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Sample records for health concepts conflicts

  1. Italian occupational health: concepts, conflicts, implications.

    PubMed Central

    Reich, M R; Goldman, R H

    1984-01-01

    This paper examines Italy's worker-based model for occupational health, especially its key concepts and its relation to social conflict. It briefly reviews the history of three approaches to occupational health in Italy: university-based, industry-based, and government-based. It then analyzes the worker-based approach, which emerged in the late 1960s and early 1970s as worker groups and trade unions mobilized around new concepts of occupational health. Five key concepts are discussed: the workers' homogeneous group; workers' subjectivity; the use of contract language; the development of local occupational health institutions; and the use of occupational hazard risk maps. The analysis illustrates how the social processes of mobilization and institutionalization affected the ideas and structures of Italian occupational health. Worker mobilization in Italy produced ideological changes in the nation's occupational health system, institutional changes in universities and governments, and legislative changes at national and local levels. The institutionalization of reforms, however, created new conflicts and problems and tended to restrict worker participation and promote expert intervention. The paper concludes with a brief outline of the history of occupational health approaches in the United States and then discusses the implications of the five Italian concepts for US occupational health policy. PMID:6380322

  2. Global Mental Health: concepts, conflicts and controversies.

    PubMed

    Whitley, Rob

    2015-08-01

    This paper introduces, describes and analyses the emerging concept of Global Mental Health (GMH). The birth of GMH can be traced to London, 2007, with the publication of a series of high-profile papers in The Lancet. Since then, GMH has developed into a movement with proponents, adherents, opponents, an ideology and core activities. The stated aims of the Movement for GMH are 'to improve services for people living with mental health problems and psychosocial disabilities worldwide, especially in low- and middle-income countries where effective services are often scarce'. GMH could be considered an attempt to right a historic wrong. During the colonial and post-colonial eras, the mental health of subject populations was accorded a very low priority. This was fuelled by scientific racism, which alleged that mental illness was uncommon in places such as Africa. As developing nations have made the epidemiological transition, the burden of mental illness has proportionately increased, with research suggesting a massive 'treatment gap' between those in need and those actually receiving formal mental health care. As such, much GMH research and action has been devoted to: (i) the identification and scale-up of cost-effective evidence-supported interventions that could be made more widely available; (ii) task-shifting of such intervention delivery to mental-health trained non-specialist Lay Health Workers. GMH has come under sustained critique. Critics suggest that GMH is colonial medicine come full circle, involving the top-down imposition of Western psychiatric models and solutions by Western-educated elites. These critiques suggest that GMH ignores the various indigenous modalities of healing present in non-Western cultures, which may be psychologically adaptive and curative. Relatedly, critics argue that GMH could be an unwitting Trojan horse for the mass medicalisation of people in developing countries, paving the way for exploitation by Big Pharma, while ignoring

  3. Guide to the Concept: Conflict. Revised Edition.

    ERIC Educational Resources Information Center

    New York Friends Group, Inc., New York. Center for War/Peace Studies.

    The outline presented here grew out of the realization that though a great deal of study has been done on conflict, there has been little effort made to organize the concept for teachers. The concept of conflict provides a rich tool for teachers to analyze much of human behavior. When applied intelligently, it can bridge the gap between very…

  4. Climate change, conflict and health.

    PubMed

    Sondorp, Egbert; Patel, Preeti

    2003-01-01

    Both conflict and climate change may produce serious negative health consequences. However, there is insufficient evidence that climate change, e.g. through environmental degradation or fresh water shortages, leads to conflict as is often claimed. Also, current theory on cause of conflict would refute this hypothesis. PMID:14584364

  5. Armed conflict and child health

    PubMed Central

    Rieder, Michael; Choonara, Imti

    2012-01-01

    Summary Armed conflict has a major impact on child health throughout the world. One in six children worldwide lives in an area of armed conflict and civilians are more likely to die than soldiers as a result of the conflict. In stark contrast to the effect on children, the international arms trade results in huge profits for the large corporations involved in producing arms, weapons and munitions. Armed conflict is not inevitable but is an important health issue that should be prevented. PMID:21393303

  6. Climate change, conflict and health.

    PubMed

    Bowles, Devin C; Butler, Colin D; Morisetti, Neil

    2015-10-01

    Future climate change is predicted to diminish essential natural resource availability in many regions and perhaps globally. The resulting scarcity of water, food and livelihoods could lead to increasingly desperate populations that challenge governments, enhancing the risk of intra- and interstate conflict. Defence establishments and some political scientists view climate change as a potential threat to peace. While the medical literature increasingly recognises climate change as a fundamental health risk, the dimension of climate change-associated conflict has so far received little attention, despite its profound health implications. Many analysts link climate change with a heightened risk of conflict via causal pathways which involve diminishing or changing resource availability. Plausible consequences include: increased frequency of civil conflict in developing countries; terrorism, asymmetric warfare, state failure; and major regional conflicts. The medical understanding of these threats is inadequate, given the scale of health implications. The medical and public health communities have often been reluctant to interpret conflict as a health issue. However, at times, medical workers have proven powerful and effective peace advocates, most notably with regard to nuclear disarmament. The public is more motivated to mitigate climate change when it is framed as a health issue. Improved medical understanding of the association between climate change and conflict could strengthen mitigation efforts and increase cooperation to cope with the climate change that is now inevitable. PMID:26432813

  7. Forces and Particles: Concepts Again in Conflict

    ERIC Educational Resources Information Center

    Gale, George

    1973-01-01

    Traces the historical developments in physics leading to the present conflict of fundamental beliefs about the nature of the physical world. It has been recently proposed that the concept of fundamental particles (corpuscularianism) be replaced with a full-blown field dynamical theory. (JR)

  8. [Conceptions and typology of conflicts between workers and managers in the context of primary healthcare in the Brazilian Unified National Health System (SUS)].

    PubMed

    Carvalho, Brígida Gimenez; Peduzzi, Marina; Ayres, José Ricardo de Carvalho Mesquita

    2014-07-01

    This study aimed to analyze perceptions of conflict between workers and managers in primary healthcare units and to present a typology of conflicts on the job. This was a comprehensive interpretive case study with a critical hermeneutic approach. Data collection techniques included: focus group with managers, workplace observation, and worker interviews, conducted from April to November 2011. The results were triangulated and indicated the coexistence of distinct concepts of conflict, typified in six modalities: lack of collaboration at work; disrespect resulting from asymmetrical relations between workers; problematic employee behavior; personal problems; asymmetry with other management levels; and inadequate work infrastructure. The relevance of (non)mutual recognition, as proposed by Axel Honneth, stood out in the interpretation of the causes and practical implications of these conflicts. PMID:25166942

  9. Dysfunctional health service conflict: causes and accelerants.

    PubMed

    Nelson, H Wayne

    2012-01-01

    This article examines the causes and accelerants of dysfunctional health service conflict and how it emerges from the health system's core hierarchical structures, specialized roles, participant psychodynamics, culture, and values. This article sets out to answer whether health care conflict is more widespread and intense than in other settings and if it is, why? To this end, health care power, gender, and educational status gaps are examined with an eye to how they undermine open communication, teamwork, and collaborative forms of conflict and spark a range of dysfunctions, including a pervasive culture of fear; the deny-and-defend lawsuit response; widespread patterns of hierarchical, generational, and lateral bullying; overly avoidant conflict styles among non-elite groups; and a range of other behaviors that lead to numerous human resource problems, including burnout, higher staff turnover, increased errors, poor employee citizenship behavior, patient dissatisfaction, increased patient complaints, and lawsuits. Bad patient outcomes include decreased compliance and increased morbidity and mortality. Health care managers must understand the root causes of these problems to treat them at the source and implement solutions that avoid negative conflict spirals that undermine organizational morale and efficiency. PMID:22534973

  10. Conflict management styles in the health professions.

    PubMed

    Sportsman, Susan; Hamilton, Patti

    2007-01-01

    The purpose of the study was to determine prevalent conflict management styles chosen by students in nursing and to contrast these styles with those chosen by students in allied health professions. The associations among the level of professional health care education and the style chosen were also determined. A convenience sample of 126 students in a comprehensive university completed the Thomas-Kilmann Conflict Mode Instrument (TKI), which requires respondents to choose behaviors most characteristic of their response to conflict and classifies these behaviors as one of five styles. There was no significant difference between the prevalent conflict management styles chosen by graduate and undergraduate nursing students and those in allied health. Some of the students were already licensed in their discipline; others had not yet taken a licensing exam. Licensure and educational level were not associated with choice of styles. Women and men had similar preferences. The prevalent style for nursing students was compromise, followed by avoidance. In contrast, avoidance, followed by compromise and accommodation, was the prevalent style for allied health students. When compared to the TKI norms, slightly more than one half of all participants chose two or more conflict management styles, commonly avoidance and accommodation at the 75th percentile or above. Only 9.8% of the participants chose collaboration at that level. Implications for nurse educators, researchers, and administrators are discussed. PMID:17540319

  11. Health Education a Conceptual Approach. Growing and Developing, Interacting, Decision Making. Concept 7: Personal Health Practices Are Affected by a Complexity of Forces, Often Conflicting. Teacher-Student Resources.

    ERIC Educational Resources Information Center

    Creswell, William H., Jr.; And Others

    The following resource guide is one in a series which presents extensive bibliographic material oriented around a specific concept, in this guide, forces affecting personal health practices. A section is devoted to selected materials related to the concept; grade levels for which each resource might be useful are indicated beside each citation. A…

  12. [Concept analysis of health literacy].

    PubMed

    Chang, Mei-Chuan; Chen, Yueh-Chih; Chang, Shu-Chuan

    2009-10-01

    Health literacy has risen to become one of the dominant issues in Taiwan's healthcare system today. Level of health literacy impacts upon public health outcomes. Nevertheless, healthcare professionals in Taiwan remain largely unfamiliar with the concept and importance of health literacy. This paper employs concept analysis as described by Walker & Avant to introduce and analyze the attributes, antecedents and consequences of health literacy. Defining attributes of health literacy include: 1. enabling an individual to function successfully in a healthcare context; 2. facilitating the obtaining, comprehending, communicating and evaluating of health information to make appropriate health decisions and conduct positive health practices; and 3. achieving a good health status. The antecedent of health literacy is literacy. Consequences of health literacy include differences in health outcomes such as health knowledge, use of healthcare services and health status. Hopefully, through concept analysis, findings can help promote nursing clinical practice and related research quality. PMID:19760583

  13. Part 2, Conflict management. Managing low-to-mid intensity conflict in the health care setting.

    PubMed

    Aschenbrener, C A; Siders, C T

    1999-01-01

    Physician executives face low to mid-level intensity conflicts, day-to-day issues and problems associated with pressures and changes in the health care environment. Such conflicts can be sorted on the basis of relationship, duration, and intensity. The authors apply the five major modes of conflict management--competition, avoidance, compromise, accommodation, and collaboration--to specific scenarios taken from their work in health care and suggest guidelines for managing conflicts with peers, supervisees, and authority figures. Thorough preparation and a portfolio of skills build flexibility through the conflict management process. In part 1 of this article series, the authors presented the conflict management checklist, a diagnostic tool for assessing conflict in organizations. PMID:10558283

  14. The Impact of Marital Conflict and Disruption on Children's Health

    ERIC Educational Resources Information Center

    Houseknecht, Sharon K.; Hango, Darcy W.

    2006-01-01

    This article investigates the effect of inconsistency between parental marital conflict and disruption on children's health. Inconsistent situations arise when minimal marital conflict precedes disruption or when marital conflict is high but there is no disruption. Using data from the National Longitudinal Survey of Youth, two alternative…

  15. Conflict Probe Concepts Analysis in Support of Free Flight

    NASA Technical Reports Server (NTRS)

    Warren, Anthony W.; Schwab, Robert W.; Geels, Timothy J.; Shakarian, Arek

    1997-01-01

    This study develops an operational concept and requirements for en route Free Flight using a simulation of the Cleveland Air Route Traffic Control Center, and develops requirements for an automated conflict probe for use in the Air Traffic Control (ATC) Centers. In this paper, we present the results of simulation studies and summarize implementation concepts and infrastructure requirements to transition from the current air traffic control system to mature Free Right. The transition path to Free Flight envisioned in this paper assumes an orderly development of communications, navigation, and surveillance (CNS) technologies based on results from our simulation studies. The main purpose of this study is to provide an overall context and methodology for evaluating airborne and ground-based requirements for cooperative development of the future ATC system.

  16. Worker Health and Safety: An Area of Conflicts

    ERIC Educational Resources Information Center

    Ashford, Nicholas A.

    1975-01-01

    The article outlines four basic conflicts concerning occupational health and safety, discusses the nature and dimensions of health and safety problems, examines the generation of information and its diffusion, and deals briefly with some economic issues. (Author)

  17. Fast-time Simulation of an Automated Conflict Detection and Resolution Concept

    NASA Technical Reports Server (NTRS)

    Windhorst, Robert; Erzberger, Heinz

    2006-01-01

    This paper investigates the effect on the National Airspace System of reducing air traffc controller workload by automating conflict detection and resolution. The Airspace Concept Evaluation System is used to perform simulations of the Cleveland Center with conventional and with automated conflict detection and resolution concepts. Results show that the automated conflict detection and resolution concept significantly decreases growth of delay as traffic demand is increased in en-route airspace.

  18. Documenting the Effects of Armed Conflict on Population Health.

    PubMed

    Levy, Barry S; Sidel, Victor W

    2016-01-01

    War and other forms of armed conflict have profound adverse effects on population health. It is important to document these effects to inform the general public and policy makers about the consequences of armed conflict, provide services to meet the needs of affected populations, protect human rights and document violations of international humanitarian law, and help to prevent future armed conflict. Documentation can be accomplished with surveillance, epidemiological surveys, and rapid assessment. Challenges include inadequate or absent data systems, social breakdown, forced migration, reporting biases, and the fog of war. The adverse effects of the Iraq War on population health demonstrate how the effects of armed conflict on population health can be documented. We recommend the establishment of an independent mechanism, operated by the United Nations or a multilateral organization, to investigate and document the effects of armed conflict on population health. PMID:26989827

  19. [On theory of sensory conflict under exposure to physical factors: main principles and concepts of formation].

    PubMed

    Rukavishnikov, V S; Pankov, V A; Kuleshova, M V; Katamanova, E V; Kartapol'tseva, N V; Rusanova, D V; Bodienkova, G M; Titov, E A

    2015-01-01

    The article presents results of longstanding studies on influence of occupational physical factors on workers health. Experimental and nature studies helped to justify basic concepts of sensory conflict theory, a trigger of occupational disease formation. Patients having occupational disease present disorders of cortex-subcortex relationships on diencephal level, central and peripheral regulatory mechanisms, central sensory mechanisms participation in pathologic processes development, changes in vegetative regulation on cerebral level, demyelination and axon demyelination changes in peripheral nerves of upper and lower limbs. Findings are also changes in central nervous, peripheral nervous systems, endocrine, immune systems, severe emotional negative strain and high level of nervous system excitation, perivascular edema in brain cortex of experimental animals. Based on key principles of the theory, the authors specified and tested new methods of treatment and prevention of occupational diseases caused by physical factors, aimed to unblock the sensory conflict. PMID:26065237

  20. [The concepts of health access].

    PubMed

    Sanchez, Raquel Maia; Ciconelli, Rozana Mesquita

    2012-03-01

    This article describes four dimensions of health access-availability, acceptability, ability to pay and information-correlating these dimensions to indicators and discussing the complexity of the concept of access. For a study of these four dimensions, searches were conducted using the PubMed/MEDLINE, LILACS, SciELO, and World Health Organization Library & Information Networks for Knowledge (WHOLIS) databases. Large-circulation media vehicles, such as The Economist, The Washington Post, and the BBC network were also searched. The concept of health access has become more complex with time. The first analyses, carried out in the 1970s, suggested a strong emphasis on geographical (availability) and financial (ability to pay) aspects. More recently, the literature has focused on less tangible aspects, such as cultural, educational, and socioeconomic issues, incorporating the element of acceptability into the notion of health access. The literature also shows that information provides the starting point for access to health, in association with health empowerment and literacy for health care decision-making. The study concludes that improvements in access to health and the guarantee of equity will not be achieved by initiatives focusing on health care systems alone, but rather will depend on intersectoral actions and social and economic policies aimed at eliminating income and education differences. PMID:22569702

  1. Health Concepts, Guides for Health Instruction.

    ERIC Educational Resources Information Center

    American Association for Health, Physical Education, and Recreation, Washington, DC.

    Concepts and supporting data pertaining to major health problems facing youth today as well as those anticipated in the next decade are enumerated in this resource. The material is designed as a reference for curriculum planners and classroom teachers in developing curriculum and teaching guides, units and instruction, and other curriculum…

  2. Marital Conflict in Older Couples: Positivity, Personality, and Health

    PubMed Central

    Iveniuk, James; Waite, Linda J.; McClintock, Martha K.; Teidt, Andrew D.

    2016-01-01

    We examine the implications of health and personality characteristics for late-life marital conflict, using data from the 2010–11 wave of the National Social Life Health and Aging Project (NSHAP), a nationally representative study with data on both partners in 955 marital and cohabitational dyads. Using these data, we relate characteristics of husbands to characteristics of their wives, and vice versa. Wives with husbands in fair or poor physical health are more likely to report high levels of marital conflict, but the reverse is not true. Similarly, wives report more conflict when their husbands are high on Neuroticism, high on Extraversion, and low on a new measure we call Positivity. Our findings point to noteworthy gender differences between men and women in the associations between individual characteristics and levels of marital conflict. We point to differences between husbands’ and wives’ marital roles as a contributor to these differences. PMID:27274569

  3. Physicians in health care management: 10. Managing conflict through negotiation.

    PubMed Central

    Lemieux-Charles, L

    1994-01-01

    The recent focus on collaborative relationships in health care means that people and groups must cooperate to accomplish clinical and management tasks. This increasing interdependence may also cause increased organizational conflict. The management of conflicts is critical to the effectiveness of an organization. Negotiating strategies, based on Fisher and Ury's method of "principled negotiation," include establishing superordinate goals, separating the people from the problem, focussing on interests, inventing options, using objective criteria and defining success in terms of gains. PMID:7922944

  4. Teaching the Concept of Limit by Using Conceptual Conflict Strategy and Desmos Graphing Calculator

    ERIC Educational Resources Information Center

    Liang, Senfeng

    2016-01-01

    Although the mathematics community has long accepted the concept of limit as the foundation of modern Calculus, the concept of limit itself has been marginalized in undergraduate Calculus education. In this paper, I analyze the strategy of conceptual conflict to teach the concept of limit with the aid of an online tool--Desmos graphing calculator.…

  5. Conflicts of Interest: Manipulating Public Health

    ERIC Educational Resources Information Center

    Stein, Richard; Davis, Devra Lee

    2014-01-01

    Evaluating the potential health impacts of chemical, physical, and biological environmental factors represents a challenging task with profound medical, public health, and historical implications. The history of public health is replete with instances, ranging from tobacco to lead and asbestos, where the ability to obtain evidence on potential…

  6. Resource conflict and cooperation between human host and gut microbiota: implications for nutrition and health.

    PubMed

    Wasielewski, Helen; Alcock, Joe; Aktipis, Athena

    2016-05-01

    Diet has been known to play an important role in human health since at least the time period of the ancient Greek physician Hippocrates. In the last decade, research has revealed that microorganisms inhabiting the digestive tract, known as the gut microbiota, are critical factors in human health. This paper draws on concepts of cooperation and conflict from ecology and evolutionary biology to make predictions about host-microbiota interactions involving nutrients. To optimally extract energy from some resources (e.g., fiber), hosts require cooperation from microbes. Other nutrients can be utilized by both hosts and microbes (e.g., simple sugars, iron) in their ingested form, which may lead to greater conflict over these resources. This framework predicts that some negative health effects of foods are driven by the direct effects of these foods on human physiology and by indirect effects resulting from microbiome-host competition and conflict (e.g., increased invasiveness and inflammation). Similarly, beneficial effects of some foods on host health may be enhanced by resource sharing and other cooperative behaviors between host and microbes that may downregulate inflammation and virulence. Given that some foods cultivate cooperation between hosts and microbes while others agitate conflict, host-microbe interactions may be novel targets for interventions aimed at improving nutrition and human health. PMID:27270755

  7. Health economics--concepts and conceptual problems.

    PubMed

    Satpathy, S K; Bansal, R D

    1982-01-01

    Awareness of the economic manifestation of health and diseases and the limited resources allocated to health care services has brought to the focus a new discipline - health economics. Cost accounting, cost benefit, cost effectiveness methods etc. are increasingly becoming an integral part of the health management and evaluation of health programmes. Various concepts and problems relating to health economics are discussed in the present paper. More efforts should be made to conduct health economic studies in hospitals and health centres by which the process of standardisation of the concepts, would be easier. Health economics should also find its due place in the medical curriculum. PMID:10310083

  8. Viewing Cognitive Conflicts as Dilemmas: Implications for Mental Health

    PubMed Central

    Feixas, Guillem; Saúl, Luis Angel; Ávila-Espada, Alejandro

    2009-01-01

    The idea that internal conflicts play a significant role in mental health has been extensively addressed in various psychological traditions, including personal construct theory. In the context of the latter, several measures of conflict have been operationalized using the Repertory Grid Technique (RGT). All of them capture the notion that change, although desirable from the viewpoint of a given set of constructs, becomes undesirable from the perspective of other constructs. The goal of this study is to explore the presence of cognitive conflicts in a clinical sample (n = 284) and compare it to a control sample (n = 322). It is also meant to clarify which among the different types of conflict studied provides a greater clinical value and to investigate its relationship to symptom severity (SCL-90-R). Of the types of cognitive conflict studied, implicative dilemmas were the only ones to discriminate between clinical and nonclinical samples. These dilemmas were found in 34% of the nonclinical sample and in 53% of the clinical sample. Participants with implicative dilemmas showed higher symptom severity, and those from the clinical sample displayed a higher frequency of dilemmas than those from the nonclinical sample. PMID:22629109

  9. Toward a Socioecological Conception of Health.

    ERIC Educational Resources Information Center

    Lawson, Hal A.

    1992-01-01

    Many academic fields claim jurisdiction over health research and practice. The paper examines dominant conceptions of health as a personal quality or state of being, noting the market-oriented, competitive relationship among fields. It presents a socioecological conception of health which emphasizes individuals but also includes societal and…

  10. Blunder Lecture to Reeducate Physiology Concepts by Cognitive Conflict Strategy

    ERIC Educational Resources Information Center

    Singh, Satendra

    2014-01-01

    Our students are not a tabula rasa in classes. These varied learners imbibe new information in relevance to others and reaffirm their own concepts. Quite often, in this journey of forming new connections, inadvertently, misconceptions are retained and may be reinforced if not corrected early. Students come to learning situations with preconceived…

  11. Physicians' and consumers' conflicting attitudes toward health care advertising.

    PubMed

    Krohn, F B; Flynn, C

    2001-01-01

    The purpose of this paper is to explore the conflicting attitudes held by physicians and health care consumers toward health care advertising in an attempt to resolve the question. The paper introduces the differing positions held by the two groups. The rationale behind physicians' attitudes is then presented that advertising can be unethical, misleading, deceptive, and lead to unnecessary price increases. They believe that word-of-mouth does and should play the major role in attracting new patients. The opposite view of consumers is then presented which contends that health care advertising leads to higher consumer awareness of services, better services, promotes competitive pricing, and lowers rather than raises health care costs. The final section of the paper compares the arguments presented and concludes that health care advertising clearly has a place in the health care industry. PMID:11968299

  12. Conflict, displacement and health in the Middle East.

    PubMed

    Mowafi, Hani

    2011-01-01

    Displacement is a hallmark of modern humanitarian emergencies. Displacement itself is a traumatic event that can result in illness or death. Survivors face challenges including lack of adequate shelter, decreased access to health services, food insecurity, loss of livelihoods, social marginalisation as well as economic and sexual exploitation. Displacement takes many forms in the Middle East and the Arab World. Historical conflicts have resulted in long-term displacement of Palestinians. Internal conflicts have driven millions of Somalis and Sudanese from their homes. Iraqis have been displaced throughout the region by invasion and civil strife. In addition, large numbers of migrants transit Middle Eastern countries or live there illegally and suffer similar conditions as forcibly displaced people. Displacement in the Middle East is an urban phenomenon. Many displaced people live hidden among host country populations in poor urban neighbourhoods - often without legal status. This represents a challenge for groups attempting to access displaced populations. Furthermore, health information systems in host countries often do not collect data on displaced people, making it difficult to gather data needed to target interventions towards these vulnerable populations. The following is a discussion of the health impacts of conflict and displacement in the Middle East. A review was conducted of published literature on migration and displacement in the region. Different cases are discussed with an emphasis on the recent, large-scale and urban displacement of Iraqis to illustrate aspects of displacement in this region. PMID:21590557

  13. Syria: effects of conflict and sanctions on public health.

    PubMed

    Sen, Kasturi; Al-Faisal, Waleed; AlSaleh, Yaser

    2013-06-01

    The past 18 months have witnessed considerable turmoil in countries of the MENA region. The Syrian Arab Republic (SAR) is one such country, currently in the midst of a civil war. This report draws attention to some of the recent achievements of its health services, where, despite a dearth of published materials, the country achieved remarkable declines in maternal mortality and infant mortality rates. Its health sector now faces destruction from on-going violence compounded by economic sanctions that has affected access to health care, to medicines and to basic essentials as well as the destruction of infrastructure. This paper draws attention to the achievements of the country's health services and explores some of the consequences of conflict and of sanctions on population health. Readers need to be mindful that the situation on the ground in a civil war can alter on a daily basis. This is the case for Syria with much destruction of health facilities and increasing numbers of people killed and injured. We retain however our focus on the core theme of this paper which is on conflict and on sanctions. PMID:23179240

  14. Alternative dispute resolution: a conflict management tool in health care.

    PubMed

    Liberman, A; Rotarius, T M; Kendall, L

    1997-12-01

    This article focuses on methods of resolving conflict either within or between health care organizations using an alternative dispute resolution (ADR) strategy. After identifying the principal sources of contemporary disagreements within health services settings, the authors describe the basis of ADR. This is followed by a discussion of some common obstacles to settling a dispute. The principal communication guidelines and stages of a mediation session are presented. An alternative dispute resolution framework is proposed that includes an Office of Dispute Resolution (ODR). Also provided is a series of attributes that together comprise the core of mediation as a discipline. PMID:10174448

  15. Madness or sadness? Local concepts of mental illness in four conflict-affected African communities

    PubMed Central

    2013-01-01

    Background Concepts of ‘what constitutes mental illness’, the presumed aetiology and preferred treatment options, vary considerably from one cultural context to another. Knowledge and understanding of these local conceptualisations is essential to inform public mental health programming and policy. Methods Participants from four locations in Burundi, South Sudan and the Democratic Republic of the Congo, were invited to describe ‘problems they knew of that related to thinking, feeling and behaviour?’ Data were collected over 31 focus groups discussions (251 participants) and key informant interviews with traditional healers and health workers. Results While remarkable similarities occurred across all settings, there were also striking differences. In all areas, participants were able to describe localized syndromes characterized by severe behavioural and cognitive disturbances with considerable resemblance to psychotic disorders. Additionally, respondents throughout all settings described local syndromes that included sadness and social withdrawal as core features. These syndromes had some similarities with nonpsychotic mental disorders, such as major depression or anxiety disorders, but also differed significantly. Aetiological concepts varied a great deal within each setting, and attributed causes varied from supernatural to psychosocial and natural. Local syndromes resembling psychotic disorders were seen as an abnormality in need of treatment, although people did not really know where to go. Local syndromes resembling nonpsychotic mental disorders were not regarded as a ‘medical’ disorder, and were therefore also not seen as a condition for which help should be sought within the biomedical health-care system. Rather, such conditions were expected to improve through social and emotional support from relatives, traditional healers and community members. Conclusions Local conceptualizations have significant implications for the planning of mental-health

  16. [Health Technology Dependency: A Concept Analysis].

