminate differences between health insurance coverage of mental health and substance use disorder benefits and coverage of medical or surgical benefits. The Affordable Care Act significantly extended the reach of the Wellstone-Domenici law by applying it to new insurance markets. We summarize the evolution of legislative and regulatory actions to bring about federal insurance parity. We also summarize available evidence on how the Wellstone-Domenici law has contributed to addressing insurance discrimination; rectifying market inefficiencies due to adverse selection; and altering utilization, spending, and health outcomes for people with mental health and substance use disorders. In addition, we highlight important gaps in knowledge about how parity has been implemented, describe the groups still lacking parity-level coverage, and make recommendations on steps to improve the likelihood that the Wellstone-Domenici law will fulfill the aims of its architects. PMID:27269016

  19. Federally-Assisted Healthcare Coverage among Male State Prisoners with Chronic Health Problems.

    PubMed

    Rosen, David L; Grodensky, Catherine A; Holley, Tara K

    2016-01-01

    Prisoners have higher rates of chronic diseases such as substance dependence, mental health conditions and infectious disease, as compared to the general population. We projected the number of male state prisoners with a chronic health condition who at release would be eligible or ineligible for healthcare coverage under the Affordable Care Act (ACA). We used ACA income guidelines in conjunction with reported pre-arrest social security benefits and income from a nationally representative sample of prisoners to estimate the number eligible for healthcare coverage at release. There were 643,290 US male prisoners aged 18-64 with a chronic health condition. At release, 73% in Medicaid-expansion states would qualify for Medicaid or tax credits. In non-expansion states, 54% would qualify for tax credits, but 22% (n = 69,827) had incomes of ≤ 100% the federal poverty limit and thus would be ineligible for ACA-mediated healthcare coverage. These prisoners comprise 11% of all male prisoners with a chronic condition. The ACA was projected to provide coverage to most male state prisoners with a chronic health condition; however, roughly 70,000 fall in the "coverage gap" and may require non-routine care at emergency departments. Mechanisms are needed to secure coverage for this at risk group and address barriers to routine utilization of health services. PMID:27479089

  20. Supporting the Saudi e-health initiative: the Master of Health Informatics programme at KSAU-HS.

    PubMed

    Altuwaijri, M M

    2010-01-01

    The health sector in Saudi Arabia has made significant progress in recent decades with some hospitals receiving international recognition. However, this has not been accompanied by advancements in the field of health informatics, which are necessary for hospitals to achieve certain objectives such as enhancing the quality of health care and reducing the time and cost of health care delivery. In this paper we describe the status of e-health in Saudi Arabia, along with some of the national e-health initiatives such the establishment of a new Master of Health Informatics degree programme and the Saudi Association for Health Informatics. A proposal for an e-health plan in Saudi Arabia is also discussed. PMID:20214169

  1. Making it work: health care provider perspectives on strategies to increase colorectal cancer screening in federally qualified health centers.

    PubMed

    Gwede, Clement K; Davis, Stacy N; Quinn, Gwendolyn P; Koskan, Alexis M; Ealey, Jamila; Abdulla, Rania; Vadaparampil, Susan T; Elliott, Gloria; Lopez, Diana; Shibata, David; Roetzheim, Richard G; Meade, Cathy D

    2013-12-01

    Colorectal cancer screening (CRCS) rates are low among men and women who seek health care at federally qualified health centers (FQHCs). This study explores health care providers' perspectives about their patient's motivators and impediments to CRCS and receptivity to preparatory education. A mixed methods design consisting of in-depth interviews, focus groups, and a short survey is used in this study. The participants of this study are 17 health care providers practicing in FQHCs in the Tampa Bay area. Test-specific patient impediments and motivations were identified including fear of abnormal findings, importance of offering less invasive fecal occult blood tests, and need for patient-centered test-specific educational materials in clinics. Opportunities to improve provider practices were identified including providers' reliance on patients' report of symptoms as a cue to recommend CRCS and overemphasis of clinic-based guaiac stool tests. This study adds to the literature on CRCS test-specific motivators and impediments. Providers offered unique approaches for motivating patients to follow through with recommended CRCS and were receptive to in-clinic patient education. Findings readily inform the design of educational materials and interventions to increase CRCS in FQHCs. PMID:23943277

  2. Making It Work: Health Care Provider Perspectives on Strategies to Increase Colorectal Cancer Screening in Federally Qualified Health Centers

    PubMed Central

    Gwede, Clement K.; Davis, Stacy N.; Quinn, Gwendolyn P.; Koskan, Alexis M.; Ealey, Jamila; Abdulla, Rania; Vadaparampil, Susan T.; Elliott, Gloria; Lopez, Diana; Shibata, David; Roetzheim, Richard G.; Meade, Cathy D.

    2013-01-01

    Objective Colorectal cancer screening (CRCS) rates are low among men and women who seek health care at federally qualified health centers (FQHCs). This study explores health care providers' perspectives about their patient's motivators and impediments to CRCS and receptivity to preparatory education. Methods A mixed methods design consisting of in-depth interviews, focus groups, and a short survey. Setting: FQHCs in the Tampa Bay area. Participants: Seventeen health care providers practicing in FQHCs. Results Test-specific patient impediments and motivations were identified including fear of abnormal findings; importance of offering less invasive fecal occult blood tests; and need for patient-centered test-specific educational materials in clinics. Opportunities to improve provider practices were identified including providers' reliance on patients' report of symptoms as a cue to recommend CRCS and overemphasis of clinic-based guaiac stool tests. Conclusions This study adds to the literature on CRCS test-specific motivators and impediments. Providers offered unique approaches for motivating patients to follow through with recommended CRCS and were receptive to in-clinic patient education and. Findings are readily inform the design of educational materials and interventions to increase CRCS in FQHCs. PMID:23943277

  3. [A framework for evaluating ethical issues of public health initiatives: practical aspects and theoretical implications].

    PubMed

    Petrini, Carlo

    2015-01-01

    The "Framework for the Ethical Conduct of Public Health Initiatives", developed by Public Health Ontario, is a practical guide for assessing the ethical implications of evidence-generating public health initiatives, whether research or non-research activities, involving people, their biological materials or their personal information. The Framework is useful not only to those responsible for determining the ethical acceptability of an initiative, but also to investigators planning new public health initiatives. It is informed by a theoretical approach that draws on widely shared bioethical principles. Two considerations emerge from both the theoretical framework and its practical application: the line between practice and research is often blurred; public health ethics and biomedical research ethics are based on the same common heritage of values. PMID:26241514

  4. Update on MSHA`s health and safety initiatives

    SciTech Connect

    Langton, J.F.

    1995-12-31

    Historically, society in general and the mining community in particular have very often used the results of major catastrophes such as mine fires, explosions, and inundations to characterize the mining industry`s health and safety record. One doesn`t have to travel too far back in time to recall the ore pass failure which occurred at the Magma Copper Mining Company in 1993, killing four miners and the South Mountain Coal Company`s No. 3 Mine explosion in 1992, which took the lives of eight miners. Both are still fresh in the public`s collective mind. These events, due to the amount of local and national media coverage that they generated, help to define in the minds of many individuals what are perceived to be the prevalent health and safety hazards in the mining industry. Fortunately, these traumatic events are becoming more the exception than the norm. The mining industry has made tremendous strides in minimizing the potential for mine disasters and they are to be commended for this accomplishment.

  5. Public health and climate change adaptation at the federal level: one agency's response to Executive Order 13514.

    PubMed

    Hess, Jeremy J; Schramm, Paul J; Luber, George

    2014-03-01

    Climate change will likely have adverse human health effects that require federal agency involvement in adaptation activities. In 2009, President Obama issued Executive Order 13514, Federal Leadership in Environmental, Energy, and Economic Performance. The order required federal agencies to develop and implement climate change adaptation plans. The Centers for Disease Control and Prevention (CDC), as part of a larger Department of Health and Human Services response to climate change, is developing such plans. We provide background on Executive Orders, outline tenets of climate change adaptation, discuss public health adaptation planning at both the Department of Health and Human Services and the CDC, and outline possible future CDC efforts. We also consider how these activities may be better integrated with other adaptation activities that manage emerging health threats posed by climate change. PMID:24432931

  6. Public Health and Climate Change Adaptation at the Federal Level: One Agency’s Response to Executive Order 13514

    PubMed Central

    Schramm, Paul J.; Luber, George

    2014-01-01

    Climate change will likely have adverse human health effects that require federal agency involvement in adaptation activities. In 2009, President Obama issued Executive Order 13514, Federal Leadership in Environmental, Energy, and Economic Performance. The order required federal agencies to develop and implement climate change adaptation plans. The Centers for Disease Control and Prevention (CDC), as part of a larger Department of Health and Human Services response to climate change, is developing such plans. We provide background on Executive Orders, outline tenets of climate change adaptation, discuss public health adaptation planning at both the Department of Health and Human Services and the CDC, and outline possible future CDC efforts. We also consider how these activities may be better integrated with other adaptation activities that manage emerging health threats posed by climate change. PMID:24432931

  7. UMTRA Project Office Federal Employee Occupational Safety and Health Program Plan. Final draft

    SciTech Connect

    Young, B.H.

    1994-02-01

    This document establishes the Federal Employee Occupational Safety and Health (FEOSH) Program for the US Department of Energy (DOE) Uranium Mill Tailings Remedial Action (UMTRA) Project Office. This program will ensure compliance with the applicable requirements of DOE Order 3790.1 B and DOE Albuquerque Operations Office (AL) Order 3790.1A. FEOSH Program responsibilities delegated by the DOE-AL to the UMTRA Project Office by AL Order 3790.1A also are assigned. The UMTRA Project Office has developed the UMTRA Project Environmental, Safety, and Health (ES&H) Plan (DOE, 1992), which establishes the basic programmatic ES&H requirements for all participants on the UMTRA Project. The ES&H plan is designed primarily to cover remedial action activities at UMTRA sites, and defines the ES&H responsibilities of both the UMTRA Project Office and its contractors. The UMTRA FEOSH Program described herein is a subset of the overall UMTRA ES&H program and covers only the federal employees working on the UMTRA Project.

  8. UMTRA project office federal employee occupational safety and health program plan. Revision 1

    SciTech Connect

    Not Available

    1994-06-01

    This document establishes the Federal Employee Occupational Safety and Health (FEOSH) Program for the US Department of Energy (DOE) Uranium Mill Tailings Remedial Action (UMTRA) Project Office. This program will ensure compliance with applicable requirements of DOE Order 3790.1B and DOE Albuquerque Operations Office (AL) Order 3790.lA. FEOSH Program responsibilities delegated by the DOE-AL to the UMTRA Project Office by AL Order 3790.1A also are assigned. The UMTRA Project Office has developed the UMTRA Project Environmental, Safety, and Health (ES&H) Plan (DOE, 1992), which establishes the basic programmatic ES&H requirements for all participants on the UMTRA Project. The ES&H plan is designed primarily to cover remedial action activities at UMTRA sites and defines the ES&H responsibilities of both the UMTRA Project Office and its contractors. The UMTRA FEOSH Program described herein is a subset of the overall UMTRA ES&H program and covers only federal employees working on the UMTRA Project.

  9. A model for linkage between health professions education and health: FAIMER international faculty development initiatives.

    PubMed

    Burdick, William; Amaral, Eliana; Campos, Henry; Norcini, John

    2011-01-01

    Linking faculty development to improvement of community health is of particular interest to health professions educators and researchers. While individuals and institutions engaged in health professions education have the potential to improve health, limited literature connects capacity building in education with improvements in health. Understanding the mechanism by which faculty development may promote development of socially accountable institutions and improve health can be useful for improving this connection and evaluating program effectiveness. PMID:21774649

  10. Multiple Healthful Dietary Patterns and Type 2 Diabetes in the Women's Health Initiative.

    PubMed

    Cespedes, Elizabeth M; Hu, Frank B; Tinker, Lesley; Rosner, Bernard; Redline, Susan; Garcia, Lorena; Hingle, Melanie; Van Horn, Linda; Howard, Barbara V; Levitan, Emily B; Li, Wenjun; Manson, JoAnn E; Phillips, Lawrence S; Rhee, Jinnie J; Waring, Molly E; Neuhouser, Marian L

    2016-04-01

    The relationship between various diet quality indices and risk of type 2 diabetes (T2D) remains unsettled. We compared associations of 4 diet quality indices--the Alternate Mediterranean Diet Index, Healthy Eating Index 2010, Alternate Healthy Eating Index 2010, and the Dietary Approaches to Stop Hypertension (DASH) Index--with reported T2D in the Women's Health Initiative, overall, by race/ethnicity, and with/without adjustment for overweight/obesity at enrollment (a potential mediator). This cohort (n = 101,504) included postmenopausal women without T2D who completed a baseline food frequency questionnaire from which the 4 diet quality index scores were derived. Higher scores on the indices indicated a better diet. Cox regression was used to estimate multivariate hazard ratios for T2D. Pearson coefficients for correlation among the indices ranged from 0.55 to 0.74. Follow-up took place from 1993 to 2013. During a median 15 years of follow-up, 10,815 incident cases of T2D occurred. For each diet quality index, a 1-standard-deviation higher score was associated with 10%-14% lower T2D risk (P < 0.001). Adjusting for overweight/obesity at enrollment attenuated but did not eliminate associations to 5%-10% lower risk per 1-standard-deviation higher score (P < 0.001). For all 4 dietary indices examined, higher scores were inversely associated with T2D overall and across racial/ethnic groups. Multiple forms of a healthful diet were inversely associated with T2D in these postmenopausal women. PMID:26940115

  11. [Health initiatives in Latin America: a historical assessment from the inception of the Pan American Sanitary Bureau to the Mesoamerican Health Initiative].

    PubMed

    Santos Preciado, José Ignacio; Franco Paredes, Carlos

    2011-01-01

    Latin America has undergone gradual transformations in public health influenced by historical events locally or at a global level. These epidemiologic transitions have also occurred through the implementation of interventions by public institutions such as the Pan-American Health Organization, by philanthropic foundations, non-governmental organizations, and bilateral or multilateral international donor organizations. These public health initiatives have produced substantial improvements in the heath status of many populations in Latin America. Overall, human development and health have advanced over the past century. However, these public health benefits have not been shared equally among all areas of Latin America. The Mesoamerican Region -the area encompassing from Southern Mexico to Panama- continues to experience profound social inequities focalized to indigenous communities and groups of African-descent living in urban, periurban, or rural areas. The Mesoamerican Health Initiative is a private-public partnership that attempts to close the gap of health inequalities affecting the most vulnerable populations in this region of Latin America. PMID:22344374

  12. Initiation of health-behaviour change among employees participating in a web-based health risk assessment with tailored feedback

    PubMed Central

    2011-01-01

    Background Primary prevention programs at the worksite can improve employee health and reduce the burden of cardiovascular disease. Programs that include a web-based health risk assessment (HRA) with tailored feedback hold the advantage of simultaneously increasing awareness of risk and enhancing initiation of health-behaviour change. In this study we evaluated initial health-behaviour change among employees who voluntarily participated in such a HRA program. Methods We conducted a questionnaire survey among 2289 employees who voluntarily participated in a HRA program at seven Dutch worksites between 2007 and 2009. The HRA included a web-based questionnaire, biometric measurements, laboratory evaluation, and tailored feedback. The survey questionnaire assessed initial self-reported health-behaviour change and satisfaction with the web-based HRA, and was e-mailed four weeks after employees completed the HRA. Results Response was received from 638 (28%) employees. Of all, 86% rated the program as positive, 74% recommended it to others, and 58% reported to have initiated overall health-behaviour change. Compared with employees at low CVD risk, those at high risk more often reported to have increased physical activity (OR 3.36, 95% CI 1.52-7.45). Obese employees more frequently reported to have increased physical activity (OR 3.35, 95% CI 1.72-6.54) and improved diet (OR 3.38, 95% CI 1.50-7.60). Being satisfied with the HRA program in general was associated with more frequent self-reported initiation of overall health-behaviour change (OR 2.77, 95% CI 1.73-4.44), increased physical activity (OR 1.89, 95% CI 1.06-3.39), and improved diet (OR 2.89, 95% CI 1.61-5.17). Conclusions More than half of the employees who voluntarily participated in a web-based HRA with tailored feedback, reported to have initiated health-behaviour change. Self-reported initiation of health-behaviour change was more frequent among those at high CVD risk and BMI levels. In general employees

  13. [Public Health initiative for improved vaccination for asylum seekers].

    PubMed

    Brockmann, Stefan O; Wjst, Stephanie; Zelmer, Ursula; Carollo, Stefanie; Schmid, Mirjam; Roller, Gottfried; Eichner, Martin

    2016-05-01

    The number of asylum seekers in Germany has increased dramatically in 2015. Their medical care includes the officially recommended vaccinations; yet, no detailed information on this is yet available in Germany. In light of the rising number of asylum seekers, we have developed a concept to facilitate their vaccination. This concept includes the coordination of different partners, the supply of vaccines and other materials through the local health office, and the cooperation with the local physicians' association. To evaluate and accelerate progress, we compared the number of vaccinations conducted by physicians independently of the vaccination concept with those conducted within the new concept. For the period of investigation, 2,256 new asylum seekers were temporarily accommodated in the facilities. The vaccination concept was applied in only some of the facilities. Twenty-eight percent of all asylum seekers (642) were vaccinated at least once; 89 % of the vaccinees (571) were vaccinated within the newly developed concept. In the facilities that were not included in this concept, only 6 % of the refugees were vaccinated, whereas in the facilities that were included up to 58 % were vaccinated. Even though the new concept has started successfully, further innovations are required to reach sufficient vaccination coverage among asylum seekers. In view of the large number of new asylum seekers expected, the adjustment and expansion of the new concept requires professional planning and coordination. Furthermore, additional resources are required. PMID:27072499

  14. 75 FR 62686 - Health Information Technology: Revisions to Initial Set of Standards, Implementation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-13

    ..., implementation specifications, and certification criteria (75 FR 2014). The certification criteria adopted in... Federal Register a final rule (75 FR 44590) to complete the Secretary's adoption of the initial set of... Register (75 FR 11328) a rule proposing the establishment of two certification programs for purposes...

  15. Approaching Health Disparities from a Population Perspective: The NIH Centers for Population Health and Health Disparities

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Addressing health disparities has been a national challenge for decades. The NIH-sponsored Centers for Population Health and Health Disparities (CPHHDs) represent the first federal initiative to support transdisciplinary multilevel research on the determinants of health disparities. Using preliminar...

  16. What cell biologists should know about the National Institutes of Health BRAIN Initiative

    PubMed Central

    Insel, Thomas R.; Koroshetz, Walter

    2015-01-01

    The BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative is an ambitious project to develop innovative tools for a deeper understanding of how the brain functions in health and disease. Early programs in the National Institutes of Health BRAIN Initiative focus on tools for next-generation imaging and recording, studies of cell diversity and cell census, and integrative approaches to circuit function. In all of these efforts, cell biologists can play a leading role. PMID:26668172

  17. Gender differences in age of smoking initiation and its association with health

    PubMed Central

    Thompson, Azure B.; Tebes, Jacob K.; McKee, Sherry A.

    2016-01-01

    Background It is generally accepted that smoking starts in adolescence and earlier initiation is associated with more negative health outcomes. Some research suggests that women initiate smoking at later ages and have more negative health outcomes than men. The purpose of this study was to examine gender differences in age of initiation and its association with health. Methods The sample included men (n=8,506) and women (n=8,479) with a history of smoking from the 2001-2002 National Epidemiological Survey of Alcohol Related Conditions. Logistic regression was used to examine gender differences in the effect of late smoking initiation on physical and mental health status after adjusting for covariates. Results At mostly all ages after 16, women exceeded men in rates of smoking initiation (59.8% vs. 50.3%, p<.001). Among late initiators (≥16), women were more likely than men to have hypertension (OR:1.24,CI:1.09-1.41), heart disease (OR:1.20,CI:1.00-1.45), major depressive disorder (OR:2.54,CI:2.22-2.92) and generalized anxiety disorder (OR:2.34,CI:1.84-2.99). Among early initiators (<16), women were more likely than men to have major depressive disorder (OR:2.42,CI:2.11-2.77) and generalized anxiety disorder (OR:2.01,CI:1.59-2.54) but there were no gender differences in the likelihood of having hypertension (OR:1.04,CI:0.89-1.22) and heart disease (OR:1.11,CI:0.90-1.36). Conclusions In late adolescence and adulthood, women exceed men in smoking initiation. Late initiation was associated with more significant physical health risks for women than men. Our findings raise questions about generally accepted notions on the age at which smoking initiation occurs and its association with health.

  18. Despite obstacles, considerable potential exists for more robust federal policy on community development and health.

    PubMed

    Arcaya, Mariana; Briggs, Xavier de Souza

    2011-11-01

    The implementation of the Affordable Care Act of 2010 and the Obama administration's urban policy create an opportunity to link community development with health in new and powerful ways. The administration's policy emphasizes improved access to and quality of care through coordinated local and regional approaches, expansion of access to healthy food, and the support of environmental health-including clean air, water, and soil-and healthy homes. New federal programs, such as the Affordable Care Act's Community Transformation Grants, seek to prevent death and disability through policy, environmental, programmatic, and infrastructure changes. But fragmented congressional jurisdiction and budget "scoring" rules pose challenges to needed reform. We argue that government agencies need to adopt so-called systems of innovation, or organizational practices and support mechanisms that seek continuously to test new models, refine promising ones, bring to scale those that work best, and restructure or terminate what does not. We also argue that a strong and well-focused policy advocacy coalition is needed to help drive reform focused on the social determinants of health. PMID:22068397

  19. The first federal budget under Prime Minister Justin Trudeau: Addressing social determinants of health?

    PubMed

    Ruckert, Arne; Labonté, Ronald

    2016-01-01

    A challenging budget environment during the Harper years has meant that crucial investments in the social determinants of health (SDHs) have increasingly been neglected. The tabling of what is widely considered a more progressive budget with expansionary fiscal elements under the new Prime Minister, Justin Trudeau, raises the question as to what extent this budget invests in policy areas that are crucial for achieving a more equitable distribution in the social determinants of health, as promised in the Liberal party platform. In this commentary, we argue that the first Liberal budget represents a step in the right direction, but that this first step needs to be followed up with a sustained commitment to address the pervasive (and unfair) social inequalities that are the root cause of persistent health inequities in Canada. We conclude that the first Trudeau budget, while moving in the right direction, does not fully embody the sustained policy changes needed to effectively address SDHs, including a more expansive role for the federal government in the redistribution of income and wealth. PMID:27526222

  20. Incorporating Preliminary Mental Health Assessment in the Initial Healthcare for Refugees in New Jersey.

    PubMed

    Al-Obaidi, AbdulKareem; West, Bernadette; Fox, Anne; Savin, Daniel

    2015-07-01

    The study aims to assess the feasibility of introducing a mental health screening tool into the initial health care assessment for refugees in New Jersey, US. A semi-structured interview was conducted with a convenience sample of professionals providing refugee health care in New Jersey and in a number of other states. There is a widespread appreciation of the need to consider the mental and emotional issues of the refugees as a priority in healthcare services. A mental health screening tool is required for practice in NJ. Community resources should be coupled with early screening for better refugee mental health outcomes. PMID:25821926

  1. Social determinants of health in Canada: Are healthy living initiatives there yet? A policy analysis

    PubMed Central

    2012-01-01

    Introduction Preventative strategies that focus on addressing the social determinants of health to improve healthy eating and physical activity have become an important strategy in British Columbia and Ontario for combating chronic diseases. What has not yet been examined is the extent to which healthy living initiatives implemented under these new policy frameworks successfully engage with and change the social determinants of health. Methods Initiatives active between January 1, 2006 and September 1, 2011 were found using provincial policy documents, web searches, health organization and government websites, and databases of initiatives that attempted to influence to nutrition and physical activity in order to prevent chronic diseases or improve overall health. Initiatives were reviewed, analyzed and grouped using the descriptive codes: lifestyle-based, environment-based or structure-based. Initiatives were also classified according to the mechanism by which they were administered: as direct programs (e.g. directly delivered), blueprints (or frameworks to tailor developed programs), and building blocks (resources to develop programs). Results 60 initiatives were identified in Ontario and 61 were identified in British Columbia. In British Columbia, 11.5% of initiatives were structure-based. In Ontario, of 60 provincial initiatives identified, 15% were structure-based. Ontario had a higher proportion of direct interventions than British Columbia for all intervention types. However, in both provinces, as the intervention became more upstream and attempted to target the social determinants of health more directly, the level of direct support for the intervention lessened. Conclusions The paucity of initiatives in British Columbia and Ontario that address healthy eating and active living through action on the social determinants of health is problematic. In the context of Canada's increasingly neoliberal political and economic policy, the public health sector may face

  2. The Delaware Geography-Health Initiative: Lessons Learned in Designing a GIS-Based Curriculum

    ERIC Educational Resources Information Center

    Rees, Peter W.; Silberman, Jordan A.