    PubMed

    Chen, Miao-Yi; Chen, Ting-Yu; Kao, Chi-Wen

    2016-02-01

    Health technology dependence is a widely recognized concept that refers to the utilization of technology, including drugs, equipment, instruments, and related devices, to compensate for a physical disability or to prevent the progression of a disability. Although technology may significantly prolong the life of a patient, technology may also increase the psychological pressure of these patients and the burdens of their caregivers. There is a current dearth of related research and discussions related to the concept of "health technology dependency". Therefore, the present paper uses the strategies of concept analysis described by Walker & Avant (2010) to analyze this concept. The characteristic definition of health technology dependence addresses individuals who: (1) currently live with health technology, (2) may perceive physical or psychological burdens due to health technology, and (3) feel physical and psychological well-being when coping positively with their health technology dependency and, further, regard health technology as a part of their body. Further, the present paper uses case examples to help analyze the general concept. It is hoped that nurses may better understand the concept of "health technology dependency", consider the concerns of health-technology-dependent patients and their families, and develop relevant interventions to promote the well-being of these patients and their families. PMID:26813069

  17. Characteristics of the Colombian armed conflict and the mental health of civilians living in active conflict zones

    PubMed Central

    2012-01-01

    Background Despite the fact that the Colombian armed conflict has continued for almost five decades there is still very little information on how it affects the mental health of civilians. Although it is well established in post-conflict populations that experience of organised violence has a negative impact on mental health, little research has been done on those living in active conflict zones. Médecins Sans Frontières provides mental health services in areas of active conflict in Colombia and using data from these services we aimed to establish which characteristics of the conflict are most associated with specific symptoms of mental ill health. Methods An analysis of clinical data from patients (N = 6,353), 16 years and over, from 2010–2011, who consulted in the Colombian departments (equivalent to states) of Nariño, Cauca, Putumayo and Caquetá. Risk factors were grouped using a hierarchical cluster analysis and the clusters were included with demographic information as predictors in logistic regressions to discern which risk factor clusters best predicted specific symptoms. Results Three clear risk factor clusters emerged which were interpreted as ‘direct conflict related violence’, ‘personal violence not directly conflict-related’ and ‘general hardship’. The regression analyses indicated that conflict related violence was more highly related to anxiety-related psychopathology than other risk factor groupings while non-conflict violence was more related to aggression and substance abuse, which was more common in males. Depression and suicide risk were represented equally across risk factor clusters. Conclusions As the largest study of its kind in Colombia it demonstrates a clear impact of the conflict on mental health. Among those who consulted with mental health professionals, specific conflict characteristics could predict symptom profiles. However, some of the highest risk outcomes, like depression, suicide risk and aggression, were more

  18. Mainland Chinese students' concept of health.

    PubMed

    Wang, W

    2004-01-01

    This investigation, which was part of a larger project, was to describe and explain the concept of health as perceived by Chinese students. Data were collected through a questionnaire from students from two primary schools, two high schools and two universities (N=946) in Shanghai, China. The results showed that Chinese students not only considered themselves healthy but also viewed adolescents as the healthiest people in comparison with children, the middle and the old-aged. Their health concept consisted of components relating to physical, psychological, and social/moral dimensions. There were more boys than girls who considered mental health to be part of general health and a tendency for boys to perceive health status as poorer along with the increase in age. The categories of the concept of health and students' views on how to enhance health status are presented. PMID:15624784

  19. Health education: concepts and strategies.

    PubMed

    Singh, T

    1996-03-01

    Physicians have a responsibility to educate people about their health as well as to treat them. In fact, achievement of "Health for All" requires that people become educated about immunization, nutrition, family planning, and environmental sanitation. The goal of health education is to change behavior by changing attitudes. Health education encourages self-reliance and motivates people to make their own health-related decisions. In order to reach patients, physicians must bridge the social gap created by the gulf between technical priorities and what is really possible for people to achieve. The process of health education moves from the sender to the message to the channel to the receivers to the effects. Appropriate methods can be used for individual or group communication and methods can focus on information provision and/or behavior change. Participatory methods are effective in changing behavior and include group analysis of a situation, group dialogue, persuasion, and educational games. An effective strategy for individual instruction is woman-to-woman or child-to-child communication, which depends upon the identification of "key" women and children. Development of a community-based health education strategy relies on community participation and the involvement of influential members of the community. After a message has been transmitted, innovators will begin the new practice, early adopters will follow, and slow adopters will wait and watch. The innovators and early adopters can help reduce resistance to the innovation. While it is a slow process, health education can improve attitudes and behavior. PMID:8810211

  20. Reforms and Challenges of Post-conflict Kosovo Health System

    PubMed Central

    Mustafa, Mybera; Berisha, Merita; Lenjani, Basri

    2014-01-01

    Before its collapse, Kosovo's healthcare system was an integrated part of the Former Yugoslav Republics System (known as relatively well advanced for its time). Standstill had begun in the last decade of the twentieth century as the result of political disintegration of the former state. The enthusiasm of the healthcare professionals and the people of Kosovo that at the end of the conflict healthcare services will consolidate did not prove just right. Although we can claim that reorganization of Kosovo healthcare was a serious push (especially in the first years after the conflict), the intensity of development begun to fall at the latter stages. Although the basic legislation for the operation of the Healthcare System today in Kosovo does exist, the largest cause for the reform stagnation is where the law is not implemented properly and measures are not set as to a meaningful system of accountability. Twelve years have passed by since the 1999 war-conflict and, although, Kosovo has made progress in many other spheres, it has not yet reached to consolidate a health system comparable to those of other European countries. Intending to get out of difficult situation, several healthcare strategic plans have been developed in the past decade in Kosovo, but attempts in this direction have not been particularly fruitful. This script describes the actual Healthcare complexity of a situation in Kosovo 12 years after the end of the 1999 war-conflict. Interconnection and historical background is also looked upon and is described in the flow of events. Finally, the description of transfer competencies from international administrators to the local authorities as well as the flow of strategic planning that took place since 1999 has also been analyzed. PMID:24944539

  1. Reforms and Challenges of Post-conflict Kosovo Health System.

    PubMed

    Mustafa, Mybera; Berisha, Merita; Lenjani, Basri

    2014-04-01

    Before its collapse, Kosovo's healthcare system was an integrated part of the Former Yugoslav Republics System (known as relatively well advanced for its time). Standstill had begun in the last decade of the twentieth century as the result of political disintegration of the former state. The enthusiasm of the healthcare professionals and the people of Kosovo that at the end of the conflict healthcare services will consolidate did not prove just right. Although we can claim that reorganization of Kosovo healthcare was a serious push (especially in the first years after the conflict), the intensity of development begun to fall at the latter stages. Although the basic legislation for the operation of the Healthcare System today in Kosovo does exist, the largest cause for the reform stagnation is where the law is not implemented properly and measures are not set as to a meaningful system of accountability. Twelve years have passed by since the 1999 war-conflict and, although, Kosovo has made progress in many other spheres, it has not yet reached to consolidate a health system comparable to those of other European countries. Intending to get out of difficult situation, several healthcare strategic plans have been developed in the past decade in Kosovo, but attempts in this direction have not been particularly fruitful. This script describes the actual Healthcare complexity of a situation in Kosovo 12 years after the end of the 1999 war-conflict. Interconnection and historical background is also looked upon and is described in the flow of events. Finally, the description of transfer competencies from international administrators to the local authorities as well as the flow of strategic planning that took place since 1999 has also been analyzed. PMID:24944539

  2. An ethical framework for identifying, preventing, and managing conflicts confronting leaders of academic health centers.

    PubMed

    Chervenak, Frank A; McCullough, Laurence B

    2004-11-01

    Leaders of academic health centers (AHCs) hold positions that by their very nature have a high potential for ethical conflict. The authors offer an ethical framework for identifying, preventing, and managing conflicts in the leadership of AHCs. This framework is based on and implements both the ethical concept of AHCs as fiduciary organizations and also the legitimate interests of various stakeholders. The authors describe practical steps that can be tools for the preventive-ethics leadership of AHCs that enable leaders to avoid strategic ambiguity and strategic procrastination and replace these with transparency. The ethical framework is illustrated by applying it to an organizational case study. The major contribution of the ethical framework is that it transforms decision making from simply negotiating power struggles to explicitly identifying and making ethical decisions based on the legitimate interests and fiduciary responsibilities of all stakeholders. PMID:15504771

  3. Chronic health conditions in adults: concept analysis.

    PubMed

    de Freitas, Maria Célia; Mendes, Maria Manuela Rino

    2007-01-01

    This study aimed to define the concept of chronic health condition in adults as presented in literature. An evolutionary perspective of concept analysis was used, as presented by Rodgers, emphasizing the essential attributes, antecedents, consequences and related concepts. The adult's chronic health condition was presented by the characteristics of permanence, irreversibility, residual handicap, incurable and degenerative as essential attributes. The antecedents were: genetic heritage, old age, birth condition, smoking and foods with saturated fat; and, for the consequences: physical, social and psychological changes, handicaps and inabilities, life style changes, needs to adapt and cope. Related concepts were: not transmissible diseases, functional deficiency, limitations, illness or impairment for more than three months. Chronic health condition is a complex construction of concepts defined as a modifying force of the life process over time. PMID:17923975

  4. Constructing a conflict resolution program for health care.

    PubMed

    Porter-O'Grady, Tim

    2004-01-01

    Resolving conflict throughout organizations requires a programmatic infrastructure and a committed management team. Leaders must recognize the need to approach conflict by building a format for learning, creating and managing an effective conflict management program. Careful attention to the elements of design and the stages of development can make all the difference in building a sustainable and useful conflict management approach. PMID:15600105

  5. Conflict on interprofessional primary health care teams--can it be resolved?

    PubMed

    Brown, Judith; Lewis, Laura; Ellis, Kathy; Stewart, Moira; Freeman, Thomas R; Kasperski, M Janet

    2011-01-01

    Increasingly, primary health care teams (PHCTs) depend on the contributions of multiple professionals. However, conflict is inevitable on teams. This article examines PHCTs members' experiences with conflict and responses to conflict. This phenomenological study was conducted using in-depth interviews with 121 participants from 16 PHCTs (10 urban and 6 rural) including a wide range of health care professionals. An iterative analysis process was used to examine the verbatim transcripts. The analysis revealed three main themes: sources of team conflict; barriers to conflict resolution; and strategies for conflict resolution. Sources of team conflict included: role boundary issues; scope of practice; and accountability. Barriers to conflict resolution were: lack of time and workload; people in less powerful positions; lack of recognition or motivation to address conflict; and avoiding confrontation for fear of causing emotional discomfort. Team strategies for conflict resolution included interventions by team leaders and the development of conflict management protocols. Individual strategies included: open and direct communication; a willingness to find solutions; showing respect; and humility. Conflict is inherent in teamwork. However, understanding the potential barriers to conflict resolution can assist PHCTs in developing strategies to resolve conflict in a timely fashion. PMID:20795830

  6. Health Hybrid Concept Analysis in Old People

    PubMed Central

    Noghabi, Ahamadali Asadi; Alhani, Fatemeh; Peyrovi, Hamid

    2013-01-01

    Background: It seems necessary to study the health status of this age group to promote their health and prevent disease as well as care planning. In order to achieve this goal, a clear definition of the concept of elderly health is essential. Method: Hybrid concept analysis, our research design, utilizes both theoretical analysis of literature and empirical observation to define a concept. We chose the hybrid concept analysis method because its inclusion of old people perspectives enriches the limited health research literature. The method consists of three phases theory, fieldwork, and analysis. Results: In comparison, we can conclude that health in the elderly people is something more than the absence of illness and 4 physical, mental, social and spiritual domains which are referred to in the definition of a theoretical stage are supported by the findings. The relative health was also proposed against the complete welfare and comfort for the elderly and it showed that their expectations are less than their ages. In addition, the elderly have expressed the family as a preference and the researcher believes that this theme is context based because it has emerged following the interview. Since the family has a special place according to the Iranian culture and religion and the family health is a priority in their health. In addition, the daily activities have been raised as a major theme that can be considered as the physical health but the elderly have expressed it apart from the physical health. Conclusion: Health among the old is a concept that is affected by genetic, environmental, healthcare services and lifestyle-related factors and involves proportional physical, mental, social, familial, spiritual, and economical welfare along with the ability to handle daily life activities which is measurable through medical and functional approaches. PMID:24171892

  7. Public health, conflict and human rights: toward a collaborative research agenda

    PubMed Central

    Thoms, Oskar NT; Ron, James

    2007-01-01

    Although epidemiology is increasingly contributing to policy debates on issues of conflict and human rights, its potential is still underutilized. As a result, this article calls for greater collaboration between public health researchers, conflict analysts and human rights monitors, with special emphasis on retrospective, population-based surveys. The article surveys relevant recent public health research, explains why collaboration is useful, and outlines possible future research scenarios, including those pertaining to the indirect and long-term consequences of conflict; human rights and security in conflict prone areas; and the link between human rights, conflict, and International Humanitarian Law. PMID:18005430

  8. Making sense of the global health crisis: policy narratives, conflict, and global health governance.

    PubMed

    Ney, Steven

    2012-04-01

    Health has become a policy issue of global concern. Worried that the unstructured, polycentric, and pluralist nature of global health governance is undermining the ability to serve emergent global public health interests, some commentators are calling for a more systematic institutional response to the "global health crisis." Yet global health is a complex and uncertain policy issue. This article uses narrative analysis to explore how actors deal with these complexities and how uncertainties affect global health governance. By comparing three narratives in terms of their basic assumptions, the way they define problems as well as the solutions they propose, the analysis shows how the unstructured pluralism of global health policy making creates a wide scope of policy conflict over the global health crisis. This wide scope of conflict enables effective policy-oriented learning about global health issues. The article also shows how exclusionary patterns of cooperation and competition are emerging in health policy making at the global level. These patterns threaten effective learning by risking both polarization of the policy debate and unanticipated consequences of health policy. Avoiding these pitfalls, the analysis suggests, means creating global health governance regimes that promote openness and responsiveness in deliberation about the global health crisis. PMID:22422655

  9. Technology, conflict early warning systems, public health, and human rights.

    PubMed

    Pham, Phuong N; Vinck, Patrick

    2012-01-01

    Public health and conflict early warning are evolving rapidly in response to technology changes for the gathering, management, analysis and communication of data. It is expected that these changes will provide an unprecedented ability to monitor, detect, and respond to crises. One of the potentially most profound and lasting expected change affects the roles of the various actors in providing and sharing information and in responding to early warning. Communities and civil society actors have the opportunity to be empowered as a source of information, analysis, and response, while the role of traditional actors shifts toward supporting those communities and building resilience. However, by creating new roles, relationships, and responsibilities, technology changes raise major concerns and ethical challenges for practitioners, pressing the need for practical guidelines and actionable recommendations in line with existing ethical principles. PMID:23568944

  10. Policy conflicts: gene patents and health care in Canada.

    PubMed

    Caulfield, Timothy

    2005-01-01

    Several recent gene patent controversies have energized and refocused the human gene patent debate in Canada. These include the use of the Myriad test for breast cancer by the provinces, patenting of the Severe Acute Respiratory Syndrome virus and a recent Supreme Court decision rejecting the patenting of 'higher life forms'. These cases place the emerging policy conflicts between the innovation and commercialization agenda of the government and the desire to provide equitable access to health care in sharp focus. Another challenge faced by Canada is the powerful influence of the United States in policy decisions. Although these issues have raised awareness about the possibility of reforming the patent system, Parliament has yet to consider any of the suggested reforms of the Canadian patent system and there are no formal proposals pending. PMID:16244476

  11. Development of Concepts of Political Conflict and Power by 5th and 8th Graders. Final Report.

    ERIC Educational Resources Information Center

    Sears, David O.

    This research investigated pre-adolescent children's concepts of political conflict and power, and the processes by which these are acquired. It focused particularly upon the acquisition of such attitudes by Black and Mexican-American children, minority groups currently involved in deep social and political conflicts. The data were obtained with a…

  12. Understanding effects of armed conflict on health outcomes: the case of Nepal

    PubMed Central

    2010-01-01

    Objective There is abundance of literature on adverse effects of conflict on the health of the population. In contrast to this, sporadic data in Nepal claim improvements in most of the health indicators during the decade-long armed conflict (1996-2006). However, systematic information to support or reject this claim is scant. This study reviews Nepal's key health indicators before and after the violent conflict and explores the possible factors facilitating the progress. Methods A secondary analysis has been conducted of two demographic health surveys-Nepal Family Health Survey (NFHS) 1996 and Nepal Demographic and Health Survey (NDHS) 2006; the latter was supplemented by a study carried out by the Nepal Health Research Council in 2006. Results The data show Nepal has made progress in 16 out of 19 health indicators which are part of the Millennium Development Goals whilst three indicators have remained static. Our analysis suggests a number of conflict and non-conflict factors which may have led to this success. Conclusion The lessons learnt from Nepal could be replicable elsewhere in conflict and post-conflict environments. A nationwide large-scale empirical study is needed to further assess the determinants of Nepal's success in the health sector at a time the country experienced a decade of armed conflict. PMID:21122098

  13. [Inequalities in health: definitions, concepts, and theories].

    PubMed

    Arcaya, Mariana C; Arcaya, Alyssa L; Subramanian, S V

    2015-10-01

    Individuals from different backgrounds, social groups, and countries enjoy different levels of health. This article defines and distinguishes between unavoidable health inequalities and unjust and preventable health inequities. We describe the dimensions along which health inequalities are commonly examined, including across the global population, between countries or states, and within geographies, by socially relevant groupings such as race/ethnicity, gender, education, caste, income, occupation, and more. Different theories attempt to explain group-level differences in health, including psychosocial, material deprivation, health behavior, environmental, and selection explanations. Concepts of relative versus absolute; dose response versus threshold; composition versus context; place versus space; the life course perspective on health; causal pathways to health; conditional health effects; and group-level versus individual differences are vital in understanding health inequalities. We close by reflecting on what conditions make health inequalities unjust, and to consider the merits of policies that prioritize the elimination of health disparities versus those that focus on raising the overall standard of health in a population. PMID:26758216

  14. Inequalities in health: definitions, concepts, and theories.

    PubMed

    Arcaya, Mariana C; Arcaya, Alyssa L; Subramanian, S V

    2015-01-01

    Individuals from different backgrounds, social groups, and countries enjoy different levels of health. This article defines and distinguishes between unavoidable health inequalities and unjust and preventable health inequities. We describe the dimensions along which health inequalities are commonly examined, including across the global population, between countries or states, and within geographies, by socially relevant groupings such as race/ethnicity, gender, education, caste, income, occupation, and more. Different theories attempt to explain group-level differences in health, including psychosocial, material deprivation, health behavior, environmental, and selection explanations. Concepts of relative versus absolute; dose-response versus threshold; composition versus context; place versus space; the life course perspective on health; causal pathways to health; conditional health effects; and group-level versus individual differences are vital in understanding health inequalities. We close by reflecting on what conditions make health inequalities unjust, and to consider the merits of policies that prioritize the elimination of health disparities versus those that focus on raising the overall standard of health in a population. PMID:26112142

  15. Inequalities in health: definitions, concepts, and theories

    PubMed Central

    Arcaya, Mariana C.; Arcaya, Alyssa L.; Subramanian, S. V.

    2015-01-01

    Individuals from different backgrounds, social groups, and countries enjoy different levels of health. This article defines and distinguishes between unavoidable health inequalities and unjust and preventable health inequities. We describe the dimensions along which health inequalities are commonly examined, including across the global population, between countries or states, and within geographies, by socially relevant groupings such as race/ethnicity, gender, education, caste, income, occupation, and more. Different theories attempt to explain group-level differences in health, including psychosocial, material deprivation, health behavior, environmental, and selection explanations. Concepts of relative versus absolute; dose–response versus threshold; composition versus context; place versus space; the life course perspective on health; causal pathways to health; conditional health effects; and group-level versus individual differences are vital in understanding health inequalities. We close by reflecting on what conditions make health inequalities unjust, and to consider the merits of policies that prioritize the elimination of health disparities versus those that focus on raising the overall standard of health in a population. PMID:26112142

  16. Health in fragile and post-conflict states: a review of current understanding and challenges ahead.

    PubMed

    Haar, Rohini J; Rubenstein, Leonard S

    2012-01-01

    Health systems face enormous challenges in fragile and post-conflict states. This paper will review recent literature to better understand how, within a context of economic volatility, political instability, infrastructural collapse and human resource scarcity, population health deteriorates and requires significant attention and resources to rebuild. Classifications of fragile and post-conflict states differ among organizations and reviewing the basic consensus as well as differences will assist in clarifying how organizations use these terms and how statistics on these nations come about. Of particular interest is the increase in local conflicts within states that may not affect national mortality and morbidity but pose heavy burdens on regional populations. Recent research on sexual and reproductive health, children's health and mental health within fragile and post-conflict states highlights the effects of healthcare systems and their breakdown on communities. We propose a research agenda to further explore knowledge gaps concerning health in fragile and post-conflict states. PMID:23421305

  17. Resolving conflict realistically in today's health care environment.

    PubMed

    Smith, S B; Tutor, R S; Phillips, M L

    2001-11-01

    Conflict is a natural part of human interaction, and when properly addressed, results in improved interpersonal relationships and positive organizational culture. Unchecked conflict may escalate to verbal and physical violence. Conflict that is unresolved creates barriers for people, teams, organizational growth, and productivity, leading to cultural disintegration within the establishment. By relying on interdependence and professional collaboration, all parties involved grow and, in turn, benefit the organization and population served. When used in a constructive manner, conflict resolution can help all parties involved see the whole picture, thus allowing freedom for growth and change. Conflict resolution is accomplished best when emotions are controlled before entering into negotiation. Positive confrontation, problem solving, and negotiation are processes used to realistically resolve conflict. Everyone walks away a winner when conflict is resolved in a positive, professional manner (Stone, 1999). PMID:11725427

  18. Persistent work-life conflict and health satisfaction - A representative longitudinal study in Switzerland

    PubMed Central

    2011-01-01

    Background The objectives of the present study were (1) to track work-life conflict in Switzerland during the years 2002 to 2008 and (2) to analyse the relationship between work-life conflict and health satisfaction, examining whether long-term work-life conflict leads to poor health satisfaction. Methods The study is based on a representative longitudinal database (Swiss Household Panel), covering a six-year period containing seven waves of data collection. The sample includes 1261 persons, with 636 men and 625 women. Data was analysed by multi-level mixed models and analysis of variance with repeated measures. Results In the overall sample, there was no linear increase or decrease of work-life conflict detected, in either its time-based or strain-based form. People with higher education were more often found to have a strong work-life conflict (time- and strain-based), and more men demonstrated a strong time-based work-life conflict than women (12.2% vs. 5%). A negative relationship between work-life conflict and health satisfaction over time was found. People reporting strong work-life conflict at every wave reported lower health satisfaction than people with consistently weak work-life conflict. However, the health satisfaction of those with a continuously strong work-life conflict did not decrease during the study period. Conclusions Both time-based and strain-based work-life conflict are strongly correlated to health satisfaction. However, no evidence was found for a persistent work-life conflict leading to poor health satisfaction. PMID:21529345

  19. The Hospice Concept: Health Occupation 305.

    ERIC Educational Resources Information Center

    Schobel, Deborah A.

    A description is provided of "The Hospice Concept," an elective course offered as part of a two-year college health occupations curriculum. The course is designed to further the students understanding of the multiple facets of death and dying and to prepare them to be hospice volunteers. Following a course description and a glossary of terms,…

  20. Concept Development for Software Health Management

    NASA Technical Reports Server (NTRS)

    Riecks, Jung; Storm, Walter; Hollingsworth, Mark

    2011-01-01

    This report documents the work performed by Lockheed Martin Aeronautics (LM Aero) under NASA contract NNL06AA08B, delivery order NNL07AB06T. The Concept Development for Software Health Management (CDSHM) program was a NASA funded effort sponsored by the Integrated Vehicle Health Management Project, one of the four pillars of the NASA Aviation Safety Program. The CD-SHM program focused on defining a structured approach to software health management (SHM) through the development of a comprehensive failure taxonomy that is used to characterize the fundamental failure modes of safety-critical software.

  1. The mental health of children affected by armed conflict: Protective processes and pathways to resilience

    PubMed Central

    Betancourt, Theresa Stichick; Khan, Kashif Tanveer

    2008-01-01

    This paper examines the concept of resilience in the context of children affected by armed conflict. Resilience has been frequently viewed as a unique quality of certain ‘invulnerable’ children. In contrast, this paper argues that a number of protective processes contribute to resilient mental health outcomes in children when considered through the lens of the child's social ecology. While available research has made important contributions to understanding risk factors for negative mental health consequences of war-related violence and loss, the focus on trauma alone has resulted in inadequate attention to factors associated with resilient mental health outcomes. This paper presents key studies in the literature that address the interplay between risk and protective processes in the mental health of war-affected children from an ecological, developmental perspective. It suggests that further research on war-affected children should pay particular attention to coping and meaning making at the individual level; the role of attachment relationships, caregiver health, resources and connection in the family, and social support available in peer and extended social networks. Cultural and community influences such as attitudes towards mental health and healing as well as the meaning given to the experience of war itself are also important aspects of the larger social ecology. PMID:18569183

  2. The mental health of children affected by armed conflict: protective processes and pathways to resilience.

    PubMed

    Betancourt, Theresa Stichick; Khan, Kashif Tanveer

    2008-06-01

    This paper examines the concept of resilience in the context of children affected by armed conflict. Resilience has been frequently viewed as a unique quality of certain 'invulnerable' children. In contrast, this paper argues that a number of protective processes contribute to resilient mental health outcomes in children when considered through the lens of the child's social ecology. While available research has made important contributions to understanding risk factors for negative mental health consequences of war-related violence and loss, the focus on trauma alone has resulted in inadequate attention to factors associated with resilient mental health outcomes. This paper presents key studies in the literature that address the interplay between risk and protective processes in the mental health of war-affected children from an ecological, developmental perspective. It suggests that further research on war-affected children should pay particular attention to coping and meaning making at the individual level; the role of attachment relationships, caregiver health, resources and connection in the family, and social support available in peer and extended social networks. Cultural and community influences such as attitudes towards mental health and healing as well as the meaning given to the experience of war itself are also important aspects of the larger social ecology. PMID:18569183

  3. The flight of white-collars: Civil conflict, availability of medical service providers and public health.

    PubMed

    Kıbrıs, Arzu; Metternich, Nils

    2016-01-01

    Civil conflicts devastate public health both in the short run and in the long run. Analyzing novel data sets that include yearly information on public health and the availability of health professionals across provinces in Turkey in the 1964-2010 period, we provide empirical evidence for our theoretical argument that a major mechanism through which civil conflicts exert their long term negative influences on public health is by discouraging medical personnel to practice in conflict regions. We also assess the effectiveness of certain policy measures that Turkish governments have tried out over the years to counteract this mechanism. Our results reveal that the long running civil conflict in Turkey has been driving away doctors and other highly trained medical personnel from conflict areas and that mandatory service requirements do help counteract this flight. PMID:26708245

  4. Tracking Official Development Assistance for Reproductive Health in Conflict-Affected Countries

    PubMed Central

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

    2009-01-01

    Background Reproductive health needs are particularly acute in countries affected by armed conflict. Reliable information on aid investment for reproductive health in these countries is essential for improving the efficiency and effectiveness of aid. The purpose of this study was to analyse official development assistance (ODA) for reproductive health activities in conflict-affected countries from 2003 to 2006. Methods and Findings The Creditor Reporting System and the Financial Tracking System databases were the chosen data sources for the study. ODA disbursement for reproductive health activities to 18 conflict-affected countries was analysed for 2003, 2004, 2005, and 2006. An average of US$20.8 billion in total ODA was disbursed annually to the 18 conflict-affected countries between 2003 and 2006, of which US$509.3 million (2.4%) was allocated to reproductive health. This represents an annual average of US$1.30 disbursed per capita in the 18 sampled countries for reproductive health activities. Non-conflict-affected least-developed countries received 53.3% more ODA for reproductive health activities than conflict-affected least-developed countries, despite the latter generally having greater reproductive health needs. ODA disbursed for HIV/AIDS prevention and treatment increased by 119.4% from 2003 to 2006. The ODA disbursed for other direct reproductive health activities declined by 35.9% over the same period. Conclusions This study provides evidence of inequity in disbursement of reproductive health ODA between conflict-affected countries and non-conflict-affected countries, and between different reproductive health activities. These findings and the study's recommendations seek to support initiatives to make aid financing more responsive to need in the context of armed conflict. PMID:19513098

  5. Chinese concepts of euthanasia and health care.

    PubMed

    Sleeboom-Faulkner, Margaret

    2006-08-01

    This article argues that taking concepts of euthanasia out of their political and economic contexts leads to violations of the premises on which the Stoic ideal of euthanasia is based: 'a quick, gentle and honourable death.' For instance, the transplantation of the narrowly defined concept of euthanasia developed under the Dutch welfare system into a developing country, such as the People's Republic of China (PRC), seems inadequate. For it cannot deal with questions of anxiety about degrading forms of dying and suffering without reference to its economic rationale, demanded by a scarcity (unequal distribution) of health care resources. The weakness of health care provisions for the terminally ill in Mainland China has become increasingly poignant since the collapse of collective health care institutions in the countryside since the reforms of the late-1980s. As in most cases where health care facilities are wanting, it is difficult to apply the criteria of gentleness and dignity at reaching death. Its solution lies not in a faster relief from suffering by euthanasia, but in extending the quality of life through distributive justice within Chinese healthcare policy-making. This paper begins with a brief description of the Dutch euthanasia law, after which it discusses Chinese conceptions of euthanasia in biomedical textbooks, the media and in surveys. It concludes by pointing out the need for a transnational framework in which both the specifics and generalities of euthanasia can be discussed. PMID:17044154

  6. Professionalization of Evaluative Research: Conflict as a Sign of Health.

    ERIC Educational Resources Information Center

    Conner, Ross F.; Dickman, Frances Baker

    1979-01-01

    Issues concerning the professionalization of evaluative research that are discussed in this reply to Morell and Flaherty include: the nature and substance of conflicts in evaluative research, conflicts over methodological perspectives, the role of the evaluator in program planning, and the appropriate uses and users of evaluative information.…

  7. Health care allocation, public consultation and the concept of 'health'.

    PubMed

    Edgar, A

    1998-09-01

    By comparing models of market-based allocation with state-controlled national health care systems, it will be suggested that the way in which different communities deal with the allocation of health care is central to their expression of what might be called a moral self-understanding. That is to say that the provision of health care may be expected to be a focus of communal debate, not simply about morally acceptable and unacceptable actions, but also about the community's understanding of what it is that makes for a worthwhile and morally defensible human life. This moral self-understanding is seen to be entwined with the different concepts of 'health' that are implicit in different systems of allocation. In conclusion, it will be suggested that decisions concerning health care allocation must be made in response to a continuing, public and open debate about what health and health care mean to a particular community. PMID:10185170

  8. The concept of stewardship in health policy.

    PubMed Central

    Saltman, R. B.; Ferroussier-Davis, O.

    2000-01-01

    There is widespread agreement that both the configuration and the application of state authority in the health sector should be realigned in the interest of achieving agreed policy objectives. The desired outcome is frequently characterized as a search for good governance serving the public interest. The present paper examines the proposal in The World Health Report 2000 that the concept of stewardship offers the appropriate basis for reconfiguration. We trace the development of stewardship from its initial religious formulation to more recent ecological and sociological permutations. Consideration is given to the potential of stewardship for encouraging state decision-making that is both normatively based and economically efficient. Various dilemmas that could impede or preclude such a shift in state behaviour are examined. We conclude that the concept of stewardship holds substantial promise if adequately developed and effectively implemented. PMID:10916910

  9. [Conflicts of interests in clinical research in primary health care].

    PubMed

    González-de Paz, L; Navarro-Rubio, M D; Sisó-Almirall, A

    2014-03-01

    Conflicts of interests between professionals and patients in biomedical research, is an ethical problem. None of the laws in Spain mention whether the clinical researcher has to clarify to participants the reasons why it proposes them to participate in a clinical trial. In this article, conflicts of interests in research are discussed in the context of primary healthcare. In this area conflicts of interests might alter the confidence between patients and healthcare professionals. Finally, we suggest some practical strategies that can help participants make the decision to participate in a clinical trial more willingly and freely. PMID:24055589

  10. Early Adolescent Health Risk Behaviors, Conflict Resolution Strategies, and School Climate

    ERIC Educational Resources Information Center

    LaRusso, Maria; Selman, Robert

    2011-01-01

    Drawing upon an ethnically and socio-economically diverse sample of 323 7th grade students from twelve urban schools within one school district, this mixed method study examined early adolescents' self-reported health risk behaviors as related to their conflict resolution strategies and their school's conflict resolution climate. Survey data…

  11. Children's coping with marital conflict and their adjustment and physical health: vulnerability and protective functions.

    PubMed

    Nicolotti, Linda; el-Sheikh, Mona; Whitson, Stephanie M

    2003-09-01

    Children's strategies for coping with parental marital conflict were examined as predictors, mediators, and moderators of the relations between marital conflict and 8- to 11-year-olds' internalizing, externalizing, and physical health problems. In the context of marital conflict, a higher level of active coping and support coping combined was a protective factor against girls' depression symptoms and self-esteem problems and both boys' and girls' health problems. Further, avoidance coping was a vulnerability factor for externalizing, internalizing, and physical health problems in boys, and distraction coping was protective against children's depression and health problems. These findings extend the literature by delineating coping strategies that either protected children against, or heightened their vulnerability to, adjustment and health problems associated with exposure to parental marital conflict. PMID:14562456

  12. Living through conflict and post-conflict: experiences of health workers in northern Uganda and lessons for people-centred health systems

    PubMed Central

    Namakula, Justine; Witter, Sophie

    2014-01-01

    Providing people-centred health systems—or any systems at all—requires specific measures to protect and retain healthcare workers during and after the conflict. This is particularly important when health staff are themselves the target of violence and abduction, as is often the case. This article presents the perspective of health workers who lived through conflict in four districts of northern Uganda—Pader, Gulu, Amuru, and Kitgum. These contained more than 90% of the people displaced by the decades of conflict, which ended in 2006. The article is based on 26 in-depth interviews, using a life history approach. This participatory tool encouraged participants to record key events and decisions in their lives, and to explore areas such as their decision to become a health worker, their employment history, and their experiences of conflict and coping strategies. These were analyzed thematically to develop an understanding of how to protect and retain staff in these challenging contexts. During the conflict, many health workers lost their lives or witnessed the death of their friends and colleagues. They also experienced abduction, ambush and injury. Other challenges included disconnection from social and professional support systems, displacement, limited supplies and equipment, increased workload and long working days and lack of pay. Health workers were not passive in the face of these challenges, however. They adopted a range of safety measures, such as mingling with community members, sleeping in the bush, and frequent change of sleeping place, in addition to psychological and practical coping strategies. Understanding their motivation and their views provides an important insight how to maintain staffing and so to continue to offer essential health care during difficult times and in marginalized areas. PMID:25274642

  13. An In-Law Comes To Stay: Examination of Interdisciplinary Conflict in a School-Based Health Center.

    ERIC Educational Resources Information Center

    Fast, Jonathan D.

    2003-01-01

    Social workers often work in settings where other professions exert a higher level of control. The organizational literature on causes of conflict and conflict resolution is briefly reviewed. A case study of a newly opened school-based health center provides an opportunity to analyze conflicts between the school and health center personnel and…

  14. Concepts for NASA longitudinal health studies

    NASA Technical Reports Server (NTRS)

    Nicogossian, A. E.; Pool, S. L.; Leach, C. S.; Moseley, E.; Rambaut, P. C.

    1983-01-01

    Clinical data collected from a 15-year study of the homogenous group of pre-Shuttle astronauts have revealed no significant long-term effects from spaceflight. The current hypothesis suggests that repeated exposures to the space environment in the Shuttle era will similarly have no long-term health effects. However, a much more heterogenous group of astronauts and non-astronaut scientists will fly in Shuttle, and data on this group's adaptation to the space environment and readaptation to earth are currently sparse. In addition, very little information is available concerning the short- and long-term medical consequences of long duration exposure to space and subsequent readaptation to the earth environment. In this paper, retrospective clinical information on astronauts is reviewed and concepts for conducting epidemiological studies examining long-term health effects of spaceflight on humans, including associated occupational risks factors, are presented.

  15. What Are the Costs of Marital Conflict and Dissolution to Children's Physical Health?

    ERIC Educational Resources Information Center

    Troxel, Wendy M.; Matthews, Karen A.

    2004-01-01

    Do parental marital conflict and dissolution influence the risk trajectory of children's physical health risk? This paper reviews evidence addressing this question in the context of understanding how early environmental adversities may trigger a succession of risks that lead to poor health in childhood and greater risk for chronic health problems…

  16. [Burnout : concepts and implications affecting public health].

    PubMed

    Segura, Omar

    2014-01-01

    Burnout was originally described as a mental condition characterized by reduced work performance, impotence, frustration and lack of capability to reach objectives or goals while performing a job. For some authors, burnout is a poorly defined mixture of symptoms and signs, while other professionals think of it as a disease and a potential threat to public health. Worldwide, it has been observed that the most afflicted professionals and technicians are those who work providing services or assistance to other people, especially those dedicated to health care. This paper focuses on the idea that burnout should be considered a disease more than a syndrome. On the other hand, definitions of health and disease have changed with time, as well as theoretical and methodological references about burnout. In addition, burnout remains a condition that is being discussed in various scientific areas, with radically opposing positions; these approaches are discussed in this article. After presenting different conceptions regarding burnout, the essay concludes with an exploration of its implications and the identification of possible treatments, especially for health workers, among whom it is more common depending on their predisposing conditions and environments. PMID:25504242

  17. Reconstruction of health service systems in the post-conflict Northern Province in Sri Lanka.

    PubMed

    Nagai, Mari; Abraham, Sandirasegaram; Okamoto, Miyoko; Kita, Etsuko; Aoyama, Atsuko

    2007-09-01

    Public health problems in armed conflicts have been well documented, however, effective national health policies and international assistance strategies in transition periods from conflict to peace have not been well established. After the long lasted conflicts in Sri Lanka, the Government and the rebel LTTE signed a cease-fire agreement in February 2002. As the peace negotiation has been disrupted since April 2003, a long-term prospect for peace is yet uncertain at present. The objective of this research is to detect unmet needs in health services in Northern Province in Sri Lanka, and to recommend fair and effective health strategies for post-conflict reconstruction. First, we compared a 20-year trend of health services and health status between the post-conflict Northern Province and other areas not directly affected by conflict in Sri Lanka by analyzing data published by Sri Lankan government and other agencies. Then, we conducted open-ended self-administered questionnaires to health care providers and inhabitants in Northern Province, and key informant interviews in Northern Province and other areas. The major health problems in Northern Province were high maternal mortality, significant shortage of human resources for health (HRH), and inadequate water and sanitation systems. Poor access to health facilities, lack of basic health knowledge, insufficient health awareness programs for inhabitants, and mental health problems among communities were pointed by the questionnaire respondents. Shortage of HRH and people's negligence for health were perceived as the major obstacles to improving the current health situation in Northern Province. The key informant interviews revealed that Sri Lankan HRH outside Northern Province had only limited information about the health issues in Northern Province. It is required to develop and allocate HRH strategically for the effective reconstruction of health service systems in Northern Province. The empowerment of inhabitants

  18. Conflict of interest in public health: should there be a law to prevent it?

    PubMed

    Gupta, Arun; Holla, Radha; Suri, Shoba

    2015-01-01

    "Conflict of interest", now being commonly cited, is a set of circumstances that creates a risk that professional judgement or actions regarding a primary interest will be unduly influenced by a secondary interest. Conflict of interest situations can be institutional or personal, and can stem from financial or other interests including post-employment opportunities or during public -private partnerships. Conflicts of interest in the creation of public policy, especially health or nutrition related policies such as the vaccine policy, tobacco control, and research related to health, can have negative impact on the lives of millions of people. While the UN Convention Against Corruption, to which India is a signatory, identifies conflict of interest as often being a precursor to corruption, there is no serious action being taken in this direction by the Indian government, in spite of the fact there are instances of serious nature coming to light that affect our peoples lives. If conflict of interest situations are allowed to continue especially in health policy it could be detrimental to millions of people; therefore, it would be in public interest that India enacts a law to prevent conflict of interest in the making of public policies, comprehensive enough to include financial and institutional conflicts of interest. PMID:26060144

  19. Wars and Child Health: Evidence from the Eritrean-Ethiopian Conflict.

    PubMed

    Akresh, Richard; Lucchetti, Leonardo; Thirumurthy, Harsha

    2012-11-01

    Conflict between and within countries can have lasting health and economic consequences, but identifying such effects can be empirically challenging. This paper uses household survey data from Eritrea to estimate the effect of exposure to the 1998-2000 Eritrea-Ethiopia war on children's health. The identification strategy exploits exogenous variation in the conflict's geographic extent and timing and the exposure of different birth cohorts to the fighting. The unique survey data include details on each household's migration history, which allows us to measure a child's geographic location during the war and without which war exposure would be incorrectly classified. War-exposed children have lower height-for-age Z-scores, with similar effects for children born before or during the war. Both boys and girls who are born during the war experience negative impacts due to conflict. Effects are robust to including region-specific time trends, alternative conflict exposure measures, and mother fixed effects. PMID:22962514

  20. Applying marketing concepts to promote health in vulnerable groups.

    PubMed

    Fontana, S A

    1991-06-01

    Public health nurses must have a valid marketing orientation. Two marketing concepts, exchange relationships and channels of distribution and their application for public health nursing practice, have relevance in this context. In spite of the complexities inherent in applying them, they can be used to promote health in at-risk populations. By incorporating these concepts in planning and delivering public health nursing services, it is hoped that the health goals of a larger number of vulnerable individuals can be achieved. PMID:1924108

  1. A diagnosis of conflict: theoretical barriers to integration in mental health services & their philosophical undercurrents

    PubMed Central

    2010-01-01

    This paper examines the philosophical substructure to the theoretical conflicts that permeate contemporary mental health care in the UK. Theoretical conflicts are treated here as those that arise among practitioners holding divergent theoretical orientations towards the phenomena being treated. Such conflicts, although steeped in history, have become revitalized by recent attempts at integrating mental health services that have forced diversely trained practitioners to work collaboratively together, often under one roof. Part I of this paper examines how the history of these conflicts can be understood as a tension between, on the one hand, the medical model and its use by the dominant profession of psychiatry, and on the other, those alternative models and practitioners in some way differentiated from the medical model camp. Examples will be given from recent policy and research to highlight the prevalence of this tension in contemporary practice. Part II of this paper explores the deeper commonalities that lay beneath the theoretical conflict outlined in Part I. These commonalities will be shown to be apart of a captivating framework that has continued to grip the conflict since its inception. By exposing this underlying framework--and the motivations inherent therein--the topic of integration appears in wholly different light, allowing a renewed philosophical basis for integration to emerge. PMID:20132546

  2. Shared understandings: negotiating the meanings of health via concept mapping.

    PubMed

    Caelli, K

    1998-05-01

    This paper discusses a project undertaken to explore the effectiveness of concept mapping in assisting students to develop positive concepts of health. Positive concepts of health are central to the notion of health promotion. While strategies for health promotion are included in all nursing education programmes in Australia, to date there have been few strategies that are oriented towards promoting the development of positive concepts of health discussed in the literature. If student nurses are to become health-promoting practitioners, health teaching in nursing education must employ teaching strategies which clarify for students the differences between positive and negative concepts of health. One such strategy is concept mapping, which was developed as an educational tool to foster meaningful learning. Concept maps work to identify misconceptions in relation to a topic by clarifying the essential points, thus opening the way for concept change. This paper discusses the results of using concept mapping within the context of an abstract subject such as health, identifies difficulties in evaluating the strategy and makes recommendations about how these might be overcome. PMID:9847717

  3. Health care alliances and alternative dispute resolution: managing trust and conflict.

    PubMed

    Rotarius, T; Liberman, A

    2000-03-01

    The U.S. health care industry has entered an unprecedented era of alliance activity. These alliances involve medical groups and hospitals, as well as many of the newer health care entities such as managed care organizations and integrated delivery systems. The increase in organizational collaboration has resulted in an increase in organizational conflict. Alternative dispute resolution (ADR) techniques can serve as a valuable tool for mitigating this type of conflict. The role of ADR is to refocus partners' attentions away from an adversarial posture and toward a complementary existence. This will permit the partners to realize the intended outcomes of the collaboration. PMID:10915338

  4. Trade policy and health: from conflicting interests to policy coherence.

    PubMed

    Blouin, Chantal

    2007-03-01

    Policy incoherence at the interface between trade policy and health can take many forms, such as international trade commitments that strengthen protection of pharmaceutical patents, or promotion of health tourism that exacerbates the shortage of physicians in rural areas. Focusing on the national policy-making process, we make recommendations regarding five conditions that are necessary, but not sufficient, to ensure that international trade policies are coherent with national health objectives. These conditions are: space for dialogue and joint fact-finding; leadership by ministries of health; institutional mechanisms for coordination; meaningful engagement with stakeholders; and a strong evidence base. PMID:17486206

  5. Human resource management in post-conflict health systems: review of research and knowledge gaps.

    PubMed

    Roome, Edward; Raven, Joanna; Martineau, Tim

    2014-01-01

    In post-conflict settings, severe disruption to health systems invariably leaves populations at high risk of disease and in greater need of health provision than more stable resource-poor countries. The health workforce is often a direct victim of conflict. Effective human resource management (HRM) strategies and policies are critical to addressing the systemic effects of conflict on the health workforce such as flight of human capital, mismatches between skills and service needs, breakdown of pre-service training, and lack of human resource data. This paper reviews published literatures across three functional areas of HRM in post-conflict settings: workforce supply, workforce distribution, and workforce performance. We searched published literatures for articles published in English between 2003 and 2013. The search used context-specific keywords (e.g. post-conflict, reconstruction) in combination with topic-related keywords based on an analytical framework containing the three functional areas of HRM (supply, distribution, and performance) and several corresponding HRM topic areas under these. In addition, the framework includes a number of cross-cutting topics such as leadership and governance, finance, and gender. The literature is growing but still limited. Many publications have focused on health workforce supply issues, including pre-service education and training, pay, and recruitment. Less is known about workforce distribution, especially governance and administrative systems for deployment and incentive policies to redress geographical workforce imbalances. Apart from in-service training, workforce performance is particularly under-researched in the areas of performance-based incentives, management and supervision, work organisation and job design, and performance appraisal. Research is largely on HRM in the early post-conflict period and has relied on secondary data. More primary research is needed across the areas of workforce supply, workforce

  6. Human resource management in post-conflict health systems: review of research and knowledge gaps

    PubMed Central

    2014-01-01

    In post-conflict settings, severe disruption to health systems invariably leaves populations at high risk of disease and in greater need of health provision than more stable resource-poor countries. The health workforce is often a direct victim of conflict. Effective human resource management (HRM) strategies and policies are critical to addressing the systemic effects of conflict on the health workforce such as flight of human capital, mismatches between skills and service needs, breakdown of pre-service training, and lack of human resource data. This paper reviews published literatures across three functional areas of HRM in post-conflict settings: workforce supply, workforce distribution, and workforce performance. We searched published literatures for articles published in English between 2003 and 2013. The search used context-specific keywords (e.g. post-conflict, reconstruction) in combination with topic-related keywords based on an analytical framework containing the three functional areas of HRM (supply, distribution, and performance) and several corresponding HRM topic areas under these. In addition, the framework includes a number of cross-cutting topics such as leadership and governance, finance, and gender. The literature is growing but still limited. Many publications have focused on health workforce supply issues, including pre-service education and training, pay, and recruitment. Less is known about workforce distribution, especially governance and administrative systems for deployment and incentive policies to redress geographical workforce imbalances. Apart from in-service training, workforce performance is particularly under-researched in the areas of performance-based incentives, management and supervision, work organisation and job design, and performance appraisal. Research is largely on HRM in the early post-conflict period and has relied on secondary data. More primary research is needed across the areas of workforce supply, workforce

  7. Technical assistance for health in non-conflict fragile states: challenges and opportunities.

    PubMed

    Gruber, Janet

    2009-10-01

    The paper examines how best technical assistance (TA) for health might be implemented in post-conflict fragile states. It does so in the light of current development trends such as harmonization and alignment and moves towards aid instruments that favour country-led approaches. A number of key issues are addressed. The first of these considers which core principles for ethical TA might apply in post-conflict fragile states; the second reviews thematic challenges, such as the need to balance 'good enough governance' with effective attention to equity, rights and working with local health capacity. A third area for discussion is how best to plan for, and implement, long-term health TA inputs in often volatile and insecure environments, while a fourth topic is the engagement of civil society in rebuilding health systems and service delivery post-conflict. Attention to gender issues in post-conflict fragile states, including the importance of acknowledging and acting upon women's roles in peacekeeping and maintenance, the necessity to apply and sustain more gender equitable approaches to health in such contexts and how TA might facilitate such participation, represents the fifth issue for debate. PMID:19957309

  8. Health literacy: applying current concepts to improve health services and reduce health inequalities.

    PubMed

    Batterham, R W; Hawkins, M; Collins, P A; Buchbinder, R; Osborne, R H

    2016-03-01

    The concept of 'health literacy' refers to the personal and relational factors that affect a person's ability to acquire, understand and use information about health and health services. For many years, efforts in the development of the concept of health literacy exceeded the development of measurement tools and interventions. Furthermore, the discourse about and development of health literacy in public health and in clinical settings were often substantially different. This paper provides an update about recently developed approaches to measurement that assess health literacy strengths and limitations of individuals and of groups across multiple aspects of health literacy. This advancement in measurement now allows diagnostic and problem-solving approaches to developing responses to identified strengths and limitations. In this paper, we consider how such an approach can be applied across the diverse range of settings in which health literacy has been applied. In particular, we consider some approaches to applying health literacy in the daily practice of health-service providers in many settings, and how new insights and tools--including approaches based on an understanding of diversity of health literacy needs in a target community--can contribute to improvements in practice. Finally, we present a model that attempts to integrate the concept of health literacy with concepts that are often considered to overlap with it. With careful consideration of the distinctions between prevailing concepts, health literacy can be used to complement many fields from individual patient care to community-level development, and from improving compliance to empowering individuals and communities. PMID:26872738

  9. Considerations of the Concept of Infant Health: A Literature Review

    ERIC Educational Resources Information Center

    Almqvist-Tangen, Gerd; Axelsson, Asa

    2006-01-01

    This study examined a wide range of literature in order to describe factors associated with the concept of infant health. The design of the study is a literature review examining 21 research studies, written in the English language. The study explored which factors were found to exert an influence on the concept of infant health. The result showed…

  10. Soil health: The concept, its role, and strategies for monitoring

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Soil health is not a new concept as evidenced by writings by both Greek and Roman philosophers who were aware of the importance of soil health to agricultural prosperity. Most recently, the concept has been recognized as a tool to help evaluate the effects of various agricultural and land management...

  11. Mental Health Professionals in Children's Advocacy Centers: Is There Role Conflict?

    ERIC Educational Resources Information Center

    Cross, Theodore P.; Fine, Janet E.; Jones, Lisa M.; Walsh, Wendy A.

    2012-01-01

    Two recent chapters in professional books have criticized children's advocacy centers for creating role conflict for mental health professionals because of their work with criminal justice and child protection professionals in children's advocacy centers as part of a coordinated response to child abuse. This article argues that these critiques…

  12. Developmental Trajectories of African American Adolescents' Family Conflict: Differences in Mental Health Problems in Young Adulthood

    ERIC Educational Resources Information Center

    Choe, Daniel Ewon; Stoddard, Sarah A.; Zimmerman, Marc A.

    2014-01-01

    Family conflict is a salient risk factor for African American adolescents' mental health problems. No study we are aware of has estimated trajectories of their family conflict and whether groups differ in internalizing and externalizing problems during the transition to young adulthood, a critical antecedent in adult mental health and…

  13. RESEARCH REPORT: Using a conflict map as an instructional tool to change student alternative conceptions in simple series electric-circuits

    NASA Astrophysics Data System (ADS)

    Tsai, Chin-Chung

    2003-03-01

    Research in science education has revealed that students have alternative conceptions when learning various domains in science. The conflict map uses a series of discrepant events, critical events, relevant scientific conceptions and perceptions to promote student conceptual change. This study was conducted to examine the effects of using a conflict map on eighth graders' conceptual change and ideational networks about simple series electric circuits. Through a quasi-experimental research design, 93 of Taiwan's eighth graders were assigned to a control group, receiving traditional instruction, while 97 eighth graders were assigned to an experimental group, which used a conflict map as an instructional tool. Research data gathered from a two-tier test revealed that the conflict map could help students overcome alternative conceptions about simple series electric circuits. Student interview data, analysed through a flow map method, also showed that the use of conflict map could help students construct greater, richer and more integrated ideational networks about electric circuits.

  14. Human resources for health through conflict and recovery: lessons from African countries.

    PubMed

    Pavignani, Enrico

    2011-10-01

    A protracted conflict affects human resources for health (HRH) in multiple ways. In most cases, the inflicted damage constitutes the main obstacle to health sector recovery. Interventions aimed at healing derelict human resources are however fraught with difficulties of a political, technical, financial and administrative order. The experience accumulated in past recovery processes has made some important players aware of the cost incurred by neglecting human resource development. Several transitions from conflict to peace have been documented, even if largely in unpublished reports. This paper presents condensed descriptions of some African HRH-related recovery processes, which provide useful lessons. The technical work demanded to resuscitate a derelict health workforce is fairly well understood. In most situations, the highest hurdles lie outside of the health domain, and are of a political and administrative nature. Success stories are rare. But useful lessons are taught by failure as well as by success. PMID:21913930

  15. Do current sports nutrition guidelines conflict with good oral health?

    PubMed

    Broad, Elizabeth M; Rye, Leslie A

    2015-01-01

    For optimal athletic performance, an athlete requires good oral health to reduce the risk of oral pain, inflammation, and infection and thereby minimize the use of analgesics and antimicrobial agents. Increased intake, frequency, and dental contact time of carbohydrate-rich foods, sports nutrition products, and acidic carbohydrate-containing sports and energy drinks may contribute to risks of dental erosion, caries, and inflammatory periodontal conditions in the athlete, especially when he or she also exhibits dehydration and poor oral hygiene habits. Examining the athlete before he or she begins participating in a sport allows the dental care provider to determine the patient's existing oral health, hygiene, and susceptibility to risk factors for erosion, caries, and inflammatory periodontal disease. This oral profile, in conjunction with the individual athlete's dietary needs, can be used to establish a treatment and preventive program, including oral health education. Good oral hygiene practices and application of topical fluoride, especially via fluoridated toothpastes and topical fluoride varnishes, must be available to the athlete. Rinsing with water or a neutral beverage after exposure to carbohydrates or acidic sports nutrition products may reduce carbohydrate contact time and bring oral pH levels back to neutral more quickly, reducing the risk of caries and erosion. Finally, the dentist should encourage the athlete to consult with an experienced sports dietitian to ensure that principles of sports nutrition are being appropriately applied for the type, frequency, and duration of exercise in consideration of the individual's oral health needs. PMID:26545270

  16. Health Literacy Concepts in Nursing Education.

    PubMed

    Kennard, Deborah K

    2016-01-01

    The impact of low health literacy on the health care system is astronomical. The ability to learn, retain, and apply health information is greatly affected by health literacy and thus greatly affects patient outcomes. The responsibility of patient education is mostly shouldered by nurses and yet nursing is the discipline that is most lacking in knowledge and awareness about health literacy. Providing nursing students with the necessary tools to assess patient health literacy and to assess their own patient teaching is a vital component of patient education. Nursing curricula is the place to start. PMID:27209875

  17. Precarious employment, working hours, work-life conflict and health in hotel work.

    PubMed

    McNamara, Maria; Bohle, Philip; Quinlan, Michael

    2011-01-01

    Precarious or temporary work is associated with adverse outcomes including low control over working hours, work-life conflict and stress. The rise in precarious employment is most marked in the service sector but little research has been done on its health effects in this sector. This study compares permanent and temporary workers in the hotel industry, where working hours are highly variable. Survey data from 150 workers from eight 3-Star hotels in urban and regional areas around Sydney were analyzed. Forty-five per cent were male and 52 per cent were female. Fifty four per cent were permanent full-time and 46 per cent were temporary workers. The effects of employment status on perceived job security, control over working hours, and work-life conflict are investigated using PLS-Graph 3.0. The effects of control over working hours, on work-life conflict and subsequent health outcomes are also explored. Temporary workers perceived themselves as less in control of their working hours, than permanent workers (β = .27). However, they also reported lower levels of work intensity (β = .25) and working hours (β = .38). The effects of low hours control (β = .20), work intensity (β = .29), and excessive hours (β = .39) on work-life conflict (r² = .50), and subsequent health effects (r² = .30), are illustrated in the final structural equation model. PMID:20643398

  18. Building an evidence base on mental health interventions for children affected by armed conflict

    PubMed Central

    Betancourt, Theresa S.; Williams, Timothy

    2009-01-01

    This paper reviews what is currently known from research about the effectiveness of interventions to address mental health problems in children and adolescents affected by armed conflict. The focus will be on interventions delivered in conflict affected countries either during active humanitarian emergencies or during the post conflict period. The paper will discuss two main paradigms of intervention dominating the field: psychosocial approaches and clinical/psychiatric approaches. The paper reviews some of the basic literature, theories and issues involved in assessment, programme planning, monitoring and evaluation of both approaches. In order to explore these issues in depth, the paper will draw from the author’s field experiences with research in the Russian Federation and in northern Uganda. The paper also presents a brief review of a handful of other published evaluations of mental health interventions for war affected children. We will close with a discussion of what future research is needed to build an evidence base regarding mental health interventions for children affected by armed conflict as well as the ethical and feasibility issues associated with carrying out this work. PMID:19997531

  19. Trauma in conflict and postconflict settings: contributions to health systems strengthening.

    PubMed

    Lunze, F I; Offergeld, C; Eichhorn, T; Tsorieva, Z; Esenov, C; Lunze, K

    2013-06-01

    Violent trauma does not only affect conflict and post conflict regions, but increasingly industrialized nations afflicted by violence from terror attacks. We conducted a comparative health systems analysis, assuming that that health systems with various backgrounds might learn from each other's health systems challenges caused by violent trauma. During the tragedy of Beslan in the Russian North Caucasus in September of 2004, more than 1000 children with their families were taken hostage in a school. Over three days, 334 people were killed and many more injured. While immediate trauma care was offered to all victims, many suffered from more complex injuries or from blast injuries to the ear caused by indoor bomb explosions, which were left untreated due to the lack of regional capacity for the required specialized microsurgery. Most if not all victims suffered from mental trauma as a consequence of violence, which also impacted surgical care-seeking. In April of 2013, two improvised explosive devices detonated at the Boston Marathon, killed three victims and injured 264, more than 20 of them critically. As a consequence of previous terror acts with mass casualties, local hospitals were prepared with drilling and coordination among health facilities, responders and government agencies. Some injury patterns similar to those in the North Caucasus emerged in the aftermath of the event and need to be addressed by the health system. Trauma from violent conflict and terrorism creates similar challenges to health systems. Preparedness for mass casualties requires revision and coordination of available services, and may prompt the strengthening of existing health systems. Health professionals should encourage victims' representatives and citizen groups to assist with assessing the prevalence and burden of injuries, including mental trauma, and to facilitate connecting affected patients to health care. Awareness for late trauma sequelae, including mental health trauma, is

  20. Utilization of maternal health care services in post-conflict Nepal

    PubMed Central

    Bhandari, Tulsi Ram; Sarma, Prabhakaran Sankara; Kutty, Vellappillil Raman

    2015-01-01

    Background Despite a decade-long armed conflict in Nepal, the country made progress in reducing maternal mortality and is on its way to achieve the Millennium Development Goal Five. This study aimed to assess the degree of the utilization of maternal health care services during and after the armed conflict in Nepal. Methods This study is based on Nepal Demographic and Health Survey data 2006 and 2011. The units of analysis were women who had given birth to at least one child in the past 5 years preceding the survey. First, we compared the utilization of maternal health care services of 2006 with that of 2011. Second, we merged the two data sets and applied logistic regression to distinguish whether the utilization of maternal health care services had improved after the peace process 2006 was underway. Results In 2011, 85% of the women sought antenatal care at least once. Skilled health workers for delivery care assisted 36.1% of the women, and 46% of the women attended postnatal care visit at least once. These figures were 70%, 18.7%, and 16%, respectively, in 2006. Similarly, women were more likely to utilize antenatal care at least once (odds ratio [OR] =2.18, confidence interval [CI] =1.95–2.43), skilled care at birth (OR =2.58, CI =2.36–2.81), and postnatal care at least once (OR =4.13, CI =3.75–4.50) in 2011. Conclusion The utilization of maternal health care services tended to increase continuously during both the armed conflict and the post-conflict period in Nepal. However, the increasing proportion of the utilization was higher after the Comprehensive Peace Process Agreement 2006. PMID:26346111

  1. Essential Concepts in Modern Health Services

    PubMed Central

    El Taguri, A

    2008-01-01

    Health services have the functions to define community health problems, to identify unmet needs and survey the resources to meet them, to establish SMART objectives, and to project administrative actions to accomplish the purpose of proposed action programs. For maximum efficacy, health systems should rely on newer approaches of management as management-by-objectives, risk-management, and performance management with full and equal participation from professionals and consumers. The public should be well informed about their needs and what is expected from them to improve their health. Inefficient use of budget allocated to health services should be prevented by tools like performance management and clinical governance. Data processed to information and intelligence is needed to deal with changing disease patterns and to encourage policies that could manage with the complex feedback system of health. e-health solutions should be instituted to increase effectiveness and improve efficiency and informing human resources and populations. Suitable legislations should be introduced including those that ensure coordination between different sectors. Competent workforce should be given the opportunity to receive lifetime appropriate adequate training. External continuous evaluation using appropriate indicators is vital. Actions should be done both inside and outside the health sector to monitor changes and overcome constraints. PMID:21499457

  2. The impact of shiftwork on work--home conflict, job attitudes and health.

    PubMed

    Demerouti, Evangelia; Geurts, Sabine A E; Bakker, Arnold B; Euwema, Martin

    2004-07-15

    The present study was designed to test the impact of rotation and timing of shifts on work--home conflict, job attitudes, health and absenteeism among the military police. A total of 3122 employees participated in the study. Discriminant analysis was used to examine the relationships between rotation and timing of shifts on the one hand, and the outcome measures on the other. Whether employees had fixed dayshifts, fixed non-day shifts including weekends, or rotating shifts with or without weekends, could be predicted on the basis of the experienced work--home conflict, job attitudes, health and absenteeism. Each of the two parameters of shiftwork differentially affected the experience of the outcome measures. Rotation was most clearly related to unfavourable job attitudes (namely job satisfaction, cynicism, turnover intentions and professional efficacy), whereas timing was most clearly related to increased work--home conflict. The results suggest that fixed non-day shifts including weekends (i.e., during highly valuable times) should be avoided in order to minimize the conflict between work and home and that rotation rosters should be designed with a high degree of individualization and flexibility. These seem to be the most promising ways to reduce the negative consequences of shiftwork for employees, their families and organizations. PMID:15204274

  3. Alternatives to litigation for health care conflicts and claims: alternative dispute resolution in medicine.

    PubMed

    Dauer, Edward A

    2002-12-01

    Health care has undergone radical changes, and it may be predicted that further changes are in the offing as the burdens and the benefits of the newer configurations become known. Change in any system stresses it, creating opportunities for conflict as people and organizations adjust to new realities and encounter changed expectations. The opportunities for conflict in health care (and legal conflict with it), therefore, have been and will continue to be a measurable part of health care's daily life. Many of these conflicts can be managed through one or another of the several forms of ADR. Some ADR procedures are most productive when used as alternatives to impending litigation. Others may be employed when litigation is not likely but when the persistence of conflict, such as that within a newly structured provider organization, would otherwise take its toll on the productivity of the organization and those who work within it. The challenge in using ADR for any of these problems is similar to what physicians understand as differential diagnosis. A good therapy applied to the wrong case yields a bad result. The world of ADR has matured to the point at which the salient features of both cases and procedures are well-enough understood to allow for low-risk and high-benefit applications. This is particularly true for disputes involving allegations of medical error, where the indicators of efficacy are very positive and the risks to safety are comfortably low. Mediation in particular, but mediation of the interest-based style rather than the settlement conference style, deserves fuller consideration and broader use. PMID:12512175

  4. A Strategy to Develop a Concept of Peace as Conflict Resolution.

    ERIC Educational Resources Information Center

    Belden, George B.