    2010-01-01

    The Delaware Geography-Health Initiative is a Web- and GIS-based set of lesson units for teaching geographic concepts and research methods within the context of the state's high school geography standards. Each unit follows a research-based, inquiry-centered model addressing questions of health because of Delaware's high incidence of cancer,…

  3. A Healthy Communities Initiative in Rural Alberta: Building Rural Capacity for Health.

    ERIC Educational Resources Information Center

    GermAnn, Kathy; Smith, Neale; Littlejohns, Lori Baugh

    Efforts of health professionals are shifting away from programs that "deliver health" toward those that build the capacity of communities to work together to create healthy places. The Healthy Communities Initiative (HCI) is a community development model in central Alberta (Canada) that involves the creation of a widely shared vision of a…

  4. RAND/Hartford initiative to build interdisciplinary geriatric health care research centers.

    PubMed

    Pincus, Harold Alan; Keyser, Donna J; Schultz, Dana J

    2007-01-01

    A RAND/John A. Hartford Foundation initiative, Building Interdisciplinary Geriatric Health Care Research Centers, seeks to promote such research through developing innovative clinical and health services interventions. Interdisciplinary education, mentoring, and training opportunities, particularly for junior investigators, are the critical components necessary to foster multiprofessional research endeavors. PMID:17211038

  5. Federal administrative health courts are unconstitutional: a reply to Elliott, Narayan, and Nasmith.

    PubMed

    Widman, Amy; Hochberg, Francine A

    2008-08-01

    This commentary responds to the essay by Elliott, Narayan, and Nasmith wherein they propose that the federal government may preclude plaintiffs with medically inflicted injuries from bringing state common-law tort claims against those whose negligence caused their injury. The administrative system championed by Elliott and other proponents is a radical departure from the current civil justice system. Specifically, we argue that the administrative health courts, as proposed, violate the commerce clause, the spending clause, the Seventh Amendment, and separation of powers principles. The commentary concludes that such a system is fatally flawed and cannot withstand constitutional scrutiny. Moreover, we are not persuaded that Congress will be able to ground such a radical constitutional restructuring in any sound public policy, as the majority of studies do not evidence Elliott, Narayan, and Nasmith's presumption that the civil justice system has failed in the medical malpractice context. PMID:18617675

  6. Reconciliation of the cloud computing model with US federal electronic health record regulations.

    PubMed

    Schweitzer, Eugene J

    2012-01-01

    Cloud computing refers to subscription-based, fee-for-service utilization of computer hardware and software over the Internet. The model is gaining acceptance for business information technology (IT) applications because it allows capacity and functionality to increase on the fly without major investment in infrastructure, personnel or licensing fees. Large IT investments can be converted to a series of smaller operating expenses. Cloud architectures could potentially be superior to traditional electronic health record (EHR) designs in terms of economy, efficiency and utility. A central issue for EHR developers in the US is that these systems are constrained by federal regulatory legislation and oversight. These laws focus on security and privacy, which are well-recognized challenges for cloud computing systems in general. EHRs built with the cloud computing model can achieve acceptable privacy and security through business associate contracts with cloud providers that specify compliance requirements, performance metrics and liability sharing. PMID:21727204

  7. New methods of financing and managing health care in the Russian Federation.

    PubMed

    Sheiman, I

    1995-01-01

    Poor outcomes in Russian Federation health care performance have led to greater efforts being devoted to the search for new methods of finance and management. The new financial and managerial scheme was designed to introduce elements of market relations into a highly bureaucratic system. Strengthening the primary care sector and granting providers more economic freedom were intended to increase the quantity and quality of medical care, and make it more accessible to the population. In the late 1980s, economic experiments started in several regions of the country. This paper highlights the new methods of management, payment of providers, and quality assurance that were the focuses of the experiments. The impact of the experiments will be discussed. PMID:10156637

  8. Reconciliation of the cloud computing model with US federal electronic health record regulations

    PubMed Central

    2011-01-01

    Cloud computing refers to subscription-based, fee-for-service utilization of computer hardware and software over the Internet. The model is gaining acceptance for business information technology (IT) applications because it allows capacity and functionality to increase on the fly without major investment in infrastructure, personnel or licensing fees. Large IT investments can be converted to a series of smaller operating expenses. Cloud architectures could potentially be superior to traditional electronic health record (EHR) designs in terms of economy, efficiency and utility. A central issue for EHR developers in the US is that these systems are constrained by federal regulatory legislation and oversight. These laws focus on security and privacy, which are well-recognized challenges for cloud computing systems in general. EHRs built with the cloud computing model can achieve acceptable privacy and security through business associate contracts with cloud providers that specify compliance requirements, performance metrics and liability sharing. PMID:21727204

  9. Research for Improved Health: Variability and Impact of Structural Characteristics in Federally Funded Community Engaged Research

    PubMed Central

    Pearson, Cythina R.; Duran, Bonnie; Oetzel, John; Margarati, Maya; Villegas, Malia; Lucero, Julie; Wallerstein, Nina

    2016-01-01

    Background Although there is strong scientific, policy, and community support for community-engaged research (CEnR)—including community-based participatory research (CBPR)—the science of CEnR is still developing. Objective To describe structural differences in federally funded CEnR projects by type of research (i.e., descriptive, intervention, or dissemination/policy change) and race/ethnicity of the population served. Methods We identified 333 federally funded projects in 2009 that potentially involved CEnR, 294 principal investigators/project directors (PI/PD) were eligible to participate in a key informant (KI) survey from late 2011 to early 2012 that asked about partnership structure (68% response rate). Results The National Institute on Minority Health & Health Disparities (19.1%), National Cancer Institute (NCI; 13.3%), and the Centers for Disease Control and Prevention (CDC; 12.6%) funded the most CEnR projects. Most were intervention projects (66.0%). Projects serving American Indian or Alaskan Native (AIAN) populations (compared with other community of color or multiple-race/unspecified) were likely to be descriptive projects (p < .01), receive less funding (p < .05), and have higher rates of written partnership agreements (p < .05), research integrity training (p < .05), approval of publications (p < .01), and data ownership (p < .01). AIAN-serving projects also reported similar rates of research productivity and greater levels of resource sharing compared with those serving multiple-race/unspecified groups. Conclusions There is clear variability in the structure of CEnR projects with future research needed to determine the impact of this variability on partnering processes and outcomes. In addition, projects in AIAN communities receive lower levels of funding yet still have comparable research productivity to those projects in other racial/ethnic communities. PMID:25981421

  10. The Federal Mine Safety and Health Act of 1977: Preserving a law that works

    SciTech Connect

    McAteer, J.D.

    1996-10-01

    The wisdom of the past has been that dead miners make the best lobbyists for mine safety laws. Today, this view suggests a troubling question: What happens to mine safety laws when the terrible disasters that produced legislation are rare? We should be grateful that the question is timely. It means that decades of progressively stronger laws have finally made a difference for miners, their families, and their communities. But this hard-won success has had one ironic result: Some people are tempted to believe that a strong statute is no longer necessary. In fact, the Federal Mine Safety and Health Act of 1977 (Mine Act) should be preserved. Mining remains a high-risk industry, and tomarrow`s miners, just like today`s, need the protection of this well-crafted and effective law. Recent legislation (H.R. 1834) seemed to view the Mine Act as a relic of the past. It would have repealed the statute, a prospect that should trouble anyone familiar with the statute`s success. As introduced, the bill would have regulated mining under a scaled-back version of the Occupational Safety and Health Act (OSH Act), and eliminated the Mine Safety and Health Administration (MSHA) as well. A host of important enforcement tools would have vanished in the process, including MSHA`s right of entry into mines, certain mandatory inspections, most civil fines, and the use of withdrawal orders except in cases of imminent danger. The bill would have made it far more difficult to issue effective safety and health standards and to preserve existing standards. Miners and their unions, as well as some industry representatives, rightly raised concerns about the bill. Now is a good time, then, to review what federal mine safety laws have achieved and how they did it. Working conditions in America`s mines are, indeed, better. They are better because of the current law and the legislation that preceded it, as representatives of the mining industry acknowledge.

  11. A Student-Led Global Health Education Initiative: Reflections on the Kenyan Village Medical Education Program

    PubMed Central

    John, Christopher; Asquith, Heidi; Wren, Tom; Mercuri, Stephanie; Brownlow, Sian

    2016-01-01

    The Kenyan Village Medical Education Program is a student-led global health initiative that seeks to improve health outcomes in rural Kenya through culturally appropriate health education. The month-long program, which is organised by the Melbourne University Health Initiative (Australia), is conducted each January in southern rural Kenya. Significance for public health The Kenyan Village Medical Education (KVME) Program is a student-led global health initiative that involves exploring well-established strategies for the prevention of disease through workshops that are conducted in southern rural Kenya. These workshops are tailored to the unique needs and circumstances of rural Kenyan communities, and are delivered to community leaders, as well as to adults and children within the wider community. Aside from the KVME Program’s emphasis on reducing the burden of preventable disease through health education, the positive impact of the KVME Program on the Program’s student volunteers also deserves consideration. Throughout the month-long KVME Program, student volunteers are presented with opportunities to develop their understanding of cultural competency, the social and economic determinants of health, as well as the unique challenges associated with working in resource-poor communities. Importantly, the KVME Program also represents an avenue through which global health leadership can be fostered amongst student volunteers. PMID:27190974

  12. A Student-Led Global Health Education Initiative: Reflections on the Kenyan Village Medical Education Program.

    PubMed

    John, Christopher; Asquith, Heidi; Wren, Tom; Mercuri, Stephanie; Brownlow, Sian

    2016-04-26

    The Kenyan Village Medical Education Program is a student-led global health initiative that seeks to improve health outcomes in rural Kenya through culturally appropriate health education. The month-long program, which is organised by the Melbourne University Health Initiative (Australia), is conducted each January in southern rural Kenya. Significance for public healthThe Kenyan Village Medical Education (KVME) Program is a student-led global health initiative that involves exploring well-established strategies for the prevention of disease through workshops that are conducted in southern rural Kenya. These workshops are tailored to the unique needs and circumstances of rural Kenyan communities, and are delivered to community leaders, as well as to adults and children within the wider community. Aside from the KVME Program's emphasis on reducing the burden of preventable disease through health education, the positive impact of the KVME Program on the Program's student volunteers also deserves consideration. Throughout the month-long KVME Program, student volunteers are presented with opportunities to develop their understanding of cultural competency, the social and economic determinants of health, as well as the unique challenges associated with working in resource-poor communities. Importantly, the KVME Program also represents an avenue through which global health leadership can be fostered amongst student volunteers. PMID:27190974

  13. International Society of Nephrology-Hydration and Kidney Health Initiative - Expanding Research and Knowledge.

    PubMed

    Moist, Louise M; Clark, William F; Segantini, Luca; Damster, Sandrine; Le Bellego, Laurent; Wong, Germaine; Tonelli, Marcello

    2016-01-01

    The purpose of this manuscript is to describe a collaborative research initiative to explore the role of hydration in kidney health. Our understanding of the effects of hydration in health and disease is surprisingly limited, particularly when we consider the vital role of hydration in basic human physiology. Recent initiatives and research outcomes have challenged the global medical community to expand our knowledge about hydration, including the differences between water, sugared beverages and other consumables. Identification of the potential mechanisms contributing to the benefits of hydration has stimulated the global nephrology community to advance research regarding hydration for kidney health. Hydration and kidney health has been a focus of research for several research centers with a rapidly expanding world literature and knowledge. The International Society of Nephrology has collaborated with Danone Nutricia Research to promote development of kidney research initiatives, which focus on the role of hydration in kidney health and the global translation of this new information. This initiative supports the use of existing data in different regions and countries to expand dialogue among experts in the field of hydration and health, and to increase scientific interaction and productivity with the ultimate goal of improving kidney health. PMID:27300138

  14. Analysis of Service-learning activities adopted in health courses of Federal University of Bahia.

    PubMed

    Baldoino, Aline Silva; Veras, Renata Meira

    2016-06-01

    is study aimed to raise and discuss the data about the integration of health courses teaching and service activities o ered at the Federal University of Bahia (UFBA), pre- senting scenarios practices and major di culties existing in the relationship between the university and the services of health. is was a qualitative study of descriptive explo- ratory character, using a questionnaire as a research tool applied to the coordinators of selected health courses. e selection was by reading the political pedagogical project, the following courses were selected: nursing, physical therapy, speech therapy, medicine, nu- trition, dentistry and public health. e results indicated eight types of teaching-service integration activities, 57 scenarios of practice and the main di culties. It was concluded that these courses are sticking to changes in academic training in health, in view of the large number of basic health units in the teaching service process. us, it emphasizes that the UFBA includes activities in health care that enable the integration-education in the higher education process, although there are some di culties in this relationship indicated by the coordinators. Esse estudo teve como objetivo levantar e discutir os dados acerca das atividades de integração ensino-serviço de cursos de saúde oferecidos na Universidade Federal da Bahia (UFBA), apresentando os cenários de práticas e as principais di culdades existentes na relação entre a uni- versidadeeosserviçosdesaúde.Tratou-sedeumapesquisaqualitativa,decaráterdescritivoexploratório,utilizando-seumquestionáriocomo instrumento de investigação aplicado aos coordenadores dos cursos de saúde selecionados. A seleção foi mediante a leitura do projeto político pedagógico, sendo selecionados os seguintes cursos: enfermagem, sioterapia, fonoaudiologia, medicina, nutrição, odontologia e saúde coletiva. Os resultados indicaram 8 tipos de atividades de integração ensino-serviço, 57 cenários de pr

  15. The Genesis, Implementation and Impact of the Better Access Mental Health Initiative Introducing Medicare-Funded Psychology Services

    ERIC Educational Resources Information Center

    Littlefield, Lyn; Giese, Jill

    2008-01-01

    The Australian Government's Better Access to Mental Health Care initiative introduced mental health reforms that included the availability of Medicare-funded psychology services. The mental health initiative has resulted in a huge uptake of these services, demonstrating the strong community demand for psychological treatment. The initiative has…

  16. 77 FR 12577 - Department of Defense (DoD) Medicare-Eligible Retiree Health Care Board of Actuaries; Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ...Under the provisions of the Federal Advisory Committee Act of 1972 (5 U.S.C., Appendix, as amended), the Government in the Sunshine Act of 1976 (5 U.S.C. 552b, as amended), and 41 CFR 102-3.150, the Department of Defense announces that the following Federal advisory committee meeting of the DoD Medicare-Eligible Retiree Health Care Board of Actuaries will take...

  17. The Smart Health Initiative in China: The Case of Wuhan, Hubei Province.

    PubMed

    Fan, Meiyu; Sun, Jian; Zhou, Bin; Chen, Min

    2016-03-01

    To introduce smart health in Wuhan, and provide some references for other cities. As the largest mega-city in central China, Wuhan is investing large amounts of resources to push forward the development of Smart Wuhan and Health Wuhan, and it has unique features. It is one of the centerpieces of China's New Healthcare Reform, and great hope is put on it to help solve the conflict between limited healthcare resources and the large population of patients. How to plan and design smart health is important. The construction of Wuhan Smart Health includes some aspects as follows, like requirement analysis, the establishment of objectives and blueprint, the architecture design of regional health information platform, evaluation and implementation, problems and solutions, and so on. Wuhan Smart Health has obtained some achievements in health network, information systems, resident's health records, information standard, and the first phase of municipal health information platform. The focus of this article is the whole construction process of smart health in Wuhan. Although there are some difficulties during this period, some smart health services and management have been reflected. Compared with other cities or countries, Wuhan Smart Health has its own advantages and disadvantages. This study aims to provide a reference for other cities. Because smart health of Wuhan is characteristic in construction mode. Though still in the initial stage, it has great potentials in the future. PMID:26667820

  18. Patient safety goals for the proposed Federal Health Information Technology Safety Center.

    PubMed

    Sittig, Dean F; Classen, David C; Singh, Hardeep

    2015-03-01

    The Office of the National Coordinator for Health Information Technology is expected to oversee creation of a Health Information Technology (HIT) Safety Center. While its functions are still being defined, the center is envisioned as a public-private entity focusing on promotion of HIT related patient safety. We propose that the HIT Safety Center leverages its unique position to work with key administrative and policy stakeholders, healthcare organizations (HCOs), and HIT vendors to achieve four goals: (1) facilitate creation of a nationwide 'post-marketing' surveillance system to monitor HIT related safety events; (2) develop methods and governance structures to support investigation of major HIT related safety events; (3) create the infrastructure and methods needed to carry out random assessments of HIT related safety in complex HCOs; and (4) advocate for HIT safety with government and private entities. The convening ability of a federally supported HIT Safety Center could be critically important to our transformation to a safe and effective HIT enabled healthcare system. PMID:25332353

  19. The Shared Health Research Information Network (SHRINE): a prototype federated query tool for clinical data repositories.

    PubMed

    Weber, Griffin M; Murphy, Shawn N; McMurry, Andrew J; Macfadden, Douglas; Nigrin, Daniel J; Churchill, Susanne; Kohane, Isaac S

    2009-01-01

    The authors developed a prototype Shared Health Research Information Network (SHRINE) to identify the technical, regulatory, and political challenges of creating a federated query tool for clinical data repositories. Separate Institutional Review Boards (IRBs) at Harvard's three largest affiliated health centers approved use of their data, and the Harvard Medical School IRB approved building a Query Aggregator Interface that can simultaneously send queries to each hospital and display aggregate counts of the number of matching patients. Our experience creating three local repositories using the open source Informatics for Integrating Biology and the Bedside (i2b2) platform can be used as a road map for other institutions. The authors are actively working with the IRBs and regulatory groups to develop procedures that will ultimately allow investigators to obtain identified patient data and biomaterials through SHRINE. This will guide us in creating a future technical architecture that is scalable to a national level, compliant with ethical guidelines, and protective of the interests of the participating hospitals. PMID:19567788

  20. The Equity and Quality (EQual) Health-Care Project: A Connecticut Health Foundation initiative with Qualidigm.

    PubMed

    Van Hoof, Thomas J; Mahier, Stephen E; Barr, Judith K; Krause, Elizabeth M S; Kelvey-Albert, Michele; Curry, Maureen; Meehan, Thomas P

    2010-05-01

    In response to the growing incidence and prevalence of diabetes, quality and disparity of care concerns, and the increasing diversity of the US and Connecticut's populations, the Connecticut Health Foundation funded Qualidigm to implement the Equity and Quality (EQual) Health-Care Project. Now in its second full year, the EQualHealth-CareProject is helping eight primary-care practices in Connecticut improve the equity and quality of diabetes care through technology, education, and quality improvement. PMID:20509420

  1. Vegetarian diets in the Adventist Health Study 2: a review of initial published findings1234

    PubMed Central

    Orlich, Michael J; Fraser, Gary E

    2014-01-01

    The Adventist Health Study 2 is a large cohort that is well suited to the study of the relation of vegetarian dietary patterns to health and disease risk. Here we review initial published findings with regard to vegetarian diets and several health outcomes. Vegetarian dietary patterns were associated with lower body mass index, lower prevalence and incidence of diabetes mellitus, lower prevalence of the metabolic syndrome and its component factors, lower prevalence of hypertension, lower all-cause mortality, and in some instances, lower risk of cancer. Findings with regard to factors related to vegetarian diets and bone health are also reviewed. These initial results show important links between vegetarian dietary patterns and improved health. PMID:24898223

  2. Vegetarian diets in the Adventist Health Study 2: a review of initial published findings.

    PubMed

    Orlich, Michael J; Fraser, Gary E

    2014-07-01

    The Adventist Health Study 2 is a large cohort that is well suited to the study of the relation of vegetarian dietary patterns to health and disease risk. Here we review initial published findings with regard to vegetarian diets and several health outcomes. Vegetarian dietary patterns were associated with lower body mass index, lower prevalence and incidence of diabetes mellitus, lower prevalence of the metabolic syndrome and its component factors, lower prevalence of hypertension, lower all-cause mortality, and in some instances, lower risk of cancer. Findings with regard to factors related to vegetarian diets and bone health are also reviewed. These initial results show important links between vegetarian dietary patterns and improved health. PMID:24898223

  3. [Regional initiative on health care reform in Latin America and the Caribbean].

    PubMed

    Crocco, P; Schroeder, P; Villen, M T; Yen, E

    2000-01-01

    Many countries throughout Latin America and the Caribbean are introducing reforms that can profoundly influence how health services are provided and who receives them. Governments in the region identified the need for a network to support health reform by building capacity in analysis and training, both at the Summit of the Americas in 1994 and at the Special Meeting on Health Sector Reform, which was convened in 1995 by an interagency committee of the Pan American Health Organization/World Health Organization, the Inter-American Development Bank, the World Bank, and other multilateral and bilateral agencies. In response, in 1997 the Pan American Health Organization and the United States Agency for the International Development launched the Latin America and Caribbean Regional Health Sector Reform Initiative. The Initiative has approximately US$ 10 million in funding through the year 2002 to support activities in Bolivia, Brazil, the Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Paraguay, and Peru. Now in its third year of implementation, the Initiative supports regional activities seeking to promote more equitable and effective delivery of basic health services. PMID:11026784

  4. The Bamako Initiative: Primary Health Care Experience. Children in the Tropics: Review of the International Children's Centre.

    ERIC Educational Resources Information Center

    Knippenberg, Rudolph; And Others

    1990-01-01

    During the 1987 World Health Organization's Regional Assembly, the Ministers of Health of the African States launched the Bamako Initiative, an effort aimed at reorganizing the health system to ensure universal, permanent accessibility of maternal and child health services. Three conditions were initially seen as necessary for success: improvement…

  5. Under the (legal) radar screen: global health initiatives and international human rights obligations

    PubMed Central

    2012-01-01

    Background Given that many low income countries are heavily reliant on external assistance to fund their health sectors the acceptance of obligations of international assistance and cooperation with regard to the right to health (global health obligations) is insufficiently understood and studied by international health and human rights scholars. Over the past decade Global Health Initiatives, like the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) have adopted novel approaches to engaging with stakeholders in high and low income countries. This article explores how this experience impacted on acceptance of the international obligation to (help) fulfil the right to health beyond borders. Methods The authors conducted an extensive review of international human rights law literature, transnational legal process literature, global public health literature and grey literature pertaining to Global Health Initiatives. To complement this desk work and deepen their understanding of how and why different legal norms evolve the authors conducted 19 in-depth key informant interviews with actors engaged with three stakeholders; the European Union, the United States and Belgium. The authors then analysed the interviews through a transnational legal process lens. Results Through according value to the process of examining how and why different legal norms evolve transnational legal process offers us a tool for engaging with the dynamism of developments in global health suggesting that operationalising global health obligations could advance the right to health for all. Conclusions In many low-income countries the health sector is heavily dependent on external assistance to fulfil the right to health of people thus it is vital that policies and tools for delivering reliable, long-term assistance are developed so that the right to health for all becomes more than a dream. Our research suggests that the Global Fund experience offers lessons to build on. PMID

  6. [Constraints and opportunities for inter-sector health promotion initiatives: a case study].

    PubMed

    Magalhães, Rosana

    2015-07-01

    This article analyzes the implementation of inter-sector initiatives linked to the Family Grant, Family Health, and School Health Programs in the Manguinhos neighborhood in the North Zone of Rio de Janeiro, Brazil. The study was conducted in 2010 and 2011 and included document review, local observation, and 25 interviews with program managers, professionals, and staff. This was an exploratory case study using a qualitative approach that identified constraints and opportunities for inter-sector health experiences, contributing to the debate on the effectiveness of health promotion and poverty relief programs. PMID:26248098

  7. [Health Education for Men by the Federal Centre of Health Education: A Contribution to the Presentation of Men as unaware of Health? (1970-1990)].