    A teaching strategy designed to help elementary students conceptualize about peace as a process of conflict resolution is described. The Baboon Troop and Netsilik Eskimo materials of "Man: A Course of Study" provide the course content in which the students learn that cooperation is the most important ingredient in group survival. Classroom…

  5. Initial Concept for Terminal Area Conflict Detection, Alerting, and Resolution Capability on or Near the Airport Surface

    NASA Technical Reports Server (NTRS)

    Green, David F.; Otero, Sharon D.; Barker, Glover D.; Jones, Denise R.

    2009-01-01

    The Next Generation Air Transportation System (NextGen) concept for 2025 envisions the movement of large numbers of people and goods in a safe, efficient, and reliable manner. The NextGen will remove many of the constraints in the current air transportation system, support a wider range of operations, and deliver an overall system capacity up to 3 times that of current operating levels. In order to achieve the NextGen vision, research is necessary in the areas of surface traffic optimization, maximum runway capacity, reduced runway occupancy time, simultaneous single runway operations, and terminal area conflict prevention, among others. The National Aeronautics and Space Administration (NASA) is conducting Collision Avoidance for Airport Traffic (CAAT) research to develop technologies, data, and guidelines to enable Conflict Detection and Resolution (CD&R) in the Airport Terminal Maneuvering Area (ATMA) under current and emerging NextGen operating concepts. In this report, an initial concept for an aircraft-based method for CD&R in the ATMA is presented. This method is based upon previous NASA work in CD&R for runway incursion prevention, the Runway Incursion Prevention System (RIPS). CAAT research is conducted jointly under NASA's Airspace Systems Program, Airportal Project and the Aviation Safety Program, Integrated Intelligent Flight Deck Project.

  6. Corporate philanthropy and conflicts of interest in public health: ExxonMobil, Equatorial Guinea, and malaria.

    PubMed

    Shah, Naman K

    2013-01-01

    Equatorial Guinea, the most prosperous country in Africa, still bears a large malaria burden. With massive wealth from oil reserves, and nearly half its population living in island ecotypes favourable for malaria control, only poor governance can explain continued parasite burden. By financially backing the country's dictator and other officials through illicit payments, the oil company ExxonMobil contributed to the state's failure. Now ExxonMobil, having helped perpetuate malaria in Equatorial Guinea, gives money to non-governmental organizations, charitable foundations, and universities to advocate for and undertake malaria work. How, and on what terms, can public health engage with such an actor? We discuss challenges in the identification and management of conflicts of interest in public health activities. We reviewed the business and foundation activities of ExxonMobil and surveyed organizations that received ExxonMobil money about their conflict of interest policies. Reforms in ExxonMobil's business practices, as well as its charitable structure, and reforms in the way public health groups screen and manage conflicts of interest are needed to ensure that any relationship ultimately improves the health of citizens. PMID:23172050

  7. Understanding resilience in armed conflict: Social resources and mental health of children in Burundi

    PubMed Central

    Hall, Brian J.; Tol, Wietse A.; Jordans, Mark J.D.; Bass, Judith; de Jong, Joop T.V.M.

    2014-01-01

    Little is known about the role of cognitive social capital among war-affected youth in low- and middle-income countries. We examined the longitudinal association between cognitive social capital and mental health (depression and posttraumatic stress disorder (PTSD) symptoms), functioning, and received social support of children in Burundi. Data were obtained from face-to-face interviews with 176 children over three measurement occasions over the span of 4-months. Cognitive social capital measured the degree to which children believed their community was trustworthy and cohesive. Mental health measures included the Depression Self-Rating Scale (DSRS) (Birleson, 1981), the Child Posttraumatic Symptom Scale (Foa, Johnson, & Feeny, 2001), and a locally constructed scale of functional impairment. Children reported received social support by listing whether they received different types of social support from self-selected key individuals. Cross-lagged path analytic modeling evaluated relationships between cognitive social capital, symptoms and received support separately over baseline (T1), 6-week follow-up (T2), and 4-month follow-up (T3). Each concept was treated and analyzed as a continuous score using manifest indicators. Significant associations between study variables were unidirectional. Cognitive social capital was associated with decreased depression between T1 and T2 (B=−0.22, p<.001) and T2 and T3 (β=−0.25, p<.001), and with functional impairment between T1 and T2 (β=−0.15, p=.005) and T2 and T3 (β=−0.14, p=.005); no association was found for PTSD symptoms at either time point. Cognitive social capital was associated with increased social support between T1 and T2 (β=0.16, p=.002) and T2 and T3 (β=0.16, p=.002). In this longitudinal study, cognitive social capital was related to a declining trajectory of children’s mental health problems and increases in social support. Interventions that improve community relations in war-affected communities

  8. Understanding resilience in armed conflict: social resources and mental health of children in Burundi.

    PubMed

    Hall, Brian J; Tol, Wietse A; Jordans, Mark J D; Bass, Judith; de Jong, Joop T V M

    2014-08-01

    Little is known about the role of cognitive social capital among war-affected youth in low- and middle-income countries. We examined the longitudinal association between cognitive social capital and mental health (depression and posttraumatic stress disorder (PTSD) symptoms), functioning, and received social support of children in Burundi. Data were obtained from face-to-face interviews with 176 children over three measurement occasions over the span of 4-months. Cognitive social capital measured the degree to which children believed their community was trustworthy and cohesive. Mental health measures included the Depression Self-Rating Scale (DSRS) (Birleson, 1981), the Child Posttraumatic Symptom Scale (Foa et al., 2001), and a locally constructed scale of functional impairment. Children reported received social support by listing whether they received different types of social support from self-selected key individuals. Cross-lagged path analytic modeling evaluated relationships between cognitive social capital, symptoms and received support separately over baseline (T1), 6-week follow-up (T2), and 4-month follow-up (T3). Each concept was treated and analyzed as a continuous score using manifest indicators. Significant associations between study variables were unidirectional. Cognitive social capital was associated with decreased depression between T1 and T2 (B = -.22, p < .001) and T2 and T3 (β = -.25, p < .001), and with functional impairment between T1 and T2 (β = -.15, p = .005) and T2 and T3 (β = -.14, p = .005); no association was found for PTSD symptoms at either time point. Cognitive social capital was associated with increased social support between T1 and T2 (β = .16, p = .002) and T2 and T3 (β = .16, p = .002). In this longitudinal study, cognitive social capital was related to a declining trajectory of children's mental health problems and increases in social support. Interventions that improve community relations in war

  9. [Health and sickness as sociological concepts].

    PubMed

    Van Rensburg, H C

    1975-07-19

    Health and illness, as widely used terms in scientific literature, leave a wide scope as to their definition and conceptual interpretation. The medicotechnical perspective refers to health and illness as objective changes in the structure and/or functioning of the human body and mind, as a result of which the bodily and mental integrity of the human organism is affected detrimentally. On the contrary, the social sciences, and especially medical sociology, define health and illness essentially in terms of the social system within which they occur. The main task of medical sociology is to pay attention to those social systemic and sociocultural aspects of health and illness which are sometimes grossly neglected or insufficiently understood by the medical sciences, thereby to contribute to a comprehensive approach to these phenomena. PMID:1154192

  10. Global health in conflict. Understanding opposition to vitamin A supplementation in India.

    PubMed

    Wallace, Sarah K

    2012-07-01

    Vitamin A supplementation is a public health intervention that clinical trials have suggested can significantly improve child survival in the developing world. Yet, prominent scientists in India have questioned its scientific validity, opposed its implementation, and accused its advocates of corruption and greed. It is ironic that these opponents were among the pioneers of populationwide vitamin A supplementation for ocular health. Historically, complex interests have shaped vitamin A supplementation resistance in India. Local social and nutritional revolutions and shifting international paradigms of global health have played a role. Other resistance movements in Indian history, such as those in response to campaigns for bacillus Calmette-Guérin and novel vaccines, have been structured around similar themes. Public health resistance is shaped by the cultural and political context in which it develops. Armed with knowledge of the history of a region and patterns of past resistance, public health practitioners can better understand how to negotiate global health conflicts. PMID:22594752

  11. Global Health in Conflict Understanding Opposition to Vitamin A Supplementation in India

    PubMed Central

    Wallace, Sarah K.

    2012-01-01

    Vitamin A supplementation is a public health intervention that clinical trials have suggested can significantly improve child survival in the developing world. Yet, prominent scientists in India have questioned its scientific validity, opposed its implementation, and accused its advocates of corruption and greed. It is ironic that these opponents were among the pioneers of populationwide vitamin A supplementation for ocular health. Historically, complex interests have shaped vitamin A supplementation resistance in India. Local social and nutritional revolutions and shifting international paradigms of global health have played a role. Other resistance movements in Indian history, such as those in response to campaigns for bacillus Calmette-Guérin and novel vaccines, have been structured around similar themes. Public health resistance is shaped by the cultural and political context in which it develops. Armed with knowledge of the history of a region and patterns of past resistance, public health practitioners can better understand how to negotiate global health conflicts. PMID:22594752

  12. Food and beverage industries' participation in health scientific events: considerations on conflicts of interest.

    PubMed

    Canella, Daniela S; Martins, Ana Paula B; Silva, Hugo F R; Passanha, Adriana; Lourenço, Bárbara H

    2015-10-01

    Several sectors of the industry (pharmaceutical, food, and other) often occupy a prominent position in scientific meetings on health. The aim of this article is to discuss the participation of food and beverage industries (Big Food and Big Soda) in events organized by scientific institutions in health and nutrition, highlighting potential conflicts of interest in such partnerships. As an example, the authors report the case of a Brazilian national event organized by a nutrition scientific association in 2011. Focused on the theme "Evidence-based Nutrition," the event's scientific program was largely influenced by corporate sponsors. For example, a symposium at this congress was organized by a beverage company known worldwide for its sugar-sweetened products and classified as the "diamond sponsor" of the event. While debating the adoption of healthy lifestyles in the current scenario of rising occurrence of obesity, the rationale for health promotion was reduced to providing information that would motivate rational individual choices, thus ignoring any political, economic, cultural, marketing, and social factors involved in the global process of nutrition transition. The authors conclude that conflicts of interest are present in the participation of food and beverage industries in health scientific events. The industries' strategy attempts to grant legitimacy to the production and marketing of their products through an association with adequate health practices. Health professionals and policy-makers should reflect on such partnerships because their main purpose is to generate profit, not the promotion of public health. PMID:26758226

  13. Active Ways to Teach Health Concepts in the Elementary Setting

    ERIC Educational Resources Information Center

    Gregory, Julie

    2015-01-01

    This article provides three movement-based activities for teaching health concepts to elementary school students. Two activities focus on nutrition concepts and the other focuses on teaching body systems. Diagrams are provided to show the setup of activities, as well as links for accessing materials to help implement the activities.

  14. Demilitarization of the Siachen conflict zone : concepts for implementation and monitoring.

    SciTech Connect

    Kanwal, Gurmeet; Hakeem, Asad; Vannoni, Michael Geoffrey; Rajen, Gaurav

    2007-09-01

    Pakistani and Indian militaries have been occupying the Siachen Glacier and surrounding regions for decades. Although a cease-fire is in place, continued occupation carries the risk of an inadvertent conflict, which could escalate into a full-fledged nuclear-backed confrontation. Political and military analysts in Pakistan and India now question the strategic significance of the Siachen Glacier and agree that under the right circumstances, military withdrawal from the Siachen Glacier region would not adversely affect either state. The difficulty lies in conducting the withdrawal in such a way that neither side feels vulnerable, and in maintaining the demilitarization in a way that can be verified. In this paper, the authors who have both held command responsibilities in the Siachen Glacier region present a process for conducting and verifying the demilitarization of the Siachen Glacier region. The authors discuss the role of monitoring and verification tools and their relevance to this border zone of conflict.

  15. Should medical students track former patients in the electronic health record? An emerging ethical conflict.

    PubMed

    Brisson, Gregory E; Neely, Kathy Johnson; Tyler, Patrick D; Barnard, Cynthia

    2015-08-01

    Medical students are increasingly using electronic health records (EHRs) in clerkships, and medical educators should seek opportunities to use this new technology to improve training. One such opportunity is the ability to "track" former patients in the EHR, defined as following up on patients in the EHR for educational purposes for a defined period of time after they have left one's direct care. This activity offers great promise in clinical training by enabling students to audit their diagnostic impressions and follow the clinical history of illness in a manner not possible in the era of paper charting. However, tracking raises important questions about the ethical use of protected health information, including concerns about compromising patient autonomy, resulting in a conflict between medical education and patient privacy. The authors offer critical analysis of arguments on both sides and discuss strategies to balance the ethical conflict by optimizing outcomes and mitigating harms. They observe that tracking improves training, thus offering long-lasting benefits to society, and is supported by the principle of distributive justice. They conclude that students should be permitted to track for educational purposes, but only with defined limits to safeguard patient autonomy, including obtaining permission from patients, having legitimate educational intent, and self-restricting review of records to those essential for training. Lastly, the authors observe that this conflict will become increasingly important with completion of the planned Nationwide Health Information Network and emphasize the need for national guidelines on tracking patients in an ethically appropriate manner. PMID:25565261

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

    PubMed

    Gaber, Sabrina; Patel, Preeti

    2013-07-01

    While scholarship on health in conflict-affected countries is growing, there has been relatively little analysis of how armed conflict affects health systems in specific African countries, especially former French colonies. There is even less literature on the role of history in shaping health systems and how historical factors such as inequity may influence health impacts of armed conflict. Based on Côte d'Ivoire, this article argues that historical multidisciplinary analysis can provide valuable insight into the macro-level political, economic and social determinants of the health system over time. It explores how armed conflict has affected health services and exacerbates historically inherited challenges to the health system including unequal distribution of health services, bias towards curative care in urban areas, inadequate human resources and weak health governance. In the post-conflict period, this understanding may assist governments and other stakeholders to develop more appropriate health policies that address both urgent and long-term health needs. PMID:23701043

  17. Support of public–private partnerships in health promotion and conflicts of interest

    PubMed Central

    Hernandez-Aguado, Ildefonso; Zaragoza, G A

    2016-01-01

    Objectives Public–private partnerships (PPPs) are considered key elements in the development of effective health promotion. However, there is little research to back the enthusiasm for these partnerships. Our objective was to describe the diversity of visions on PPPs and to assess the links between the authors and corporations engaged in such ventures. Methods We reviewed the scientific literature through PubMed in order to select all articles that expressed a position or recommendation on governments and industries engaging in PPPs for health promotion. We included any opinion paper that considered agreements between governments and corporations to develop health promotion. Papers that dealt with healthcare provision or clinical preventive services and those related to tobacco industries were excluded. We classified the articles according to the authors' position regarding PPPs: strongly agree, agree, neutral, disagree and strongly disagree. We related the type of recommendation to authors' features such as institution and conflicts of interest. We also recorded whether the recommendations were based on previous assessments. Results Of 46 papers analysed, 21 articles (45.6%) stated that PPPs are helpful in promoting health, 1 was neutral and 24 (52.1%) were against such collaborations. 26 papers (57%) set out conditions to assure positive outcomes of the partnerships. Evidence for or against PPPs was mentioned in 11 papers that were critical or neutral (44%) but not in any of those that advocated collaboration. Where conflicts were declared (26 papers), absence of conflicts was more frequent in critics than in supporters (86% vs 17%). Conclusions Although there is a lack of evidence to support PPPs for health promotion, many authors endorse this approach. The prevalence of ideas encouraging PPPs can affect the intellectual environment and influence policy decisions. Public health researchers and professionals must make a contribution in properly framing the PPP

  18. Ebola in the context of conflict affected states and health systems: case studies of Northern Uganda and Sierra Leone.

    PubMed

    McPake, Barbara; Witter, Sophie; Ssali, Sarah; Wurie, Haja; Namakula, Justine; Ssengooba, Freddie

    2015-01-01

    Ebola seems to be a particular risk in conflict affected contexts. All three of the countries most affected by the 2014-15 outbreak have a complex conflict-affected recent history. Other major outbreaks in the recent past, in Northern Uganda and in the Democratic Republic of Congo are similarly afflicted although outbreaks have also occurred in stable settings. Although the 2014-15 outbreak in West Africa has received more attention than almost any other public health issue in recent months, very little of that attention has focused on the complex interaction between conflict and its aftermath and its implications for health systems, the emergence of the disease and the success or failure in controlling it. The health systems of conflict-affected states are characterized by a series of weaknesses, some common to other low and even middle income countries, others specifically conflict-related. Added to this is the burden placed on health systems by the aggravated health problems associated with conflict. Other features of post conflict health systems are a consequence of the global institutional response. Comparing the experience of Northern Uganda and Sierra Leone in the emergence and management of Ebola outbreaks in 2000-1 and in 2014-15 respectively highlights how the various elements of these conflict affected societies came together with international agencies responses to permit the outbreak of the disease and then to successfully contain it (in Northern Uganda) or to fail to do so before a catastrophic cost had been incurred (in Sierra Leone). These case studies have implications for the types of investments in health systems that are needed to enable effective response to Ebola and other zoonotic diseases where they arise in conflict- affected settings. PMID:26257823

  19. Psychometrics of the Laffrey Health Conception Scale for adolescents.

    PubMed

    Yarcheski, Adela; Mahon, Noreen E; Yarcheski, Thomas J

    2005-01-01

    The purposes of this methodological study were to factor analyze the Laffrey Health Conception Scale (LHCS) and to assess construct validity of the instrument with early adolescents. The final sample consisted of 230 early adolescents, aged 12 to 14, who responded to instrument packets in classrooms in an urban middle school. Data obtained on the LHCS were subjected to principal components factor analysis with oblique rotation. A two-factor solution was accepted, which is consistent with early adolescents' conceptions of health. Factor I was labeled Wellness and Factor II was labeled Clinical Health. A higher order factor analysis yielded one factor with 26 items, labeled the LHCS for Early Adolescents. The 26-item LHCS had a coefficient alpha of .95. Construct validity was assessed by testing three theoretical propositions, which significantly linked health conception to social support, self-esteem, and positive health practices. The findings indicate that the LHCS is a reliable and valid measure of health conceptions in early adolescents. Results also offer flexibility to researchers interested in testing theory involving the constructs of the definition of health, wellness, and clinical health in early adolescents. PMID:16315571

  20. Challenges and conflicts in the delivery of mental health services to ultra-orthodox Jews.

    PubMed

    Greenberg, David; Witztum, Eliezer

    2013-02-01

    Ultra-orthodox Jews are a religious group that lives apart, valuing its separateness and ascribing sanctity to its life style. Community members are reticent to seek help from mental health services, especially if provided by professionals from outside the community. Therapeutic interventions should be explained in terms meaningful to the patient's explanatory model. Community members may face stigmatic attitudes of service providers. Situations are presented of the challenges and conflicts that confront ultra-orthodox Jews and mental health service providers concerning seeking help, understanding idioms of distress, providing appropriate rehabilitation services and negotiating arranged matches for marriage (shidduchim). PMID:23380322

  1. Public health week: marketing the concept of public health.

    PubMed

    Evans, C A; Margolis, L A

    1992-01-01

    The Public Health Programs and Services (PHP&S) Branch of the Los Angeles County Department of Health Services began a strategic planning effort in January 1986 to meet new disease trends, curb rising health care costs, consolidate limited resources, and handle shifting demographics. A strategic plan was designed to assess the opportunities and challenges facing the agency over a 5-year horizon. Priority areas were recognized, and seven strategic directives were formulated to guide PHP&S in expanding public health services to a changing community. Health promotion was acknowledged as a critical target of the strategic planning process. Among the most significant results of the health promotion directive was the establishment of an annual Public Health Week in Los Angeles County. Beginning in 1988, 1 week per year was selected to enhance the community's awareness of public health programs and the leadership role PHP&S plays in providing these programs to nearly 9 million residents of Los Angeles County. Events in Public Health Week include a professional lecture series and the honoring of an outstanding public health activist and a media personality who has fostered health promotion. Other free community activities such as mobile clinics, screenings, and health fairs are held throughout the county. With intensive media coverage of Public Health Week, PHP&S has been aggressive in promoting its own services and accomplishments while also educating the community on vital wellness issues. The strategic methodology employed by PHP&S, with its emphasis on long-range proactive planning, is receiving national recognition and could be adopted by similar agencies wishing to enhance their image and develop unique health promotion projects in their communities. PMID:1738801

  2. Annual Research Review: Resilience and Mental Health in Children and Adolescents Living in Areas of Armed Conflict--A Systematic Review of Findings in Low- and Middle-Income Countries

    ERIC Educational Resources Information Center

    Tol, Wietse A.; Song, Suzan; Jordans, Mark J. D.

    2013-01-01

    Background: Researchers focused on mental health of conflict-affected children are increasingly interested in the concept of resilience. Knowledge on resilience may assist in developing interventions aimed at improving positive outcomes or reducing negative outcomes, termed promotive or protective interventions. Methods: We performed a systematic…

  3. Managing the conflict between individual needs and group interests--ethical leadership in health care organizations.

    PubMed

    Shale, Suzanne

    2008-03-01

    This paper derives from a grounded theory study of how Medical Directors working within the UK National Health Service manage the moral quandaries that they encounter as leaders of health care organizations. The reason health care organizations exist is to provide better care for individuals through providing shared resources for groups of people. This creates a paradox at the heart of health care organization, because serving the interests of groups sometimes runs counter to serving the needs of individuals. The paradox presents ethical dilemmas at every level of the organization, from the boardroom to the bedside. Medical Directors experience these organizational ethical dilemmas most acutely by virtue of their position in the organization. As doctors, their professional ethic obliges them to put the interests of individual patients first. As executive directors, their role is to help secure the delivery of services that meet the needs of the whole patient population. What should they do when the interests of groups of patients, and of individual patients, appear to conflict? The first task of an ethical healthcare organization is to secure the trust of patients, and two examples of medical ethical leadership are discussed against this background. These examples suggest that conflict between individual and population needs is integral to health care organization, so dilemmas addressed at one level of the organization inevitably re-emerge in altered form at other levels. Finally, analysis of the ethical activity that Medical Directors have described affords insight into the interpersonal components of ethical skill and knowledge. PMID:18382123

  4. Genomic conflicts and sexual antagonism in human health: insights from oxytocin and testosterone.

    PubMed

    Mokkonen, Mikael; Crespi, Bernard J

    2015-04-01

    We review the hypothesized and observed effects of two of the major forms of genomic conflicts, genomic imprinting and sexual antagonism, on human health. We focus on phenotypes mediated by peptide and steroid hormones (especially oxytocin and testosterone) because such hormones centrally mediate patterns of physical and behavioral resource allocation that underlie both forms of conflict. In early development, a suite of imprinted genes modulates the human oxytocinergic system as predicted from theory, with paternally inherited gene expression associated with higher oxytocin production, and increased solicitation to mothers by infants. This system is predicted to impact health through the incompatibility of paternal-gene and maternal-gene optima and increased vulnerability of imprinted gene systems to genetic and epigenetic changes. Early alterations to oxytocinergic systems have long-term negative impacts on human psychological health, especially through their effects on attachment and social behavior. In contrast to genomic imprinting, which generates maladaptation along an axis of mother-infant attachment, sexual antagonism is predicted from theory to generate maladaptation along an axis of sexual dimorphism, modulated by steroid and peptide hormones. We describe evidence of sexual antagonism from studies of humans and other animals, demonstrating that sexually antagonistic effects on sex-dimorphic phenotypes, including aspects of immunity, life history, psychology, and behavior, are commonly observed and lead to forms of maladaptation that are demonstrated, or expected, to impact human health. Recent epidemiological and psychiatric studies of schizophrenia in particular indicate that it is mediated, in part, by sexually antagonistic alleles. The primary implication of this review is that data collection focused on (i) effects of imprinted genes that modulate the oxytocin system, and (ii) effects of sexually antagonistic alleles on sex-dimorphic, disease

  5. Genomic conflicts and sexual antagonism in human health: insights from oxytocin and testosterone

    PubMed Central

    Mokkonen, Mikael; Crespi, Bernard J

    2015-01-01

    We review the hypothesized and observed effects of two of the major forms of genomic conflicts, genomic imprinting and sexual antagonism, on human health. We focus on phenotypes mediated by peptide and steroid hormones (especially oxytocin and testosterone) because such hormones centrally mediate patterns of physical and behavioral resource allocation that underlie both forms of conflict. In early development, a suite of imprinted genes modulates the human oxytocinergic system as predicted from theory, with paternally inherited gene expression associated with higher oxytocin production, and increased solicitation to mothers by infants. This system is predicted to impact health through the incompatibility of paternal-gene and maternal-gene optima and increased vulnerability of imprinted gene systems to genetic and epigenetic changes. Early alterations to oxytocinergic systems have long-term negative impacts on human psychological health, especially through their effects on attachment and social behavior. In contrast to genomic imprinting, which generates maladaptation along an axis of mother–infant attachment, sexual antagonism is predicted from theory to generate maladaptation along an axis of sexual dimorphism, modulated by steroid and peptide hormones. We describe evidence of sexual antagonism from studies of humans and other animals, demonstrating that sexually antagonistic effects on sex-dimorphic phenotypes, including aspects of immunity, life history, psychology, and behavior, are commonly observed and lead to forms of maladaptation that are demonstrated, or expected, to impact human health. Recent epidemiological and psychiatric studies of schizophrenia in particular indicate that it is mediated, in part, by sexually antagonistic alleles. The primary implication of this review is that data collection focused on (i) effects of imprinted genes that modulate the oxytocin system, and (ii) effects of sexually antagonistic alleles on sex-dimorphic, disease

  6. Wars and Child Health: Evidence from the Eritrean-Ethiopian Conflict *

    PubMed Central

    Akresh, Richard; Lucchetti, Leonardo; Thirumurthy, Harsha

    2012-01-01

    Conflict between and within countries can have lasting health and economic consequences, but identifying such effects can be empirically challenging. This paper uses household survey data from Eritrea to estimate the effect of exposure to the 1998–2000 Eritrea-Ethiopia war on children’s health. The identification strategy exploits exogenous variation in the conflict’s geographic extent and timing and the exposure of different birth cohorts to the fighting. The unique survey data include details on each household’s migration history, which allows us to measure a child’s geographic location during the war and without which war exposure would be incorrectly classified. War-exposed children have lower height-for-age Z-scores, with similar effects for children born before or during the war. Both boys and girls who are born during the war experience negative impacts due to conflict. Effects are robust to including region-specific time trends, alternative conflict exposure measures, and mother fixed effects. PMID:22962514

  7. Political violence, ethnic conflict, and contemporary wars: broad implications for health and social well-being.

    PubMed

    Pedersen, Duncan

    2002-07-01

    Ethnic conflict, political violence and wars that presently shape many parts of world have deep-seated structural causes. In poor and highly indebted countries, economic and environmental decline, asset depletion, and erosion of the subsistence base lead to further impoverishment and food insecurity for vast sectors of the population. Growing ethnic and religious tensions over a shrinking resource base often escort the emergence of predatory practices, rivalry, political violence, and internal wars. The nature of armed conflict has changed substantially over time and most strategic analysts agree that in the second half of the 20th century, contemporary wars are less of a problem of relations between states than a problem within states. Despite the growing number of armed conflicts and wars throughout the world, not enough attention has been paid to the local patterns of distress being experienced and the long-term health impact and psychosocial consequences of the various forms of political violence against individuals, communities, or specific ethnic groups. The short or long-term impact assessment on civilian populations of poor countries affected by war have been scarce, and studies focussing on experiences of collective suffering and trauma-related disorders among survivors are beginning to emerge in the scientific literature. The medicalization of collective suffering and trauma reflects a poor understanding of the relationships among critically important social determinants and the range of possible health outcomes of political violence. PMID:12144134

  8. First do no harm: the impact of recent armed conflict on maternal and child health in Sub-Saharan Africa

    PubMed Central

    O'Hare, Bernadette A M; Southall, David P

    2007-01-01

    Objectives To compare the rates of under-5 mortality, malnutrition, maternal mortality and other factors which influence health in countries with and without recent conflict. To compare central government expenditure on defence, education and health in countries with and without recent conflict. To summarize the amount spent on SALW and the main legal suppliers to countries in Sub-Saharan African countries (SSA), and to summarize licensed production of Small Arms and Light Weapons (SALW) in these countries. Design We compared the under-5 mortality rate in 2004 and the adjusted maternal mortality ratio in SSA which have and have not experienced recent armed conflict (post-1990). We also compared the percentage of children who are underweight in both sets of countries, and expenditure on defence, health and education. Setting Demographic data and central government expenditure details (1994-2004) were taken from UNICEF's The State of the World's Children 2006 report. Main outcome measures Under-5 mortality, adjusted maternal mortality, and government expenditure. Results 21 countries have and 21 countries have not experienced recent conflict in this dataset of 42 countries in SSA. Median under-5 mortality in countries with recent conflict is 197/1000 live births, versus 137/1000 live births in countries without recent conflict. In countries which have experienced recent conflict, a median of 27% of under-5s were moderately underweight, versus 22% in countries without recent conflict. The median adjusted maternal mortality in countries with recent conflict was 1000/100,000 births versus 690/100,000 births in countries without recent conflict. Median reported maternal mortality ratio is also significantly higher in countries with recent conflict. Expenditure on health and education is significantly lower and expenditure on defence significantly higher if there has been recent conflict. Conclusions There appears to be an association between recent conflict and higher

  9. Politics and Power in Global Health: The Constituting Role of Conflicts

    PubMed Central

    Askheim, Clemet; Heggen, Kristin; Engebretsen, Eivind

    2016-01-01

    In a recent article, Gorik Ooms has drawn attention to the normative underpinnings of the politics of global health. We claim that Ooms is indirectly submitting to a liberal conception of politics by framing the politics of global health as a question of individual morality. Drawing on the theoretical works of Chantal Mouffe, we introduce a conflictual concept of the political as an alternative to Ooms’ conception. Using controversies surrounding medical treatment of AIDS patients in developing countries as a case we underline the opportunity for political changes, through political articulation of an issue, and collective mobilization based on such an articulation. PMID:26927399

  10. Cognitive Factors in Fibromyalgia: The Role of Self-Concept and Identity Related Conflicts

    PubMed Central

    Compañ, Victoria; Feixas, Guillem; Varlotta-Domínguez, Nicolás; Torres-Viñals, Mercedes; Aguilar-Alonso, Ángel; Dada, Gloria; Ángel Saúl, Luís

    2010-01-01

    Fibromyalgia is a syndrome characterized by the presence of diffuse and chronic musculoskeletal pain of unknown etiology. Clinical diagnosis and the merely palliative treatments considerably affect the patient's experience and the chronic course of the disease. Therefore, several authors have emphasized the need to explore issues related to self in these patients. The repertory grid technique (RGT), derived from personal construct theory, is a method designed to assess the patient's construction of self and others. A group of women with fibromyalgia (n = 30) and a control group (n = 30) were assessed using RGT. Women with fibromyalgia also completed the Fibromyalgia Impact Questionnaire and a visualanalogue scale for pain, and painful tender points were explored. Results suggest that these women had a higher present self–ideal self discrepancy and a lower perceived adequacy of others, and it was more likely to find implicative dilemmas among them compared to controls. These dilemmas are a type of cognitive conflict in which the symptom is construed as “enmeshed” with positive characteristics of the self. Finally, implications of these results for the psychological treatment of fibromyalgia are suggested to give a more central role to self-identity issues and to the related cognitive conflicts. PMID:22629110

  11. Current concepts on airborne particles and health

    SciTech Connect

    Mauderly, J.L.

    1994-11-01

    Epidemiological evidence of associations between environmental particulate concentrations and both acute and chronic health effects has grown with numerous recent studies conducted in the US and other countries. An association between short-term changes in particulate levels and acute mortality now seems certain. The association is consistent among studies and coherent among indicators of mortality and morbidity. Effects observed at surprisingly low pollution levels have raised concern for current exposures even in modestly polluted cities. Toxicology did not predict the acute mortality effect, and causal mechanisms are difficult to rationalize. Present data suggest that the fine fraction of particulate pollution is more toxic than larger particles, but the contribution of specific particulate species is poorly understood.

  12. [Concepts of health education by public health nurses].

    PubMed

    Coscrato, Gisele; Bueno, Sonia Maria Villela

    2013-06-01

    This qualitative study identifies the ideas regarding health education of 12 nurses who are part of the public health service of a city in the São Paulo countryside, and proposes a corresponding educational action. In this study, we used the methodology of action research. Data collection occurred in the second half of 2009 in the public health units of the mentioned municipality. Participant observation and interviews were implemented. The analysis and interpretation of data were conducted through categorization, based on the theory by Paulo Freire. As a result, the reductionism of health education in the pedagogical approach involving the transmission of knowledge was exposed, envisioning a biologicist tendency of academic training. However, in discussion circles, the awakening of political awareness related to the theme and the promotion of health was assumed. In conclusion, there is a need for changes in such training and for the facilitation of new modes of scientific production in the quest for social transformation. PMID:24601151

  13. Relations of Parenting Quality, Interparental Conflict, and Overnights with Mental Health Problems of Children in Divorcing Families with High Legal Conflict

    PubMed Central

    Sandler, Irwin N.; Wheeler, Lorey A.; Braver, Sanford L.

    2013-01-01

    The current study examined the associations between child mental health problems and the quality of maternal and paternal parenting, and how these associations were moderated by three contextual factors, quality of parenting by the other parent, interparental conflict, and the number of overnights parents had with the child. Data for the current study come from a sample of divorcing families who are in high legal conflict over developing or maintaining a parenting plan following divorce. Analyses revealed that the associations between child mental health problems and positive maternal and paternal parenting were moderated by the quality of parenting provided by the other parent and by the number of overnights children spent with parents, but not by the level of interparental conflict. When both parenting by the other parent and number of overnights were considered in the same model, only number of overnights moderated the relations between parenting and child behavior problems. The results support the proposition that the well-being of children in high conflict divorcing families is better when they spend adequate time with at least one parent who provides high quality parenting. PMID:24098960

  14. Agreement and disagreement on health care quality concepts among academic health professionals: the Saudi case.

    PubMed

    Mahrous, Mohamed Saad

    2014-01-01

    A systematic and rigorous implementation of quality improvement processes is likely to improve the well-being of staff members and heighten their job satisfaction. Assessing professionals' perceptions of health care quality should lead to the betterment of health care services. In Saudi Arabia, no previous studies examine how university health professionals view health care quality concepts. A cross-sectional analytical study employing a self-administered questionnaire with 43 statements assessing quality perceptions of academic health care professionals was used. Despite the agreement of health professionals on numerous quality concepts addressed in this study, there was insufficient agreement on 10 core quality concepts, 3 of which were the following: "quality focuses on customers" (50%), "quality is tangible and therefore measurable" (29.3%), and "quality is data-driven" (62%). Hence, providing health professionals with relevant training likely will generate a better understanding of quality concepts and optimize their performance. PMID:23897553

  15. Mental health services in Cambodia, challenges and opportunities in a post-conflict setting.

    PubMed

    Jegannathan, Bhoomikumar; Kullgren, Gunnar; Deva, Parameshvara

    2015-02-01

    Cambodia had suffered enormously due to war and internecine conflict during the latter half of the twentieth century, more so during the Vietnam War. Total collapse of education and health systems during the Pol Pot era continues to be a challenge for developing the necessary infrastructure and human resources to provide basic minimum mental health care which is compounded by the prevailing cultural belief and stigma over mental, neurological and substance abuse disorders (MNSDs). The mental health research and services in Cambodia had been predominantly 'trauma focused', a legacy of war, and there is a need to move toward epidemiologically sound public health oriented mental health policy and service development. Integrating mental health program with primary health care services with specifically stated minimum package of activities at primary level and complementary package of activities at secondary level is an opportunity to meet the needs and rights of persons with mental, neurological and substance abuse disorders (PWMNSDs) in Cambodia, provided there is mental health leadership, government commitment and political will. PMID:25563073

  16. Concept of Educational Assistance to Health Protection of the Individual

    PubMed Central

    Levanova, Elena Aleksandrovna; Kokorina, Olga Rafailovna; Nikitin, Yuriy Vladimirovich; Perepelkina, Tatiyna Vladislavovna; Segodina, Polina Anatolievna

    2016-01-01

    The article describes the theoretical and practical need for the development of the concept of assistance to health protection of the individual in order to address the problem of health protection of students and teachers in the conditions of a higher pedagogical education. The problem of studying human health, its entirety, systemacity and connection with the environment attracts particular attention in recent years. This was one of the reasons to study the problem of “healthy lifestyle” as the qualitative characteristic of a human life aimed at health, due to the fact that a healthy lifestyle is one of the determinants of health. This is made possible with the use of specific health-protecting technologies aimed at searching for ways and means of protection and conservation of health of students and teachers in the conditions of the educational process and using educational tools, which is currently included into the priorities of education. PMID:26493439

  17. The Colombian conflict: a description of a mental health program in the Department of Tolima

    PubMed Central

    2009-01-01

    Colombia has been seriously affected by an internal armed conflict for more than 40 years affecting mainly the civilian population, who is forced to displace, suffers kidnapping, extortion, threats and assassinations. Between 2005 and 2008, Médecins Sans Frontières-France provided psychological care and treatment in the region of Tolima, a strategic place in the armed conflict. The mental health program was based on a short-term multi-faceted treatment developed according to the psychological and psychosomatic needs of the population. Here we describe the population attending during 2005-2008, in both urban and rural settings, as well as the psychological treatment provided during this period and its outcomes. We observed differences between the urban and rural settings in the traumatic events reported, the clinical expression of the disorders, the disorders diagnosed, and their severity. Although the duration of the treatment was limited due to security reasons and access difficulties, patient condition at last visit improved in most of the patients. These descriptive results suggest that further studies should be conducted to examine the role of short-term psychotherapy, adapted specifically to the context, can be a useful tool to provide psychological care to population affected by an armed conflict. PMID:20030811

  18. Mental Health and Self-Esteem of Institutionalized Adolescents Affected by Armed Conflict.

    PubMed

    War, Firdous Ahmad; Ved, Rifat Saroosh; Paul, Mohammad Altaf

    2016-04-01

    The primary purpose of this paper was to compare the epidemiology of mental health problems and self-esteem of conflict hit adolescents living in charitable seminaries with their counterparts brought up in natural homes. Substantive body of the literature illustrates the emotional and behavioral issues experienced by these adolescents. In this study, 27 adolescents from a charitable Muslim seminary and 30 adolescents from a regular school were recruited. Self-report measures and clinical interview were used to measure mental health and self-esteem. The findings indicate that adolescents in institution setting may not be having mental health and self-esteem-related issues when compared to adolescents living in intact by parent homes. While the authors acknowledge the limitations of the study, these findings need further research to examine the causes for these differences. PMID:25930059

  19. Equality and Human Capital: Conflicting Concepts within State-Funded Adult Education in Ireland

    ERIC Educational Resources Information Center

    Hurley, Kevin

    2015-01-01

    This article offers a critique of the concept of equality as it informs the White Paper on Adult Education: Learning for Life (2000). It also outlines the extent to which human capital theory can be seen to have effectively colonised lifelong learning from the outset of its adoption by the European Union with highly constraining implications for…

  20. Democracy, Education, and Governance: A Developmental Conception. SUNY Series, Global Conflict and Peace Education.

    ERIC Educational Resources Information Center

    Snauwaert, Dale T.

    The central thesis of this book is that the developmental conception of democracy provides the theoretical foundation for an alternative model of school governance devoted not to efficient integration of students into a hierarchical labor force, but to development as unique human beings. This will necessitate an organizational structure that…

  1. The mental health of populations directly and indirectly exposed to violent conflict in Indonesia

    PubMed Central

    2010-01-01

    Background Large disasters affect people who live both near and far from the areas in which they occur. The mental health impact is expected to be similar to a ripple effect, where the risk of mental health consequences generally decreases with increasing distance from the disaster center. However, we have not been able to identify studies of the ripple effect of man-made disaster on mental health in low-income countries. Objectives The objective was to examine the hypothesis of a ripple effect on the mental health consequences in populations exposed to man-made disasters in a developing country context, through a comparison of two different populations living in different proximities from the center of disaster in Mollucas. Methods Cross-sectional longitudinal data were collected from 510 Internally Displaced Persons (IDPs) living in Ambon, who were directly exposed to the violence, and non-IDPs living in remote villages in Mollucas, Indonesia, who had never been directly exposed to violence in Mollucas. Data were collected during home visits and statistical comparisons were conducted by using chi square tests, t-test and logistic regression. Results There was significantly more psychological distress "caseness" in IDPs than non-IDPs. The mental health consequences of the violent conflict in Ambon supported the ripple effect hypothesis as displacement status appears to be a strong risk factor for distress, both as a main effect and interaction effect. Significantly higher percentages of IDPs experienced traumatic events than non-IDPs in all six event types reported. Conclusions This study indicates that the conflict had an impact on mental health and economic conditions far beyond the area where the actual violent events took place, in a diminishing pattern in line with the hypothesis of a ripple effect. PMID:20673322

  2. IS WORK-FAMILY CONFLICT A MULTILEVEL STRESSOR LINKING JOB CONDITIONS TO MENTAL HEALTH? EVIDENCE FROM THE WORK, FAMILY AND HEALTH NETWORK

    PubMed Central

    Moen, Phyllis; Kaduk, Anne; Kossek, Ellen Ernst; Hammer, Leslie; Buxton, Orfeu M.; O’Donnell, Emily; Almeida, David; Fox, Kimberly; Tranby, Eric; Oakes, J. Michael; Casper, Lynne

    2015-01-01

    Purpose Most research on the work conditions and family responsibilities associated with work-family conflict and other measures of mental health uses the individual employee as the unit of analysis. We argue that work conditions are both individual psychosocial assessments and objective characteristics of the proximal work environment, necessitating multilevel analyses of both individual- and team-level work conditions on mental health. Methodology/approach This study uses multilevel data on 748 high-tech professionals in 120 teams to investigate relationships between team- and individual-level job conditions, work-family conflict, and four mental health outcomes (job satisfaction, emotional exhaustion, perceived stress, and psychological distress). Findings We find that work-to-family conflict is socially patterned across teams, as are job satisfaction and emotional exhaustion. Team-level job conditions predict team-level outcomes, while individuals’ perceptions of their job conditions are better predictors of individuals’ work-to-family conflict and mental health. Work-to-family conflict operates as a partial mediator between job demands and mental health outcomes. Practical implications Our findings suggest that organizational leaders concerned about presenteeism, sickness absences, and productivity would do well to focus on changing job conditions in ways that reduce job demands and work-to-family conflict in order to promote employees’ mental health. Originality/value of the chapter We show that both work-to-family conflict and job conditions can be fruitfully framed as team characteristics, shared appraisals held in common by team members. This challenges the framing of work-to-family conflict as a “private trouble” and provides support for work-to-family conflict as a structural mismatch grounded in the social and temporal organization of work. PMID:25866431

  3. Striving for better health through health research in post-conflict Timor-Leste

    PubMed Central

    2012-01-01

    The Cabinet of Health Research and Development (CHRD) has recently been established as the first health research institute in one of the world's newest nations, Timor-Leste. We discuss the development of this initiative to build health research capacity within the context of Timor-Leste's health system, history and future goals. PMID:22490170

  4. New skills for a new age: leading the introduction of public health concepts in healthcare curricula.

    PubMed

    el Ansari, W; Russell, J; Spence, W; Ryder, E; Chambers, C

    2003-03-01

    Health policy in the UK is going through significant changes. At the heart of the transformation is a dedicated focus on public health. The new primary-care-based health system will not only be premised on a specialist public health workforce, but also on broader based public-health-oriented health professionals. Within primary care, widening the foundation of health professionals with public health competencies suggests that higher education bodies will need to adapt their curricula to an approach that highlights population-based health principles, preventive philosophy, and public health concepts and methods. The first part of this paper describes the mapping of the public health content of healthcare curricula at one university in England, based on the 10 public health standard areas of competencies of the Faculty of Public Health Medicine. The second part examines, through the findings of a strengths, weaknesses, opportunities, threats (SWOT) analysis, the factors that advocates for a public-health-oriented educational strategy must examine before embarking on the instigation and development of public health concepts in the healthcare curricula. The aspects that necessitate consideration include strengths such as the prevailing policy, market forces, commitment, and motivation to the effort, and the availability of resources, information and external contacts. Features such as political drive and advocacy, interest in the education debate, collaborative links through joint working and partnerships, and ongoing internal reforms and restructuring could all act as opportunities. However, resistance and anxiety are to be expected, the operationalization of the effort and empowerment of those leading it need to be thought about, and issues of control and interests are critical. The presence of conflicting priorities and competition or the lack of vision and directives, or uncertainty about change, could act as threats and barriers to the effort. If shifting the

  5. Making tenofovir accessible in the brazilian public health system: patent conflicts and generic production.

    PubMed

    Veras, Juliana

    2014-08-01

    In May 2011, the Brazilian Ministry of Health announced the distribution of the first batch of locally produced generic tenofovir disoproxil fumarate (TDF) to support its program of universal and free access for the treatment of HIV/AIDS. The inclusion of TDF in the public health program illustrates what has been considered the 'Brazilian model' of HIV/AIDS response, as it illustrates the current phase of the Brazilian pharmaceutical economy. Brazil is known for having managed to control the expansion of HIV/AIDS through a unique initiative combining the public health and the industrial production of generics. But, if at first local manufacturers could freely copy ARVs and produce cheaper generic versions that were delivered to the Ministry of Health, since the country started to grant patents on drugs in 1996, the sustainability of this policy has been challenged by the high cost of patented second-line HIV/AIDS treatments. In order to assure continuity of the local production of ARVs, and keep the program of public health alive, Brazilians are now forced to deal with conflicts of drugs' intellectual property rights in order to open the path to generic production. This article aims to describe the experiences surrounding TDF in Brazil and the unprecedented conflicts and challenges it has brought for our different interviewees. Blurring the frontier between the public and the private, the TDF case was driven at the same time by an ethic of drug access and regulation of drug quality, which has inspired Brazilians to intervene and transform the world they live in. PMID:24889312

  6. Public health challenges in the political economy of conflict: the case of Syria.

    PubMed

    Sen, Kasturi; Faisal, Waleed Al

    2015-01-01

    Recent uprisings in the Arab world and a full-scale war in Syria are widely viewed as popular demand for political voice against repressive regimes. However, growing economic inequalities and serious economic dysfunction played a role as trigger for conflict than is commonly accepted. Tunisia, Egypt and Syria all implemented policies of liberalization over the past two decades, leading to the worsening of living standards for the majority. The various forms of liberalization played a significant role in embedding social division and discontent whose outcomes affected other countries of the region with the onset of market reforms in nascent welfare states. Egypt, for example, was viewed by the World Bank as an economic 'best performer', despite regular riots over food prices, job losses and land expropriation for tourism. Tunisia was praised by donors just prior to the uprising (in 2010), for 'weathering well' the global economic downturn through 'sound macroeconomic management'. In Syria, the market economy made its mark over the 90s, but macroeconomic adjustment policies were implemented in a bilateral agreement with the European Union and approved by the International Monetary Fund in 2003. The economic stabilization programme that followed had limited concern for social impacts such as jobs losses, price rises and national debt, which ultimately caused immense hardship for the population at large, acting as a trigger for the initial uprising in 2011, prior to its transformation into a fully blown conflict. This article focuses on reforms implemented in the health sector and sets these in the context of the current political economy of Syria. It suggests that a protective approach to public health services during and in the aftermath of conflict may increase the possibilities of reconstruction and reconciliation between warring sides. PMID:26358960

  7. Conflict and development: challenges in responding to sexual and reproductive health needs in Timor-Leste.

    PubMed

    Wayte, Kayli; Zwi, Anthony B; Belton, Suzanne; Martins, Joao; Martins, Nelson; Whelan, Anna; Kelly, Paul M

    2008-05-01

    In April and May 2006, internal conflict in Timor-Leste led to the displacement of approximately 150,000 people, around 15% of the population. The violence was most intense in Dili, the capital, where many residents were displaced into camps in the city or to the districts. Research utilising in-depth qualitative interviews, service statistics and document review was conducted from September 2006 to February 2007 to assess the health sector's response to reproductive health needs during the crisis. The study revealed an emphasis on antenatal care and a maternity waiting camp for pregnant women, but the relative neglect of other areas of reproductive health. There remains a need for improved coordination, increased dialogue and advocacy around sensitive reproductive health issues as well as greater participation of the health sector in response to gender-based violence. Strengthening neglected areas and including all components of sexual and reproductive health in coordination structures will provide a stronger foundation through which to respond to any future crises in Timor-Leste. PMID:18513610

  8. Cash income, intrahousehold cooperative conflict, and child health in central Mozambique.

    PubMed

    Pfeiffer, James

    2003-01-01

    This study presents qualitative data on individual cash income generation and intrahousehold bargaining in a sample of 100 households in central Mozambique. It is now recognized that intrahousehold resource allocation patterns can be critical determinants of children's health in the developing world. Recently developed "bargaining-power" models suggest that individual incomes are often not pooled in households and that decisions are the result of a bargaining process that involves cooperation and conflict between men and women. Women's income, many believe, is more often spent on child welfare. Development projects should target benefits to women for greater impact on child health. Some argue that households consist of separate, gendered spheres of economic responsibility that intersect through a "conjugal contract" that defines the terms of cooperation. The findings here support the "separate-spheres" depiction of the household and reveal women's subordinated position in the external cash economy, which undermines their intrahousehold bargaining power. PMID:12745636

  9. War exposure, daily stressors, and mental health in conflict and post-conflict settings: bridging the divide between trauma-focused and psychosocial frameworks.

    PubMed

    Miller, Kenneth E; Rasmussen, Andrew

    2010-01-01

    This paper seeks to bridge the divisive split between advocates of trauma-focused and psychosocial approaches to understanding and addressing mental health needs in conflict and post-conflict settings by emphasizing the role that daily stressors play in mediating direct war exposure and mental health outcomes. The authors argue that trauma-focused advocates tend to overemphasize the impact of direct war exposure on mental health, and fail to consider the contribution of stressful social and material conditions (daily stressors). Drawing on the findings of recent studies that have examined the relationship of both war exposure and daily stressors to mental health status, a model is proposed in which daily stressors partially mediate the relationship of war exposure to mental health. Based on that model, and on the growing body of research that supports it, an integrative, sequenced approach to intervention is proposed in which daily stressors are first addressed, and specialized interventions are then provided for individuals whose distress does not abate with the repair of the social ecology. PMID:19854552

  10. A systematic review of resilience and mental health outcomes of conflict-driven adult forced migrants

    PubMed Central

    2014-01-01

    Background The rising global burden of forced migration due to armed conflict is increasingly recognised as an important issue in global health. Forced migrants are at a greater risk of developing mental disorders. However, resilience, defined as the ability of a person to successfully adapt to or recover from stressful and traumatic experiences, has been highlighted as a key potential protective factor. This study aimed to review systematically the global literature on the impact of resilience on the mental health of adult conflict-driven forced migrants. Methodology Both quantitative and qualitative studies that reported resilience and mental health outcomes among forcibly displaced persons (aged 18+) by way of exploring associations, links, pathways and causative mechanisms were included. Fourteen bibliographic databases and seven humanitarian study databases/websites were searched and a four stage screening process was followed. Results Twenty three studies were included in the final review. Ten qualitative studies identified highlighted family and community cohesion, family and community support, individual personal qualities, collective identity, supportive primary relationships and religion. Thirteen quantitative studies were identified, but only two attempted to link resilience with mental disorders, and three used a specific resilience measure. Over-reliance on cross-sectional designs was noted. Resilience was generally shown to be associated with better mental health in displaced populations, but the evidence on this and underlying mechanisms was limited. Discussion The review highlights the need for more epidemiological and qualitative evidence on resilience in forcibly displaced persons as a potential avenue for intervention development, particularly in resource-poor settings. PMID:25177360

  11. The potential conflict between policy and ethics in caring for undocumented immigrants at academic health centers.

    PubMed

    Cacari Stone, Lisa; Steimel, Leah; Vasquez-Guzman, Estela; Kaufman, Arthur

    2014-04-01

    Academic health centers (AHCs) are at the forefront of delivering care to the diverse medically underserved and uninsured populations in the United States, as well as training the majority of the health care workforce, who are professionally obligated to serve all patients regardless of race or immigration status. Despite AHCs' central leadership role in these endeavors, few consolidated efforts have emerged to resolve potential conflicts between national, state, and local policies that exclude certain classifications of immigrants from receiving federal public assistance and health professionals' social missions and ethical oath to serve humanity. For instance, whereas the 2010 Patient Protection and Affordable Care Act provides a pathway to insurance coverage for more than 30 million Americans, undocumented immigrants and legally documented immigrants residing in the United States for less than five years are ineligible for Medicaid and excluded from purchasing any type of coverage through state exchanges. To inform this debate, the authors describe their experience at the University of New Mexico Hospital (UNMH) and discuss how the UNMH has responded to this challenge and overcome barriers. They offer three recommendations for aligning AHCs' social missions and professional ethics with organizational policies: (1) that AHCs determine eligibility for financial assistance based on residency rather than citizenship, (2) that models of medical education and health professions training provide students with service-learning opportunities and applied community experience, and (3) that frontline staff and health care professionals receive standardized training on eligibility policies to minimize discrimination towards immigrant patients. PMID:24556759

  12. The impact of holistic medicine, medical groups, and health concepts.

    PubMed

    Yahn, G

    1979-11-16

    Holistic medicine (Greek, holos, meaning entire or whole) focuses on the whole person--mind-body-spirit, well-being, and wellness. It is a new health care movement or medical approach that is gaining momentum. The basic concepts are simple and clear, avoiding a piecemeal approach to health with treatment of one disease. Two or three physicians may form holistic medical groups, sometimes inviting nonphysician health care professionals to join. Some of these nonphysicians are not licensed, and standards need to be devised. Governmental agencies are impressed by low-cost resuits, especially with chronically ill patients. There are also groups that have spiritual health care modalities and ministrations. Nevertheless, there are commercialistic tendencies and faddism in some centers, and the literature has been criticized as being for laymen by laymen; however, the movement deserves a sympathetic hearing. PMID:490807

  13. Health financing in fragile and post-conflict states: what do we know and what are the gaps?

    PubMed

    Witter, Sophie

    2012-12-01

    There has been a growing concern with post-conflict and fragile states over the past decade, both in relation to their high level of health and development needs but also for the risk they pose to the wider international community. This paper presents an exploratory literature review to analyse the themes and findings of recent writing on one important pillar of the health system--health financing--in these countries. It finds that here is a growing but still very limited literature. Most of the insights from existing literature relate to the role of donors. There is a need for more work on access to care and equity over the post-conflict period, the mix and sequencing of financing mechanisms, resource allocation, regulation, public financial management, payment systems and incentives at facility and health worker levels, and on overall health financing strategies and their possible contribution to wider state-building. Topics which have received attention, such as contracting and non-state actors, could benefit from more rigorous analysis with a longer time perspective. A longitudinal approach, which examines how decisions taken in the immediate post-conflict period may or may not influence longer term developments, would provide important insights. As health systems in fragile and post-conflict states are often forced to innovate, they can generate useful lessons for other settings too. PMID:23040083

  14. A critique of ecosystem health concepts and indexes

    SciTech Connect

    Suter, G.W. II . Environmental Sciences Div.)

    1993-09-01

    Because people wish to preserve their health and do something equivalent for ecosystems, the metaphor of ecosystem health springs to mind. This paper presents the argument that it is a mistake for environmental scientists to treat this metaphor as reality. First, the metaphor fails because it misrepresents both ecology and health science. Ecosystems are not organisms, so they do not behave like organisms and do not have properties of organisms such as health. Also, health is not an operational concept for physicians or health risk assessors because they must predict, diagnose, and treat specific states called diseases or injuries; they do not calculate indexes of health. Second, attempts to operationally define ecosystem health result in the creation of indexes of heterogeneous variables. Such indexes have no meaning; they cannot be predicted, so they are not applicable to most regulatory problems; they have no diagnostic power; effects on one component are eclipsed by responses of other components; and the reason for a high or low index value is unknown. Their only virtue is that they reduce the complex array of ecosystem responses to various disturbances to one number with a reassuring name. A better alternative is to assess the real array of ecosystem responses so that causes can be diagnosed, future states can be predicted, and benefits of treatments can be compared.

  15. Health Recommender Systems: Concepts, Requirements, Technical Basics and Challenges

    PubMed Central

    Wiesner, Martin; Pfeifer, Daniel

    2014-01-01

    During the last decades huge amounts of data have been collected in clinical databases representing patients' health states (e.g., as laboratory results, treatment plans, medical reports). Hence, digital information available for patient-oriented decision making has increased drastically but is often scattered across different sites. As as solution, personal health record systems (PHRS) are meant to centralize an individual's health data and to allow access for the owner as well as for authorized health professionals. Yet, expert-oriented language, complex interrelations of medical facts and information overload in general pose major obstacles for patients to understand their own record and to draw adequate conclusions. In this context, recommender systems may supply patients with additional laymen-friendly information helping to better comprehend their health status as represented by their record. However, such systems must be adapted to cope with the specific requirements in the health domain in order to deliver highly relevant information for patients. They are referred to as health recommender systems (HRS). In this article we give an introduction to health recommender systems and explain why they are a useful enhancement to PHR solutions. Basic concepts and scenarios are discussed and a first implementation is presented. In addition, we outline an evaluation approach for such a system, which is supported by medical experts. The construction of a test collection for case-related recommendations is described. Finally, challenges and open issues are discussed. PMID:24595212

  16. The challenges facing mental health programs for post-conflict and refugee communities.

    PubMed

    Silove, Derrick

    2004-01-01

    The majority of refugees and communities exposed to warfare and oppression live in low-income countries with few resources or special skills. Yet, epidemiological studies have identified high levels of traumatic stress reactions in such populations. These stress reactions can be intensified by harsh policies aimed at deterring survivors from seeking refuge in technologically advanced societies. The scale of the problem of mass violence and displacement creates formidable challenges for mental health professionals in their efforts to develop practical frameworks for responding to the extensive needs of displaced persons. In this article, a model is proposed for low-income, post-conflict countries, based on a two-tiered formulation. At the eco-social level, mental health professionals can play a supportive, but not a lead, role in facilitating recovery of core adaptive systems that hasten natural recovery from stress for the majority of the population. Where small-scale, community mental health services are established, the emphasis should be on assisting persons and their families who are at greatest survival and adaptive risk. Training and promotion of local workers to assume leadership in such programs are essential. In technologically advanced societies in which refugees are in a minority, torture and trauma services can focus more specifically on traumatic stress reactions, acculturation, and resettlement. In a historical epoch in which displaced persons are facing particularly harsh treatment, there is a pressing need for consensus amongst mental health professionals in advocating for their needs. PMID:15453165

  17. SSFF Health Management Analysis Report. Part 2: Proof of Concept

    NASA Technical Reports Server (NTRS)

    Wilson, L.; Spruill, J.; Hong, Y.