    PubMed

    Pfütsch, Pierre

    2015-01-01

    This article offers a close consideration about the gender-specific contents of health education campaigns in the Federal Republic of Germany from 1970 to 1990. By using educational publications issued by the Bundeszentrale für gesundheitliche Aufklärung (BZgA), it is shown which breaks and continuities emerged and which kinds of role models are thereby conveyed. Whereas the health education of the 1950s and 1960s was characterised by a didactical approach towards men and women, this changed as from the 1970s. By deconstructing exemplary education campaigns and including internal files of the BZgA, it can be shown, that the societal discourse on the feminism in the FRG contributed to the fact, that during the 1970s the switch has been made to an increased use of positive role models. However, within the men-specific health education there was no break; the health deficiency discourse was still applied in many and diverse ways in order to describe male health behaviour and knowledge. PMID:26219193

  8. Finding Funding: A Guide to Federal Sources for Out-of-School Time and Community School Initiatives.

    ERIC Educational Resources Information Center

    Reder, Nancy D.

    Noting the increasing need for improved access to quality after-school services, this guide to federal funding sources for out-of-school time programs and community schools (OST/CS) is designed to assist program leaders, policymakers, and others in nonprofit, public, and private organizations in taking advantage of federal funding opportunities.…

  9. [Perspectives on veterinary public health, food security, and the "One Health" joint initiative].

    PubMed

    Cartín-Rojas, Andrés

    2014-09-01

    Veterinarians play a key role in food security. The health of millions of people, stimulation of national economies, development of sustainable livestock production related to this food source, and the different agricultural production systems that compose value chains, and access to more profitable international markets all depend on their efficient and transparent work. Shifting nutritional patterns globally, along with expected population growth, and the increase in marketable food commodity routes and volumes, forecast that demand for animal source food will steadily intensify over the coming decades. To successfully address these challenges, the veterinary profession should establish more practical and up-to-date conceptual and methodological frameworks for academic and professional profiles, focusing the profession on the different public health subject areas, in undergraduate and graduate courses. Furthermore, interdisciplinary alliances should also be developed--such as the "One Health" approach proposed by the United Nations Food and Agriculture Organization (FAO), the World Organization for Animal Health (OIE), and the World Health Organization (WHO)--to establish frameworks for joint work and public policies more in line with the domestic conditions of Latin American countries, using a collaborative, sustainable, and comprehensive approach to animal health, food security, and public health policy. PMID:25418770

  10. The Federal Government's Deinstitutionalization Program Initiatives: A Status Report (A Litany of Reports, Studies, Recommendations, Policy Debates, and Even Some Progress).

    ERIC Educational Resources Information Center

    Ross, E. Clarke

    1979-01-01

    Analysis of six federal government studies on deinstitutionalization is followed by a discussion of initiatives enacted by the 95th Congress and proposals under consideration in the 96th. Among studies described are reports by the U.S. Government Accounting Office ("Returning the Mentally Disabled to the Community: Government Needs to Do More");…

  11. Addressing the Social Determinants of Health through the Alameda County, California, Place Matters Policy Initiative

    PubMed Central

    Schaff, Katherine; Flournoy, Rebecca; Carson, Keith; Drenick, Teresa; Fujii, Darlene; Lee, Anna; Luginbuhl, Jessica; Mena, Mona; Shrago, Amy; Siegel, Anita; Stahl, Robert; Watkins-Tartt, Kimi; Willow, Pam; Witt, Sandra; Woloshin, Diane; Yamashita, Brenda

    2013-01-01

    In Alameda County, California, significant health inequities by race/ethnicity, income, and place persist. Many of the county's low-income residents and residents of color live in communities that have faced historical and current disinvestment through public policies. This disinvestment affects community conditions such as access to economic opportunities, well-maintained and affordable housing, high-quality schools, healthy food, safe parks, and clean water and air. These community conditions greatly affect health. At the invitation of the Joint Center for Political and Economic Studies' national Place Matters initiative, Alameda County Supervisor Keith Carson's Office and the Alameda County Public Health Department launched Alameda County Place Matters, an initiative that addresses community conditions through local policy change. We describe the initiative's creation, activities, policy successes, and best practices. PMID:24179279

  12. Addressing the social determinants of health through the Alameda County, California, place matters policy initiative.

    PubMed

    Schaff, Katherine; Desautels, Alexandra; Flournoy, Rebecca; Carson, Keith; Drenick, Teresa; Fujii, Darlene; Lee, Anna; Luginbuhl, Jessica; Mena, Mona; Shrago, Amy; Siegel, Anita; Stahl, Robert; Watkins-Tartt, Kimi; Willow, Pam; Witt, Sandra; Woloshin, Diane; Yamashita, Brenda

    2013-11-01

    In Alameda County, California, significant health inequities by race/ethnicity, income, and place persist. Many of the county's low-income residents and residents of color live in communities that have faced historical and current disinvestment through public policies. This disinvestment affects community conditions such as access to economic opportunities, well-maintained and affordable housing, high-quality schools, healthy food, safe parks, and clean water and air. These community conditions greatly affect health. At the invitation of the Joint Center for Political and Economic Studies' national Place Matters initiative, Alameda County Supervisor Keith Carson's Office and the Alameda County Public Health Department launched Alameda County Place Matters, an initiative that addresses community conditions through local policy change. We describe the initiative's creation, activities, policy successes, and best practices. PMID:24179279

  13. Potential Sources of Federal Support for School-Based and School-Linked Health Services. Volume III. A Guide to School-Based and School-Linked Health Centers.

    ERIC Educational Resources Information Center

    Steinschneider, Janice

    Volume III of a three-volume guide to school-based and school-linked health centers, this document notes that communities that wish to continue existing school-based health clinics or to start new ones may need to explore federal support for health center operations. This manual identifies federal health, education, and social programs which…

  14. Considerations for Community-Based mHealth Initiatives: Insights From Three Beacon Communities

    PubMed Central

    2013-01-01

    Mobile health (mHealth) is gaining widespread attention for its potential to engage patients in their health and health care in their daily lives. Emerging evidence suggests that mHealth interventions can be used effectively to support behavior change, but numerous challenges remain when implementing these programs at the community level. This paper provides an overview of considerations when implementing community-based mHealth initiatives, based on the experiences of three Beacon Communities across the United States that have launched text messaging (short message service, SMS) pilot programs aimed at diabetes risk reduction and disease management. The paper addresses lessons learned and suggests strategies to overcome challenges related to developing text message content, conducting marketing and outreach, enrolling participants, engaging providers, evaluating program effectiveness, and sustaining and scaling the programs. PMID:24128406

  15. Impact of electronic health record (EHR) reminder on human papillomavirus (HPV) vaccine initiation and timely completion

    PubMed Central

    Ruffin, Mack T.; Plegue, Melissa A.; Rockwell, Pamela G.; Young, Alisa P.; Patel, Divya A.; Yeazel, Mark W.

    2016-01-01

    Background Initiation and timely completion of the HPV vaccine in young women is critical. We compared initiation and completion of HPV vaccine among women in two community-based networks with electronic health records: one with a prompt and reminder system (prompted cohort) and one without (unprompted cohort). Methods Female patients aged 9–26 years seen between March 1, 2007 and January 25, 2010 were used as retrospective cohorts. Patient demographics and vaccination dates were extracted from the electronic health record. Results Patients eligible for the vaccine included 6019 from the prompted cohort and 9096 from the unprompted cohort. Mean age at initiation was 17.3 years in prompted cohort and 18.1 years at unprompted cohort with significantly more (p<0.001) patients initiating in the prompted cohort (34.9%) compared to the unprompted cohort (21.5%). African Americans age 9–18 years with three or more visits during the observation period were significantly more likely to initiate in the prompted cohort (p<0.001). Prompted cohort was significantly more (p<0.001) likely to complete the vaccine series timely compared to unprompted cohort. Conclusion More patients age 9–26 years initiated and timely completed the HPV vaccine series in clinics using an electronic health record system with prompts compared to clinics without prompts. PMID:25957365

  16. Overview of Federal, New York State, and New York City Law Regarding Environmental Health and Safety in Schools.

    ERIC Educational Resources Information Center

    Advocates for Children of New York, Inc., Long Island City.

    This document presents many of the federal, state, and New York City laws that apply to the health, safety, and environmental conditions of schools. The relevant portions of the law have been selected along with the mechanisms of legal enforcement that may exist and contact information where applicable. Legislative categories covered include air…

  17. Evaluation of a "traditional food for health" intervention in Pohnpei, Federated States of Micronesia.

    PubMed

    Kaufer, Laura; Englberger, Lois; Cue, Roger; Lorens, Adelino; Albert, Kiped; Pedrus, Podis; Kuhnlein, Harriet V

    2010-04-01

    Federated States of Micronesia (FSM) faces increasing rates of non-communicable diseases related to the neglect of the traditional food system and the shift to consumption of imported food and adoption of sedentary lifestyles. To reverse this trend, a two-year, food-based intervention in one Pohnpeian community in FSM promoted local food production and consumption using a variety of approaches including education, training, agriculture and social marketing following a "Go Local" message. Foods promoted were banana, giant swamp taro, breadfruit and pandanus varieties, green leafy vegetables and fruits for their provitamin A and total carotenoids, vitamins, minerals and fiber content. An evaluation was conducted in a random sample of households (n=47) to examine the extent of dietary changes following the intervention. Results indicated increased (110%) provitamin A carotenoid intake; increased frequency of consumption of local banana (53%), giant swamp taro (475%), and local vegetables (130%); and increased dietary diversity from local food. Exposure to intervention activities was high and there were positive changes in attitudes towards local food. The intervention approaches appear to have been successful in this short period. It is likely that similar approaches in additional communities in Pohnpei and other parts of the Pacific would also be successful in promoting local food. Evidence gathering should continue to document the long-term health outcomes of increased reliance on local food. PMID:20968237

  18. Food security and nutrition in the Russian Federation – a health policy analysis

    PubMed Central

    Lunze, Karsten; Yurasova, Elena; Idrisov, Bulat; Gnatienko, Natalia; Migliorini, Luigi

    2015-01-01

    Background In the Russian Federation (Russia), an elevated burden of premature mortality attributable to non-communicable diseases (NCDs) has been observed since the country's economic transition. NCDs are largely related to preventable risk factors such as unhealthy diets. Objective This health policy study's aim was to analyze past and current food production and nutritional trends in Russia and their policy implications for Russia's NCD burden. Design We examined food security and nutrition in Russia using an analytical framework of food availability, access to food, and consumption. Results Agricultural production declined during the period of economic transition, and nutritional habits changed from high-fat animal products to starches. However, per-capita energy consumption remained stable due to increased private expenditures on food and use of private land. Paradoxically, the prevalence of obesity still increased because of an excess consumption of unsaturated fat, sugar, and salt on one side, and insufficient intake of fruit and vegetables on the other. Conclusions Policy and economic reforms in Russia were not accompanied by a food security crisis or macronutrient deprivation of the population. Yet, unhealthy diets in contemporary Russia contribute to the burden of NCDs and related avoidable mortality. Food and nutrition policies in Russia need to specifically address nutritional shortcomings and food-insecure vulnerable populations. Appropriate, evidence-informed food and nutrition policies might help address Russia's burden of NCDs on a population level. PMID:26112143

  19. Integrating the environment, the economy, and community health: a Community Health Center's initiative to link health benefits to smart growth.

    PubMed

    McAvoy, Peter V; Driscoll, Mary Beth; Gramling, Benjamin J

    2004-04-01

    The Sixteenth Street Community Health Center (SSCHC) in Milwaukee, Wis, is making a difference in the livability of surrounding neighborhoods and the overall health of the families it serves. SSCHC is going beyond traditional health care provider models and working to link the environment, the economy, and community health through urban brownfield redevelopment and sustainable land-use planning. In 1997, SSCHC recognized that restoration of local air and water quality and other environmental conditions, coupled with restoring family-supporting jobs in the neighborhood, could have a substantial impact on the overall health of families. Recent events indicate that SSCHC's pursuit of smart growth strategies has begun to pay off. PMID:15053995

  20. Trading health for a healthy weight: the uncharted side of healthy weights initiatives.

    PubMed

    Pinhas, Leora; McVey, Gail; Walker, Kathryn S; Norris, Mark; Katzman, Debra; Collier, Sarah

    2013-01-01

    Healthy eating and weight initiatives have been incorporated into many schools to combat the growing obesity problem. There is little research, however, on the effectiveness of these programs or any inadvertent harmful effects on children's mental health. Our aims were to report on how school-based healthy weights initiatives can trigger the adoption of unhealthy behaviours for some children. This is a case series of four children seen at specialized eating disorder clinics. Each child attributed eating pattern changes to information garnered from school-based healthy eating curricula. Unanticipated consequences of these initiatives are described and alternative approaches are discussed. PMID:23421694

  1. The Impacts of State Health Reform Initiatives on Adults in New York and Massachusetts

    PubMed Central

    Long, Sharon K; Stockley, Karen

    2011-01-01

    Objective To analyze the effects of health reform efforts in two large states—New York and Massachusetts. Data Sources/Study Setting National Health Interview Survey (NHIS) data from 1999 to 2008. Study Design We take advantage of the “natural experiments” that occurred in New York and Massachusetts to compare health insurance coverage and health care access and use for adults before and after the implementation of the health policy changes. To control for underlying trends not related to the reform initiatives, we subtract changes in the outcomes over the same time period for comparison groups of adults who were not affected by the policy changes using a differences-in-differences framework. The analyses are conducted using multiple comparison groups and different time periods as a check on the robustness of the findings. Data Collection/Extraction Methods Nonelderly adults ages 19–64 in the NHIS. Principal Findings We find evidence of the success of the initiatives in New York and Massachusetts at expanding insurance coverage, with the greatest gains reported by the initiative that was broadest in scope—the Massachusetts push toward universal coverage. There is no evidence of improvements in access to care in New York, reflecting the small gains in coverage under that state's reform effort and the narrow focus of the initiative. In contrast, there were significant gains in access to care in Massachusetts, where the impact on insurance coverage was greater and a more comprehensive set of reforms were implemented to improve access to a full array of health care services. The estimated gains in coverage and access to care reported here for Massachusetts were achieved in the early period under health reform, before the state's reform initiative was fully implemented. Conclusions Comprehensive reform initiatives are more successful at addressing gaps in coverage and access to care than are narrower efforts, highlighting the potential gains under national

  2. Mapping of initiatives to increase membership in mutual health organizations in Benin

    PubMed Central

    2012-01-01

    Introduction Mutual health organizations (MHO) have been implemented across Africa to increase access to healthcare and improve financial protection. Despite efforts to develop MHOs, low levels of both initial enrolment and membership renewals continue to threaten their financial viability. The purpose of this study was to map initiatives implemented to increase the pool of MHO members in Benin. Methods A multiple case study was conducted to assess MHOs supported by five major promoters in Benin. Three months of fieldwork resulted in 23 semi-structured interviews and two focus groups with MHO promoters, technicians, elected members, and health professionals affiliated with the MHOs. Fifteen non-structured interviews provided additional information and a valuable source of triangulation. Results MHOs have adopted a wide range of initiatives targeting different entry points and involving a variety of stakeholders. Initiatives have included new types of collective health insurance packages and efforts to raise awareness by going door-to-door and organizing health education workshops. Different types of partnerships have been established to strengthen relationships with healthcare professionals and political leaders. However, the selection and implementation of these initiatives have been limited by insufficient financial and human resources. Conclusions The study highlights the importance of prioritizing sustainable strategies to increase MHO membership. No single MHO initiative has been able to resolve the issue of low membership on its own. If combined, existing initiatives could provide a comprehensive and inclusive approach that would target all entry points and include key stakeholders such as household decision-makers, MHO elected members, healthcare professionals, community leaders, governmental authorities, medical advisors, and promoters. There is a need to evaluate empirically the implementation of these interventions. Mechanisms to promote dialogue between

  3. A student-initiated and student-facilitated international health elective for preclinical medical students

    PubMed Central

    Vora, Nirali; Chang, Mina; Pandya, Hemang; Hasham, Aliya; Lazarus, Cathy

    2010-01-01

    Introduction Global health education is becoming more important for developing well-rounded physicians and may encourage students toward a career in primary care. Many medical schools, however, lack adequate and structured opportunities for students beginning the curriculum. Methods Second-year medical students initiated, designed, and facilitated a pass–fail international health elective, providing a curricular framework for preclinical medical students wishing to gain exposure to the clinical and cultural practices of a developing country. Results All course participants (N=30) completed a post-travel questionnaire within one week of sharing their experiences. Screening reflection essays for common themes that fulfill university core competencies yielded specific global health learning outcomes, including analysis of health care determinants. Conclusion Medical students successfully implemented a sustainable global health curriculum for preclinical student peers. Financial constraints, language, and organizational burdens limit student participation. In future, long-term studies should analyze career impact and benefits to the host country. PMID:20186283

  4. Dietary patterns are associated with disease risk among participants in the women's health initiative observational study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Coronary heart disease (CHD) is the leading cause of death in women. A nested case-control study tested whether dietary patterns predicted CHD events among 1224 participants in the Women’s Health Initiative-Observational Study (WHI-OS) with centrally confirmed CHD, fatal or nonfatal myocardial infar...

  5. 75 FR 44589 - Health Information Technology: Initial Set of Standards, Implementation Specifications, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-28

    ...The Department of Health and Human Services (HHS) is issuing this final rule to complete the adoption of an initial set of standards, implementation specifications, and certification criteria, and to more closely align such standards, implementation specifications, and certification criteria with final meaningful use Stage 1 objectives and measures. Adopted certification criteria establish the......

  6. U.S. Public School Enrollment-Based Health Insurance Initiatives and America's Uninsured.

    ERIC Educational Resources Information Center

    Romund, Camilla M.; Farmer, Frank L.; Tilford, John M.

    1997-01-01

    Reviews current literature on school enrollment-based health insurance programs underway or pending in the United States, focusing on initiatives in Florida, New Hampshire, Arkansas, and Texas and discussing programs in several other states. The paper discusses problems with uninsuredness in the United States and examines innovations in child…

  7. 77 FR 286 - Medicaid Program: Initial Core Set of Health Care Quality Measures for Medicaid-Eligible Adults

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-04

    ... HUMAN SERVICES Office of the Secretary Medicaid Program: Initial Core Set of Health Care Quality...: This final notice announces the initial core set of health care quality measures for Medicaid-eligible... administered under title XIX of the Social Security Act, health insurance issuers and managed care...

  8. The Role of Prevention in Promoting Continuity of Health Care in Prisoner Reentry Initiatives

    PubMed Central

    Lanza, A. Stephen; Dyson, William; Gordon, Derrick M.

    2013-01-01

    Most incarcerated individuals will return to the community, and their successful reentry requires consideration of their health and how their health will affect their families and communities. We propose the use of a prevention science framework that integrates universal, selective, and indicated strategies to facilitate the successful reentry of men released from prison. Understanding how health risks and disparities affect the transition from prison to the community will enhance reentry intervention efforts. To explore the application of the prevention rubric, we evaluated a community-based prisoner reentry initiative. The findings challenge all involved in reentry initiatives to reconceptualize prisoner reentry from a program model to a prevention model that considers multilevel risks to and facilitators of successful reentry. PMID:23488516

  9. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services

    PubMed Central

    Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

    2016-01-01

    Background A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. Methods This is a sub-analysis of a national population-based survey of postpartum women entitled “Birth in Brazil”, performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Results Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk–adjusted OR of 2.3 (CI 1.5–3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1–2.3) for women of high obstetric risk. Conclusion The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care. PMID:27196102

  10. How federal health-care policies interface with urban and rural areas: a comparison of three systems.

    PubMed

    Baracskay, Daniel

    2012-01-01

    Global public health policies span national borders and affect multitudes of people. The spread of infectious disease has neither political nor economic boundaries, and when elevated to a status of pandemic proportions, immediate action is required. In federal systems of government, the national level leads the policy formation and implementation process, but also collaborates with supranational organisations as part of the global health network. Likewise, the national level of government cooperates with sub-national governments located in both urban and rural areas. Rural areas, particularly in less developed countries, tend to have higher poverty rates and lack the benefits of proper medical facilities, communication modes and technology to prevent the spread of disease. From the perspective of epidemiological surveillance and intervention, this article will examine federal health policies in three federal systems: Australia, Malaysia and the USA. Using the theoretical foundations of collaborative federalism, this article specifically examines how collaborative arrangements and interactions among governmental and non-governmental actors help to address the inherent discrepancies that exist between policy implementation and reactions to outbreaks in urban and rural areas. This is considered in the context of the recent H1N1 influenza pandemic, which spread significantly across the globe in 2009 and is now in what has been termed the 'post-pandemic era'. PMID:22043815

  11. Initial Treatment of Men With Newly Diagnosed Lower Urinary Tract Dysfunction in the Veterans Health Administration

    PubMed Central

    Erickson, Bradley A.; Lu, Xin; Vaughan-Sarrazin, Mary; Kreder, Karl J.; Breyer, Benjamin N.; Cram, Peter

    2014-01-01

    OBJECTIVE To examine initial treatments given to men with newly diagnosed lower urinary tract dysfunction (LUTD) within a large integrated health care system in the United States. METHODS We used data from 2003 to 2009 from the Veteran's Health Administration to identify newly diagnosed cases of LUTD using established ICD-9CM codes. Our primary outcome was initial LUTD treatment (3 months), categorized as watchful waiting (WW), medical therapy (MT), or surgical therapy (ST); our secondary outcome was pharmacotherapy class received. We used logistic regression models to examine patient, provider, and health system factors associated with receiving MT or ST when compared with WW. RESULTS There were 393,901 incident cases of LUTD, of which 58.0% initially received WW, 41.8% MT, and 0.2% ST. Of the MT men, 79.8% received an alpha-blocker, 7.7% a 5-alpha reductase inhibitor, 3.3% an anticholinergic, and 7.3% combined therapy (alpha-blocker and 5-alpha reductase inhibitor). In our regression models, we found that age (higher), race (white/black), income (low), region (northeast/south), comorbidities (greater), prostate-specific antigen (lower), and provider (nonurologist) were associated with an increased odds of receiving MT. We found that age (higher), race (white), income (low), region (northeast/south), initial provider (urologist), and prostate-specific antigen (higher) increased the odds of receiving ST. CONCLUSION Most men with newly diagnosed LUTD in the Veteran's Health Administration receive WW, and initial surgical treatment is rare. A large number of men receiving MT were treated with monotherapy, despite evidence that combination therapy is potentially more effective in the long-term, suggesting opportunities for improvement in initial LUTD management within this population. PMID:24286603

  12. Developing a web-based data mining application to impact community health improvement initiatives: the Virginia Atlas of Community Health.

    PubMed

    Wilson, Jeffrey L

    2006-01-01

    This article describes how a team from the Virginia Department of Health (VDH) and the Virginia Center for Healthy Communities (VCHC) attended the UNC Management Academy for Public Health to learn skills to address Virginia's commitment to using technology to improve the public's health. After creating a business plan for a food-safety information Web site, team members used that experience as well as Management Academy training in information technology, the management of data and finances, and strategic partnering to create a comprehensive tool with which to place customizable population data in the hands of anyone interested in pursuing population health improvement. The Virginia Atlas of Community Health, launched through the VCHC in 2003, places clear, compelling data in the hands of those who can influence decisions at the local level and create the most impact for health. Since the program's inception, more than 2,000 individuals have registered as ongoing users of the Virginia Atlas. Initially funded by a Turning Point grant from the Robert Wood Johnson Foundation, the program is sustained through a series of smaller grants and funding from the VDH. PMID:16912611

  13. Using GIS to profile health-care costs of VA Quality-Enhancement Research Initiative diseases.

    PubMed

    Yu, Wei; Cowper, Diane; Berger, Magdalena; Kuebeler, Mark; Kubal, Joe; Manheim, Larry

    2004-06-01

    The Health Services Research and Development (HSR&D) Service at the Department of Veterans Affairs (VA) Health Care System launched a Quality Enhancement Research Initiative (QUERI) in 1998. This study estimated health-care costs of nine diseases under the QUERI project and analyzed geographic differences in health-care costs and utilization across 22 VA Integrated Service Networks (VISNs), using a geographic information system (GIS). Patients with these diseases were identified from diagnoses recorded between October 1999 and September 2000. Annual health-care costs for each disease were estimated in four categories: inpatient medical or surgical, other inpatient, outpatient, and outpatient pharmacy. Geographic differences of costs and health-care utilization across the 22 VISNs for chronic heart failure, diabetes, and spinal-cord injury were mapped using a GIS package. Average costs and patterns of health-care utilization varied substantially across the 22 VISNs. The observed differences in health-care utilization across geographic regions raised questions for further investigation. PMID:15446617

  14. Tobacco Surcharges on 2015 Health Insurance Plans Sold in Federally Facilitated Marketplaces: Variations by Age and Geography and Implications for Health Equity

    PubMed Central

    Drope, Jeffrey M.; Graetz, Ilana; Waters, Teresa M.; Kaplan, Cameron M.