    1995-01-01

    In this Proof of Concept analysis on SSFF Health Management the following area was described: the Gas Distribution Subsystem (GDS) was studied and evaluated utilizing the PDR Configuration and with respect to the design features encompassing Health Management (HM) aspects outlined in the Generic Handbook. From the results of this study, it was found that there is a definite need for coordinating measurements within and between the subsystems that will ensure that Functional Failures are properly revealed and substantiated as valid by other measurements, even those from other interfacing subsystems.

  18. Spirituality Concept by Health Professionals in Iran: A Qualitative Study

    PubMed Central

    2016-01-01

    Background. For years, researchers have sought to provide a clear definition of spirituality and its features and consequences, but the definitions provided of this concept still lack transparency. The present qualitative research was conducted to clarify this concept within the religious-cultural context of Iran. Materials and Methods. The present conventional qualitative content analysis was conducted with an inductive approach. Data were collected through semistructured interviews with 17 spiritual health experts and activists selected through purposive sampling. Results. Three themes emerged from the analysis of the data, including (1) the structure of spirituality, (2) defects in the conceptualization of spirituality, and (3) spirituality in practice, which are explained in this paper with their relevant subthemes and codes. The definition which this study proposes for this concept is that “spirituality is the sublime aspect of human existence bestowed on all humans in order for them to traverse the path of transcendence that is closeness to God (Allah).” Conclusion. The definition provided by this study is similar to the previous definitions of this concept in its main part (transcendence) and in incorporating a God-centered view of spirituality within the context of an Islamic society. This definition has implications for health services' education, research, and practice in similar societies. PMID:27493675

  19. Spirituality Concept by Health Professionals in Iran: A Qualitative Study.

    PubMed

    Memaryan, Nadereh; Rassouli, Maryam; Mehrabi, Maryam

    2016-01-01

    Background. For years, researchers have sought to provide a clear definition of spirituality and its features and consequences, but the definitions provided of this concept still lack transparency. The present qualitative research was conducted to clarify this concept within the religious-cultural context of Iran. Materials and Methods. The present conventional qualitative content analysis was conducted with an inductive approach. Data were collected through semistructured interviews with 17 spiritual health experts and activists selected through purposive sampling. Results. Three themes emerged from the analysis of the data, including (1) the structure of spirituality, (2) defects in the conceptualization of spirituality, and (3) spirituality in practice, which are explained in this paper with their relevant subthemes and codes. The definition which this study proposes for this concept is that "spirituality is the sublime aspect of human existence bestowed on all humans in order for them to traverse the path of transcendence that is closeness to God (Allah)." Conclusion. The definition provided by this study is similar to the previous definitions of this concept in its main part (transcendence) and in incorporating a God-centered view of spirituality within the context of an Islamic society. This definition has implications for health services' education, research, and practice in similar societies. PMID:27493675

  20. The Afghan symptom checklist: a culturally grounded approach to mental health assessment in a conflict zone.

    PubMed

    Miller, Kenneth E; Omidian, Patricia; Quraishy, Abdul Samad; Quraishy, Naseema; Nasiry, Mohammed Nader; Nasiry, Seema; Karyar, Nazar Mohammed; Yaqubi, Abdul Aziz

    2006-10-01

    This article describes a methodology for developing culturally grounded assessment measures in conflict and postconflict situations. A mixed-method design was used in Kabul, Afghanistan, to identify local indicators of distress and develop the 22-item Afghan Symptom Checklist (ASCL). The ASCL contains several indigenous items and items familiar to Western mental health professionals. The ASCL was pilot tested and subsequently administered to 324 adults in 8 districts of Kabul. It demonstrated excellent reliability (alpha=.93) and good construct validity, correlating strongly with a measure of exposure to war-related violence and loss (r=.70). Results of the survey indicate moderate levels of distress among Afghan men and markedly higher levels of distress and impaired functioning among women (and widows in particular). PMID:17209710

  1. Ensuring accountability through health professional regulatory bodies: the case of conflict of interest.

    PubMed

    Zelisko, Debra; Baumann, Andrea; Gamble, Brenda; Laporte, Audrey; Deber, Raisa B

    2014-09-01

    How do self-regulated health professions' regulatory bodies address financial conflict of interest (coi) and ensure accountability to the public? using document analysis, we examined how four ontario regulatory colleges (physicians, nurses, physiotherapists, audiologists/speech-language pathologists) defined coi and the education, guidance and enforcement they provided for coi-related issues. These colleges are upholding the mandates to define, identify and address financial coi by providing regulations or standards and guidelines to their membership; they differed in the amount of educational materials provided to their registrants and in the possible coi scenarios they presented. Although there were few disciplinary hearings pertaining to financial coi, findings for the hearings that did occur were documented and posted on the college public registers (the listing of all registered college members along with all relevant practice information), informing the public of any limitations or restrictions placed on a member as a result of the hearing. PMID:25305394

  2. Ensuring Accountability through Health Professional Regulatory Bodies: The Case of Conflict of Interest

    PubMed Central

    Zelisko, Debra; Baumann, Andrea; Gamble, Brenda; Laporte, Audrey; Deber, Raisa B.

    2014-01-01

    How do self-regulated health professions' regulatory bodies address financial conflict of interest (COI) and ensure accountability to the public? Using document analysis, we examined how four Ontario regulatory colleges (physicians, nurses, physiotherapists, audiologists/speech-language pathologists) defined COI and the education, guidance and enforcement they provided for COI-related issues. These colleges are upholding the mandates to define, identify and address financial COI by providing regulations or standards and guidelines to their membership; they differed in the amount of educational materials provided to their registrants and in the possible COI scenarios they presented. Although there were few disciplinary hearings pertaining to financial COI, findings for the hearings that did occur were documented and posted on the college public registers (the listing of all registered college members along with all relevant practice information), informing the public of any limitations or restrictions placed on a member as a result of the hearing. PMID:25305394

  3. The concept of race and health status in America.

    PubMed Central

    Williams, D R; Lavizzo-Mourey, R; Warren, R C

    1994-01-01

    Race is an unscientific, societally constructed taxonomy that is based on an ideology that views some human population groups as inherently superior to others on the basis of external physical characteristics or geographic origin. The concept of race is socially meaningful but of limited biological significance. Racial or ethnic variations in health status result primarily from variations among races in exposure or vulnerability to behavioral, psychosocial, material, and environmental risk factors and resources. Additional data that capture the specific factors that contribute to group differences in disease must be collected. However, reductions in racial disparities in health will ultimately require change in the larger societal institutions and structures that determine exposure to pathogenic conditions. More attention needs to be given to the ways that racism, in its multiple forms, affects health status. Socio-economic status is a central determinant of health status, overlaps the concept of race, but is not equivalent to race. Inadequate attention has been given to the range of variation in social, cultural, and health characteristics within and between racial or ethnic minority populations. There is a growing emphasis, both within and without the Federal Government, on the collection of racial or ethnic identifiers in health data systems, but noncoverage of the Asian and Pacific Islander population, Native Americans, and subgroups of the Hispanic population is still a major problem. However, for all racial or ethnic groups, we need not only more data but better data. We must be more active in directly measuring the health-related aspects of belonging to these social categories. PMID:8303011

  4. Treating substance abuse as a consequence of conflict and displacement: a call for a more inclusive global mental health.

    PubMed

    Lai, Lucinda

    2014-01-01

    In settings of conflict and displacement, the provision of appropriate mental health services is essential. While most mental health research has focused on identifying rates of post-traumatic stress and other common disorders in post-conflict settings, there has been little recognition of substance abuse as both a cause and consequence of mental health problems. Problems that arise when people begin to abuse substances to cope with the severe stress of emergency situations include the depletion of finite family and community resources, violence, exploitation, neglect of children and other protection threats. As a case in point, refugee camps on the Thai-Burma border have become a fertile breeding ground for drug and alcohol addiction. A more inclusive view of global mental health--one that addresses the problems of substance use in post-conflict and displacement contexts--will better enable health professionals to make meaningful contributions to conflict resolution and longer-term peace-building processes. PMID:25144954

  5. Generating Conflict for Greater Good: Utilizing Contingency Theory to Assess Black and Mainstream Newspapers as Public Relations Vehicles to Promote Better Health among African Americans

    PubMed Central

    Lumpkins, Crystal Y.; Bae, Jiyang; Cameron, Glen T.

    2010-01-01

    The potential use of strategic conflict management ( Wilcox and Cameron, 2006; Cameron, Wilcox, Reber and Shin ( in press) as a health advocacy tool in US African-American and mainstream newspapers, arguing that escalation of conflict can increase effectiveness of health-related news releases. For health communicators focusing on at-risk populations with poor health outcomes, such goals would include increased awareness of health problems and solutions, along with increased motivation arising from indignation over health disparities. Content analysis of 1,197 stories in 24 Black and 12 mainstream newspapers showed that more conflict factors were present in Black vs. mainstream newspapers, suggesting a way to strategically place health messages in news releases disseminated to newspapers that motivate at-risk publics to better health. The findings suggest that conflict factors such as racial disparity data regarding health issues may enhance media advocacy. PMID:22822291

  6. Generating Conflict for Greater Good: Utilizing Contingency Theory to Assess Black and Mainstream Newspapers as Public Relations Vehicles to Promote Better Health among African Americans.

    PubMed

    Lumpkins, Crystal Y; Bae, Jiyang; Cameron, Glen T

    2010-03-01

    The potential use of strategic conflict management ( Wilcox and Cameron, 2006; Cameron, Wilcox, Reber and Shin ( in press) as a health advocacy tool in US African-American and mainstream newspapers, arguing that escalation of conflict can increase effectiveness of health-related news releases. For health communicators focusing on at-risk populations with poor health outcomes, such goals would include increased awareness of health problems and solutions, along with increased motivation arising from indignation over health disparities. Content analysis of 1,197 stories in 24 Black and 12 mainstream newspapers showed that more conflict factors were present in Black vs. mainstream newspapers, suggesting a way to strategically place health messages in news releases disseminated to newspapers that motivate at-risk publics to better health. The findings suggest that conflict factors such as racial disparity data regarding health issues may enhance media advocacy. PMID:22822291

  7. Armed conflicts, health and health services in Africa. An epidemiological framework of reference.

    PubMed

    Loretti, A

    1997-01-01

    Because of war, between the 1980s and early '90s Africa suffered about 5 million excess deaths and economic losses estimated at US $13 billion per year. In 1995, war was directly or indirectly affecting 550 million people in 35 countries. Besides violent deaths, injuries and disabilities, displacements of population increase the risk for acute respiratory infections, diarrhoeas, epidemics and parasitic disease. The risk for malnutrition and deficiencies is made worse by the loss of means of production, of food stocks, of commerce and by banditism. Military operations target water plants and health facilities as means of deliberately hurting civilians. Economic crisis curtails the budgets of the social sectors and, together with social distress, undermines national capacities. The delivery of health care is hampered right when hazards and vulnerabilities increase, with general greater risk of illness and death. With the cessation of hostilities, the need for curative and preventative health activities increases and is a matter of emergency, as equitable access to services is important for peace. Repatriation of refugees, demobilization of soldiers and demining require special health activities. War leaves behind new hazards and vulnerabilities such as landmines, wide availability of weapons, artificial concentrations of population, loss of national capacities and psychological disorders. All this interacts tragically with Africa's wider epidemiological realities of poverty, food insecurity, proneness to natural disasters and endemic diseases. PMID:9290329

  8. Comment on Cross, Fine, Jones, and Walsh (2012): Do Mental Health Professionals Who Serve on/with Child Advocacy Centers Experience Role Conflict?

    ERIC Educational Resources Information Center

    Friend, Colleen

    2012-01-01

    Cross, Fine, Jones, and Walsh's (2012) article "Mental Health Professionals in Children's Advocacy Centers: Is There Role Conflict?" challenges two recent publications' criticisms that child advocacy centers create role conflict for mental health professionals and explains how child advocacy centers actually work, describing the different roles…

  9. [Conflict of interest and bioethics].

    PubMed

    Kemelmajer De Carlucci, Aida

    2014-06-01

    "Conflicts of interests" is a multi-meaning expression. To give a juridical concept is not easy because this concept is applied in public and private law. Maybe this is the reason of not having a law giving a valid definition in any case In health area, a conflict of interests is present many times, i.e. at the beginning of a research, when informing its results, etc. This conflict of interests may affect different aspects of the research work, economic or not; sometimes totally or partially. The economic resources is one of the most common reasons of the conflict of interests. The mass media often cause conflicts of interests informing the general public about new scientific discovery in a simple way to be understood but without been quite assertive. Other times, great enterprises hide information about new and better medicines due to the fact that they have many old medicines that should be sold before introducing in the market the new ones. From the academic point of view, conflicts may arise when the public funds are wrongly used to support unworthy researches. PMID:25272794

  10. Using a Conflict Map as an Instructional Tool To Change Student Conceptions in Simple Series Electric-Circuits.

    ERIC Educational Resources Information Center

    Tsai, Chin-Chung

    2003-01-01

    Examines the effects of using a conflict map on 8th grade students' conceptual change and ideational networks about simple series electric circuits. Analyzes student interview data through a flow map method. Shows that the use of conflict maps could help students construct greater, richer, and more integrated ideational networks about electric…

  11. Big pharma and health care: unsolvable conflict of interests between private enterprise and public health.

    PubMed

    Brezis, Mayer

    2008-01-01

    A landmark paper on Game Theory showed that individual maximization of profit necessarily endangers the public good, and since the problem has no technical solution, "it requires a fundamental extension in morality" (1). We propose here that public health, as a public good, now emerges as a grave example of this problem. Recent events and reports increasingly suggest misalignment between the interests of the pharmaceutical industry and those of public health. Johnson & Johnson illegally and effectively promoted Propulsid off-label for children despite internal company documents raising safety concerns. Death in drug trial has been described as a "trade secret." On Vioxx, Topol wrote: "Sadly, it is clear that Merck's commercial interest exceeded its concern about the drug's toxicity" (2). More and more concerns are raised by scholars and major journal editors about the type and the quality of published evidence, often biased towards efficacy of new products. The industry, funding over 80% of trials, sets up a research agenda guided more by marketing than by clinical considerations. Smart statistical and epidemiological tactics help obtain the desired results. Budget for marketing is by far greater than for research. Massive advertising to physicians and to the public gets increasingly sophisticated: ghost writing, professional guidelines, targeting of consumer groups and manipulating media for disease mongering. Pervasive lobbying and political ties limit the independence of regulatory bodies. Obligation to shareholders overriding public health considerations is not unique to the pharmaceutical industry. The chemical, tobacco and food industries share similar tactics: proclaiming doubts about safety issues, buying researchers, infiltrating universities, boards, media and legislative agencies. By contrast, powerful and cheap health promoting activities, poorly supported by industry because they are too cheap and not patented, are markedly underutilized: technologies

  12. Global agenda, local health: including concepts of health security in preparedness programs at the jurisdictional level.

    PubMed

    Eby, Chas

    2014-01-01

    The Global Health Security Agenda's objectives contain components that could help health departments address emerging public health challenges that threaten the population. As part of the agenda, partner countries with advanced public health systems will support the development of infrastructure in stakeholder health departments. To facilitate this process and augment local programs, state and local health departments may want to include concepts of health security in their public health preparedness offices in order to simultaneously build capacity. Health security programs developed by public health departments should complete projects that are closely aligned with the objectives outlined in the global agenda and that facilitate the completion of current preparedness grant requirements. This article identifies objectives and proposes tactical local projects that run parallel to the 9 primary objectives of the Global Health Security Agenda. Executing concurrent projects at the international and local levels in preparedness offices will accelerate the completion of these objectives and help prevent disease epidemics, detect health threats, and respond to public health emergencies. Additionally, future funding tied or related to health security may become more accessible to state and local health departments that have achieved these objectives. PMID:25396695

  13. Resolving conflicts in public health protection and ecosystem service provision at designated bathing waters.

    PubMed

    Quilliam, Richard S; Kinzelman, Julie; Brunner, Joel; Oliver, David M

    2015-09-15

    Understanding and quantifying the trade-off between the requirement for clean safe bathing water and beaches and their wider ecosystem services is central to the aims of the European Union (EU) Marine Strategy Framework Directive (MSFD), and vital for the sustainability and economic viability of designated bathing waters. Uncertainty surrounding the impacts of ensuing bathing water policy transitions, e.g. the EU revised Bathing Waters Directive (rBWD), puts new urgency on our need to understand the importance of natural beach assets for human recreation, wildlife habitat and for protection from flooding and erosion. However, managing coastal zones solely in terms of public health could have potentially negative consequences on a range of other social and cultural ecosystem services, e.g. recreation. Improving our knowledge of how bathing waters, surrounding beach environments and local economies might respond to shifts in management decisions is critical in order to inform reliable decision-making, and to evaluate future implications for human health. In this paper we explore the conflicts and trade-offs that emerge at public beach environments, and propose the development of an evaluative framework of viable alternatives in environmental management whereby bathing waters are managed for their greatest utility, driven by identifying the optimal ecosystem service provision at any particular site. PMID:26188988

  14. Health care professionals and industry: reducing conflicts of interest and established best practices.

    PubMed

    Weber, L J; Wayland, M T; Holton, B

    2001-12-01

    The relationship between health care providers and pharmaceutical companies and other commercial interests is ethically complex. The common practice of gift giving takes many forms including free samples, sponsorship of medical education, loan of equipment, and gifts ranging from those of nominal value such as pens to more valuable gifts such as golf outings or dinners. Gift giving is a practice that serves both the recipient and the giver, but, in the medical setting, it raises the question of whether this is to the detriment of patient care. Although health care professionals may believe they are able to ignore influence from commercial interests, human judgment research indicates that decision-makers are generally unaware of biases affecting their decisions. This is an issue of organizational ethics as well. Institutions that allow commercial interests to give some form of gift are allowing the appearance of bias as well as placing the burden of avoiding bias on the individual rather than on the institution. Conflict-of-interest analysis indicates that best practice is to limit or eliminate the influence of commercial interests, ensuring that professionals are better able to exercise their independent objective judgment. PMID:11805916

  15. The impact of social action funds on child health in a conflict affected country: evidence from Angola.

    PubMed

    Djimeu, Eric W

    2014-04-01

    Although recent evidence shows significant and long-lasting detrimental effects of armed conflict on child health, there is lack of studies rigorously assessing the effectiveness of different social and economic development interventions aiming to mitigate the impact of armed conflict on child health. In order to fill this knowledge gap, this study assesses the impact of health projects and water, sanitation, and waste management interventions financed by the Angola Social Action Fund (ASAF) from 1994 to 2001 on child health. I use data from Inquérito aos Agregados Familiares sobre Despesas e Receitas 2000/2001(IDR 2001), a household survey on expenditures and incomes conducted between February 2000 and February 2001 in Angola. IDR 2001 uses a stratified sampling design in which 12 households were surveyed in a random fashion in each aldeia (village) in rural areas and bairro (neighborhood) in urban areas. Using propensity score matching, a fixed effects model, and propensity-based weighted regression, I find that ASAF leads to a statistically significant increase of the height-for-age Z-scores (HAZ) by 0.335 standard deviations of children less than 5 years. This finding is robust to different implementations of the propensity score model specification and when conducting the sensitivity analysis of hidden bias. The main result that emerges from an analysis of heterogeneous effects shows that ASAF has no impact on children living in war displaced households. Despite many challenges faced by conflict affected countries, social funds which are one the key instruments of the World Bank used to promote development at the local level can be used to mitigate the impact of armed conflict on child health. For children living in war displaced households, specific interventions should be designed to mitigate the impact of armed conflict. PMID:24530615

  16. Instruction in Conflict Resolution.

    ERIC Educational Resources Information Center

    Jandt, Fred E.; Hare, Mark

    Intended for use by teachers who are concerned with making effective responses to conflict in the classroom, this booklet describes the nature of adolescent conflict and the differences between conflict, competition, and cooperation. The theory section of this work analyzes some of the major concepts and research findings emphasized in the study…

  17. An analysis of Liberia's 2007 national health policy: lessons for health systems strengthening and chronic disease care in poor, post-conflict countries

    PubMed Central

    2011-01-01

    Background Globally, chronic diseases are responsible for an enormous burden of deaths, disability, and economic loss, yet little is known about the optimal health sector response to chronic diseases in poor, post-conflict countries. Liberia's experience in strengthening health systems and health financing overall, and addressing HIV/AIDS and mental health in particular, provides a relevant case study for international stakeholders and policymakers in other poor, post-conflict countries seeking to understand and prioritize the global response to chronic diseases. Methods We conducted a historical review of Liberia's post-conflict policies and their impact on general economic and health indicators, as well as on health systems strengthening and chronic disease care and treatment. Key sources included primary documents from Liberia's Ministry of Health and Social Welfare, published and gray literature, and personal communications from key stakeholders engaged in Liberia's Health Sector Reform. In this case study, we examine the early reconstruction of Liberia's health care system from the end of conflict in 2003 to the present time, highlight challenges and lessons learned from this initial experience, and describe future directions for health systems strengthening and chronic disease care and treatment in Liberia. Results Six key lessons emerge from this analysis: (i) the 2007 National Health Policy's 'one size fits all' approach met aggregate planning targets but resulted in significant gaps and inefficiencies throughout the system; (ii) the innovative Health Sector Pool Fund proved to be an effective financing mechanism to recruit and align health actors with the 2007 National Health Policy; (iii) a substantial rural health delivery gap remains, but it could be bridged with a robust cadre of community health workers integrated into the primary health care system; (iv) effective strategies for HIV/AIDS care in other settings should be validated in Liberia and

  18. Offering Mental Health Services in a Conflict Affected Region of Pakistan: Who Comes, and Why?

    PubMed Central

    Shah, Safieh; Van den Bergh, Rafael; Van Bellinghen, Benedicte; Severy, Nathalie; Sadiq, Sana; Afridi, Sher Ali; Akhtar, Asma; Maïkére, Jacob; Van Overloop, Catherine; Saeed-ur-Rehman; Khilji, Tahir Bashir-ud-Din; Saleem-ur-Rehman; van Griensven, Johan; Schneider, Serge; Bosman, Philippe; Guillergan, Erwin Lloyd D.; Dazzi, Francesca; Zachariah, Rony

    2014-01-01

    Background North West Pakistan is an area ravaged by conflict and population displacement for over three decades. Recently, drone attacks and military operations have aggravated underlying mental disorders, while access to care is limited. Among patients attending a mental health clinic integrated in district hospital conducted by psychologists; we describe service utilization, patient characteristics, presenting complaints, morbidity patterns, and follow-up details. Methodology/Principal Findings A retrospective study using routinely collected programme data was conducted from February to December 2012. A total of 1545 consultations were conducted for 928 patients (86% females). There were 71(8%) children and adolescents. An increase was observed from February to July, followed by a decline. 163 new patients (18%) were on psychotropic medication at presentation. The most common morbidity in females (36%) were symptoms of adjustment disorders and acute reactions. Depression and anxiety were common in both genders while post traumatic disorder was frequent in males (21%). Out of the 928 new patients, 639(69%) had a follow up visit planned with their psychologist, but only 220(34%) new patients returned for a follow up visit. Conclusion In a district hospital, mental health services managed by psychologists were well attended. There is a need to consider widening the current package of care to cater to the diversity of mental health disorders, gender difference, children and adolescents. Standardized diagnostic and monitoring tools would also need to be adapted accordingly and to assess patient progress. Innovative approaches to tackle the problem of the low return rate are needed. PMID:24963793

  19. Goal orientation and conflicts: Motors of change in development projects in health care service.

    PubMed

    Elg, Mattias; Kollberg, Beata; Lindmark, Jan; Olsson, Jesper

    2007-01-01

    In this article we present parts of a larger research study, which aims at explaining how a process-oriented innovation unfolds and develops over time in Swedish health care. Through a longitudinal field study of a national and a local development project, we analyze how the flow model--a process-oriented innovation that emphasizes the sequence of activities a patient undertakes through the health care system--has been developed in Swedish health care. We propose to explain how the development projects unfold over time through the use of process theories of organizational development and change. The national project is best understood as a process of evolution from the phase of selection of projects and teleological (goal-oriented, socially constructed development) and dialectic theory (development via conflict of 2 opposing ideas from different organizational entities) through the process in which national ideas face real-world practice. We also propose a synthesis of dialectics and teleological motors for explaining local development. This synthesis proposes that local development teams have a rather broad notion of what it takes to implement the flow model. The team knows the goal, procedures, and activities from a broad perspective. Through a search-and-interact process, in which other organizational entities such as IT consultants, medical units and politicians have a heavy influence, the group sets and implements goals. Details of how to proceed are, however, constructed in the process of acting. This occurs as ideas are developed and tested in real settings. We conclude the article by presenting managerial implications for understanding these process patterns. PMID:17235254

  20. Internally displaced human resources for health: villager health worker partnerships to scale up a malaria control programme in active conflict areas of eastern Burma.

    PubMed

    Lee, C I; Smith, L S; Shwe Oo, E K; Scharschmidt, B C; Whichard, E; Kler, Thart; Lee, T J; Richards, A K

    2009-01-01

    Approaches to expand malaria control interventions in areas of active conflict are urgently needed. Despite international agreement regarding the imperative to control malaria in eastern Burma, there are currently no large-scale international malaria programmes operating in areas of active conflict. A local ethnic health department demonstrated that village health workers are capable of implementing malaria control interventions among internally displaced persons (IDPs). This paper describes how these internally displaced villagers facilitated rapid expansion of the programme. Clinic health workers received training in malaria diagnosis and treatment, vector control and education at training sites along the border. After returning to programme areas inside Burma, they trained villagers to perform an increasingly comprehensive set of interventions. This iterative training strategy to increase human resources for health permitted the programme to expand from 3000 IDPs in 2003 to nearly 40,000 in 2008. It was concluded that IDPs are capable of delivering essential malaria control interventions in areas of active conflict in eastern Burma. In addition, health workers in this area have the capacity to train community members to take on implementation of such interventions. This iterative strategy may provide a model to improve access to care in this population and in other conflict settings. PMID:19384681

  1. Fetal microchimerism and maternal health: a review and evolutionary analysis of cooperation and conflict beyond the womb.

    PubMed

    Boddy, Amy M; Fortunato, Angelo; Wilson Sayres, Melissa; Aktipis, Athena

    2015-10-01

    The presence of fetal cells has been associated with both positive and negative effects on maternal health. These paradoxical effects may be due to the fact that maternal and offspring fitness interests are aligned in certain domains and conflicting in others, which may have led to the evolution of fetal microchimeric phenotypes that can manipulate maternal tissues. We use cooperation and conflict theory to generate testable predictions about domains in which fetal microchimerism may enhance maternal health and those in which it may be detrimental. This framework suggests that fetal cells may function both to contribute to maternal somatic maintenance (e.g. wound healing) and to manipulate maternal physiology to enhance resource transmission to offspring (e.g. enhancing milk production). In this review, we use an evolutionary framework to make testable predictions about the role of fetal microchimerism in lactation, thyroid function, autoimmune disease, cancer and maternal emotional, and psychological health. Also watch the Video Abstract. PMID:26316378

  2. Integrated System Health Management: Foundational Concepts, Approach, and Implementation

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando

    2009-01-01

    A sound basis to guide the community in the conception and implementation of ISHM (Integrated System Health Management) capability in operational systems was provided. The concept of "ISHM Model of a System" and a related architecture defined as a unique Data, Information, and Knowledge (DIaK) architecture were described. The ISHM architecture is independent of the typical system architecture, which is based on grouping physical elements that are assembled to make up a subsystem, and subsystems combine to form systems, etc. It was emphasized that ISHM capability needs to be implemented first at a low functional capability level (FCL), or limited ability to detect anomalies, diagnose, determine consequences, etc. As algorithms and tools to augment or improve the FCL are identified, they should be incorporated into the system. This means that the architecture, DIaK management, and software, must be modular and standards-based, in order to enable systematic augmentation of FCL (no ad-hoc modifications). A set of technologies (and tools) needed to implement ISHM were described. One essential tool is a software environment to create the ISHM Model. The software environment encapsulates DIaK, and an infrastructure to focus DIaK on determining health (detect anomalies, determine causes, determine effects, and provide integrated awareness of the system to the operator). The environment includes gateways to communicate in accordance to standards, specially the IEEE 1451.1 Standard for Smart Sensors and Actuators.

  3. Work–family conflict and health in Swedish working women and men: a 2-year prospective analysis (the SLOSH study)

    PubMed Central

    Baltzer, Maria; Magnusson Hanson, Linda L.; Westerlund, Hugo

    2013-01-01

    Background: Research has suggested that gender is related to perceptions of work–family conflict (WFC) and an underlying assumption is that interference of paid work with family life will burden women more than men. There is, however, mixed evidence as to whether men and women report different levels of WFC. Even less studies investigate gender differences in health outcomes of WFC. Also the number of longitudinal studies in this field is low. Methods: Based on the Swedish Longitudinal Occupational Survey of Health, we prospectively examined the effects of WFC on three different health measures representing a wide spectrum off ill health (i.e. self-rated health, emotional exhaustion and problem drinking). Logistic regression analyses were used to analyse multivariate associations between WFC in 2008 and health 2 years later. Results: The results show that WFC was associated with an increased risk of emotional exhaustion among both men and women. Gender differences are suggested as WFC was related to an increased risk for poor self-rated health among women and problem drinking among men. Interaction analyses revealed that the risk of poor self-rated health was substantially more influenced by WFC among women than among men. Conclusions: We conclude that, despite the fact that women experience conflict between work and family life slightly more often than men, both men’s and women’s health is negatively affected by this phenomenon. PMID:22683777

  4. Education and Work-Family Conflict: Explanations, Contingencies and Mental Health Consequences

    ERIC Educational Resources Information Center

    Schieman, Scott; Glavin, Paul

    2011-01-01

    Using data from a representative sample of American workers, we examine the association between education and work-to-family conflict--a form of inter-role conflict in which role pressures from each domain are incompatible in some way. The well-educated tend to occupy professional jobs with more income and pressures, and experience more…

  5. Cultures in conflict: a challenge to faculty of academic health centers.

    PubMed

    Magill, M K; Catinella, A P; Haas, L; Hughes, C C

    1998-08-01

    Academic health centers (AHCs) are experiencing turmoil in all three of their traditional missions of teaching, research, and patient care. The authors examine origins of universities and medical education to place in historical context the stresses affecting AHCs at the end of the 20th century. They describe the cultures of the university to suggest strategies for successful adaptation to these stresses. Clashes of values and norms of the cultures within universities and AHCs can hinder effective adaptation to external change. Administrators, researchers, teachers, and clinicians can have strongly conflicting perspectives. For example, business skill is of increasing importance to the survival of the clinical enterprise, but not typically valued by faculty members. University faculty have often considered accountability as antithetical to academic freedom, and, until recently, accountability was not strongly demanded of AHCs. The authors conclude that AHC faculty must transcend the outdated view that the roles of the scholar, scientist, and healer are in opposition to those of the leader and manager. If AHCs are to survive and prosper through their current cultural transition, their faculty must understand all these roles as part of their intellectual and organizational responsibility. PMID:9736847

  6. HEALTH GeoJunction: place-time-concept browsing of health publications

    PubMed Central

    2010-01-01

    Background The volume of health science publications is escalating rapidly. Thus, keeping up with developments is becoming harder as is the task of finding important cross-domain connections. When geographic location is a relevant component of research reported in publications, these tasks are more difficult because standard search and indexing facilities have limited or no ability to identify geographic foci in documents. This paper introduces HEALTH GeoJunction, a web application that supports researchers in the task of quickly finding scientific publications that are relevant geographically and temporally as well as thematically. Results HEALTH GeoJunction is a geovisual analytics-enabled web application providing: (a) web services using computational reasoning methods to extract place-time-concept information from bibliographic data for documents and (b) visually-enabled place-time-concept query, filtering, and contextualizing tools that apply to both the documents and their extracted content. This paper focuses specifically on strategies for visually-enabled, iterative, facet-like, place-time-concept filtering that allows analysts to quickly drill down to scientific findings of interest in PubMed abstracts and to explore relations among abstracts and extracted concepts in place and time. The approach enables analysts to: find publications without knowing all relevant query parameters, recognize unanticipated geographic relations within and among documents in multiple health domains, identify the thematic emphasis of research targeting particular places, notice changes in concepts over time, and notice changes in places where concepts are emphasized. Conclusions PubMed is a database of over 19 million biomedical abstracts and citations maintained by the National Center for Biotechnology Information; achieving quick filtering is an important contribution due to the database size. Including geography in filters is important due to rapidly escalating attention to

  7. Environmental pollutions associated to conflicts in Iraq and related health problems.

    PubMed

    Al-Shammari, Ahmed Majeed

    2016-06-01

    Several wars and a 13-year embargo as well as several years of civil war with the recent war on terrorism have cumulatively damaged Iraq's land, air, water, and health infrastructure. The sand particles in Iraq contain toxic substances, which dates back to the pollution caused by military actions that disassemble the desert sands and turn it into light dust. This dust reaches cities as dust storms that effect most Iraqi cities. The presence of depleted uranium (DU) in the Iraqi food chain is documented by measuring the uranium in animals organs in different Iraqi cities with the highest concentration in the south of Iraq. One of the major sites of pollution in Iraq is the Al-twaitha nuclear research site. The nuclear research reactors were destroyed in the 1991 Gulf War. Barrels containing radioactive materials and sources were stolen from the site in the 2003 war. This resulted in considerable radioactive pollution at the site and in its surrounding areas. Soil sample have been found to be contaminated by Cs-137and Co-60. Cancer and birth defects are most associated with the environmental pollution caused by the conflicts. All studies related to this by Iraqi researchers are discussed in this review. From studying the Iraqi scientific publications, we can conclude that Basrah, Baghdad, Faluja, Mosul and Thi-Qar are the most effected cities in Iraq. This review concludes that the presence of a heavily contaminated environment with war related pollutants in most of the Iraqi cities needs much attention and huge effort to reduce the related health problems. PMID:26512425

  8. Predicting positive mental health in internally displaced persons in Indonesia: the roles of economic improvement and exposure to violent conflict.

    PubMed

    Saragih Turnip, Sherly; Sörbom, Dag; Hauff, Edvard

    2016-01-01

    Positive mental health, rather than just the absence of mental illness, is rarely investigated among the internally displaced persons (IDPs) affected by violent conflict in low-income countries. The purpose of this study was to investigate a model that could explain the interrelationship between factors contributing to positive mental health in displaced populations. In a longitudinal study we examine poverty, exposure to traumatic events and the change of material well-being after one year. We collected data in two consecutive years (2005 and 2006) from a community-based sample of IDPs in Ambon, Indonesia, through face-to-face structured interviews with consenting adults. Participants of this study were IDPs lived in Ambon during the violent conflict period. We interviewed 471 IDPs in the first year and reinterviewed 399 (85%) of the same subjects in the second year. The IDPs possessed good sense of coherence and subjective well-being. Our final model, which was generated by the use of structural equation modeling, fits the data well (χ(2) = 52.51, df = 45, p = .21, CFI = .99, RMSEA = .019). Exposure to violent conflict had a negative impact on IDPs' mental health initially and better economic conditions improved it (r = -.30 and .29 respectively). Mental health status one year previously was a strong predictor of future mental health, followed by individual economic growth in the past year (r = .43 and .29 respectively). On a group level the IDPs were resilient and adaptive to survive in adverse living conditions after devastating violent conflict, and the economic improvement contributed to it. PMID:26059612

  9. Integrating quantitative and qualitative methodologies for the assessment of health care systems: emergency medicine in post-conflict Serbia

    PubMed Central

    Nelson, Brett D; Dierberg, Kerry; Šćepanović, Milena; Mitrović, Mihajlo; Vuksanović, Miloš; Milić, Ljiljana; VanRooyen, Michael J

    2005-01-01

    Background Due to the complexity of health system reform in the post-conflict, post-disaster, and development settings, attempts to restructure health services are fraught with pitfalls that are often unanticipated because of inadequate preliminary assessments. Our proposed Integrated Multimodal Assessment – combining quantitative and qualitative methodologies – may provide a more robust mechanism for identifying programmatic priorities and critical barriers for appropriate and sustainable health system interventions. The purpose of this study is to describe this novel multimodal assessment using emergency medicine in post-conflict Serbia as a model. Methods Integrated quantitative and qualitative methodologies – system characterization and observation, focus group discussions, free-response questionnaires, and by-person factor analysis – were used to identify needs, problems, and potential barriers to the development of emergency medicine in Serbia. Participants included emergency and pre-hospital personnel from all emergency medical institutions in Belgrade. Results Demographic data indicate a loosely ordered network of part-time emergency departments supported by 24-hour pre-hospital services and an academic emergency center. Focus groups and questionnaires reveal significant impediments to delivery of care and suggest development priorities. By-person factor analysis subsequently divides respondents into distinctive attitudinal types, compares participant opinions, and identifies programmatic priorities. Conclusions By combining quantitative and qualitative methodologies, our Integrated Multimodal Assessment identified critical needs and barriers to emergency medicine development in Serbia and may serve as a model for future health system assessments in post-conflict, post-disaster, and development settings. PMID:15715917

  10. Transforming Ottawa Charter health promotion concepts into Swedish public health policy.

    PubMed

    Pettersson, Bosse

    2007-01-01

    Swedish public health policy clearly illustrates how the concept of the Ottawa Charter for health promotion can be utilized at a national level. The impact has been more implicit than explicit. Public health has a long history in Sweden and much of the present and future is, and will be, linked to traditional values and structures. International input, however, has been essential to prompt new approaches and change. Health inequalities remain the major shortcoming. The Swedish system offers universal access to healthcare in a decentralized system. Still, primary healthcare, and the health services as a whole have not yet sufficiently embraced the idea of health promotion. Political attention to modern public health at the Prime Minister level was established in late 1980s. Since, continuous initiatives in terms of organization, infrastructure and funding have taken place. With regard to funding, a vast majority of the resources allocated to health promotion will be found outside the health sector. An interesting observation is that the Swedish public health policy with its 11 objective domains remains the same, also after a change of government. Future challenges include maintaining and developing an intersectoral mechanism for implementation, allocating more resources for intervention research to strengthen knowledge-based health promotion, and developing tools for coping better with the challenges of globalisation identified in the Bangkok Charter. PMID:18372877

  11. Initial Concept for Terminal Area Conflict Detection, Alerting, and Resolution Capability On or Near the Airport Surface, Version 2.0

    NASA Technical Reports Server (NTRS)

    Otero, Sharon D.; Barker, Glover D.; Jones, Denise R.

    2013-01-01

    The Next Generation Air Transportation System (NextGen) concept for 2025 envisions the movement of large numbers of people and goods in a safe, efficient, and reliable manner. The NextGen will remove many of the constraints in the current air transportation system, support a wider range of operations, and deliver an overall system capacity up to 3 times that of current operating levels. In order to achieve the NextGen vision, research is necessary in the areas of surface traffic optimization, maximum runway capacity, reduced runway occupancy time, simultaneous single runway operations, and terminal area conflict prevention, among others. The National Aeronautics and Space Administration (NASA) is conducting Collision Avoidance for Airport Traffic (CAAT) research to develop technologies, data, and guidelines to enable Conflict Detection and Resolution (CD&R) in the Airport Terminal Maneuvering Area (ATMA) under current and emerging NextGen operating concepts. The term ATMA was created to reflect the fact that the CD&R concept area of operation is focused near the airport within the terminal maneuvering area. In the following, an initial concept for an aircraft-based method for CD&R in the ATMA is presented. This method is based upon previous NASA work in CD&R for runway incursion prevention, the Runway Incursion Prevention System (RIPS).

  12. Health and Beyond... Strategies for a Better India: Concept Paper on Primary Health Care in India

    PubMed Central

    Bhaumik, Soumyadeep

    2014-01-01

    Background: India is one of the fastest growing economies of the world, and is posed to overtake China in terms of being the most populous nation of the world. The very essential components of primary health care – promotion of food supply, proper nutrition, safe water and basic sanitation and provision for quality health information concerning the prevailing health problems – is largely ignored. Access to healthcare services, provision of essential medicines and scarcity of doctors are other bottlenecks in the primary health care scenario. Complete absence of evidence-based guidelines on clinical scenarios and treatment plans in the primary health care sector, together with overburdening of the secondary and tertiary care sectors, has substantially lowered the quality of care in the nation. Aim: To discuss a strategy for a better primary healthcare model. Methods: This is a concept paper with an exploratory view of various problems and a suggested strategy to counter it. Results: This concept paper suggests a triad of strategies (technology, accountability and ink-blot strategy) that can be adapted to various problems in the primary healthcare scenario. Discussion: The concept paper is a preliminary document on a suggested model that needs to be worked out on a broader basis across all stakeholders with operational definitions, standards of procedure and protocols finalised. PMID:25161962

  13. Understanding and Improving Cardiovascular Health: An Update on the American Heart Association's Concept of Cardiovascular Health.

    PubMed

    Shay, Christina M; Gooding, Holly S; Murillo, Rosenda; Foraker, Randi

    2015-01-01

    The American Heart Association's 2020 Strategic Impact Goal is "By 2020, to improve the cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular diseases and stroke by 20%." To monitor progress towards this goal, a new construct "ideal cardiovascular health" (iCVH) was defined that includes the simultaneous presence of optimal levels of seven health behaviors (physical activity, smoking, dietary intake, and body mass index) and factors (total cholesterol, blood pressure and fasting blood glucose). In this review, we present a summary of major concepts related to the concept of iCVH and an update of the literature in this area since publication of the 2020 Strategic Impact Goal, including trends in iCVH prevalence, new determinants and outcomes related to iCVH, strategies for maintaining or improving iCVH, policy implications of the iCVH model, and the remaining challenges to reaching the 2020 Strategic Impact Goal. PMID:25958016

  14. The concept of "the will to thrive" in mental health.

    PubMed

    Powers, Cassandra; Hart, Valerie A; Shattell, Mona; MacCulloch, Tony

    2012-11-01

    Mental health nursing is focused on patients moving along the continuum between failing and thriving in terms of emotional functioning. This differs dramatically from a medical model of disease/cure. A variety of nursing theorists have both directly and indirectly identified the importance of patient's "will to thrive" although this term has never been used. Peplau spoke of self-efficacy and self-esteem. Barrett's model focuses on the patient's participation in their own recovery as a key component. This article explores the concept, akin to failure to thrive in infants, of the will to thrive in the chronically ill and its role in assessment and nursing intervention. A particular emphasis on the importance of patient responsibility is identified as vital to the process of true change. PMID:23146016

  15. Types of Conflict Management Strategies Used in Three Kinds of Organizations: 50 Cases from Schools, Community Health Centres, and Schools of Nursing. Executive Summary.

    ERIC Educational Resources Information Center

    Fris, Joe; And Others

    Findings of a study that examined the ways in which school principals, directors of nursing education programs, and supervisors of community health centers manage conflict are presented in this paper. The study attempted to determine the applicability of research on conflict management in noneducational settings to school organizations. Interviews…

  16. Mental health impact of the Iraq and Afghanistan conflicts: a review of US research, service provision, and programmatic responses.

    PubMed

    Wells, Timothy S; Miller, Shannon C; Adler, Amy B; Engel, Charles C; Smith, Tyler C; Fairbank, John A

    2011-04-01

    Although documentation that war inflicts psychological casualties dates back to the American Civil War and earlier, most research began after the Vietnam conflict, when studies focused on post-traumatic stress disorder (PTSD). With ongoing conflicts in Iraq and Afghanistan, there has been significant research to illuminate the epidemiology of war-related psychological casualties. Significant findings include an appreciation for the role combat plays in the development of mental disorders, including PTSD and traumatic brain injury (TBI). Recent research has endeavoured to understand and improve psychological resilience to temper potentially adverse mental health effects of military service in the theatre of combat operations. Over 2 million US service members have now deployed and returned over 3 million times to the Iraq and Afghanistan conflicts. Mental health providers in the Departments of Defense and Veterans Affairs healthcare systems have consequently observed steep increases in mental health service use among these personnel. The Departments have responded aggressively to bolster staffing levels, increase capacity, improve available services, and anticipate future needs. Scientists and clinicians continue efforts to understand the determinants, prevention, recognition, and treatment of combat-related mental disorders. PMID:21521083

  17. Mexico’s northern border conflict: collateral damage to health and human rights of vulnerable groups

    PubMed Central

    Beletsky, Leo; Martinez, Gustavo; Gaines, Tommi; Nguyen, Lucie; Lozada, Remedios; Rangel, Gudelia; Vera, Alicia; McCauley, Heather L.; Sorensen, Andrea; Strathdee, Steffanie A.

    2013-01-01

    Objective To compare distributions of human rights violations and disease risk; to juxtapose these patterns against demographic and structural environmental variables, and to formulate implications for structural interventions. Methods Female sex workers who inject drugs were surveyed in Tijuana and Ciudad Juarez, Mexico. Structured interviews and testing for sexually transmitted infections (STIs) were conducted (October 2008 to October 2009). Frequencies of individual and environmental factors, including police abuse, risk of HIV infection, and protective behaviors, were compared between sites using univariate logistic regression. Results Of 624 women, almost half reported police syringe confiscation despite syringes being legal; 55.6% reported extortion (past 6 months), with significantly higher proportions in Ciudad Juarez (P < 0.001). Reports of recent solicitation of sexual favors (28.5% in Tijuana, 36.5% in Ciudad Juarez, P = 0.04) and sexual abuse (15.7% in Tijuana, 18.3% in Ciudad Juarez) by police were commonplace. Prevalence of STIs was significantly lower in Tijuana than in Ciudad Juarez (64.2% and 83.4%, P < 0.001), paralleling the lower prevalence of sexual risk behaviors there. Ciudad Juarez respondents reported significantly higher median number of monthly clients (6.8 versus 1.5, P < 0.001) and lower median pay per sex act (US$ 10 versus US$ 20, P < 0.001) (in the past month). Relative to Tijuana, security deployment, especially the army’s presence, was perceived to have increased more in Ciudad Juarez in the past year (72.1% versus 59.2%, P = 0.001). Conclusions Collateral damage from police practices in the context of Mexico’s drug conflict may affect public health in the Northern Border Region. Itinerant officers may facilitate disease spread beyond the region. The urgency for mounting structural interventions is discussed. PMID:22767041

  18. Consumer Health Concepts That Do Not Map to the UMLS: Where Do They Fit?

    PubMed Central

    Keselman, Alla; Smith, Catherine Arnott; Divita, Guy; Kim, Hyeoneui; Browne, Allen C.; Leroy, Gondy; Zeng-Treitler, Qing

    2008-01-01

    Objective This study has two objectives: first, to identify and characterize consumer health terms not found in the Unified Medical Language System (UMLS) Metathesaurus (2007 AB); second, to describe the procedure for creating new concepts in the process of building a consumer health vocabulary. How do the unmapped consumer health concepts relate to the existing UMLS concepts? What is the place of these new concepts in professional medical discourse? Design The consumer health terms were extracted from two large corpora derived in the process of Open Access Collaboratory Consumer Health Vocabulary (OAC CHV) building. Terms that could not be mapped to existing UMLS concepts via machine and manual methods prompted creation of new concepts, which were then ascribed semantic types, related to existing UMLS concepts, and coded according to specified criteria. Results This approach identified 64 unmapped concepts, 17 of which were labeled as uniquely “lay” and not feasible for inclusion in professional health terminologies. The remaining terms constituted potential candidates for inclusion in professional vocabularies, or could be constructed by post-coordinating existing UMLS terms. The relationship between new and existing concepts differed depending on the corpora from which they were extracted. Conclusion Non-mapping concepts constitute a small proportion of consumer health terms, but a proportion that is likely to affect the process of consumer health vocabulary building. We have identified a novel approach for identifying such concepts. PMID:18436906

  19. [Principles of the Unified Health System nurses' conception of the Family Health Strategy].

    PubMed

    Linard, Andrea Gomes; Chaves, Emilia Soares; Rolim, Isaura Letícia Tavares Palmeira; de Aguiar, Maria Isis Freire

    2011-03-01

    The study aims to examine nurses' understanding of the principles of the Unified Health System. universality, equity and integrality. This is a descriptive study conducted from August to September, 2008, through semi-structured interviews with 26 nurses of the basic units of Health fom Fortaleza, Ceará, Brazil The technique o f content analysis was used toorganize the data. The results show that nurses perceive universality as a universal access for all users of health services; equity as an equal attendance of the population, guaranteeing special attention to the poor; and integrality of care as the provision of services at all three levels of care. The conclusion shows that the practitioners' conception of these principles are similar to those presented in the Federal Constitution. This represents an important element for the implementation and strengthening of the model of health care in Brazil. PMID:21888211

  20. Integrated System Health Management: Foundational Concepts, Approach, and Implementation.

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Schmalzel, John; Walker, Mark; Venkatesh, Meera; Kapadia, Ravi; Morris, Jon; Turowski, Mark; Smith, Harvey

    2009-01-01

    Implementation of integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive to an accurate and reliable assessment of its health. We present concepts, procedures, and a specific approach as a foundation for implementing a credible ISHM capability. The capability stresses integration of DIaK from all elements of a system. The intent is also to make possible implementation of on-board ISHM capability, in contrast to a remote capability. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems (rocket engine test facilities). The paper will address the following topics: 1. ISHM Model of a system 2. Detection of anomaly indicators. 3. Determination and confirmation of anomalies. 4. Diagnostic of causes and determination of effects. 5. Consistency checking cycle. 6. Management of health information 7. User Interfaces 8. Example implementation ISHM has been defined from many perspectives. We define it as a capability that might be achieved by various approaches. We describe a specific approach that has been matured throughout many years of development, and pilot implementations. ISHM is a capability that is achieved by integrating data, information, and knowledge (DIaK) that might be distributed throughout the system elements (which inherently implies capability to manage DIaK associated with distributed sub-systems). DIaK must be available to any element of a system at the right time and in accordance with a meaningful context. ISHM Functional Capability Level (FCL) is measured by how well a system performs the following

  1. Mental Health Disorders Among Women Victims of Conflict-Related Sexual Violence in the Democratic Republic of Congo.

    PubMed

    Dossa, Nissou Ines; Zunzunegui, Maria Victoria; Hatem, Marie; Fraser, William Donald

    2015-08-01

    To assess the effects of sexual violence (SV) in armed conflicts on women's mental health, on its own and in conjunction with reproductive health issues such as fistula or chronic pelvic pain (CPP). A cross-sectional population-based study of 320 women living in Goma, the Democratic Republic of Congo, aged 15 to 45 years, was conducted. Women who experienced conflict-related sexual violence (CRSV) were compared with those who experienced non-conflict-related sexual violence (NCRSV) and those who never experienced such acts. Data were gathered through individual interviews by local staff using standardized questionnaires. The outcomes investigated were post-traumatic stress disorder (PTSD) symptoms severity and psychological distress symptoms (PDS) severity. Experience of SV in either context was associated with more severe PDS (p < .0001). Only CRSV was associated with more severe PTSD symptoms (p < .0001). Women who suffered from fistula or CPP also had a higher PDS score mean (p < .0001 and p = .007) and a higher PTSD symptoms score mean (p < .0001, for both reproductive health issues). Multivariate analyses showed that compared with women who never experienced SV and never suffered from fistula or CPP, those who experienced CRSV and suffered from fistula or CPP had the most severe PDS and PTSD symptoms after adjustment for potential confounders. The differences in PDS and PTSD symptoms severity were all significant (p < .0001). Psychological and physical health care are urgently needed for women who experienced CRSV, particularly those with additional issues of fistula or CPP. Current interventions should simultaneously seek to improve both reproductive and mental health. PMID:25304667

  2. [The notion of conflict of interest in the field of health and environment: philosophical and legal approaches].

    PubMed

    Hermitte, M-A; Le Coz, P

    2014-06-01

    This paper considers the conflict of interest in philosophical and legal perspective. The philosophical approach comes from two perspectives: political philosophy focuses on the role of the link of interest in the city considered in the light of a broader reflection on the conditions of living together. Antiquity philosophers have enhanced the interest link as privileged vector of humanization and socialization of individuals. In the eighteenth century, Adam Smith considers the pursuit of individual interests a stronger social base that love of neighbor advocated by Christians. Moral philosophy focuses specifically on the passage of interest linked to the conflict of interest. It wondered if we should be impartial in all circumstances or whether it's right to give priority to our friends and loved ones. Thus, it poses the question of whether introspection is sufficient to detect conflicts of interest or if the look of an external third party is still required. The legal process differs from the philosophical approach at two levels; on the one hand, its scope is more limited: the law doesn't envisage the benefits of links of interest on social life even though it may protect some of them (in the context of the family, for example) and is intended to prevent bias that may taint the decision public. On the other hand, the lawyer doesn't enter the interiority of individuals but stands by what appears on the outside: it tracks the suspicion of bias can have serious impacts, such as health and the environment. Somehow, it is more radical. It's noteworthy that despite its many developments, the law can't to stop conflicts of interest in research. Several reasons account for this impasse: scientists receive mission to partner with industry to develop products but they must remain independent in order to assess the risks; there is a tendency to always choose the same experts; there are conflicts of interest intellectuals which are not easy to detect. PMID:25272793

  3. [Domestic violence in the conception of health professionals trainers].

    PubMed

    de Souza, Edinilsa Ramos; Ribeiro, Adalgisa Peixoto; Penna, Lúcia Helena Garcia; Ferreira, Ana Lúcia; dos Santos, Neuci Cunha; Tavares, Claudia Mara de Melo

    2009-01-01

    This article identifies the conceptions and suggestions of professors of medicine and nursing courses about the insertion of this subject in the formation of their students. An exploratory research was carried out using a questionnaire applied to coordinators of disciplines in such courses at public and private universities in the cities of Rio de Janeiro and Cuiabá. Many of them recognizes violence as a health problem, although 40.7% of medicine professors and 71.1% of nursing professors of the two cities discusses this subject in their classes. The medicine professors suggests the insertion of the violence subject in their students formation with visits to institutions, meeting groups with people in violence situations and interviews with experienced professionals of the area. The nursing professors prefer resources such as films and videos, seminaries and conferences. Gaps were also identified in the students and professors formation, which do not feel able to discuss this thematic. It is indicated that a renovation in the curriculum is urgently necessary. PMID:19851583

  4. Uneasy money: the Instituto Carlos Slim de la Salud, tobacco philanthropy and conflict of interest in global health.

    PubMed

    Burch, Tiffany; Wander, Nathaniel; Collin, Jeff

    2010-12-01

    In May 2007, the Instituto Carso de la Salud-now Instituto Carlos Slim de la Salud (ICSS)-was endowed with US$500 million to focus on priority health issues in Latin America, notably issues of 'globalisation and non-communicable diseases'. ICSS was soon criticised, however, on the grounds that its funding was derived from tobacco industry profits and that its founder Carlos Slim Hélu remained an active industry principal. Collaboration with ICSS was said to run counter to the WHO Framework Convention on Tobacco Control. The Institute's then Executive President Julio Frenk disputed these charges. This research employs an archive of tobacco industry documents triangulated with materials from commercial, media, regulatory and NGO sources to examine the financial relations between Slim and the tobacco industry. The paper analyses Slim's continuing service to the industry and role in ICSS. It demonstrates a prima facie conflict of interest between ICSS's health mission and its founder's involvement in cigarette manufacturing and marketing, reflected on ICSS's website as a resounding silence on issues of tobacco and health. It is concluded that the reliance of international health agencies upon the commercial sector requires more robust institutional policies to effectively regulate conflicts of interest. PMID:21088061

  5. Uneasy money: the Instituto Carlos Slim de la Salud, tobacco philanthropy and conflict of interest in global health

    PubMed Central

    Burch, Tiffany; Wander, Nathaniel; Collin, Jeff

    2015-01-01

    In May 2007, the Instituto Carso de la Salud—now Instituto Carlos Slim de la Salud (ICSS)—was endowed with US$500 million to focus on priority health issues in Latin America, notably issues of ‘globalisation and non-communicable diseases’. ICSS was soon criticised, however, on the grounds that its funding was derived from tobacco industry profits and that its founder Carlos Slim Hélu remained an active industry principal. Collaboration with ICSS was said to run counter to the WHO Framework Convention on Tobacco Control. The Institute's then Executive President Julio Frenk disputed these charges. This research employs an archive of tobacco industry documents triangulated with materials from commercial, media, regulatory and NGO sources to examine the financial relations between Slim and the tobacco industry. The paper analyses Slim's continuing service to the industry and role in ICSS. It demonstrates a prima facie conflict of interest between ICSS's health mission and its founder's involvement in cigarette manufacturing and marketing, reflected on ICSS's website as a resounding silence on issues of tobacco and health. It is concluded that the reliance of international health agencies upon the commercial sector requires more robust institutional policies to effectively regulate conflicts of interest. PMID:21088061

  6. Predicting the Impact of the 2011 Conflict in Libya on Population Mental Health: PTSD and Depression Prevalence and Mental Health Service Requirements

    PubMed Central

    Charlson, Fiona J.; Steel, Zachary; Degenhardt, Louisa; Chey, Tien; Silove, Derrick; Marnane, Claire; Whiteford, Harvey A.

    2012-01-01

    Background Mental disorders are likely to be elevated in the Libyan population during the post-conflict period. We estimated cases of severe PTSD and depression and related health service requirements using modelling from existing epidemiological data and current recommended mental health service targets in low and middle income countries (LMIC’s). Methods Post-conflict prevalence estimates were derived from models based on a previously conducted systematic review and meta-regression analysis of mental health among populations living in conflict. Political terror ratings and intensity of exposure to traumatic events were used in predictive models. Prevalence of severe cases was applied to chosen populations along with uncertainty ranges. Six populations deemed to be affected by the conflict were chosen for modelling: Misrata (population of 444,812), Benghazi (pop. 674,094), Zintan (pop. 40,000), displaced people within Tripoli/Zlitan (pop. 49,000), displaced people within Misrata (pop. 25,000) and Ras Jdir camps (pop. 3,700). Proposed targets for service coverage, resource utilisation and full-time equivalent staffing for management of severe cases of major depression and post-traumatic stress disorder (PTSD) are based on a published model for LMIC’s. Findings Severe PTSD prevalence in populations exposed to a high level of political terror and traumatic events was estimated at 12.4% (95%CI 8.5–16.7) and was 19.8% (95%CI 14.0–26.3) for severe depression. Across all six populations (total population 1,236,600), the conflict could be associated with 123,200 (71,600–182,400) cases of severe PTSD and 228,100 (134,000–344,200) cases of severe depression; 50% of PTSD cases were estimated to co-occur with severe depression. Based upon service coverage targets, approximately 154 full-time equivalent staff would be required to respond to these cases sufficiently which is substantially below the current level of resource estimates for these regions. Discussion

  7. Workplace conflict resolution and the health of employees in the Swedish and Finnish units of an industrial company.

    PubMed

    Hyde, Martin; Jappinen, Paavo; Theorell, Tores; Oxenstierna, Gabriel

    2006-10-01

    New patterns of working, the globalisation of production and the introduction of information technologies are changing the way we work. This new working environment has eliminated some risks whilst introducing others. The importance of the psychosocial working environment for the health of employees is now well documented, but the effects of managerial style have received relatively little attention. Yet management is an increasingly important aspect of companies' policies. In this paper, we examine the relationship between conflict management in the workplace and self-reported measures of stress, poor general health, exhaustion and sickness absence due to overstrain or fatigue. Our sample consists of non-supervisory employees (N = 9309) working in the Swedish and Finnish plants of a multinational forestry company who were surveyed in 2000. Bivariate analyses show that those who report that differences are resolved through discussion are least likely to report stress, poor general health, exhaustion or sickness absence. Those who report that authority is used or that no attempts are made to resolve differences have quite similar rates across all measures. Binary logistic regression analyses were performed for all health outcomes controlling for age, sex, occupational group, job complexity, job autonomy and support from superiors. Results show significantly lower likelihoods of reporting stress, poor general health, exhaustion or sickness absence amongst employees who report that differences of opinion are resolved through discussion compared to those who report that no attempts are made. No significant differences were found between those who reported that differences were resolved through use of authority and subjects in the 'no attempt' category. These results suggest that the workplace conflict resolution is important in the health of employees in addition to traditional psychosocial work environment risk factors. PMID:16782255

  8. Mental Health and Sexual Self-Concept Discrepancies in a Sample of Young Black Women.

    ERIC Educational Resources Information Center

    Holmes, Marcelle Christian

    2002-01-01

    Addressed the mental health consequences of sexual self-concept discrepancies among young black women. Participant surveys examined differences between their actual, ideal, and "ought" sexual selves. Overall, sexual self-concept discrepancies did not predict mental health outcomes. Women who were bothered by the differences between whom they…

  9. 78 FR 24154 - Notice of Availability of a National Animal Health Laboratory Network Reorganization Concept Paper

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-24

    ... Network Reorganization Concept Paper AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION... Plant Health Inspection Service is making available a concept paper that describes a revised structure... paper we are making available for comment presents a structure we believe will give the NAHLN...