    2015-01-01

    In 2014, few health insurance plans sold in the Affordable Care Act’s Federally Facilitated Marketplaces had age-dependent tobacco surcharges, possibly because of a system glitch. The 2015 tobacco surcharges show wide variation, with more plans implementing tobacco surcharges that increase with age. This underscores concerns that older tobacco users will find postsubsidy health insurance premiums difficult to afford. Future monitoring of enrollment will determine whether tobacco surcharges cause adverse selection by dissuading tobacco users, particularly older users, from buying health insurance. PMID:26447913

  15. 76 FR 9968 - Regulation for the Enforcement of Federal Health Care Provider Conscience Protection Laws

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-23

    ... of Federal Law'' (73 FR 50274). In the preamble to the 2008 Final Rule, the Department concluded that... Federal Law,'' 73 FR 78072, 78074, 45 CFR part 88 (Dec. 19, 2008)). The 2008 Final Rule was published in...'' (74 FR 10207). The Department sought public comment in order to determine whether or not to...

  16. United States Federal Health Care Websites: A Multimethod Evaluation of Website Accessibility for Individuals with Disabilities

    ERIC Educational Resources Information Center

    Brobst, John L.

    2012-01-01

    The problem addressed by this study is the observed low levels of compliance with federal policy on website accessibility. The study examines the two key federal policies that promote website accessibility, using a side-by-side policy analysis technique. The analysis examines the Americans with Disabilities Act of 1990 and Section 508 of the…

  17. Finding Funding: A Guide to Federal Sources for Out-of-School TIme and Community School Initiatives. Revised and Updated.

    ERIC Educational Resources Information Center

    Padgette, Heather Clapp

    Noting the growing nation-wide demand for affordable, high-quality, out-of-school time and community school programs, this guide is intended to assist program developers, policy makers, and community leaders identify federal funding sources to support out-of-school time or broader-based community school services. The guide provides an overview of…

  18. The Administration's American Competitiveness Initiative: Providing Federal Funding for Basic Research in the Physical Sciences. BHEF Issue Brief

    ERIC Educational Resources Information Center

    Business-Higher Education Forum (NJ1), 2006

    2006-01-01

    Investing in research, which drives industrial development and innovation, is essential to ensuring America's economic prosperity, national security, and leadership in a global economy. Although U.S. commitment to research and development (R&D) has traditionally been strong and sustained, federal funding of R&D as a share of U.S. gross domestic…

  19. 76 FR 23999 - Federal Advisory Committee; Defense Health Board (DHB) Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-29

    ... Psychological Health External Advisory Subcommittee and the Trauma and Injury Subcommittee. Additionally, the... Integration of Services. The Board will also vote on issues presented by the Psychological Health...

  20. Palliative Care in Rural Minnesota: Findings from Stratis Health's Minnesota Rural Palliative Care Initiative.

    PubMed

    McKinley, Deb; Shearer, Janelle; Weng, Karla

    2016-01-01

    Palliative care, which involves managing symptoms, controlling pain and addressing stress caused by a chronic or terminal illness, has been shown to keep patients out of the hospital and allow them to stay home and live more comfortably with their illness. Typically, it is provided by an interdisciplinary team led by a physician trained in palliative medicine. Rural areas have not always had access to such specialists. Yet, today, rural health care organizations are finding ways to create palliative care programs that meet the needs of their chronically ill and aging populations. This article describes a six-year initiative led by Stratis Health to advance palliative care in rural Minnesota. It highlights the work of FirstLight Health System in Mora and describes Stratis Health's Rural Palliative Care Measurement Pilot Project, an effort to develop and test measures for evaluating rural palliative care programs. PMID:26897897

  1. A Performance Management Initiative for Local Health Department Vector Control Programs

    PubMed Central

    Gerding, Justin; Kirshy, Micaela; Moran, John W.; Bialek, Ron; Lamers, Vanessa; Sarisky, John

    2016-01-01

    Local health department (LHD) vector control programs have experienced reductions in funding and capacity. Acknowledging this situation and its potential effect on the ability to respond to vector-borne diseases, the U.S. Centers for Disease Control and Prevention and the Public Health Foundation partnered on a performance management initiative for LHD vector control programs. The initiative involved 14 programs that conducted a performance assessment using the Environmental Public Health Performance Standards. The programs, assisted by quality improvement (QI) experts, used the assessment results to prioritize improvement areas that were addressed with QI projects intended to increase effectiveness and efficiency in the delivery of services such as responding to mosquito complaints and educating the public about vector-borne disease prevention. This article describes the initiative as a process LHD vector control programs may adapt to meet their performance management needs. This study also reviews aggregate performance assessment results and QI projects, which may reveal common aspects of LHD vector control program performance and priority improvement areas. LHD vector control programs interested in performance assessment and improvement may benefit from engaging in an approach similar to this performance management initiative. PMID:27429555

  2. The Maternal and Child Health Bureau's Initiative for Mental Health in Schools. Report from the Summit. (Washington, DC, March 7, 1998).

    ERIC Educational Resources Information Center

    Adelman, Howard; Taylor, Linda

    When the Maternal and Child Health Bureau implemented an initiative in 1995 to support mental health for school-age children and youth by strengthening the capacity of school-linked health programs to address psychosocial issues and mental health problems, two national centers and five state projects were developed. The work of projects in…

  3. A simple methodology to finance public health initiatives: reimbursement for tuberculosis directly observed therapy services in New York State.

    PubMed

    Klein, S J; Laufer, F N

    1995-01-01

    New York State (NYS) used Medicaid reimbursement to create incentives for health care providers to offer directly observed therapy (DOT) services for active tuberculosis (TB) disease. This resulted in proliferation of 26 new TB DOT providers and expanded capacity for the New York City (NYC). Department of Health. As a result, over 1,200 individuals now receive DOT in NYC. The reimbursement methodology was also used for other NYS public health initiatives. It is applicable for public health initiatives elsewhere. PMID:10186645

  4. 45 CFR 60.13 - Reporting Federal or state criminal convictions related to the delivery of a health care item or...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... related to the delivery of a health care item or service. 60.13 Section 60.13 Public Welfare DEPARTMENT OF... § 60.13 Reporting Federal or state criminal convictions related to the delivery of a health care item... against health care practitioners, providers, and suppliers related to the delivery of a health care......

  5. 45 CFR 60.13 - Reporting Federal or state criminal convictions related to the delivery of a health care item or...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... related to the delivery of a health care item or service. 60.13 Section 60.13 Public Welfare Department of... § 60.13 Reporting Federal or state criminal convictions related to the delivery of a health care item... against health care practitioners, providers, and suppliers related to the delivery of a health care......

  6. International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals.

    PubMed

    Di Renzo, Gian Carlo; Conry, Jeanne A; Blake, Jennifer; DeFrancesco, Mark S; DeNicola, Nathaniel; Martin, James N; McCue, Kelly A; Richmond, David; Shah, Abid; Sutton, Patrice; Woodruff, Tracey J; van der Poel, Sheryl Ziemin; Giudice, Linda C

    2015-12-01

    Exposure to toxic environmental chemicals during pregnancy and breastfeeding is ubiquitous and is a threat to healthy human reproduction. There are tens of thousands of chemicals in global commerce, and even small exposures to toxic chemicals during pregnancy can trigger adverse health consequences. Exposure to toxic environmental chemicals and related health outcomes are inequitably distributed within and between countries; universally, the consequences of exposure are disproportionately borne by people with low incomes. Discrimination, other social factors, economic factors, and occupation impact risk of exposure and harm. Documented links between prenatal exposure to environmental chemicals and adverse health outcomes span the life course and include impacts on fertility and pregnancy, neurodevelopment, and cancer. The global health and economic burden related to toxic environmental chemicals is in excess of millions of deaths and billions of dollars every year. On the basis of accumulating robust evidence of exposures and adverse health impacts related to toxic environmental chemicals, the International Federation of Gynecology and Obstetrics (FIGO) joins other leading reproductive health professional societies in calling for timely action to prevent harm. FIGO recommends that reproductive and other health professionals advocate for policies to prevent exposure to toxic environmental chemicals, work to ensure a healthy food system for all, make environmental health part of health care, and champion environmental justice. PMID:26433469

  7. Health Sector Initiatives for Disaster Risk Management in Ethiopia: A Narrative Review

    PubMed Central

    Tadesse, Luche; Ardalan, Ali

    2014-01-01

    Background: Natural and man-made disasters are prevailing in Ethiopia mainly due to drought, floods, landslides, earthquake, volcanic eruptions, and disease epidemics. Few studies so far have critically reviewed about medical responses to disasters and little information exists pertaining to the initiatives being undertaken by health sector from the perspective of basic disaster management cycle. This article aimed to review emergency health responses to disasters and other related interventions which have been undertaken in the health sector. Methods: Relevant documents were identified by searches in the websites of different sectors in Ethiopian and international non-governmental organizations and United Nations agencies. Using selected keywords, articles were also searched in the data bases of Medline, CINAHL, Scopus, and Google Scholar. In addition, pertinent articles from non-indexed journals were referred to. Results: Disaster management system in Ethiopia focused on response, recovery, and rehabilitation from 1974 to 1988; while the period between 1988 and 1993 marked the transition phase towards a more comprehensive approach. Theoretically, from 1993 onwards, the disaster management system has fully integrated the mitigation, prevention, and preparedness phases into already existing response and recovery approach, particularly for drought. This policy has changed the emergency response practices and the health sector has taken some initiatives in the area of emergency health care. Hence, drought early warning system, therapeutic feeding program in hospitals, health centers and posts in drought prone areas to manage promptly acute malnutrition cases have all been put in place. In addition, public health disease emergencies have been responded to at all levels of health care system. Conclusions: Emergency health responses to drought and its ramifications such as acute malnutrition and epidemics have become more comprehensive in the context of basic disaster

  8. 3 CFR - Medicare Demonstration To Test Medical Homes in Federally Qualified Health Centers

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Memorandum for the Secretary of Health and Human Services My Administration is committed to building a high-quality, efficient health care system and improving access to health care for all Americans. Health... recommended by the Medicare Payment Advisory Commission, an independent advisory body to the...

  9. Support for At-Risk Girls: A School-Based Mental Health Nursing Initiative.

    PubMed

    Adamshick, Pamela

    2015-09-01

    Mental health problems often go undiagnosed or unaddressed until a crisis or extreme event brings the problem to the forefront. Youth are particularly at risk for lack of identification and treatment in regard to mental health issues. This article describes an advanced nursing practice mental health initiative for at-risk teenage girls based on Hildegard Peplau's nursing theory, group process, and healing through holistic health approaches. A support group, RICHES, was developed with focus on core components of relationships, identity, communication, health, esteem, and support. The acronym RICHES was chosen as the name of the support group. Selected themes and issues addressed in this school-based support group are illustrated in case vignettes. Through a collaborative approach with the community and school, this practice initiative presents a unique healing process that extends knowledge in the realm of intervention with at-risk teenage girls. Further research is needed on the efficacy of support groups to modify risk factors and to address goals for primary prevention in at-risk teenage girls. PMID:25549962

  10. Community pharmacy and emerging public health initiatives in developing Southeast Asian countries: a systematic review.

    PubMed

    Hermansyah, Andi; Sainsbury, Erica; Krass, Ines

    2016-09-01

    The development of health and healthcare systems in South-East Asia has influenced the practice of community pharmacy. Over the years, community pharmacy in the region has striven to expand services beyond dispensing to encompass more involvement in public health issues. Searches were conducted in Scopus, EMBASE, MEDLINE and PubMed for articles published between January 2000 and December 2014, with 21 studies in five countries meeting the inclusion criteria. The findings showed increasing interest in research into the delivery of pharmacy services and public health initiatives. Overall, the review found that provision of some health services in pharmacies was common; however, most public health initiatives appeared to be poorly implemented, had limited evidence and were not demonstrated to be sustainable across the sector. This indicates that the practice of community pharmacy in the region has not significantly changed over the past 14 years with respect to the scope and quality of pharmacy services provided, and fundamental policy changes are necessary to improve this situation. PMID:26427905

  11. The legacy of the Child Health and Nutrition Research Initiative (CHNRI).

    PubMed

    Black, Robert E

    2016-06-01

    Under the Global Forum for Health Research, the Child Health and Nutrition Research Initiative (CHNRI) began its operations in 1999 and became a Swiss foundation in 2006. The vision of CHNRI was to improve child health and nutrition of all children in low- and middle-income countries (LMIC) through research that informs health policy and practice. Specific objectives included expanding global knowledge on childhood disease burden and cost-effectiveness of interventions, promoting priority setting in research, ensuring inclusion of institutions and scientists in LMIC in setting priorities, promoting capacity development in LMIC and stimulating donors and countries to increase resources for research. CHNRI created a knowledge network, funded research through multiple rounds of a global competitive process and published research papers and policy briefs. A signature effort was to develop a systematic methodology for prioritizing health and nutrition research investments. The "CHNRI method" has been extensively applied to global health problems and is now the most commonly used method for prioritizing health research questions. PMID:26955468

  12. Geographically varying effects of weather on tobacco consumption: implications for health marketing initiatives.

    PubMed

    Govind, Rahul; Garg, Nitika; Sun, Wenbin

    2014-01-01

    Weather and its fluctuations have been found to influence the consumption of negative hedonic goods. However, such findings are of limited use to health marketers who cannot control the weather, and hence, its effects. The current research utilizes data obtained at the zip-code level to study geographical variations in the effect of weather on tobacco consumption across the entire continental United States. The results allow health marketers to identify areas that will be most responsive to marketing efforts aimed at curtailing negative hedonic consumption and thus implement more effective, region-specific initiatives. PMID:24617722

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

    PubMed

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

    2016-05-01

    Preconception wellness reflects a woman's overall health before conception as a strategy to affect health outcomes for the woman, the fetus, and the infant. Preconception wellness is challenging to measure because it attempts to capture health status before a pregnancy, which may be affected by many different service points within a health care system. The Clinical Workgroup of the National Preconception Health and Health Care Initiative proposes nine core measures that can be assessed at initiation of prenatal care to index a woman's preconception wellness. A two-stage web-based modified Delphi survey and a face-to-face meeting of key opinion leaders in women's reproductive health resulted in identifying seven criteria used to determine the core measures. The Workgroup reached unanimous agreement on an aggregate of nine preconception wellness measures to serve as a surrogate but feasible assessment of quality preconception care within the larger health community. These include indicators for: 1) pregnancy intention, 2) access to care, 3) preconception multivitamin with folic acid use, 4) tobacco avoidance, 5) absence of uncontrolled depression, 6) healthy weight, 7) absence of sexually transmitted infections, 8) optimal glycemic control in women with pregestational diabetes, and 9) teratogenic medication avoidance. The focus of the proposed measures is to quantify the effect of health care systems on advancing preconception wellness. The Workgroup recommends that health care systems adopt these nine preconception wellness measures as a metric to monitor performance of preconception care practice. Over time, monitoring these baseline measures will establish benchmarks and allow for comparison within and among regions, health care systems, and communities to drive improvements. PMID:27054935

  14. An examination of the Total Quality Management (TQM) concept given current Federal/DoD competition initiatives

    NASA Astrophysics Data System (ADS)

    Stabile, Michael E.

    1992-06-01

    Quality is vital to our defense and quality improvement is key to increasing productivity. The Department of Defense (DoD) Total Quality Management (TQM) effort has been given top priority by the Secretary of Defense. Many questions exist concerning the problems encountered when implementing TQM throughout DoD. This thesis looks at the compatibility of the TQM philosophy with current Federal Acquisition Regulation competition requirements. The writer concludes that the TQM philosophy implementation is compatible with existing competition policy.

  15. Trends in Characteristics of Children Served by the Children’s Mental Health Initiative: 1994–2007

    PubMed Central

    Walrath, Christine; Garraza, Lucas Godoy; Stephens, Robert; Azur, Melissa; Miech, Richard; Leaf, Philip

    2009-01-01

    Data from 14 years of the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program were used to understand the trends of the emotional and behavioral problems and demographic characteristics of children entering services. The data for this study were derived from information collected at intake into service in 90 sites who received their initial federal funding between 1993 and 2004. The findings from this study suggest children entering services later in a site’s funding cycle had lower levels of behavioral problems and children served in sites funded later in the 14 year period had higher levels of behavioral problems. Females have consistently entered services with more severe problems and children referred from non-mental health sources, younger children, and those from non-white racial/ethnic backgrounds have entered system of care services with less severe problems. The policy and programming implications, as well as implications for local system of care program development and implementation are discussed. PMID:19641987

  16. Implementing global knowledge in local practice: a WHO lung health initiative in Nepal.

    PubMed

    ten Asbroek, A H A; Delnoij, D M J; Niessen, L W; Scherpbier, R W; Shrestha, N; Bam, D S; Gunneberg, C; van der Hor, C W; Klazinga, N S

    2005-09-01

    Clinical practice guidelines are used widely to improve the quality of primary health care in different health systems, including those of low-income countries. Often developed at international level and adapted to national contexts to increase the feasibility of effective uptake, guideline initiatives aim to transfer global scientific knowledge into local practice. The WHO's Practical Approach to Lung Health (PAL) is an example of such an initiative and is currently being developed to improve the quality of care for youths and adults with respiratory diseases. We assessed ex-ante the feasibility of successful implementation of PAL in a pilot programme in rural Nepal, studying three components: the quality of the innovation (i.e. the guidelines), the effectiveness of the implementation strategy (i.e. training) and the receptiveness of the social system of health staff at all levels (i.e. social and organizational characteristics). We assessed the guideline innovation with the AGREE instrument for guidelines, the intended implementation strategy by critical comparison with literature on effective strategies, and the social system with both a stakeholder analysis and a descriptive analysis of the health care system at district level. This ex-ante assessment of an adaptive local implementation of international WHO guidelines showed that in July 2002 the 'implementability' of the package was challenged on the three components studied. To increase the chances of successful implementation, the national guideline development process should be improved and the implementation strategy needs to be upgraded. In order to successfully transfer global knowledge into local practice, we need to develop additional multifactorial sustained interventions that tackle other culture-specific and health system-specific barriers as well. The primary health workers are key informants for these barriers. PMID:16000368

  17. 77 FR 22355 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-13

    .../1980)), and Secretary of Labor's Order No. 1-2012 (77 FR 3912 (1/25/2012)). Signed at Washington, DC... Federal Agency Recordkeeping rule; and H1N1 recommendations the Secretary of Labor (Secretary)...

  18. Moving science into state child and adolescent mental health systems: Illinois' evidence-informed practice initiative.

    PubMed

    Starin, Amy C; Atkins, Marc S; Wehrmann, Kathryn C; Mehta, Tara; Hesson-McInnis, Matthew S; Marinez-Lora, A; Mehlinger, Renee

    2014-01-01

    In 2005, the Illinois State Mental Health Authority embarked on an initiative to close the gap between research and practice in the children's mental health system. A stakeholder advisory council developed a plan to advance evidence informed practice through policy and program initiatives. A multilevel approach was developed to achieve this objective, which included policy change, stakeholder education, and clinician training. This article focuses on the evidence-informed training process designed following review of implementation research. The training involved in-person didactic sessions and twice-monthly telephone supervision across 6 cohorts of community based clinicians, each receiving 12 months of training. Training content initially included cognitive behavioral therapy and behavioral parent training and was adapted over the years to a practice model based on common element concepts. Evaluation based on provider and parent report indicated children treated by training clinicians generally showed superior outcomes versus both a treatment-as-usual comparison group for Cohorts 1 to 4 and the statewide child population as a whole after 90 days of care for Cohorts 5 to 6. The results indicated primarily moderate to strong effects for the evidence-based training groups. Moving a large public statewide child mental health system toward more effective services is a complex and lengthy process. These results indicate training of community mental health providers in Illinois in evidence-informed practice was moderately successful in positively impacting child-level functional outcomes. These findings also influenced state policy in committing resources to continuing the initiative, even in difficult economic times. PMID:24175571

  19. Predictors of Initial Engagement in Child Anxiety Mental Health Specialty Services

    PubMed Central

    Zerr, Argero A.; Pina, Armando A.

    2013-01-01

    Background Child and family mental health services remain largely underutilized despite the relatively high rate of youth suffering from mental, emotional, and behavioral (MEB) disorders. As such, it is important to address challenges and examine factors related to child mental health service use and engagement, especially when it comes to children in need of services for anxiety. Objective Informed by the Behavioral Model of Health Services Use (BMHS), the present study sought to examine predictors of service use and engagement for families seeking assistance for their anxious children. Initial levels of engagement in culturally tailored services were predicted from predisposing characteristics (e.g., child age, ethnicity), enabling resources (e.g., Spanish services, transportation), and need characteristics (e.g., child clinical severity). Method Participants included Latino (n = 126) and Caucasian (n = 116) families who presented to a specialty clinic due to child emotional and behavior problems related to anxiety. Initial service utilization and engagement was assessed along the following levels toward services care: (1) initiated contact and completed a clinical intake, (2) completed a home screen, and (3) completed an on-site diagnostic assessment. All procedures were culturally tailored to the presenting needs of families. Results Predisposing characteristics, enabling resources and need characteristics emerged as significant predictors of child mental health service use, with some variations. Child age, ethnicity, referral source, and enabling resources predicted completion of a home screen. Proximity to services predicted completion of the on-site diagnostic assessment. Conclusion Knowledge of factors that predict engagement in child mental health services can help identify avenues to promote service utilization, especially among ethnic minority children and families. Our culturally tailored approach to serving families appears to be promising in bridging

  20. Applying a global justice lens to health systems research ethics: an initial exploration.

    PubMed

    Pratt, Bridget; Hyder, Adnan A

    2015-03-01

    Recent scholarship has considered what, if anything, rich people owe to poor people to achieve justice in global health and the implications of this for international research. Yet this work has primarily focused on international clinical research. Health systems research is increasingly being performed in low and middle income countries and is essential to reducing global health disparities. This paper provides an initial description of the ethical issues related to priority setting, capacity-building, and the provision of post-study benefits that arise during the conduct of such research. It presents a selection of issues discussed in the health systems research literature and argues that they constitute ethical concerns based on their being inconsistent with a particular theory of global justice (the health capability paradigm). Issues identified include the fact that priority setting for health systems research at the global level is often not driven by national priorities and that capacity-building efforts frequently utilize one-size-fits-all approaches. PMID:25843119

  1. Using data to guide action in polio health communications: experience from the Polio Eradication Initiative (PEI).

    PubMed

    Taylor, Sebastian; Shimp, Lora

    2010-01-01

    Health communication is increasingly considered a priority element of investments and interventions intended to improve personal and public health (Piotrow et al., 1997). But a prevailing focus in health communication on information, education, awareness, and knowledge--and their assumed relation to changing behaviour among target individuals or households--can underestimate the complexity of wider ecological conditions that influence and limit individual, household, and even community choices and capacity to choose. Experience from the Polio Eradication Initiative (PEI)--drawing on evidence from the India and Nigeria country programmes--provides some insights into how the health communication interventions can be strengthened through the adoption of a more holistic ecological model of people and their health-related behaviours analysed in the context of larger social, economic, political, and cultural forces (see, for example, Kelly et al., 2008). In particular, polio eradication health communication offers useful lessons in the importance of generating and using data of sufficient quality to enable a more ecological analysis--combining and measuring specific communication inputs and epidemiological "outputs." PMID:20455166

  2. Using photovoice as a participatory evaluation tool in Kaiser Permanente's Community Health Initiative.

    PubMed

    Kramer, Leila; Schwartz, Pamela; Cheadle, Allen; Rauzon, Suzanne

    2013-09-01

    Photovoice is a community-based participatory research method that provides participants who traditionally have little voice in community policy decisions, with training in photography, ethics, critical dialogue, photo captioning, and policy advocacy. Photovoice has been used primarily as a needs assessment and advocacy tool and only rarely as a pre-/postintervention evaluation method. This article describes the use of Photovoice as a participatory evaluation method in the Community Health Initiative, a 6-year, multisite community-based obesity prevention initiative, sponsored by Kaiser Permanente. Fifty community participants (including six youth) from six Community Health Initiative communities used photos and captions to identify, from their perspective, the most significant accomplishments from the initiative at both baseline and follow-up. Accomplishments identified included increased access to fresh/healthy food in local neighborhoods; policy changes supporting a "healthy eating, active living" community; increased access to physical activity; changes to the built environment creating increased neighborhood walkability/safety; and leadership development. PMID:23159999

  3. The Monterey County Health Initiative. A post-mortem analysis of a California Medicaid demonstration project.

    PubMed

    Aved, B M

    1987-01-01

    Twenty months after the California State Department of Health Services turned its Medicaid program in Monterey County over to a local health care authority, the Monterey County Health Initiative (MCHI), the state terminated the pilot project in favor of a return to fee-for-service reimbursement. The MCHI, plagued from its inception with shaky provider support and a flawed program design, failed to demonstrate its anticipated cost savings. The key features of this failure were overly generous fees for primary case managers, inadequate utilization control measures, a general hesitancy to assume the necessary gatekeeper function, and a management information system that was not fully operational until well into the implementation of the program. Policy implications and recommendations for future state-sponsored Medicaid demonstration projects are discussed. PMID:3543525

  4. The Laboratory Efficiencies Initiative: Partnership for Building a Sustainable National Public Health Laboratory System

    PubMed Central

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

    2013-01-01

    Beginning in early 2011, the Centers for Disease Control and Prevention and the Association of Public Health Laboratories launched the Laboratory Efficiencies Initiative (LEI) to help public health laboratories (PHLs) and the nation's entire PHL system achieve and maintain sustainability to continue to conduct vital services in the face of unprecedented financial and other pressures. The LEI focuses on stimulating substantial gains in laboratories' operating efficiency and cost efficiency through the adoption of proven and promising management practices. In its first year, the LEI generated a strategic plan and a number of resources that PHL directors can use toward achieving LEI goals. Additionally, the first year saw the formation of a dynamic community of practitioners committed to implementing the LEI strategic plan in coordination with state and local public health executives, program officials, foundations, and other key partners. PMID:23997300

  5. [THE PERSPECTIVES OF DEVELOPMENT OF HEALTH CARE OF THE RUSSIAN FEDERATION].

    PubMed

    Schepin, O P; Korotkikh, R V

    2015-01-01

    The article considers actual conditions and characteristics of reformation of health care of Russia. The comparison is applied to such sectoral aspects as decentralization, medical care accessibility, public sector of health care, health of healthy population, resources distribution, medical insurance, paid medical services, etc. The comprehensive approach is proposed to resolving problems of national health care and alternatives of main direction of sectoral development. PMID:27116828

  6. The Bamako Initiative in Benin and Guinea: improving the effectiveness of primary health care.

    PubMed

    Levy-Bruhl, D; Soucat, A; Osseni, R; Ndiaye, J M; Dieng, B; De Bethune, X; Diallo, A T; Conde, M; Cisse, M; Moussa, Y; Drame, K; Knippenberg, R

    1997-06-01

    The objective of the health system revitalization undergone in Benin and Guinea since 1986 is to improve the effectiveness of primary health care at the periphery. Second in a series of five, this article presents the results of an analysis of data from the health centres involved in the Bamako Initiative in Benin and Guinea since 1988. Data for the expanded programme of immunization, antenatal care and curative care, form the core of the analysis which confirms the improved effectiveness of primary health care at the peripheral level over a period of six years. The last available national data show a DPT3 immunization coverage of 80% in 1996 in Benin and 73% in 1995 in Guinea. In the Bamako Initiative health centres included in our analysis, the average immunization coverage, as measured by the adequate coverage indicator, increased from 19% to 58% in Benin and from less than 5% to 63% in Guinea between 1989 to 1993. Average antenatal care coverage has increased from 5% in Benin and 3% in Guinea to 43% in Benin and 51% Guinea. Utilization of coverage with curative care has increased from less than 0.05 visit per capita per year to 0.34 in Guinea and from 0.09 visit per capita per year to 0.24 in Benin. Further analysis attempts to uncover the reasons which underlie the different levels of effectiveness obtained in individual health centres. Monitoring and microplanning through a problem-solving approach permit a dynamic process of adaptation of strategies leading to a step by step increase of coverage over time. However, the geographical location of centres represents a constraint in that certain districts in both countries face accessibility problems. Outreach activities are shown to play an especially positive role in Guinea, in improving both immunization and antenatal care coverage. PMID:10173106

  7. Establishing a health demographic surveillance site in Bhaktapur district, Nepal: initial experiences and findings

    PubMed Central

    2012-01-01

    Background A health demographic surveillance system (HDSS) provides longitudinal data regarding health and demography in countries with coverage error and poor quality data on vital registration systems due to lack of public awareness, inadequate legal basis and limited use of data in health planning. The health system in Nepal, a low-income country, does not focus primarily on health registration, and does not conduct regular health data collection. This study aimed to initiate and establish the first HDSS in Nepal. Results We conducted a baseline survey in Jhaukhel and Duwakot, two villages in Bhaktapur district. The study surveyed 2,712 households comprising a total population of 13,669. The sex ratio in the study area was 101 males per 100 females and the average household size was 5. The crude birth and death rates were 9.7 and 3.9/1,000 population/year, respectively. About 11% of births occurred at home, and we found no mortality in infants and children less than 5 years of age. Various health problems were found commonly and some of them include respiratory problems (41.9%); headache, vertigo and dizziness (16.7%); bone and joint pain (14.4%); gastrointestinal problems (13.9%); heart disease, including hypertension (8.8%); accidents and injuries (2.9%); and diabetes mellitus (2.6%). The prevalence of non-communicable disease (NCD) was 4.3% (95% CI: 3.83; 4.86) among individuals older than 30 years. Age-adjusted odds ratios showed that risk factors, such as sex, ethnic group, occupation and education, associated with NCD. Conclusion Our baseline survey demonstrated that it is possible to collect accurate and reliable data in a village setting in Nepal, and this study successfully established an HDSS site. We determined that both maternal and child health are better in the surveillance site compared to the entire country. Risk factors associated with NCDs dominated morbidity and mortality patterns. PMID:22950751

  8. Private initiatives and policy options: recent health system experience in India.

    PubMed

    Purohit, B C

    2001-03-01

    In the recent past the impact of structural adjustment in the Indian health care sector has been felt in the reduction in central grants to States for public health and disease control programmes. This falling share of central grants has had a more pronounced impact on the poorer states, which have found it more difficult to raise local resources to compensate for this loss of revenue. With the continued pace of reforms, the likelihood of increasing State expenditure on the health care sector is limited in the future. As a result, a number of notable trends are appearing in the Indian health care sector. These include an increasing investment by non-resident Indians (NRIs) in the hospital industry, leading to a spurt in corporatization in the States of their original domicile and an increasing participation by multinational companies in diagnostics aiming to capture the potential of the Indian health insurance market. The policy responses to these private initiatives are reflected in measures comprising strategies to attract private sector participation and management inputs into primary health care centres (PHCs), privatization or semi-privatization of public health facilities such as non-clinical services in public hospitals, innovating ways to finance public health facilities through non-budgetary measures, and tax incentives by the State governments to encourage private sector investment in the health sector. Bearing in mind the vital importance of such market forces and policy responses in shaping the future health care scenario in India, this paper examines in detail both of these aspects and their implications for the Indian health care sector. The analysis indicates that despite the promising newly emerging atmosphere, there are limits to market forces; appropriate refinement in the role of government should be attempted to avoid undesirable consequences of rising costs, increasing inequity and consumer exploitation. This may require opening the health

  9. Evaluation of the Healthy School Meals Initiative in Texas Private Schools and Residential Child Care Institutions for Federal Fiscal Years 1997 and 1998.

    ERIC Educational Resources Information Center

    Ahmad, Mahassen

    In 1995 the United States Department of Agriculture (USDA) developed the Health School Menus Initiative (HSMI) to ensure that school age children are provided meals that are consistent with dietary guidelines and current nutrition information. The USDA developed review instruments to evaluate the implementation of the HSMI nationwide. These…

  10. Wisconsin's Lifecourse Initiative for Healthy Families: application of the maternal and child health life course perspective through a regional funding initiative.

    PubMed

    Frey, Catherine A; Farrell, Philip M; Cotton, Quinton D; Lathen, Lorraine S; Marks, Katherine

    2014-02-01

    National experts are calling for more integrated approaches such as the life course perspective to reduce health disparities and achieve greater health equity. The translation and application of the life course perspective is therefore of great interest to public health planners, policy makers and funders to promote community-wide improvements in maternal and child health. However, few organizations have applied the life course perspective in designing strategic funding initiatives. For over three decades, Wisconsin has observed persistent racial disparities in birth outcomes. This complex public health issue led to the development of the Lifecourse Initiative for Health Families, a regional multi-million dollar funding initiative created and supported by the Wisconsin Partnership Program of the University of Wisconsin School of Medicine and Public Health (Created by the UW SMPH from an endowment following the conversion of Blue Cross Blue Shield United of Wisconsin, the Partnership Program makes investments in research, education, and public health and prevention initiatives that improve health and reduce health disparities in the state.). Over a 2-year period, the program funded four collaboratives to adopt a life course perspective and develop strategic plans for improving African American birth outcomes. The Twelve-point plan to close the black-white gap in birth outcomes provided the framework for the planning process. Despite the conceptual challenges, the life course perspective was embraced by the collaboratives, challenged community assumptions on the root causes of poor birth outcomes and provided a unifying funding construct for organizing and planning complementary individual-level interventions with social and physical environmental change strategies. These integrated and complimentary approaches provide a long-term opportunity to address the persistent racial birth outcome disparity in Wisconsin. PMID:23595565

  11. Housing Characteristics and Children’s Respiratory Health in the Russian Federation

    PubMed Central

    Spengler, John D.; Jaakkola, Jouni J. K.; Parise, Helen; Katsnelson, Boris A.; Privalova, Larissa I.; Kosheleva, Anna A.

    2004-01-01

    Objectives. We studied housing characteristics, parental factors, and respiratory health conditions in Russian children. Methods. We studied a population of 5951 children from 9 Russian cities, whose parents answered a questionnaire on their children’s respiratory health, home environment, and housing characteristics. The health outcomes were asthma conditions, current wheeze, dry cough, bronchitis, and respiratory allergy. Results. Respiratory allergy and dry cough increased in association with the home being adjacent to traffic. Consistent positive associations were observed between some health conditions and maternal smoking during pregnancy, many health conditions and lifetime exposure to environmental tobacco smoke (ETS), and nearly all health conditions and water damage and molds in the home. Conclusions. Vicinity to traffic, dampness, mold, and ETS are important determinants of children’s respiratory health in Russia. PMID:15054021

  12. Management Knowledge and Skills Required in the Health Care System of the Federation Bosnia and Herzegovina

    PubMed Central

    Slipicevic, Osman; Masic, Izet

    2012-01-01

    Extremely complex health care organizations, by their structure and organization, operate in a constantly changing business environment, and such situation implies and requires complex and demanding health management. Therefore, in order to manage health organizations in a competent manner, health managers must possess various managerial skills and be familiar with problems in health care. Research, identification, analysis, and assessment of health management education and training needs are basic preconditions for the development and implementation of adequate programs to meet those needs. Along with other specific activities, this research helped to determine the nature, profile, and level of top-priority needs for education. The need for knowledge of certain areas in health management, as well as the need for mastering concrete managerial competencies has been recognized as top-priorities requiring additional improvement and upgrading. PMID:23922519

  13. Medicaid patients seen at federally qualified health centers use hospital services less than those seen by private providers.

    PubMed

    Rothkopf, Jennifer; Brookler, Katie; Wadhwa, Sandeep; Sajovetz, Michael

    2011-07-01

    Federally qualified health centers, also known as community health centers, play an essential role in providing health care to millions of Americans. In return for providing primary care to underserved, homeless, and migrant populations, these centers are reimbursed at a higher rate than other providers by public programs such as Medicaid. Under the Affordable Care Act of 2010, the role of the centers is expected to grow. To examine the quality of care that the centers provide, the Colorado Department of Health Care Policy and Financing compared the use of costly hospital-related services by Medicaid clients whose usual source of care was a community health center with the use by clients whose usual source of care was a private, fee-for-service provider. The study found that community health center users were about one-third less likely than the other group to have emergency department visits, inpatient hospitalizations, or preventable hospital admissions. Public funders such as states should work with community health centers to improve the quality and reduce the cost of care even further. PMID:21734208

  14. The PAR Framework Proof of Concept: Initial Findings from a Multi-Institutional Analysis of Federated Postsecondary Data

    ERIC Educational Resources Information Center

    Ice, Phil; Diaz, Sebastian; Swan, Karen; Burgess, Melissa; Sharkey, Mike; Sherrill, Jonathan; Huston, Dan; Okimoto, Hae

    2012-01-01

    Despite high enrollment numbers, postsecondary completion rates have generally remained unchanged for the past 30 years and half of these students do not attain a degree within six years of initial enrollment. Although online learning has provided students with a convenient alternative to face-to-face instruction, there remain significant…

  15. The India Local Initiatives Program: a model for expanding reproductive and child health services.

    PubMed

    Paxman, John M; Sayeed, Abu; Buxbaum, Ann; Huber, Sallie Craig; Stover, Charles

    2005-09-01

    The India Local Initiatives Program adapted a model used in Indonesia and Bangladesh to implement the government's reproductive and child health strategy. From 1999 to 2003, three Indian nongovernmental organizations (NGOs) provided services for 784,000 people in four northern states. The program established health committees in 620 villages, recruited and trained 1,850 community health volunteers, and added 232 sites to extend government services. Using three strategies--demand creation, increased access to services, and local capacity building--the NGOs increased contraceptive-use rates by 78 percent, on average; child immunizations by 67 percent; and antenatal care by 78 percent among the populations served. Community resources--such as local health personnel, community-supplied clinic sites, and community drug funds--added 40 cents to every dollar provided by donors. This model proved to be a suitable platform upon which to build health-care service delivery and create behavioral change, and the NGOs quickly found ways to sustain and expand services. PMID:16209178

  16. Interventions to increase initial appointment attendance in mental health services: a systematic review.

    PubMed

    Schauman, Oliver; Aschan, Lisa Ellinor; Arias, Nicole; Beards, Stephanie; Clement, Sarah

    2013-12-01

    OBJECTIVE Although nonattendance at initial appointments in mental health services is a substantial problem, the phenomenon is poorly understood. This review synthesized findings of randomized controlled trials (RCTs) of interventions to increase initial appointment attendance and determined whether theories or models contributed to intervention design. METHODS Six electronic databases were systematically searched, and reference lists of identified studies were also examined. Studies included were RCTs (including "quasi-randomized" controlled trials) that compared standard practice with an intervention to increase attendance at initial appointments in a sample of adults who had a scheduled initial appointment in a mental health or substance abuse service setting. RESULTS Of 144 potentially relevant studies, 21 met inclusion criteria. These studies were reported in 20 different research papers. Of these, 16 studies (N=3,673 participants) were included in the analyses (five were excluded because they reported only nonattendance at the initial appointment). Separate analyses were conducted for each intervention type (opt-in systems, telephone reminders and prompts, orientation and reminder letters, accelerated intake, preappointment completion of psychodynamic questionnaires, and "other"). Narrative synthesis was used for analysis because the high level of heterogeneity between studies precluded a meta-analysis. The results were mixed for all types of intervention. Some isolated high-quality studies of opt-in systems, orientation and reminder letters, and more novel interventions demonstrated a beneficial effect. CONCLUSIONS The synthesized findings indicated that orientation and reminder letters may have a small beneficial effect. Consistent evidence for the efficacy of other types of common interventions is lacking. More novel interventions, such as asking clients to formulate plans to deal with obstacles to attendance and giving clients a choice of therapist style

  17. Sexual initiation among adolescents (10 to 14 years old) and health behaviors

    PubMed Central

    Gonçalves, Helen; Machado, Eduardo Coelho; Soares, Ana Luiza Gonçalves; Camargo-Figuera, Fabio Alberto; Seering, Lenise Menezes; Mesenburg, Marília Arndt; Guttier, Marília Cruz; Barcelos, Raquel Siqueira; Buffarini, Romina; Assunção, Maria Cecília Formoso; Hallal, Pedro Curi; Menezes, Ana Maria Baptista

    2015-01-01

    Objective To assess the prevalence of sexual initiation until the age of 14 years old, as well as sociodemographic and behavioral factors. Methods In 2008, 4,325 from the 5,249 adolescents of the 1993 birth cohort in Pelotas, Rio Grande do Sul, were interviewed. Sexual initiation was defined as the first intercourse up to the age of 14 years old. The information was obtained by interviewing adolescents in their houses, during the 2008 follow-up. The analyzed variables were: skin color, asset index, maternal and adolescents’ schooling, experimental use of tobacco and alcohol, drunkenness episode, use of any illicit drug, illegal drug use by friends and involvement in fights during the past year. Use of condoms and contraceptive methods, number of partners and the age of sexual initiation were also analyzed. Results The prevalence of sexual initiation by the age of 14 was of 18.6%. Lower schooling, asset index and maternal education were related to higher prevalence of sexual initiation until the age of 14, as well as being male or being born to adolescent mothers. Sexual intercourse was also related to the behavioral variables analyzed. Among adolescent girls who had intercourse up to the age of 14, 30% did not use contraception and 18% did not use condoms in the last sexual intercourse. Boys reported a higher number of sexual partners than girls. Conclusion The results suggest a relationship between sexual intercourse (≤ 14 years) and some health-risk behaviors. The non-use of condoms and contraceptives may make them vulnerable to experiencing unwanted situations. Education and sociocultural strategies for health should be implemented from the beginning of adolescence. PMID:25651009

  18. WIC mothers' social environment and postpartum health on breastfeeding initiation and duration.

    PubMed

    Darfour-Oduro, Sandra Asantewaa; Kim, Juhee

    2014-12-01

    A low breastfeeding rate has been a consistent maternal and child health problem in the United States, especially for low-income families. Understanding mothers' social environment and overall well-being is important in determining how mothers will take care of themselves and their infants during the postnatal period in relation to the breastfeeding rate among low-income mothers. In this study, we examined the effects of the social environment of mothers enrolled in a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program in eastern Illinois and their postpartum health on breastfeeding initiation (n=103) and maintaining breastfeeding for at least 3 months (n=73). Using logistic regression models, a significant positive association (adjusted odds ratio [AOR]=3.47; 95% confidence interval [CI], 1.15-10.47; p=0.03) between marital status and breastfeeding initiation and a significant negative association (AOR=0.23; 95% CI, 0.06-0.88) between receiving food stamps and breastfeeding initiation were found. WIC mothers who were married were 4.1 times as likely to maintain any breastfeeding for at least 3 months than single mothers, and the association was significant (AOR=4.08; 95% CI, 1.36-12.27; p=0.01). The breastfeeding initiation rate was 77.7%, however, the mean±standard deviation age of the child when breastfeeding stopped was 2.2±1.4 months. There was a nonsignificant association between postpartum depression and breastfeeding initiation and maintaining any breastfeeding for 3 months. This study has shown that the familial environment of mothers plays a very important role in improving breastfeeding rates among WIC mothers. In addition, there is a negative relationship between using a food assistance program and breastfeeding among low-income women. PMID:25188784

  19. The Structured Operational Research and Training Initiative for public health programmes.

    PubMed

    Ramsay, A; Harries, A D; Zachariah, R; Bissell, K; Hinderaker, S G; Edginton, M; Enarson, D A; Satyanarayana, S; Kumar, A M V; Hoa, N B; Tweya, H; Reid, A J; Van den Bergh, R; Tayler-Smith, K; Manzi, M; Khogali, M; Kizito, W; Ali, E; Delaunois, P; Reeder, J C

    2014-06-21

    In 2009, the International Union Against Tuberculosis and Lung Disease (The Union) and Médecins sans Frontières Brussels-Luxembourg (MSF) began developing an outcome-oriented model for operational research training. In January 2013, The Union and MSF joined with the Special Programme for Research and Training in Tropical Diseases (TDR) at the World Health Organization (WHO) to form an initiative called the Structured Operational Research and Training Initiative (SORT IT). This integrates the training of public health programme staff with the conduct of operational research prioritised by their programme. SORT IT programmes consist of three one-week workshops over 9 months, with clearly-defined milestones and expected output. This paper describes the vision, objectives and structure of SORT IT programmes, including selection criteria for applicants, the research projects that can be undertaken within the time frame, the programme structure and milestones, mentorship, the monitoring and evaluation of the programmes and what happens beyond the programme in terms of further research, publications and the setting up of additional training programmes. There is a growing national and international need for operational research and related capacity building in public health. SORT IT aims to meet this need by advocating for the output-based model of operational research training for public health programme staff described here. It also aims to secure sustainable funding to expand training at a global and national level. Finally, it could act as an observatory to monitor and evaluate operational research in public health. Criteria for prospective partners wishing to join SORT IT have been drawn up. PMID:26399203

  20. Parents' Perspectives of School Mental Health Promotion Initiatives Are Related to Parents' Self-Assessed Parenting Capabilities

    ERIC Educational Resources Information Center

    Askell-Williams, Helen

    2016-01-01

    Achieving broad-scale parent engagement with school initiatives has proven elusive. This article reports survey data from 287 Maltese parents about their perceptions of the quality of their child's school's initiatives for promoting students' wellbeing and mental health. Findings indicate that, on average, parents rated school initiatives highly.…

  1. ''Newly Invited ... into Government'': Origins of Federal Government Information on Maternal and Child Health

    ERIC Educational Resources Information Center

    Pierce, Jennifer Burek

    2004-01-01

    The Sheppard-Towner Act, popularly known as the Maternity and Infancy Act of 1921, was one of the first pieces of federal legislation designed to address the concerns of nationally enfranchised women voters. The Act also represented one of the earliest instances of U.S. women acting as producers and consumers of government information. In response…

  2. 78 FR 77399 - Basic Health Program: Proposed Federal Funding Methodology for Program Year 2015

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-23

    ... through Exchanges. In the September 25, 2013 Federal Register (78 FR 59122), we published a proposed rule...-adult coverage through BHP), household size, and income range as a percentage of FPL. Thus, there would.../Files/Downloads/market-reforms-guidance-2-25-2013.pdf . Both children and adults under age 21...

  3. 78 FR 60653 - Federal Employees Health Benefits Program: Members of Congress and Congressional Staff

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-02

    ... Abortion Services OPM received over 59,000 comments regarding coverage of abortion services for Members of... Congress and congressional staff include abortion services. Current law prohibits the use of Federal funds to pay for abortions, except in the case of rape, incest, or when the life of the woman is...

  4. "Unless They Are Kept Alive": Federal Indian Schools and Student Health, 1878-1918

    ERIC Educational Resources Information Center

    Dejong, David H.

    2007-01-01

    During the first decades of the federal government's Indian boarding schools, stories of morbidity and mortality among students were prevalent. In August 1915 Commissioner of Indian Affairs Cato Sells arrived in San Francisco to address the Congress of Indian Progress, an organization dedicated to the social advancement of American Indians. Waxing…

  5. 29 CFR 500.133 - Substantive Federal and State safety and health standards defined.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., DEPARTMENT OF LABOR REGULATIONS MIGRANT AND SEASONAL AGRICULTURAL WORKER PROTECTION Motor Vehicle Safety and Insurance for Transportation of Migrant and Seasonal Agricultural Workers, Housing Safety and Health...

  6. 29 CFR 500.133 - Substantive Federal and State safety and health standards defined.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., DEPARTMENT OF LABOR REGULATIONS MIGRANT AND SEASONAL AGRICULTURAL WORKER PROTECTION Motor Vehicle Safety and Insurance for Transportation of Migrant and Seasonal Agricultural Workers, Housing Safety and Health...

  7. Perceptions of interprofessionalism in health professional students participating in a novel community service initiative.

    PubMed

    Tsang, Erica S; Cheung, Christopher C; Sakakibara, Todd

    2016-01-01

    Interprofessional collaboration is integral to effective patient care in today's healthcare system. Early exposure to other professions in a hands-on manner during education can be helpful for future practice. However, opportunities for interprofessional education are typically faculty driven and remain limited. Thirty-eight students from different health professions at the University of British Columbia worked collaboratively to promote cardiovascular risk reduction in Vancouver's Downtown Eastside. Student attitudes toward interprofessionalism were assessed using the Interdisciplinary Education Perception Scale (IEPS). While 38 participants (55%) completed the survey prior to participation in this initiative, only 21 individuals completed the follow-up survey After participation, there were significant improvements in the competency and autonomy (p = 0.02) and perception of actual cooperation (p = 0.04). Students did not report any difference in their perceived need for cooperation after participation in the initiative. These results suggest that student-led community service initiatives can be an effective method for interprofessional education amongst health professional students. PMID:26790043

  8. The Border Environmental Health Initiative-investigating the transboundary Santa Cruz watershed

    USGS Publications Warehouse

    Norman, Laura M.; Callegary, James; van Riper, Charles, III; Gray, Floyd

    2010-01-01

    In 2004 the U.S. Geological Survey (USGS) launched the Border Environmental Health Initiative (BEHI), a major project encompassing the entire U.S.-Mexico border region. In 2009, a study of the Santa Cruz River Watershed (SCW), located in the border region of Arizona and Sonora, Mexico, was initiated as part of the BEHI. In this borderland region of the desert Southwest, human health and the ecosystems on which humans rely depend critically on limited water resources. Surface water is scarce during much of the year, and groundwater is the primary source for industrial, agricultural, and domestic use. In order to identify risks to water resources in the SCW, and the potential consequences to riparian ecosystems and ultimately human health, the USGS is using an interdisciplinary and integrative approach that incorporates the expertise of geographers, hydrologists, biologists, and geologists to track organic and inorganic contaminants and their effects from sources to sinks in sediment, water, plants, and animals. Existing groundwater and surface-water models are being used and modified to assess contaminant and sediment transport.

  9. Nutrition and health risks in the elderly: the nutrition screening initiative.

    PubMed Central

    Posner, B M; Jette, A M; Smith, K W; Miller, D R

    1993-01-01

    OBJECTIVES. The Nutrition Screening Initiative is a national collaborative effort committed to the identification and treatment of nutritional problems in older persons. METHODS. A 14-item checklist of characteristics associated with nutritional status was administered to a random sample of Medicare beneficiaries, aged 70 years and older, in New England. Regression analysis was used to derive item weights that would predict poor nutrient intakes and low perceived health status. Sensitivity and specificity values were reviewed to define low, moderate, and high nutritional risk scores. RESULTS. A revised checklist containing 10 yes/no items was adopted. Scores of 6 or more points defined persons at high nutritional risk. Twenty-four percent of the Medicare population was estimated to be at high nutritional risk according to the checklist. Among those in the high-risk group, 56% perceived their health to be "fair" or "poor" and 38% had dietary intakes below 75% of the recommended dietary allowances for three or more nutrients. CONCLUSIONS. The Nutrition Screening Initiative Checklist is a brief, easily scored instrument that can accurately identify noninstitutionalized older persons at risk for low nutrient intake and health problems. PMID:8328619

  10. Reviewing institutions of rural health centres: the Performance Initiative in Butare, Rwanda.

    PubMed

    Meessen, Bruno; Musango, Laurent; Kashala, Jean-Pierre I; Lemlin, Jackie

    2006-08-01

    In many low-income countries, performance of pyramidal health systems with a public purpose is not meeting the expectations and needs of the populations they serve. A question that has not been studied and tested sufficiently is, 'What is the right package of institutional mechanisms required for organisations and individuals working in these health systems?' This paper presents the experience of the Performance Initiative, an innovative contractual approach that has reshaped the incentive structure in place in two rural districts of Rwanda. It describes the general background, the initial analysis, the institutional arrangement and the results after 3 years of operations. At this stage of the experience, it shows that 'output-based payment + greater autonomy' is a feasible and effective strategy for improving the performance of public health centres. As part of a more global package of strategies, contracting-in approaches could be an interesting option for governments, donors and non-governmental organisations in their effort to achieve some of the Millennium Development Goals. PMID:16903893

  11. The effects of global health initiatives on country health systems: a review of the evidence from HIV/AIDS control

    PubMed Central

    Biesma, Regien G; Brugha, Ruairí; Harmer, Andrew; Walsh, Aisling; Spicer, Neil; Walt, Gill

    2009-01-01

    This paper reviews country-level evidence about the impact of global health initiatives (GHIs), which have had profound effects on recipient country health systems in middle and low income countries. We have selected three initiatives that account for an estimated two-thirds of external funding earmarked for HIV/AIDS control in resource-poor countries: the Global Fund to Fight AIDS, TB and Malaria, the World Bank Multi-country AIDS Program (MAP) and the US President's Emergency Plan for AIDS Relief (PEPFAR). This paper draws on 31 original country-specific and cross-country articles and reports, based on country-level fieldwork conducted between 2002 and 2007. Positive effects have included a rapid scale-up in HIV/AIDS service delivery, greater stakeholder participation, and channelling of funds to non-governmental stakeholders, mainly NGOs and faith-based bodies. Negative effects include distortion of recipient countries’ national policies, notably through distracting governments from coordinated efforts to strengthen health systems and re-verticalization of planning, management and monitoring and evaluation systems. Sub-national and district studies are needed to assess the degree to which GHIs are learning to align with and build the capacities of countries to respond to HIV/AIDS; whether marginalized populations access and benefit from GHI-funded programmes; and about the cost-effectiveness and long-term sustainability of the HIV and AIDS programmes funded by the GHIs. Three multi-country sets of evaluations, which will be reporting in 2009, will answer some of these questions. PMID:19491291

  12. Working with Local, State and Federal Partners to Address Health Education Needs of Hurricane Katrina Evacuees in Houston: A CDC Case Study

    ERIC Educational Resources Information Center

    Hoover, D. Michele; Dopson, Stephanie; Drehobl, Patricia

    2010-01-01

    For health educators to successfully meet the challenges of responding to public health emergencies, it is important to establish and understand the role of collaborations with local, state and federal partners in identifying potential public health issues and to develop theory-based models or strategies to address these issues before, during and…

  13. 45 CFR 61.8 - Reporting Federal or State criminal convictions related to the delivery of a health care item or...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... related to the delivery of a health care item or service. 61.8 Section 61.8 Public Welfare DEPARTMENT OF... Reporting Federal or State criminal convictions related to the delivery of a health care item or service. (a... providers, suppliers, and practitioners related to the delivery of a health care item or service...

  14. 45 CFR 61.8 - Reporting Federal or State criminal convictions related to the delivery of a health care item or...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... related to the delivery of a health care item or service. 61.8 Section 61.8 Public Welfare DEPARTMENT OF... Reporting Federal or State criminal convictions related to the delivery of a health care item or service. (a... providers, suppliers, and practitioners related to the delivery of a health care item or service...

  15. Universal health coverage in emerging economies: findings on health care utilization by older adults in China, Ghana, India, Mexico, the Russian Federation, and South Africa

    PubMed Central

    Peltzer, Karl; Williams, Jennifer Stewart; Kowal, Paul; Negin, Joel; Snodgrass, James Josh; Yawson, Alfred; Minicuci, Nadia; Thiele, Liz; Phaswana-Mafuya, Nancy; Biritwum, Richard Berko; Naidoo, Nirmala; Chatterji, Somnath

    2014-01-01

    Background and objective The achievement of universal health coverage (UHC) in emerging economies is a high priority within the global community. This timely study uses standardized national population data collected from adults aged 50 and older in China, Ghana, India, Mexico, the Russian Federation, and South Africa. The objective is to describe health care utilization and measure association between inpatient and outpatient service use and patient characteristics in these six low- and middle-income countries. Design Secondary analysis of data from the World Health Organization’s Study on global AGEing and adult health Wave 1 was undertaken. Country samples are compared by socio-demographic characteristics, type of health care, and reasons for use. Logistic regressions describe association between socio-demographic and health factors and inpatient and outpatient service use. Results In the pooled multi-country sample of over 26,000 adults aged 50-plus, who reported getting health care the last time it was needed, almost 80% of men and women received inpatient or outpatient care, or both. Roughly 30% of men and women in the Russian Federation used inpatient services in the previous 3 years and 90% of men and women in India used outpatient services in the past year. In China, public hospitals were the most frequently used service type for 52% of men and 51% of women. Multivariable regression showed that, compared with men, women were less likely to use inpatient services and more likely to use outpatient services. Respondents with two or more chronic conditions were almost three times as likely to use inpatient services and twice as likely to use outpatient services compared with respondents with no reported chronic conditions. Conclusions This study provides a basis for further investigation of country-specific responses to UHC. PMID:25363363

  16. [Adaptation to climate change-associated health risks as a task of environmental health protection. Analysis of a nationwide investigation by the Federal Environment Agency].

    PubMed

    Kandarr, J; Reckert, H; Mücke, H-G

    2014-10-01

    The German Strategy for Adaptation to Climate Change (DAS, 2008) identified 'human health' as an important sector with a need for adaptation. In line with the DAS, the Federal Environment Agency (UBA) and the Robert Koch Institute jointly elaborated guidelines for decision makers and stakeholders. Building on these, in 2013/2014, UBA has conducted a nationwide survey, collecting data on completed, ongoing and planned adaptation measures. UBA also analysed 32 adaptation strategies of the Federal States. Selected best practice examples of potential health-related prevention and adaptation measures concerning heat stress, UV radiation exposure and the spread of Ambrosia artemisiifolia are presented in this article. The data collection with more than 330 activities can be found on the website of the German National Environment and Health Action Plan (APUG; www.apug.de , in German only). In the course of this project, the APUG website was also significantly extended with comprehensive information and overviews on health risks of climate change, hence creating a central platform for this particular topic. PMID:25227958

  17. Computers and Mental Health Care Delivery. A Resource Guide to Federal Information.

    ERIC Educational Resources Information Center

    Levy, Louise

    Prepared for the mental health professional or administrator who is involved in the planning, developing, or implementation of an automated information system in a mental health environment, this guide is limited to the electronic processing and storage of information for management and clinical functions. Management application areas include…

  18. 78 FR 48337 - Federal Employees Health Benefits Program: Members of Congress and Congressional Staff

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ... reasonable reading of the statute is that enrollment in FEHB contracted plans under chapter 89 of title 5... of Meaning of ``Health Benefit Plan Under This Chapter'' As Used in 5 U.S.C. 8905(b) and 5 U.S.C...'' or ``approving'' health benefit plans that are offered through the Exchanges, there is no doubt...

  19. Youth mental health first aid: a description of the program and an initial evaluation

    PubMed Central

    2011-01-01

    Background Adolescence is the peak age of onset for mental illness, with half of all people who will ever have a mental illness experiencing their first episode prior to 18 years of age. Early onset of mental illness is a significant predictor for future episodes. However, adolescents and young adults are less likely than the population as a whole to either seek or receive treatment for a mental illness. The knowledge and attitudes of the adults in an adolescent's life may affect whether or not help is sought, and how quickly. In 2007, the Youth Mental Health First Aid Program was launched in Australia with the aim to teach adults, who work with or care for adolescents, the skills needed to recognise the early signs of mental illness, identify potential mental health-related crises, and assist adolescents to get the help they need as early as possible. This paper provides a description of the program, some initial evaluation and an outline of future directions. Methods The program was evaluated in two ways. The first was an uncontrolled trial with 246 adult members of the Australian public, who completed questionnaires immediately before attending the 14 hour course, one month later and six months later. Outcome measures were: recognition of schizophrenia or depression; intention to offer and confidence in offering assistance; stigmatising attitudes; knowledge about adolescent mental health problems and also about the Mental Health First Aid action plan. The second method of evaluation was to track the uptake of the program, including the number of instructors trained across Australia to deliver the course, the number of courses they delivered, and the uptake of the YMHFA Program in other countries. Results The uncontrolled trial found improvements in: recognition of schizophrenia; confidence in offering help; stigmatising attitudes; knowledge about adolescent mental health problems and application of the Mental Health First Aid action plan. Most results were

  20. Integration of Oral Health Into the Well-Child Visit at Federally Qualified Health Centers: Study of 6 Clinics, August 2014–March 2015

    PubMed Central

    Gebel, Christina; Vargas, Clemencia; Geltman, Paul; Walter, Ashley; Garcia, Raul I.; Tinanoff, Norman

    2016-01-01

    Introduction Early childhood caries, the most common chronic childhood disease, affects primary dentition and can impair eating, sleeping, and school performance. The disease is most prevalent among vulnerable populations with limited access to pediatric dental services. These same children generally receive well-child care at federally qualified health centers. The objective of this study was to identify facilitators and barriers to the integration of oral health into pediatric primary care at health centers to improve problem recognition, delivery of preventive measures, and referral to a dentist. Methods We collected and analyzed background data and data from structured observations and 39 interviews with administrators and staff at 6 clinics in 2 states, Maryland and Massachusetts. Results Participants valued oral health across professional roles but cited limited time, lack of training and expertise, low caregiver literacy, and lack of shared medical and dental electronic records as barriers to cooperation. Facilitators included an upper-level administration with the vision to see the value of integration, designated team leaders, and champions. An administration’s vision, not structural determinants, patient characteristics, or geographic location, predicted the level of integration. Interviewees generated multilevel recommendations to promote delivery of oral health preventive measures and services during a well-child visit. Conclusion Poor oral health contributes to health care disparities. Barriers to integrating dental care into pediatric medical practice at health centers must be overcome to improve oral health for children living in poverty, with a disability, at a rural address, or any combination of these. Implementation will require adapting delivery systems to support multidisciplinary collaboration. Strategies suggested here may point the way to enhancing children’s oral health. PMID:27126556

  1. Improving Health Care Linkages for Persons: The Cook County Jail Medicaid Enrollment Initiative.

    PubMed

    Riedel, Lauren E; Barry, Colleen L; McGinty, Emma E; Bandara, Sachini N; Webster, Daniel W; Toone, Robert E; Huskamp, Haiden A

    2016-07-01

    The Affordable Care Act has created an unprecedented opportunity to enroll criminal justice-involved individuals in Medicaid. Many jurisdictions within Medicaid expansion states are launching efforts to enroll this population in health insurance and provide connections to services in the community. This study examined one early initiative to enroll individuals in Medicaid during the intake process at the Cook County Jail in Illinois. Several elements were identified as critical to the program's success: key early planning decisions made within the context of a cross-agency group, a high level of dedication among partnering organization leaders, program buy-in among security personnel, and the unique way in which Cook County verifies inmate identity for Medicaid enrollment purposes. These features can potentially guide other jurisdictions attempting to implement similar initiatives. PMID:27302704

  2. Patient initiatives and physician-challenging behaviors: the views of Israeli health professionals.

    PubMed

    Shye, D; Javetz, R; Shuval, J T

    1990-01-01

    The views of Israeli physicians, nurses, physiotherapists, occupational therapists, and medical social workers were compared regarding patient behaviors which express autonomy and initiative in the doctor-patient interaction. The data show that these professionals do not view such behaviors positively. Gender is relevant to the physicians' views, with male physicians, particularly the specialists, having the least negative views, and female residents and general practitioners the most negative. Allied health professionals express less negative views than the physicians, and attribute to the physicians more negative views than those actually expressed by the physicians. There is overall agreement among the different professional groups about the relative acceptability of these behaviors. Those which threaten the physician's dominance in the process of diagnosis and prescription of treatment are rejected outright, while others are tolerated but not accepted. The findings are interpreted in the light of the status-related motives of Israeli health professionals. PMID:2244213

  3. Promoting policy and environmental change using photovoice in the Kaiser Permanente Community Health Initiative.

    PubMed

    Kramer, Leila; Schwartz, Pamela; Cheadle, Allen; Borton, J Elaine; Wright, Merrick; Chase, Charlie; Lindley, Corina

    2010-05-01

    Creative ways must be found to engage both community residents and political leaders around policy and environmental solutions to public health issues. Photovoice is a community-based, participatory approach to documentary photography that provides people with training on photography, ethics, critical discussion, and policy advocacy. Photovoice projects have been implemented across the nation as part of Kaiser Permanente's Community Health Initiative-a community-based obesity prevention effort. This article focuses on the first Photovoice project implemented in three communities in Colorado. Photovoice themes related to healthy eating and active living include a lack of access to healthy food choices in stores and schools, unsafe street crossings and sidewalks, and the need to redevelop certain areas to encourage safe recreation. The involvement of policy leaders in the project combined with several dissemination activities has contributed to healthier food offerings in schools and neighborhoods and city planning efforts that emphasize walkability and access to healthy food, and park revitalization. PMID:19843702

  4. Local newspapers, community partnerships, and health improvement projects: their roles in a comprehensive community initiative.

    PubMed

    Hubbell, Anne P; Dearing, James W

    2003-10-01

    To understand local media's role in a community health initiative, a content analysis of 1,709 paragraphs from 173 news articles and editorials was undertaken. The articles were from three local newspapers, one in each of three communities. Analyses focused on article content combined with reflective personal interviews with local campaign directors. Results suggest that local campaign staff can be successful using commercial media to achieve objectives. Surprisingly, most coverage was not about projects with observable and easily identifiable benefits for local residents, but rather partnerships among influential residents engaged in decision-making about such projects. We conclude that the politics of resource distribution is more newsworthy to local journalists than tangible topics like access to health information, insurance coverage, and service provision. PMID:14535601

  5. Implementing the World Mental Health Survey Initiative in Portugal – rationale, design and fieldwork procedures

    PubMed Central

    2013-01-01

    Background The World Mental Health Survey Initiative was designed to evaluate the prevalence, the correlates, the impact and the treatment patterns of mental disorders. This paper describes the rationale and the methodological details regarding the implementation of the survey in Portugal, a country that still lacks representative epidemiological data about psychiatric disorders. Methods The World Mental Health Survey is a cross-sectional study with a representative sample of the Portuguese population, aged 18 or older, based on official census information. The WMH-Composite International Diagnostic Interview, adapted to the Portuguese language by a group of bilingual experts, was used to evaluate the mental health status, disorder severity, impairment, use of services and treatment. Interviews were administered face-to-face at respondent’s dwellings, which were selected from a nationally representative multi-stage clustered area probability sample of households. The survey was administered using computer-assisted personal interview methods by trained lay interviewers. Data quality was strictly controlled in order to ensure the reliability and validity of the collected information. Results A total of 3,849 people completed the main survey, with 2,060 completing the long interview, with a response rate of 57.3%. Data cleaning was conducted in collaboration with the WMHSI Data Analysis Coordination Centre at the Department of Health Care Policy, Harvard Medical School. Collected information will provide lifetime and 12-month mental disorders diagnoses, according to the International Classification of Diseases and to the Diagnostic and Statistical Manual of Mental Disorders. Conclusions The findings of this study could have a major influence in mental health care policy planning efforts over the next years, specially in a country that still has a significant level of unmet needs regarding mental health services organization, delivery of care and epidemiological

  6. Student Leadership in Public Health Advocacy: Lessons Learned From the Hepatitis B Initiative

    PubMed Central

    Hsu, Leslie D.; DeJong, William; Hsia, Renee; Chang, Michael; Ryou, Marvin; Yeh, Ellen

    2003-01-01

    Increasing hepatitis B vaccination rates for Asian Americans and Pacific Islanders is a priority. Laws requiring vaccination prior to school enrollment have helped, yet many youths remain unvaccinated. The Hepatitis B Initiative (HBI), launched in 1997 and operated by public health and medical school students, provides free screenings and vaccinations to Boston’s Asian American/Pacific Islander community, with a focus on youths. By October 2002, 997 HBI patients from Boston’s Chinatown had received free hepatitis B screenings. Of these, 384 patients (39%) were deemed susceptible to the hepatitis B virus and provided with free vaccination. PMID:12893606

  7. Student leadership in public health advocacy: lessons learned from the hepatitis B initiative.

    PubMed

    Hsu, Leslie D; DeJong, William; Hsia, Renee; Chang, Michael; Ryou, Marvin; Yeh, Ellen

    2003-08-01

    Increasing hepatitis B vaccination rates for Asian Americans and Pacific Islanders is a priority. Laws requiring vaccination prior to school enrollment have helped, yet many youths remain unvaccinated. The Hepatitis B Initiative (HBI), launched in 1997 and operated by public health and medical school students, provides free screenings and vaccinations to Boston's Asian American/Pacific Islander community, with a focus on youths. By October 2002, 997 HBI patients from Boston's Chinatown had received free hepatitis B screenings. Of these, 384 patients (39%) were deemed susceptible to the hepatitis B virus and provided with free vaccination. PMID:12893606

  8. Community Asthma Initiative to Improve Health Outcomes and Reduce Disparities Among Children with Asthma.

    PubMed

    Woods, Elizabeth R; Bhaumik, Urmi; Sommer, Susan J; Chan, Elaine; Tsopelas, Lindsay; Fleegler, Eric W; Lorenzi, Margarita; Klements, Elizabeth M; Dickerson, Deborah U; Nethersole, Shari; Dulin, Rick

    2016-01-01

    Black and Hispanic children are hospitalized with complications of asthma at much higher rates than white children. The Boston Children's Hospital Community Asthma Initiative (CAI) provides asthma case management and home visits for children from low-income neighborhoods in Boston, Massachusetts, to address racial/ethnic health disparities in pediatric asthma outcomes. CAI objectives were to evaluate 1) case management data by parent/guardian report for health outcomes and 2) hospital administrative data for comparison between intervention and comparison groups. Data from parent/guardian reports indicate that CAI decreased the number of children with any (one or more) asthma-related hospitalizations (decrease of 79% at 12 months) and any asthma-related emergency department visits (decrease of 56% at 12 months) among children served, most of whom were non-Hispanic black or Hispanic. Hospital administrative data also indicate that the number of asthma-related hospitalizations per child significantly decreased among CAI participants compared with a comparison group. The CAI model has been replicated in other cities and states with adaptations to local cultural and systems variations. Health outcome and cost data have been used to contribute to a business case to educate legislators and insurers about outcomes and costs for this enhanced approach to care. Strong partnerships with public health, community, and housing agencies have allowed CAI to leverage its outcomes to expand systemic changes locally and statewide to reduce asthma morbidity. PMID:26916259

  9. New health and safety initiatives at the Department of Energy (DOE)

    NASA Technical Reports Server (NTRS)

    Ziemer, Paul L.

    1993-01-01

    This document touches on some of the more important lessons learned and the more noteworthy initiatives DOE has put into motion in the last three years to protect the health and safety of our contractor employees. What we have learned in the process should come as no surprise to those of you who have been working in the field: (1) that management commitment to safety and health is critical to a successful program; (2) that meaningful employee participation in all aspects of the program enhances its effectiveness at every level; and (3) that the dedication and expertise of medical and occupational safety and health professionals are needed if the challenging problems presented by the complex and technologically advanced environment at DOE facilities are to be overcome. I believe that we have made a good beginning in the long and arduous task of building an Occupational Safety and Health Program that will serve as a model for others, and I can assure you that we intend to continue our efforts to protect every worker within the complex from occupational injury and disease.

  10. A Pilot Physical Activity Initiative to Improve Mental Health Status amongst Iranian Institutionalized Older People

    PubMed Central

    Matlabi, Hossein; Shaghaghi, Abdolreza; Amiri, Shahriar

    2014-01-01

    Background: Sufficient level of physical activity may promote overall and mental health of old people. This study was carried out to investigate the practi­cability of a physical activity promotion initiative amongst institutionalized older people in Tabriz, Iran. Methods: Purposive sampling method was used in this semi-experimental study to recruit 31 older people living in a selected residential care in Tabriz. Moderate-intensity aerobic and mus­cle-strengthening activity was planned for those who had not severe baseline cognitive impairment or were not too frail to undertake the survey. The General Health Questionnaire (GHQ-28) was used to measure mental health status be­fore and after intervention through a face-to-face interview. Descriptive statistics, Wilkcoxon rank-sum, Mann-Whitney U and Chi-Square tests were employed to analyses the data. Results: The applied intervention was significantly improved status of physical health, anxiety and insomnia, social dysfunction and severe depression. Conclusion: Incorporation of physical activity promotion programs into routines of older people residential care homes in Iran is feasible but may need training of physical activity specialists to work with older people based on their physical endurance and limitations. PMID:25097839

  11. Participatory GIS in action, a public health initiative from Kerala, India

    NASA Astrophysics Data System (ADS)

    Soman, B.

    2014-11-01

    Community ownership is essential for sustainable public health initiatives. The advantages of getting active involvement of homebound village women in a public health campaign to establish community health surveillance are being reported in this paper. With the support of the local self government authorities, we had selected 120 village women, and they were given extensive training on various healthcare schemes, home based management of local ailments, leadership skills and survey techniques. Afterwards, they had been asked to share their knowledge with at least 10-15 women in their neighbourhood. This had improved their status in the neighbourhood, as more and more people started getting their advice on healthcare and social services related matters. Subsequently, they had collected the socio-demographic and morbidity details of the entire households, including the geometric coordinates (longitude and latitude) of the households and public offices. In this process, they began to use the geographic position system (GPS) machines, dismissing the myth that women are not that techno savvy, further improving their acceptability in the community. Many among them were seen proudly describing the implications of the thematic maps to the village people and line department staff in the monthly subcentre meetings. Many were offered seats in the local body elections by leading political parties, a few of them did stand in the elections and three of them had won the elections. This experience reinforces our belief that the empowerment of villagers with newer technology could be a public health tool with much wider positive implications.

  12. Legal rights during pandemics: federalism, rights and public health laws--a view from Australia.

    PubMed

    Bennett, B

    2009-03-01

    Pandemic influenza will cause significant social and economic disruption. Legal frameworks can play an important role in clarifying the rights and duties of individuals, communities and governments for times of crisis. In addressing legal frameworks, there is a need for jurisdictional clarity between different levels of government in responding to public health emergencies. Public health laws are also informed by our understandings of rights and responsibilities for individuals and communities, and the balancing of public health and public freedoms. Consideration of these issues is an essential part of planning for pandemic influenza. PMID:19249066

  13. The Children of Russia Are in Danger! The Danger Comes from the Ministry of Health and the Ministry of General and Professional Education of the Russian Federation.

    ERIC Educational Resources Information Center

    Medvedeva, Irina; Shishova, Tat'iana

    1998-01-01

    Argues against the international project called "Sex Education for the Schoolchildren of Russia" that is a sex education program intended for students in the seventh through ninth grades and is carried out by the Ministry of General and Professional Education of the Russian Federation and the Ministry of Health of the Russian Federation (CMK)

  14. 76 FR 5340 - Federal Advisory Committee; Defense Health Board (DHB) Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    ... following Defense Health Board Subcommittees will present updates to the Board: Trauma and Injury... proposed research priorities of the Trauma and Injury Subcommittee. Pursuant to 5 U.S.C. 552b, as...

  15. 78 FR 63969 - Defense Health Board; Notice of Federal Advisory Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ... Defense Health Board will take place. DATES: Monday, November 18, 2013 8:00 a.m.-8:45 a.m. (Administrative Working Meeting) 9:00 a.m.-12:00 p.m. (Open Session) 12:00 p.m.-1:00 p.m. (Administrative Working Meeting... Working Meeting) ADDRESSES: Defense Health Headquarters (DHHQ), Pavilion Salons B-C, 7700 Arlington...

  16. 50 Years of U.S. Federal Support to Promote the Health of Mothers, Children and Handicapped Children in America: 1935-1985. A review of Federal Appropriations and Allocations to States for Health and Related Programs of Title V of the Social Security Act of 1935 and the Omnibus Reconciliaton Act of 1981.

    ERIC Educational Resources Information Center

    Magee, Eamon M.; Pratt, Magaret W.

    This document provides information on U.S. federal support for maternal and child health programs from 1935-1985. After a brief history of the Children's Bureau, which was the first unit of the federal government concerned with maternal and child health, funding and allocation formulas for Title V of the Social Security Act of 1935 are examined.…

  17. Awareness of Federal Dietary Guidance in persons aged 16 years and older: results from the National Health and Nutrition Examination Survey 2005-2006.

    PubMed

    Wright, Jacqueline D; Wang, Chia-Yih

    2011-02-01

    The National Health and Nutrition Examination Survey 2005-2006 included questions on awareness of the Dietary Guidelines for Americans (DGA), the Food Guide Pyramid, and the 5 A Day for Better Health Program. Prevalence of awareness of federal dietary guidance was estimated and differences were tested across demographic traits, health characteristics, and diet-related attitudes and behavior. The continuous National Health and Nutrition Examination Survey uses a nationally representative cross-sectional sample design. The analytic sample consisted of 5,499 persons aged 16 years and older with complete data. Among persons aged 16 years and older, 83.8% had heard of at least one of the initiatives: 49.2% had heard of the DGA, 80.6% had heard of the Food Guide Pyramid, and 51.2% had heard of the 5 A Day program. There was a linear trend of decreasing awareness of at least one of the guidance efforts with increasing age. Differences by sex, race/ethnicity, education, and income were also observed. Differences by body mass index were not statistically significant; however, significant differences were seen with fatalistic beliefs about body weight. Differences by smoking, self-assessed diet quality, and eating out frequency were not statistically significant after adjustment for sex, age, race/ethnicity, education, and income. These results may be useful in promotion of the upcoming edition of the DGA and to suggest population groups that may benefit from strengthened and more innovative education efforts at the public health program level and at the clinic level. PMID:21272706

  18. [The federal health expenditure on the uninsured population: Mexico 1980-1995].

    PubMed

    Lara, A; Gómez-Dantés, O; Urdapilleta, O; Bravo, M L

    1997-01-01

    In the last fifteen years Mexico suffered several economic crisis which have negatively affected public expenditure in social welfare and, as a consequence, public expenditure in health. This paper discusses the relationship between the adjustment policies adopted to confront these crisis and public expenditure in health care for the non-insured population, as well as the regional distribution of this expenditure. In part one, the evolution of general public expenditure, public expenditure in social welfare, and public expenditure in health between 1980 and 1995 is described. In part two, the distribution of public health expenditure for the non-insured population among the five regions in which the country was divided by the National Health Survey II is discussed. The main conclusion of this paper is that, between 1980 and 1995, the public expenditure gaps that have existed for a long time in Mexico among regions remained unchanged. These gaps basically affect the southern states of the country, are not related to health needs, and may deepen in view of the new relative cuts in public expenditure in social welfare announced by the new administration. PMID:9254433

  19. Women's Health Initiative diet intervention did not increase macular pigment optical density in an ancillary study of a subsample of the Women's Health Initiative.

    PubMed

    Moeller, Suzen M; Voland, Rick; Sarto, Gloria E; Gobel, Vicki L; Streicher, Sharyn L; Mares, Julie A

    2009-09-01

    In this study, we examined the impact of long-term (>8 y), low-fat, high-fruit and -vegetable diets on levels of lutein and zeaxanthin in the macula of the retina, as indicated by the OD of macular pigment. Macular pigment OD, measured by heterochromatic flicker photometry, was compared in women aged 60-87 y, who, 7-18 mo earlier (median 12 mo), had been in the dietary modification intervention (n = 158) or comparison (n = 236) groups of the Women's Health Initiative (WHI) at the Madison, WI site for a mean of 8.5 y. Women in the intervention group ate more fruits and vegetables (mean +/- SEM) (6.1 +/- 0.2 vs. 4.6 +/- 0.2 servings/d; P < 0.0001) and had higher intakes of lutein and zeaxanthin from foods and supplements (2.7 +/- 0.2 vs. 2.1 +/- 0.1 mg/d; P = 0.0003) than the comparison group. However, macular pigment density did not differ between the intervention (0.36 +/- 0.02 OD units) and comparison (0.35 +/- 0.01 OD units) groups. It tended to be higher (11%; P = 0.11) in women consuming lutein and zeaxanthin in the highest compared with the lowest quintile (median 6.4 vs. 1.1 mg/d). The increase in fruit and vegetable intake among dietary modification participants of this WHI subsample was not of sufficient magnitude to alter the mean density of retinal carotenoids, given other existing dietary conditions in this sample. PMID:19587126

  20. Access to In-Network Emergency Physicians and Emergency Departments Within Federally Qualified Health Plans in 2015

    PubMed Central

    Dorner, Stephen C.; Camargo, Carlos A.; Schuur, Jeremiah D.; Raja, Ali S.

    2016-01-01

    Introduction Under regulations established by the Affordable Care Act, insurance plans must meet minimum standards in order to be sold through the federal Marketplace. These standards to become a qualified health plan (QHP) include maintaining a provider network sufficient to assure access to services. However, the complexity of emergency physician (EP) employment practices – in which the EPs frequently serve as independent contractors of emergency departments, independently establish insurance contracts, etc… – and regulations governing insurance repayment may hinder the application of network adequacy standards to emergency medicine. As such, we hypothesized the existence of QHPs without in-network access to EPs. The objective is to identify whether there are QHPs without in-network access to EPs using information available through the federal Marketplace and publicly available provider directories. Results In a national sample of Marketplace plans, we found that one in five provider networks lacks identifiable in-network EPs. QHPs lacking EPs spanned nearly half (44%) of the 34 states using the federal Marketplace. Conclusion Our data suggest that the present regulatory framework governing network adequacy is not generalizable to emergency care, representing a missed opportunity to protect patient access to in-network physicians. These findings and the current regulations governing insurance payment to EPs dis-incentivize the creation of adequate physician networks, incentivize the practice of balance billing, and shift the cost burden to patients. PMID:26823925

  1. Characteristics of federally licensed firearms retailers and retail establishments in the United States: initial findings from the firearms licensee survey.

    PubMed

    Wintemute, Garen J

    2013-02-01

    Firearms have widely supported legitimate purposes but are also frequently used in violent crimes. Owners and senior executives of federally licensed firearms dealers and pawnbrokers are a potentially valuable source of information on retail commerce in firearms, links between legal and illegal commerce, and policies designed to prevent the firearms they sell from being used in crimes. To our knowledge, there has been no prior effort to gather such information. In 2011, we conducted the Firearms Licensee Survey on a probability sample of 1,601 licensed dealers and pawnbrokers in the United States believed to sell 50 or more firearms per year. This article presents details of the design and execution of the survey and describes the characteristics of the respondents and their business establishments. The survey was conducted by mail, using methods developed by Dillman and others. Our response rate was 36.9 % (591 respondents), similar to that for other establishment surveys using similar methods. Respondents had a median age of 54; 89 % were male, 97.6 % were White, and 98.1 % were non-Hispanic. Those who held licenses under their own names had been licensed for a median of 18 years. A large majority of 96.3 % agreed that "private ownership of guns is essential for a free society"; just over half (54.9 %) believed that "it is too easy for criminals to get guns in this country." A match between the job and a personal interest in the shooting sports was the highest-ranking reason for working as a firearms retailer; the highest-ranking concerns were that "there are too many 'gun control' regulations" and that "the government might confiscate my guns." Most respondents (64.3 %) were gun dealers, with significant variation by region. Residential dealers accounted for 25.6 % of all dealers in the Midwest. Median annual sales volume was 200 firearms for both dealers and pawnbrokers. Dealers appeared more likely than pawnbrokers to specialize; they were more likely

  2. Building capacity of Indian scientists to conduct systematic reviews in child health: an ICMR initiative.

    PubMed

    Sinha, Anju; Shah, Dheeraj; Tharyan, Prathap

    2015-03-01

    Knowledge and training in evidence-based medicine is essential for informed clinical decision-making and treatment choices. Systematic reviews identify, appraise and synthesize research-based evidence and present it in accessible format. The Indian Council of Medical Research has promoted evidence-based medicine in India by establishing an Advanced Center for evidence based medicine that hosted the South Asian Cochrane Network and Center at the Christian Medical College, Vellore; procuring a national subscription to The Cochrane Library making it accessible to all Indian scientists; and establishing a Center for Advanced research on evidence- based child health at Post Graduate Institute of Medical Education and Research, Chandigarh. This article informs about a national level initiative by ICMR that aims to harness the translational potential of secondary research, by funding systematic reviews aligned to national health priorities selected through a national competitive process; and to provide training, mentoring, and quality assurance. A continuing scheme of funding high-quality systematic reviews on priority areas of Child Health may follow. PMID:25848991

  3. [Mixed design for the evaluation of the Mesoamerica Health 2015 initiative].

    PubMed

    Gutiérrez, Juan Pablo; Téllez-Rojo, Marta María; Torres, Pilar; Romero, Martín; Bertozzi, Stefano M

    2011-01-01

    Since the Salud Mesoamerica 2015 initiative (SM-2015) aim is to improve health and nutrition conditions of those most vulnerable in Mesoamerica, the goal of the evaluation is to generate evidence of the joint effectiveness of a package of interventions designed to improve the health conditions. We propose a mix design for the evaluation, which will allow to know the magnitude of changes attributable to the interventions, as well as the meanings of these changes for the target population, taking into account the specificities of each country. The main axis of this design is a locality panel where information about individuals, households, and health facilities (first and second level) will also be collected. The evaluation design described in this paper was developed between June and December, 2009, and it was integrated during workshops in Cuernavaca (Mexico), Managua (Nicaragua), and San Jose (Costa Rica). The proposed design will allow to generate evidence about the joint effectiveness of the package of interventions proposed for the SM-2015. The success of this design rests on the political commitment of countries and donors. PMID:22344383

  4. Insights from the Women's Health Initiative: individualizing risk assessment for hormone therapy decisions.

    PubMed

    Wild, Robert A; Manson, JoAnn E

    2014-11-01

    Identifying appropriate candidates for menopausal hormone therapy (HT) is challenging given the complex profile of risks and benefits associated with treatment. Most professional societies agree that HT should not be used for chronic disease prevention. Recent findings from the Women's Health Initiative and other randomized trials suggest that a woman's age, proximity to menopause, underlying cardiovascular risk factor status, and various biological characteristics may modify health outcomes with HT. An emerging body of evidence suggests that it may be possible to assess individual risk and therefore better predict who is more likely to have favorable outcomes versus adverse effects when taking HT. Thus, once a woman is identified as a potential candidate for HT due to moderate-to-severe menopausal symptoms or other indications, risk stratification may be an important tool for minimizing patient risk. This individualized approach holds great promise for improving the safety of HT. We review here the evidence for this approach, focusing on vascular health because of limited data on other outcomes. The ultimate goal of this research is to develop a personalized risk/benefit prediction model to be used when a woman seeks therapy for symptom management. Patient centered outcomes including quality of life and sense of well-being should also be incorporated and will directly impact the benefit: risk ratio and compliance. Additional research on hormone dose, formulation, and route of delivery will be important for improving this model. PMID:25321420

  5. The labor movement's role in gaining federal safety and health standards to protect America's workers.

    PubMed

    Weinstock, Deborah; Failey, Tara

    2014-11-01

    In the United States, unions sometimes joined by worker advocacy groups (e.g., Public Citizen and the American Public Health Association) have played a critical role in strengthening worker safety and health protections. They have sought to improve standards that protect workers by participating in the rulemaking process, through written comments and involvement in hearings; lobbying decision-makers; petitioning the Department of Labor; and defending improved standards in court. Their efforts have culminated in more stringent exposure standards, access to information about the presence of potentially hazardous toxic chemicals, and improved access to personal protective equipment-further improving working conditions in the United States. PMID:25261030

  6. An evaluation of an initiative to improve Veterans Health Administration mental health services: broad impacts of the VHA's Mental Health Strategic Plan.

    PubMed

    Greenberg, Greg A; Rosenheck, Robert A

    2009-12-01

    In federal fiscal year (FY) 2005 the Department of Veterans Affairs (VA) implemented the comprehensive Mental Health Strategic Plan (MHSP). This study used performance measures from six broad domains to examine changes in the overall delivery of mental health services in the VA since the implementation of the MHSP. Performance measures from fiscal year 2004, the year before implementation of the MHSP, were compared with measures from fiscal years 2005, 2006, and 2007, the first 3 years of MHSP implementation. We combined heterogeneous performance measures within domains through the use of standardized scores or "z-scores." An overall improvement of 0.32 standardized units was observed from FY 2004 to FY 2007, representing moderate to large changes by conventional standards. The domains with the greatest improvement (>1.0 standard deviation units) from FY 2004 to FY 2007 were population coverage/access, outpatient care quality, economic performance (primarily efficiency), and global functioning. There was a 0.3 standard deviation decline in inpatient satisfaction and a slight increase in reliance on inpatient care. Overall improvement in VA mental health care was thus substantial and continuing. PMID:20055066

  7. Contribution of the Nordic School of Public Health to the public mental health research field: a selection of research initiatives, 2007-2014.

    PubMed

    Forsman, Anna K; Fredén, Lars; Lindqvist, Rafael; Wahlbeck, Kristian

    2015-08-01

    The field of public mental health has been defined by an expert group convened by the Nordic School of Public Health (NHV) as encompassing the experience, occurrence, distribution and trajectories of positive mental health and mental health problems and their determinants; mental health promotion and prevention of mental disorders; as well as mental health system policies, governance and organization. The mental health priorities of the Nordic Council of Ministers in 2010 signalled a mutual Nordic exchange of knowledge in the following thematic areas: child and adolescent mental health; working life and mental health; mental health in older people; strengthening the role of primary care in mental health service provision; stronger involvement of users and carers; and reduction of use of coercion in psychiatric care. Efforts to realize these priorities included commissioning the Nordic Research Academy for Mental Health, an NHV-based network of research institutions with a common interest in mental health research across the Nordic countries, to develop, organize and follow-up projects on public mental health. The research initiatives included mental health policy analysis, register-based research and research focused on the users' perspective in a Nordic context, as well as EU-level research policy analysis. The public mental health research conducted at the NHV highlighted the complexity of mental health and emphasized that the broad determinants of mental health need to be increasingly addressed in both public health research and practice. For example, health promotion actions, improved access to health care, a healthy alcohol policy and prevention of suicides and violence are all needed to reduce the life expectancy gap - a red flag indicator of public health inequalities. By exchanging knowledge and best practice, the collaboration between the Nordic countries contributes to the welfare of the region. The expertise and traditions developed at the NHV are of

  8. Armed Conflict in the Federally Administered Tribal Areas of Pakistan and the Role of NGOs in Restoring Health Services.

    PubMed

    Khan, Muhammad Ammad; Xiaoying, Jian; Kanwal, Nazish

    2016-07-01

    The Federally Administered Tribal Areas (FATA) of Pakistan have been a hotbed of terrorists' violence since 9/11. The unremitted armed conflict in the region and limited role of the government in delivering fundamental health services has left the people at the disposal of nongovernmental organizations (NGOs). This research aims at empirically substantiating the successful strategies adopted by the NGOs to run their projects under threats and to know the perceptions of the community toward NGOs and their services. Triangulation methodology was adopted in collecting data. Based on results, the research found that health care is a highly demanded service in the study area, and the government does not have the capacity nor the resources to ensure decent health coverage for all the people of the region. NGOs indeed have a crucial role not only in building the capacity of the government and the community but also in restoring and providing health services in the region, but still many efforts are required to overcome the challenges they are facing. By implication, the research places forward some recommendations. PMID:27030112

  9. The Alaska Area Specimen Bank: a tribal-federal partnership to maintain and manage a resource for health research.

    PubMed

    Parkinson, Alan J; Hennessy, Thomas; Bulkow, Lisa; Smith, H Sally

    2013-01-01

    Banked biospecimens from a defined population are a valuable resource that can be used to assess early markers for illness or to determine the prevalence of a disease to aid the development of intervention strategies to reduce morbidity and mortality. The Alaska Area Specimen Bank (AASB) currently contains 266,353 residual biologic specimens (serum, plasma, whole blood, tissue, bacterial cultures) from 83,841 persons who participated in research studies, public health investigations and clinical testing conducted by the U.S. Public Health Service and Alaska Native tribal health organisations dating back to 1961. The majority (95.7%) are serum specimens, 77% were collected between 1981 and 1994 and 85% were collected from Alaska Native people. Oversight of the specimen bank is provided by a working group with representation from tribal, state and federal health organisations, the Alaska Area IRB and a specimen bank committee which ensures the specimens are used in accordance with policies and procedures developed by the working group. PMID:23599909

  10. Federal Policy Mandating Safer Cigarettes: A Hypothetical Simulation of the Anticipated Population Health Gains or Losses

    ERIC Educational Resources Information Center

    Tengs, Tammy O.; Ahmad, Sajjad; Moore, Rebecca; Gage, Eric

    2004-01-01

    If manufacturing a safer cigarette is technically possible--an open question--then mandating that tobacco manufacturers improve the safety of cigarettes would likely have both positive and negative implications for the nation's health. On the one hand, removing toxins may reduce the incidence of smoking-related diseases and premature mortality in…

  11. 75 FR 32972 - Federal Employees Health Benefits Program; Medically Underserved Areas for 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-10

    ..., North Dakota, Oklahoma, South Carolina, South Dakota, and Wyoming. Oklahoma has been added for the 2011 calendar year. DATES: Effective Date: January 1, 2011. FOR FURTHER INFORMATION CONTACT: Lynelle T. Frye... Employees Health Benefits (FEHB) Program for calendar year 2011. This is necessary to comply with...

  12. The sustainability of an Australian initiative designed to improve interdisciplinary collaboration in mental health care

    PubMed Central

    2013-01-01

    Background The Australian Mental Health Professionals Network (MHPN) is fostering a collaborative, interdisciplinary approach to mental health care through the establishment of local interdisciplinary networks of mental health professionals. This paper reports on those factors seen by MHPN participants and staff as having affected the formation and continuation of interdisciplinary networks, and therefore the likely sustainability of these groups. Method The paper draws on qualitative data from focus groups with mental health professionals participating in MHPN activities and MHPN staff. Results The findings suggest that MHPN’s approach to establishing sustainable interdisciplinary networks has been influenced by a number of factors at the micro-, meso-and macro levels. At the micro-level, factors such as clarity and structure of ongoing meetings, individual dynamics and the role of ‘champions’ can promote or constrain sustainability of ongoing networks. Those networks that had established following an initial workshop and had continued to meet as an interdisciplinary network tended to be led by well-respected co-ordinators, involve members who are enthusiastic and keen to learn from each other, have a flexible structure and meet regularly for a well-defined purpose. These features are underpinned by good communication between network members and with MHPN administration. At the meso- and macro-levels, the key issue relates to resourcing, as well as the wider policy context. Conclusions The support and practical resources provided by MHPN have been crucial in guiding successful networks as they form and continue to meet on a regular basis. The networks have also required internal leadership and support, and a clear purpose in order to form and to continue their activities. These findings are consistent with the literature, which states that sustainability of programs is reliant on factors at the project design and implementation level, as well as on factors

  13. Analysis & commentary. Health care reform is likely to widen federal budget deficits, not reduce them.

    PubMed

    Holtz-Eakin, Douglas; Ramlet, Michael J

    2010-06-01

    The federal government faces a daunting fiscal outlook, which makes the budgetary impact of the Patient Protection and Affordable Care Act even more important. The official Congressional Budget Office (CBO) analysis indicates modest deficit reduction over the next ten years and beyond. We examine the underpinnings of the CBO's projection and conclude that it is built on a shaky foundation of omitted costs, premiums shifted from other entitlements, and politically dubious spending cuts and revenue increases. A more comprehensive and realistic projection suggests that the new reform law will raise the deficit by more than $500 billion during the first ten years and by nearly $1.5 trillion in the following decade. PMID:20530343

  14. Intrauterine devices at six months: does patient age matter? Results from an urban family medicine Federally Qualified Health Center (FQHC) network

    PubMed Central

    Ravi, Anita; Prine, Linda; Waltermaurer, Eve; Miller, Natasha; Rubin, Susan E.

    2014-01-01

    Background Federally Qualified Health Centers (FQHCs) can address high unintended adolescent pregnancy rates in the United States by increasing access to intrauterine devices (IUDs) in underserved settings. Despite national guidelines endorsing IUDs in adolescents, some physicians remain concerned about IUD tolerance and safety in adolescents. Thus, we compared adolescents and adults in a family physician staffed FQHC network with regard to: (1) IUD post-insertion experience, (2) device discontinuation and (3) sexually transmitted infection (STI) rates. Methods We conducted a retrospective cohort study among women less than 36 years of age who had a 2011 IUD insertion at a New York City family physician staffed FQHC network. Results 684 women (27 % adolescents, 73% adults) were included. During the six month post-insertion period, 59% of adolescent and 43% of adults initiated IUD related post-insertion clinical contact, most commonly for bleeding changes and pelvic or abdominal pain. There were no significant differences between groups in IUD expulsion, removal or STI rates. Conclusions Urban FQHC providers may anticipate that, as compared to their adult IUD utilizers, adolescents will initiate more clinical follow-up visits post-insertion. However both groups will have similar clinical concerns, reasons for and rate of device discontinuation and low STI rates. PMID:25381080

  15. The Green Heart Initiative: Using Air Quality Information to Reduce Adverse Health Effects in Patients with Heart and Vascular Disease

    EPA Science Inventory

    The Green Heart Initiatives designed to raise public awareness about the role outdoor air pollution plays in cardiovascular health. Developed by the U.S. Environmental Protection Agency (EPA) to complement the national Million Hearts” initiative1, Green Heart seeks to teach healt...

  16. The Psychology School Mental Health Initiative: An Innovative Approach to the Delivery of School-Based Intervention Services

    ERIC Educational Resources Information Center

    Millar, Golden M.; Lean, Debra; Sweet, Susan D.; Moraes, Sabrina C.; Nelson, Victoria

    2013-01-01

    Evidence suggests that schools have, by default, become the primary mental health system for students in Canada. The goal of the present study was to design, implement, and evaluate the Psychology School Mental Health Initiative (PSMHI). The PSMHI is an innovative attempt to increase the capacity of school-based psychology staff to deliver…

  17. The Community-Engaged Scholarship for Health Collaborative: A National Change Initiative Focused on Faculty Roles and Rewards

    ERIC Educational Resources Information Center

    Seifer, Sarena D.; Wong, Kristine; Gelmon, Sherril B.; Lederer, Miriam

    2009-01-01

    This issue of Metropolitan Universities includes papers emanating from the work of the Community-Engaged Scholarship for Health Collaborative, a three-year (2004-2007) initiative designed to build capacity for community-engaged scholarship (CES) in health professional schools. As the core principles and challenges of CES are similar across…

  18. Finding the Impact in a Messy Intervention: Using an Integrated Design to Evaluate a Comprehensive Citywide Health Initiative

    ERIC Educational Resources Information Center

    Weitzman, Beth C.; Mijanovich, Tod; Silver, Diana; Brecher, Charles

    2009-01-01

    This article uses the evaluation of the Robert Wood Johnson Foundation's (RWJF) Urban Health Initiative (UHI), a 10-year effort to improve health and safety outcomes in distressed cities, to demonstrate the strength of an evaluation design that integrates theory of change and quasi-experimental approaches, including the use of comparison cities.…

  19. 76 FR 41221 - Federal Advisory Committee; Defense Health Board (DHB) Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... Board (DHB) announces that it will meet on August 8 and 9, 2011. Subject to the availability of space..., and complementary and alternative medicine use in the DoD. The Psychological Health External Advisory... of space, the DHB meeting from 9:30 a.m. to 12:30 p.m. and from 1:30 to 5 p.m. on August 8, 2011...

  20. A federal tax credit to encourage employers to offer health coverage.

    PubMed

    Meyer, J A; Wicks, E K

    2001-01-01

    Many firms that employ low-wage workers cannot afford to offer an employee health plan, and many of the uninsured work for such firms. This article makes the case for an employer tax credit, administered by the Internal Revenue Service, as a way to extend health coverage to uninsured workers and their families. The permanent, fixed-dollar, refundable credit would be available to all low-wage employers (those with average wages of $10 per hour and less), including those already offering coverage. The credit would be graduated depending on average wage: the maximum credit would equal 50% of the cost of a standard benefit package; the minimum would equal 30% of the package. It also would vary by family size and could be used to cover part-time and temporary workers. Participating employers would be required to pay at least 50% of the health insurance premium, proof of which would be shown on firms' tax returns. The paper provides justification for this approach. It closes with a discussion of strengths and weaknesses of this approach and alternative design features. PMID:11529516

  1. Evaluation of health care delivery integration: the case of the Russian Federation.

    PubMed

    Sheiman, Igor; Shevski, Vladimir

    2014-04-01

    Fragmentation in organization and discontinuities in the provision of medical care are problems in all health systems, whether it is the mixed public-private one in the USA, national health services in the UK, or insurance based one in Western Europe and Russia. In all of these countries a major challenge is to strengthen integration in order to enhance efficiency and health outcomes. This article assesses issues related to fragmentation and integration in conceptual terms and argues that key attributes of integration are teamwork, coordination and continuity of care. It then presents a summary of service integration problems in Russia and the results of a large survey of physicians concerning the attributes of integration. It is argued that characteristics of the national service delivery model don't ensure integration. The Semashko model is not an equivalent to the integrated model. Big organizational forms of service provision, like polyclinics and integrated hospital-polyclinics, don't have higher scores of integration indicators than smaller ones. Proposals to improve integration in Russia are presented with the focus on the regular evaluation of integration/fragmentation, regulation of integration activities, enhancing the role of PHC providers, economic incentives. PMID:24461718

  2. What if the Women's Health Initiative had used transdermal estradiol and oral progesterone instead?

    PubMed

    Simon, James A

    2014-07-01

    The author considers hypothetical comparisons between oral conjugated equine estrogens and transdermal estradiol and between oral medroxyprogesterone acetate and oral micronized progesterone for their effects on four primary outcomes of the Women's Health Initiative (WHI): cardiovascular disease risk, cerebrovascular disease risk, venous thromboembolism risk, and breast cancer risk. Although the discussion in this article focuses on transdermal estradiol delivered through patches, gels, or lotions, it could be broadened to include all forms of nonoral estrogen administration. After a brief review of the WHI and a survey of the relevant literature in which the safety of these various hormone therapies is assessed or compared, the author uses statistical methods to ascertain the attributable risk of venous thromboembolism for transdermal estradiol versus oral hormone therapy and imputes those risks into the WHI primary outcomes. PMID:24398406

  3. Depressive symptoms and longitudinal changes in cognition: Women's Health Initiative Study of Cognitive Aging

    PubMed Central

    Goveas, Joseph S.; Espeland, Mark A.; Hogan, Patricia E.; Tindle, Hilary A.; Shih, Regina A.; Kotchen, Jane M.; Robinson, Jennifer G.; Barnes, Deborah E.; Resnick, Susan M.

    2015-01-01

    Elevated Depressive symptoms (DS) are associated with incident mild cognitive impairment and probable dementia in postmenopausal women. We examined the association of elevated DS with domain-specific cognitive changes, and the moderating role of cardiovascular risk factor (CVRF) severity and cardiovascular disease (CVD). 2221 elderly women who participated in the Women's Health Initiative Study of Cognitive Aging were separated into those with (N = 204) and without (N = 2017) elevated DS. DS and multi-domain cognitive outcomes were measured annually for an average follow-up of 5.04 years. Women with elevated DS showed baseline multi-domain cognitive deficits, but longitudinal declines in global cognition only. Persistent DS was related to greater global cognition, and verbal knowledge and fluency, and memory declines. Significant DS-CVD interactions were observed cross-sectionally (but not longitudinally) for figural memory and fine motor speed. Future studies should investigate the role of nonvascular mechanisms linking DS and cognitive decline. PMID:24584465

  4. Building on Individual, State, and Federal Initiatives for Advance Care Planning, an Integral Component of Palliative and End-of-Life Cancer Care

    PubMed Central

    Epstein, Andrew S.; Volandes, Angelo E.; O'Reilly, Eileen M.

    2011-01-01

    Federal and state provisions for advance care planning—the process by which patients, families, and medical professionals plan for future and, in particular, end-of-life care—continue to receive attention. Such planning remains an integral component of palliative care, complementing the recognition and treatment of pain and other symptoms that patients with advanced malignancies and their families encounter. Historically, advance care planning interventions (particularly those involving advance directives) have been unable to consistently demonstrate positive outcomes for patients with life-threatening illnesses. However, more recent literature, including that on patients with cancer, illustrates that both patients and caregivers report improved quality of life and less distress after discussions with their health care teams about end-of-life care. Herein, we discuss recent federal and state public policy that focuses on advance care planning, suggesting the promise for care delivery improvements and the means by which existing barriers might be surmounted. These care delivery issues apply to several disease states but are particularly pertinent to the adult oncology setting. PMID:22379415

  5. Structural health and prognostics management for offshore wind turbines : an initial roadmap.

    SciTech Connect

    Griffith, Daniel Todd; Resor, Brian Ray; White, Jonathan Randall; Paquette, Joshua A.; Yoder, Nathanael C.

    2012-12-01

    Operations and maintenance costs for offshore wind plants are expected to be significantly higher than the current costs for onshore plants. One way in which these costs may be able to be reduced is through the use of a structural health and prognostic management system as part of a condition based maintenance paradigm with smart load management. To facilitate the creation of such a system a multiscale modeling approach has been developed to identify how the underlying physics of the system are affected by the presence of damage and how these changes manifest themselves in the operational response of a full turbine. The developed methodology was used to investigate the effects of a candidate blade damage feature, a trailing edge disbond, on a 5-MW offshore wind turbine and the measurements that demonstrated the highest sensitivity to the damage were the local pitching moments around the disbond. The multiscale method demonstrated that these changes were caused by a local decrease in the blade's torsional stiffness due to the disbond, which also resulted in changes in the blade's local strain field. Full turbine simulations were also used to demonstrate that derating the turbine power by as little as 5% could extend the fatigue life of a blade by as much as a factor of 3. The integration of the health monitoring information, conceptual repair cost versus damage size information, and this load management methodology provides an initial roadmap for reducing operations and maintenance costs for offshore wind farms while increasing turbine availability and overall profit.

  6. The CROWN Initiative: journal editors invite researchers to develop core outcomes in women’s health

    PubMed Central

    2014-01-01

    Clinical trials, systematic reviews and guidelines compare beneficial and non-beneficial outcomes following interventions. Often, however, various studies on a particular topic do not address the same outcomes, making it difficult to draw clinically useful conclusions when a group of studies is looked at as a whole. This problem was recently thrown into sharp focus by a systematic review of interventions for preterm birth prevention, which found that among 103 randomised trials, no fewer than 72 different outcomes were reported. There is a growing recognition among clinical researchers that this variability undermines consistent synthesis of the evidence, and that what is needed is an agreed standardised collection of outcomes - a "core outcomes set" - for all trials in a specific clinical area. Recognising that the current inconsistency is a serious hindrance to progress in our specialty, the editors of over 50 journals related to women's health have come together to support The CROWN (CoRe Outcomes in WomeN's health) Initiative. PMID:25050130

  7. The CROWN Initiative: journal editors invite researchers to develop core outcomes in women’s health

    PubMed Central

    2014-01-01

    Clinical trials, systematic reviews and guidelines compare beneficial and non-beneficial outcomes following interventions. Often, however, various studies on a particular topic do not address the same outcomes, making it difficult to draw clinically useful conclusions when a group of studies is looked at as a whole. This problem was recently thrown into sharp focus by a systematic review of interventions for preterm birth prevention, which found that among 103 randomised trials, no fewer than 72 different outcomes were reported. There is a growing recognition among clinical researchers that this variability undermines consistent synthesis of the evidence, and that what is needed is an agreed standardised collection of outcomes - a “core outcomes set” - for all trials in a specific clinical area. Recognising that the current inconsistency is a serious hindrance to progress in our specialty, the editors of over 50 journals related to women’s health have come together to support The CROWN (CoRe Outcomes in WomeN’s health) Initiative. PMID:24993666

  8. The CROWN initiative: journal editors invite researchers to develop core outcomes in women’s health

    PubMed Central

    2014-01-01

    Clinical trials, systematic reviews and guidelines compare beneficial and non-beneficial outcomes following interventions. Often, however, various studies on a particular topic do not address the same outcomes, making it difficult to draw clinically useful conclusions when a group of studies is looked at as a whole. This problem was recently thrown into sharp focus by a systematic review of interventions for preterm birth prevention, which found that among 103 randomised trials, no fewer than 72 different outcomes were reported. There is a growing recognition among clinical researchers that this variability undermines consistent synthesis of the evidence, and that what is needed is an agreed standardised collection of outcomes - a "core outcomes set" - for all trials in a specific clinical area. Recognising that the current inconsistency is a serious hindrance to progress in our specialty, the editors of over 50 journals related to women's health have come together to support The CROWN (CoRe Outcomes in WomeN's health) Initiative. PMID:25048583

  9. The CROWN initiative: journal editors invite researchers to develop core outcomes in women’s health

    PubMed Central

    2014-01-01

    Clinical trials, systematic reviews and guidelines compare beneficial and non-beneficial outcomes following interventions. Often, however, various studies on a particular topic do not address the same outcomes, making it difficult to draw clinically useful conclusions when a group of studies is looked at as a whole. This problem was recently thrown into sharp focus by a systematic review of interventions for preterm birth prevention, which found that among 103 randomised trials, no fewer than 72 different outcomes were reported. There is a growing recognition among clinical researchers that this variability undermines consistent synthesis of the evidence, and that what is needed is an agreed standardised collection of outcomes - a “core outcomes set” - for all trials in a specific clinical area. Recognising that the current inconsistency is a serious hindrance to progress in our specialty, the editors of over 50 journals related to women’s health have come together to support The CROWN (CoRe Outcomes in WomeN’s health) Initiative. PMID:24957208

  10. Urinary cadmium and estimated dietary cadmium in the Women's Health Initiative.

    PubMed

    Quraishi, Sabah M; Adams, Scott V; Shafer, Martin; Meliker, Jaymie R; Li, Wenjun; Luo, Juhua; Neuhouser, Marian L; Newcomb, Polly A

    2016-05-01

    Cadmium, a heavy metal dispersed in the environment as a result of industrial and agricultural applications, has been implicated in several human diseases including renal disease, cancers, and compromised bone health. In the general population, the predominant sources of cadmium exposure are tobacco and diet. Urinary cadmium (uCd) reflects long-term exposure and has been frequently used to assess cadmium exposure in epidemiological studies; estimated dietary intake of cadmium (dCd) has also been used in several studies. The validity of dCd in comparison with uCd is unclear. This study aimed to compare dCd, estimated from food frequency questionnaires, to uCd measured in spot urine samples from 1,002 participants of the Women's Health Initiative. Using linear regression, we found that dCd was not statistically significantly associated with uCd (β=0.006, P-value=0.14). When stratified by smoking status, dCd was not significantly associated with uCd both in never smokers (β=0.006, P-value=0.09) and in ever smokers (β=0.003, P-value=0.67). Our results suggest that because of the lack of association between estimated dCd and measured uCd, dietary estimation of cadmium exposure should be used with caution in epidemiologic studies. PMID:26015077

  11. Better Health for Our Children: A National Strategy. The Report of the Select Panel for the Promotion of Child Health to the United States Congress and the Secretary of Health and Human Services. Volume II: Analysis and Recommendations for Selected Federal Programs.

    ERIC Educational Resources Information Center

    Public Health Service (DHHS), Rockville, MD.

    This second volume of the 1981 Report of the Select Panel for the Promotion of Child Health presents an examination of selected federal programs affecting maternal and child health and proposes detailed recommendations for federal legislative, regulatory, and other administrative improvements. Five federal programs, identified by the panel as…

  12. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for National Institute of Health

    SciTech Connect

    Schey, Stephen; Francfort, Jim

    2014-11-01

    This report focuses on the National Institute of Health (NIH) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of plug-in electric vehicles (PEVs) into the agencies’ fleets. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle (BEV) or plug-in hybrid electric vehicle (PHEV) (collectively plug-in electric vehicles, or PEVs) can fulfill the mission requirements.

  13. Linking Public Health, Housing, and Indoor Environmental Policy: Successes and Challenges at Local and Federal Agencies in the United States

    PubMed Central

    Jacobs, David E.; Kelly, Tom; Sobolewski, John

    2007-01-01

    We describe the successes and challenges faced by federal and local government agencies in the United States as they have attempted in recent years to connect public and environmental health, housing, community development, and building design with environmental, housing, and building laws, codes, and policies. These policies can either contribute to or adversely affect human physical and mental health, with important implications for economic viability, research, policy development, and overall social stability and progress. Policy impediments include tension between housing affordability and health investment that causes inefficient cost-shifting, privacy issues, unclear statutory authority, and resulting gaps in responsibility for housing, indoor air, and the built environment. We contrast this with other environmental frameworks such as ambient air and water quality statutes where the concept of “shared commons” and the “polluter pays” is more robust. The U.S. experiences in childhood lead poisoning prevention, indoor air, and mold provide useful policy insights. Local programs can effectively build healthy homes capacity through local laws and housing codes. The experience of coordinating remediation for mold, asthma triggers, weatherization, and other healthy housing improvements in Cuyahoga County, Ohio, is highlighted. The U.S. experience shows that policymakers should adopt a prevention-oriented, comprehensive multi-disciplinary approach at all levels of government to prevent unhealthy buildings, houses, and communities. PMID:17589610

  14. Development of the behaviorally focused fruits & Veggies--More Matters public health initiative.

    PubMed

    Pivonka, Elizabeth; Seymour, Jennifer; McKenna, Jeff; Baxter, Suzanne Domel; Williams, Simon

    2011-10-01

    Due to changing recommendations for fruit and vegetable (F/V) intake, public health and private organizations recognized the need to revise communications and programs that promote F/V consumption. This article describes formative research conducted in 2005 to develop a new identity for the 5 A Day Program, updated to the Fruits & Veggies--More Matters program. The objective was to re-brand the 5 A Day Program's campaign message to be adaptable, sustainable, and compelling, while leveraging the program's existing message dissemination infrastructure. Formative research included interviews with representatives from government, nonprofit organizations, and industry, and consumer perspectives from interviews, focus groups, and an online survey. Public health and private organizations agreed that a compelling emotional benefit was needed to motivate consumers to eat more F/V and that messaging needed to be used consistently among national, state, and local programs. Interviews and focus groups targeted mothers who believed they and their families were getting enough F/V, knew they could eat more, but needed to be convinced why they should do so. The most effective messages appealed to mothers' emotional needs to be responsible, leveraged functional intrinsic values of F/V, did not try to quantify "enough," and focused on small steps. When the Fruits & Veggies-More Matters slogan and graphic were viewed together, the majority (62%) said it increased their interest in eating more F/V. The Fruits & Veggies-More Matters brand offers numerous opportunities for promoting F/V consumption through this public health initiative. PMID:21963025

  15. The Baltimore Youth Ammunition Initiative: A Model Application of Local Public Health Authority in Preventing Gun Violence

    PubMed Central

    Lewin, Nancy L.; Vernick, Jon S.; Beilenson, Peter L.; Mair, Julie S.; Lindamood, Melisa M.; Teret, Stephen P.; Webster, Daniel W.

    2005-01-01

    In 2002, the Baltimore City Health Department, in collaboration with the Baltimore Police Department and the Johns Hopkins Center for Gun Policy and Research, launched the Youth Ammunition Initiative. The initiative addressed Baltimore’s problem of youth gun violence by targeting illegal firearm ammunition sales to the city’s young people. The initiative included undercover “sting” investigations of local businesses and issuance of health department violation and abatement notices. Intermediate results included the passage of 2 Baltimore city council ordinances regulating ammunition sales and reducing the number of outlets eligible to sell ammunition. Although it is too early to assess effects on violent crime, the intervention could theoretically reduce youth violence by interrupting one source of ammunition to youths. More important, the initiative can serve as a policy model for health commissioners seeking to become more active in gun violence prevention efforts. PMID:15855448

  16. Impact evaluation of the Urban Health Initiative in urban Uttar Pradesh, India

    PubMed Central

    Achyut, Pranita; Benson, Aimee; Calhoun, Lisa M.; Corroon, Meghan; Guilkey, David K.; Kebede, Essete; Lance, Peter M.; Mishra, Anurag; Nanda, Priya; O'Hara, Rick; Sengupta, Ranajit; Speizer, Ilene S.; Stewart, John F.; Winston, Jennifer

    2016-01-01

    Objectives The Urban Health Initiative (UHI) was initiated in 2009 with the goal of increasing family planning (FP) use among the poor in urban areas of Uttar Pradesh, India. The Measurement, Learning & Evaluation project (MLE) was tasked with rigorous impact evaluation of the UHI. This paper presents the impact evaluation findings of the UHI program. Study design The MLE design includes a longitudinal sample of women and health facilities with baseline (2010) and endline (2014) data collection in six cities in Uttar Pradesh, India. At baseline, samples representative of women in each city were selected with oversampling of the poor. Eighty-four percent of women interviewed at baseline were reinterviewed 4 years later at endline. The longitudinal data support a within/fixed-effects approach to identification of program impact on changes in modern FP use. Results Impact evaluation results show significant effects of exposure to both demand and supply side program activities. In particular, women exposed to brochures (marginal effect: 6.96, p < .001), billboards/posters/wall hangings (marginal effect: 2.09, p < .05), and FP on the television (marginal effect: 2.46, p < .001) were significantly more likely to be using a modern method at endline. In addition, we found borderline significance for being exposed to a community health worker (marginal effect: 1.66, p < .10) and living close to an improved public and private supply environment where UHI undertook activities (marginal effects and p values: 2.48, p < .05 and 1.56, p < .10, respectively). Conclusions UHI program activities were designed to complement the Government of India's strategies aimed at ensuring access to and provision of FP to urban poor populations. The effective demand- and supply-side strategies of the UHI program are therefore likely to be sustainable and scalable to other urban areas in India. Implications statement Findings from this study are important for designing sustainable and

  17. National Take-Back Initiative

    MedlinePlus

    ... Physicians Drug Disposal Information Drug and Chemical Information E-commerce Initiatives Federal Agencies & Related Links Federal Register Notices ... Physicians Drug Disposal Information Drug and Chemical Information E-commerce Initiatives Federal Agencies & Related Links Federal Register Notices ...

  18. What's behind health insurance rate increases? an examination of what insurers reported to the federal government in 2013-2014.

    PubMed

    McCue, Michael J; Hall, Mark A

    2015-01-01

    The Affordable Care Act requires health insurers to justify rate increases that are 10 percent or more for nongrandfathered plans in the individual and small-group markets. Analyzing these filings for renewals taking effect from mid-2013 through mid-2014, this brief finds that the average rate increase submitted for review was 13 percent. Insurers attributed the great bulk of these larger rate increases to routine factors such as trends in medical costs. Most insurers did not attribute any portion of these medical cost trends to factors related to the Affordable Care Act. The ACA-related factors mentioned most often were nonmedical: the new federal taxes on insurers, and the fee for the transitional reinsurance program. On average, insurers that quantified any ACA impact attributed about a third of their larger rate increases to these new ACA assessments. PMID:25807591

  19. 76 FR 8743 - Indian Health Professions Preparatory, Indian Health Professions Pre-Graduate and Indian Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-15

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Indian Health Professions Preparatory, Indian Health Professions Pre-Graduate and Indian Health Professions Scholarship Programs Announcement Type: Initial. ] CFDA Numbers: 93.971, 93.123, and 93.972. DATES:...

  20. 78 FR 78976 - Indian Health Professions Preparatory, Indian Health Professions Pre-graduate and Indian Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Indian Health Professions Preparatory, Indian Health Professions Pre-graduate and Indian Health Professions Scholarship Programs Announcement Type: Initial. CFDA Numbers: 93.971, 93.123, AND 93.972 Key...