  10. The Development of Children's Concepts of Health and Illness.

    ERIC Educational Resources Information Center

    Bibace, Roger; Walsh, Mary E.

    This study examines the development of children's concepts of illness in light of Piagetian findings regarding the ontogenesis of causal relations. The Concept of Illness protocol was administered to 72 3-, 7-, and 11-year-old children; 24 from each age group. Children were interviewed individually in a school setting. Raters assigned subjects'…

  11. Impact of service provision platforms on maternal and newborn health in conflict areas and their acceptability in Pakistan: a systematic review.

    PubMed

    Lassi, Zohra S; Aftab, Wafa; Ariff, Shabina; Kumar, Rohail; Hussain, Imtiaz; Musavi, Nabiha B; Memon, Zahid; Soofi, Sajid B; Bhutta, Zulfiqar A

    2015-01-01

    Various models and strategies have been implemented over the years in different parts of the world to improve maternal and newborn health (MNH) in conflict affected areas. These strategies are based on specific needs and acceptability of local communities. This paper has undertaken a systematic review of global and local (Pakistan) information from conflict areas on platforms of health service provision in the last 10 years and information on acceptability from local stakeholders on effective models of service delivery; and drafted key recommendations for improving coverage of health services in conflict affected areas. The literature search revealed ten studies that described MNH service delivery platforms. The results from the systematic review showed that with utilisation of community outreach services, the greatest impacts were observed in skilled birth attendance and antenatal consultation rates. Facility level services, on the other hand, showed that labour room services for an internally displaced population (IDP) improved antenatal care coverage, contraceptive prevalence rate and maternal mortality. Consultative meetings and discussions conducted in Quetta and Peshawar (capitals of conflict affected provinces) with relevant stakeholders revealed that no systematic models of MNH service delivery, especially tailored for conflict areas, are available. During conflict, even previously available services and infrastructure suffered due to various barriers specific to times of conflict and unrest. A number of barriers that hinder MNH services were discussed. Suggestions for improving MNH services in conflict areas were also laid down by participants. The review identified some important steps that can be undertaken to mitigate the effects of conflict on MNH services, which include: improve provision and access to infrastructure and equipment; development and training of healthcare providers; and advocacy at different levels for free access to healthcare

  12. Concepts of health and well-being in managers: An organizational study

    PubMed Central

    Boness, Christian

    2011-01-01

    Global changes and new managerial challenges require new concepts of health and well-being in organizational contexts. In the South African context, health and well-being of managers have gained relevance in organizations and in management sciences. International organizations, in particular, attempt to address the increasing demand for health care and the delivery of health services to their managers. Careful and appropriate health management requires research to evaluate context-specific health concepts and strategies. The purpose and aim of this article is to assess managerial concepts on health and well-being that could be used by the organization to contribute to managerial well-being by implementing health promotion according to managerial needs. At the same time, this article contributes to salutogenetic health research that is very rare with regard to the South African organizational management research. This study is a multi-method research study conducted in a selected international organization in South Africa. However, in this article, selected qualitative findings will only be presented. This organizational study presents selected research findings on health concepts and strategies employed by managers. Findings demonstrate that the managerial concepts of health and strategies mainly refer to not only physical but also to mental and spiritual aspects, with a priority on physical health and well-being. The findings presented are based on qualitative research methods and their research criteria. This assessment serves as a foundation for new approaches to health management within the international work context in South Africa. It also contributes to a paradigm shift from pathogenetic to salutogenetic concepts of health and well-being within the South African organizational work context. The article produces new insights into the qualitative health concepts of South African managers and expatriates and contributes to promoting salutogenesis in

  13. Concepts of health and well-being in managers: An organizational study.

    PubMed

    Mayer, Claude-Hélène; Boness, Christian

    2011-01-01

    Global changes and new managerial challenges require new concepts of health and well-being in organizational contexts. In the South African context, health and well-being of managers have gained relevance in organizations and in management sciences. International organizations, in particular, attempt to address the increasing demand for health care and the delivery of health services to their managers. Careful and appropriate health management requires research to evaluate context-specific health concepts and strategies. The purpose and aim of this article is to assess managerial concepts on health and well-being that could be used by the organization to contribute to managerial well-being by implementing health promotion according to managerial needs. At the same time, this article contributes to salutogenetic health research that is very rare with regard to the South African organizational management research.This study is a multi-method research study conducted in a selected international organization in South Africa. However, in this article, selected qualitative findings will only be presented.This organizational study presents selected research findings on health concepts and strategies employed by managers. Findings demonstrate that the managerial concepts of health and strategies mainly refer to not only physical but also to mental and spiritual aspects, with a priority on physical health and well-being.The findings presented are based on qualitative research methods and their research criteria.This assessment serves as a foundation for new approaches to health management within the international work context in South Africa. It also contributes to a paradigm shift from pathogenetic to salutogenetic concepts of health and well-being within the South African organizational work context.The article produces new insights into the qualitative health concepts of South African managers and expatriates and contributes to promoting salutogenesis in organization

  14. [Evaluation in the health sector: concepts and methods].

    PubMed

    Contandriopoulos, A P; Champagne, F; Denis, J L; Avargues, M C

    2000-12-01

    The practice of evaluation has existed in one form or another for as long as one can remember and is central to all processes of learning. Today, evaluation is a popular concept grouping together multiple and diverse realities. This article aims to propose a conceptual framework for evaluation that is broad and universal enough to allow all those concerned with evaluation of health services (regardless of their disciplines and interests) to better understand each other, to perform better evaluations, and to use them in a more pertinent manner. We will begin by defining evaluation as the process which consists of making a judgement on the value of an intervention by implementing a system which can provide scientifically valid and socially legitimate information on regarding this particular intervention (or any of its components) to the different stakeholders concerned, such that they can form an opinion from their perspective on the intervention and reach a judgement which can translate into action. We define "intervention" as any organized system of action (a structure, actors and their practices, processes of action, one or many finalities and an environment) aiming to, in a given environment, during a given time period, modify the foreseeable course of a phenomenon to correct a problematic situation. An intervention can be a technique, a medication, a treatment, an organisation, a program, a policy or even a complex system like the health care system. Various interventions, regardless of their nature, can be the object of two types of evaluation. Normative evaluation is based on appreciation of each component of the intervention according to criteria and standards. This type of evaluation is defined as an activity which consists of making a judgement regarding an intervention by comparing the resources utilized and their organisation (structure); services and goods produced (process) and results obtained to criteria and standards (in other words, summaries of

  15. [Socioeconomic impact of armed conflict on the health of women and children in the Democratic Republic of the Congo].

    PubMed

    Omba Kalonda, J C

    2011-04-01

    Since 1996, the Democratic Republic of Congo (DRC) has been the theatre of armed conflict. More than 5.4 millions have died and 500,000 to 1,000,000 women have been raped. As a result of permanent insecurity including frequent massacres, burning of villages and plundering of personal property and crops, millions of Congolese people especially in eastern regions have been displaced with around 1.3 million in internal refugee camps. Rural populations have abandoned farming that was the main source of employment, food, and income. The purpose of this paper is to describe the socioeconomic impact of this armed conflict particularly on the health of women and children. Consequences include i) decreased food production, ii) worsening food insecurity and malnutrition, iii) reduced household income, and iv) inadequate health care leading to epidemic outbreaks of diseases such as cholera, measles, and meningitis. Food insecurity and poverty affect around 70% of the population. Chronic malnutrition and growth retardation affect 38% of children. The mortality rate for children under 5 has reached 205 per 1000 live births. Other than achieving lasting peace that is a prerequisite for development in the DRC, the main priority must be to provide victims with multiform assistance aimed at restarting the economy and ensuring food self-sufficiency, thereby reducing both malnutrition and child mortality. Better access to healthcare and to psychosocial, medical, and legal services is also needed for rape victims. PMID:21695885

  16. Livestock/Animal Assets Buffer the Impact of Conflict-Related Traumatic Events on Mental Health Symptoms for Rural Women

    PubMed Central

    Glass, Nancy; Perrin, Nancy A.; Kohli, Anjalee; Remy, Mitima Mpanano

    2014-01-01

    Background In the context of multiple adversities, women are demonstrating resilience in rebuilding their futures, through participation in microfinance programs. In addition to the economic benefits of microfinance, there is evidence to suggest that it is an effective vehicle for improving health. Methods The parent study is a community-based trial to evaluate the effectiveness of a livestock microfinance intervention, Pigs for Peace (PFP), on health and economic outcomes with households in 10 villages in eastern Democratic Republic of Congo. The analysis for this manuscript includes only baseline data from female participants enrolled in the ongoing parent study. Multiple regression analysis was used to examine if livestock/animal asset value moderates the relationship between conflict-related traumatic events and current mental health symptoms. Findings The majority of women are 25 years or older, married, have on average 4 children in the home and have never attended school. Nearly 50% of women report having at least one livestock/animal asset at baseline. Over the past 10 years, women report on average more than 4 (M = 4.31, SD 3·64) traumatic events (range 0–18). Women reported symptoms consistent with PTSD with a mean score of ·2.30 (SD = 0·66range 0–4) and depression with a mean score of 1.86 (SD  = 0·49, range 0–3.47). The livestock/animal asset value by conflict-related traumatic events interaction was significant for both the PTSD (p = 0·021) and depression (p = 0·002) symptom models. Interpretation The study provides evidence of the moderating affect of livestock/animal assets on mental health symptoms for women who have experienced conflict. The findings supports evidence about the importance of livestock/animal assets to economics in rural households but expands on previous research by demonstrating the psychosocial effects of these assets on women's health. Trial Registration clinicaltrials.gov NCT02008708 PMID

  17. International cooperation and health. Part I: issues and concepts

    PubMed Central

    McKee, M.; Gilmore, A.; Schwalbe, N.

    2005-01-01

    The world is increasingly shaped by powerful global forces, many of which have consequences for human health and the social, economic, and environmental factors that influence health are increasingly determined at a supranational level. As a result, local or national level efforts to influence health determinants can have only a limited impact and it is all too easy for the individual public health practitioner to feel powerless. Yet while public health practitioners, on their own, may indeed be comparatively powerless, together they can achieve a great deal. Part I of this glossary explores a range of issues that arise as they seek to make a difference. PMID:16020637

  18. Assessing public health emergency preparedness: concepts, tools, and challenges.

    PubMed

    Nelson, Christopher; Lurie, Nicole; Wasserman, Jeffrey

    2007-01-01

    Policymakers are increasingly seeking to determine whether the federal government's recent investments in public health preparedness have left the public health system better prepared to respond to large-scale public health emergencies. Yet, there remain questions about how to define "public health emergency preparedness," how much preparedness is enough, and how preparedness can be measured and assessed. This chapter identifies the key challenges associated with measuring public health preparedness and reviews approaches currently in use. We also identify some emerging measurement techniques that might help address some of these challenges. PMID:17129174

  19. International cooperation and health. Part I: Issues and concepts.

    PubMed

    McKee, Martin; Gilmore, Anna B; Schwalbe, Nina

    2005-08-01

    The world is increasingly shaped by powerful global forces, many of which have consequences for human health and the social, economic, and environmental factors that influence health are increasingly determined at a supranational level. As a result, local or national level efforts to influence health determinants can have only a limited impact and it is all too easy for the individual public health practitioner to feel powerless. Yet while public health practitioners, on their own, may indeed be comparatively powerless, together they can achieve a great deal. Part I of this glossary explores a range of issues that arise as they seek to make a difference. PMID:16020637

  20. International cooperation and health policy implementation in a post-conflict situation: the case of East Timor.

    PubMed

    Fonseca, Luiz Eduardo; Almeida, Celia

    2015-01-01

    This study centers on relationships among national and international actors in preparation of the first health policy document for East Timor, under the United Nations transitional administration, between 1999 and 2002. International cooperation support for the health system rehabilitation process during the post-conflict period is analyzed as part of reconstruction of the State in parallel with construction of the country's political and institutional framework. Knowledge, ideas, "ways of doing," and induced and accepted practices permeate an interplay of power relationships that condition both national political alliance-building and the architecture of international aid, pointing to input to a discussion of how these mechanisms interact at different conjunctures and times in different negotiating frameworks. PMID:25742102

  1. Implementing the learning health system: from concept to action.

    PubMed

    Greene, Sarah M; Reid, Robert J; Larson, Eric B

    2012-08-01

    Clinicians and health systems are facing widespread challenges, including changes in care delivery, escalating health care costs, and the need to keep up with rapid scientific discovery. Reorganizing U.S. health care and changing its practices to render better, more affordable care requires transformation in how health systems generate and apply knowledge. The "rapid-learning health system"-posited as a conceptual strategy to spur such transformation-leverages recent developments in health information technology and a growing health data infrastructure to access and apply evidence in real time, while simultaneously drawing knowledge from real-world care-delivery processes to promote innovation and health system change on the basis of rigorous research. This article describes an evolving learning health system at Group Health Cooperative, the 6 phases characterizing its approach, and examples of organization-wide applications. This practical model promotes bidirectional discovery and an open mind at the system level, resulting in willingness to make changes on the basis of evidence that is both scientifically sound and practice-based. Rapid learning must be valued as a health system property to realize its full potential for knowledge generation and application. PMID:22868839

  2. The Role of Games and Simulations to Teach Abstract Concepts of Anarchy, Cooperation, and Conflict in World Politics

    ERIC Educational Resources Information Center

    McCarthy, Mary M.

    2014-01-01

    Games and simulations are increasingly used in courses on international politics. This study explores the hypothesis that games are better than simulations (as well as only reading and lectures) in introducing students to abstract concepts integral to an understanding of world politics. The study compares a two-level Prisoner's Dilemma game…

  3. Examining the Concept of Choice in Sexual Health Interventions for Young People

    ERIC Educational Resources Information Center

    Spencer, Grace; Doull, Marion; Shoveller, Jean A.

    2014-01-01

    Concepts of choice are often drawn upon within sexual health promotion discourses to encourage young people to take "responsibility" for and promote their own sexual health and reproductive control. A systematic literature search using predefined inclusion criteria identified peer-reviewed articles focusing on sexual health interventions…

  4. Changing Concepts of Health and Illness among Children of Primary School Age in Western Kenya

    ERIC Educational Resources Information Center

    Onyango-Ouma, W.; Aagaard-Hansen, J.; Jensen, B. B.

    2004-01-01

    This paper examines changes in children's concepts of health and illness following an action-oriented health education intervention in Bondo district of Western Kenya. The study is a feasibility study exploring a specific educational approach, and it combines elements of health education research and anthropological research. Forty primary…

  5. [Concept and history of public health in Mexico (XVIII to XX century)].

    PubMed

    Fierros Hernández, Arturo

    2014-01-01

    This paper is a brief history of public health. I review the concept of public health and its origins in the West, and also analyze the input of politics in the Mexican health system through the government of Porfirio Diaz. PMID:24604003

  6. Children's Perceptions of Health and Illness: Images and Lay Concepts in Preadolescence

    ERIC Educational Resources Information Center

    Piko, Bettina F.; Bak, Judit

    2006-01-01

    Despite a growing body of research into children's concepts of illness, many basic questions still remain. This study aims to describe 8- to 11-year olds' lay beliefs of health, illness, health promotion and disease prevention. Children responded to open-ended questions about health and illness by drawing and writing their responses. Two primary…

  7. Managing Ethical Challenges to Mental Health Research in Post‐Conflict Settings

    PubMed Central

    Khan, Muhammad Naseem; Rahman, Atif; Frith, Lucy

    2015-01-01

    Abstract Recently the World Health Organization (WHO) has highlighted the need to strengthen mental health systems following emergencies, including natural and manmade disasters. Mental health services need to be informed by culturally attuned evidence that is developed through research. Therefore, there is an urgent need to establish rigorous ethical research practice to underpin the evidence‐base for mental health services delivered during and following emergencies. PMID:25580875

  8. Managing Ethical Challenges to Mental Health Research in Post-Conflict Settings.

    PubMed

    Chiumento, Anna; Khan, Muhammad Naseem; Rahman, Atif; Frith, Lucy

    2016-04-01

    Recently the World Health Organization (WHO) has highlighted the need to strengthen mental health systems following emergencies, including natural and manmade disasters. Mental health services need to be informed by culturally attuned evidence that is developed through research. Therefore, there is an urgent need to establish rigorous ethical research practice to underpin the evidence-base for mental health services delivered during and following emergencies. PMID:25580875

  9. The role of Northern NGOs (Non-Governmental Organisations) in rehabilitating the health sector in post-conflict settings: a need for a critical analysis.

    PubMed

    Putoto, G

    1997-01-01

    The paper addresses issues of the health sector rehabilitation in post-conflict situation, and in particular the role of Northern Non-Governmental Organisations (NNGOs) in this process. While armed conflicts are regarded as public health issues for their negative implications on health and health systems, post-conflict situation is considered, despite its complexity, as having both risks and opportunities for making the health system more equitable and sustainable. In this respect, NNGOs are believed to be able to play an efficient and effective role in rehabilitating the health system. The paper asserts that the assumed good qualities of the whole NNGOs sector in this specific context is not based on evidence and that a critical analysis is needed. Problems affecting NNGOs interventions are then highlighted. These include their political neutrality, technical accountability to policy, planning and quality development. These problems may have their roots at conceptual, operational and political levels. To avoid generalisations and unproved assumptions, research is therefore needed to distinguish NNGOs' characteristics, roles and motivations and to assess the extent to which NNGOs' interventions are effective in rehabilitating the health system in post-conflict settings as well as in strengthening local institutions. PMID:10174540

  10. Changing Work and Work-Family Conflict: Evidence from the Work, Family, and Health Network*

    PubMed Central

    Kelly, Erin L.; Moen, Phyllis; Oakes, J. Michael; Fan, Wen; Okechukwu, Cassandra; Davis, Kelly D.; Hammer, Leslie; Kossek, Ellen; King, Rosalind Berkowitz; Hanson, Ginger; Mierzwa, Frank; Casper, Lynne

    2013-01-01

    Schedule control and supervisor support for family and personal life are work resources that may help employees manage the work-family interface. However, existing data and designs have made it difficult to conclusively identify the effects of these work resources. This analysis utilizes a group-randomized trial in which some units in an information technology workplace were randomly assigned to participate in an initiative, called STAR, that targeted work practices, interactions, and expectations by (a) training supervisors on the value of demonstrating support for employees’ personal lives and (b) prompting employees to reconsider when and where they work. We find statistically significant, though modest, improvements in employees’ work-family conflict and family time adequacy and larger changes in schedule control and supervisor support for family and personal life. We find no evidence that this intervention increased work hours or perceived job demands, as might have happened with increased permeability of work across time and space. Subgroup analyses suggest the intervention brings greater benefits to employees more vulnerable to work-family conflict. This study advances our understanding of the impact of social structures on individual lives by investigating deliberate organizational changes and their effects on work resources and the work-family interface with a rigorous design. PMID:25349460

  11. Changing Work and Work-Family Conflict: Evidence from the Work, Family, and Health Network*

    PubMed

    Kelly, Erin L; Moen, Phyllis; Oakes, J Michael; Fan, Wen; Okechukwu, Cassandra; Davis, Kelly D; Hammer, Leslie; Kossek, Ellen; King, Rosalind Berkowitz; Hanson, Ginger; Mierzwa, Frank; Casper, Lynne

    2014-06-01

    Schedule control and supervisor support for family and personal life are work resources that may help employees manage the work-family interface. However, existing data and designs have made it difficult to conclusively identify the effects of these work resources. This analysis utilizes a group-randomized trial in which some units in an information technology workplace were randomly assigned to participate in an initiative, called STAR, that targeted work practices, interactions, and expectations by (a) training supervisors on the value of demonstrating support for employees' personal lives and (b) prompting employees to reconsider when and where they work. We find statistically significant, though modest, improvements in employees' work-family conflict and family time adequacy and larger changes in schedule control and supervisor support for family and personal life. We find no evidence that this intervention increased work hours or perceived job demands, as might have happened with increased permeability of work across time and space. Subgroup analyses suggest the intervention brings greater benefits to employees more vulnerable to work-family conflict. This study advances our understanding of the impact of social structures on individual lives by investigating deliberate organizational changes and their effects on work resources and the work-family interface with a rigorous design. PMID:25349460

  12. Impact of Mahatma Gandhi's concepts on mental health: Reflections

    PubMed Central

    Tandon, Abhinav; Singh, V. K.

    2013-01-01

    Mahatma Gandhi can be looked upon as one of the greatest visionaries born. His life tells us about the varied emotions he went through as a boy and young adult during difficult times, and the experiments he did to cope up with these problems. It was his perseverance and dedication to an unrelenting pursuit of his goal that finally led to his transformation. His concepts like nonviolence, satyagraha, brahmcharya and the concepts related to ‘Truth’ and ‘God’ can give psychological strength and mental resilience to any individual trying to cope up with the demands of life. PMID:23858259

  13. Tufts academic health information network: concept and scenario.

    PubMed

    Stearns, N S

    1986-04-01

    Tufts University School of Medicine's new health sciences education building, the Arthur M. Sackler Center for Health Communications, will house a modern medical library and computer center, classrooms, auditoria, and media facilities. The building will also serve as the center for an information and communication network linking the medical school and adjacent New England Medical Center, Tufts' primary teaching hospital, with Tufts Associated Teaching Hospitals throughout New England. Ultimately, the Tufts network will join other gateway networks, information resource facilities, health care institutions, and medical schools throughout the world. The center and the network are intended to facilitate and improve the education of health professionals, the delivery of health care to patients, the conduct of research, and the implementation of administrative management approaches that should provide more efficient utilization of resources and save dollars. A model and scenario show how health care delivery and health care education are integrated through better use of information transfer technologies by health information specialists, practitioners, and educators. PMID:3708191

  14. Career and Vocational Education. Concepts of Health Management System.

    ERIC Educational Resources Information Center

    Larson, Curtis G.; Fiedler, Beatrice

    This curriculum guide is designed to assist students in developing the ability to understand the many aspects of personal/social/mental health. It emphasizes student performance objectives in physical well-being, disease, reproduction, heredity, mental health and aging. It is also designed to assist the local teacher with organization and…

  15. Health concepts, issues, and experience in the Abakaliki area, Nigeria.

    PubMed Central

    Chukwuma, C

    1994-01-01

    Environmental health problems are increasingly receiving global attention. The health of entire nations may not only be affected by adverse environmental conditions, but by nutritional deficiencies that lead to morbidity and mortality. The type and extent of adverse health effects in a population depend on the potential for exposure to some environmental factors and pathogens as well as other environmental variables like industrialization, sanitation conditions, and urbanization. National and international comparisons between health status indicators can reveal the extent of any differences that exist, including dynamic changes in prevailing environmental conditions which may be helpful in characterizing the role of specific risk factors. Improvements in collection of environmental data related to health can help to identify, control, and eliminate many of the factors that are associated with environmental risk in the Abakaliki area of eastern Nigeria. PMID:9644193

  16. Identifying and Addressing Students' Alternative Conceptions of the Causes of Global Warming: The Need for Cognitive Conflict

    NASA Astrophysics Data System (ADS)

    Meadows, George; Wiesenmayer, Randall L.

    1999-09-01

    School-age children are frequently exposed to issues related to global warming/global climatic change. Yet, their conceptions regarding the scope and nature of this phenomenon are often incomplete or even inconstant with predominant scientific understandings. The complex conceptual knowledge required to understand issues related to global warming create learning situations that harbor the development of incomplete or inaccurate ideas related to global warming. This study presents some of those misconceptions and discusses strategies for mitigation.

  17. Priorities of Nutritional Concepts Assigned by Health Professionals and Students.

    ERIC Educational Resources Information Center

    Gautreau, Sybil; Monsen, E. R.

    1979-01-01

    Medical faculty, practicing physicians, medical students, and dietitians/nutritionists rated nutritional concepts as to their importance for inclusion in the medical school curricula and indicated the best method for accomplishing this. Based on this study, recommendations are made regarding nutrition education in the medical school curricula.…

  18. Survivors of the war in the Northern Kosovo: violence exposure, risk factors and public health effects of an ethnic conflict

    PubMed Central

    2010-01-01

    Background The aim of this population-based study was to assess the long-lasting effects of ethnic conflict on health and well-being (with a focus on injury and persistent pain) at family and community level. We have also investigated possible risk factors for victimisation during the conflict and factors contributing to healing. Methods We conducted a district-level cross-sectional cluster survey of 1,115 households with a population of 6,845. Interviews were carried out in Mitrovicë district in Northern Kosovo from September to October 2008, using standardised questionnaire to collect lifetime violence exposure, lifestyle factors and health information on individual and household. Results Ethnic Albanians made up 95% of the sample population. Crude mortality and under-five mortality rate was not high in 2008. Over 90% of families had been exposed to at least two categories of violence and human rights violations, and 493 individuals from 341 families reported torture experiences. During the two weeks before the survey, 20% of individuals had suffered physical or mental pain. There were differences in pain complaints according to gender and age, and whether people had been injured within 12 months, had lifetime exposure to violence-related injury, or had been tortured. Patterns of social and political participation in a family could affect the proportion of family members complaining of pain. The proportion of family members with pain complaints was related to a decline in the household income (coef = 9.31, 95% CI = 6.16-12.46, P < 0.001) and the fact of borrowing money (coef = 6.11, 95% CI = 2.91-9.30, P < 0.001) because of an injured person in the household. Families that were affiliated with the Kosovo Liberation Army, or had participated in a protest before or during the war, were likely to be targeted by Serbian paramilitary and law enforcement agencies. Conclusions Mitrovicë district is currently characterised by a low level of violence, but the effects of

  19. 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

  20. Conflicting paradigms in radiation protection: 20 Questions with answers from the regulator, the health physicist, the scientist, and the lawyers

    SciTech Connect

    Strom, D.J.; Stansbury, P.S.; Porter, S.W. Jr.

    1995-01-01

    George Orwell`s {open_quotes}doublethink{close_quotes} should be generalized to {open_quotes}polythink{close_quotes} to describe the multiplicity of views that radiation protection professionals must simultaneously accommodate. The paradigms, that is, organizing principles and beliefs, that (1) regulators, (2) operational health physicists, (3) scientists, (4) lawyers for the defendant, and (5) lawyers for the plaintiff use in their approaches to radiation protection are presented. What we believe as scientists often conflicts with what we do for purposes of radiation protection. What we need to do merely to protect humankind and the environment from harmful effects of radiation is far less than what we must do to satisfy the regulator, whose paradigm has checklists, score-keeping, and penalties. In the hands of lawyers, our work must overcome different challenges. Even if the paradigms of the operational health physicist, the scientist, and the regulator match, the odds against the lawyers paradigms also matching are astronomical. The differing paradigms are illustrated by example questions and answers. It is important for educators, trainers, and health physicists to recognize and separate the score-keeping, practice, science, and legal issues in health physics.

  1. Risk for family rejection and associated mental health outcomes among conflict-affected adult women living in rural eastern Democratic Republic of the Congo.

    PubMed

    Kohli, Anjalee; Perrin, Nancy A; Mpanano, Remy Mitima; Mullany, Luke C; Murhula, Clovis Mitima; Binkurhorhwa, Arsène Kajabika; Mirindi, Alfred Bacikengi; Banywesize, Jean Heri; Bufole, Nadine Mwinja; Ntwali, Eric Mpanano; Glass, Nancy

    2014-01-01

    Stigma due to sexual violence includes family rejection, a complex outcome including economic, behavioral, and physical components. We explored the relationship among conflict-related trauma, family rejection, and mental health in adult women living in rural eastern Democratic Republic of the Congo, who participate in a livestock-based microfinance program, Pigs for Peace. Exposure to multiple and different types of conflict-related trauma, including sexual assault, was associated with increased likelihood of family rejection, which in turn was associated with poorer mental health outcomes. Design of appropriate and effective interventions will require understanding family relationships and exposure to different types of trauma in postconflict environments. PMID:24660941

  2. Using GoNoodle to Introduce Health Concepts in the K-5 Classroom

    ERIC Educational Resources Information Center

    Whitney, Elizabeth A.

    2016-01-01

    This article introduces readers to the GoNoodle platform for incorporating physical activity throughout the school day, and describes how one of the features, Ultimate Champ Training, can be used to teach health concepts in the elementary school classroom.

  3. A Lifetime of Trauma: Mental Health Challenges for Higher Education in a Conflict Environment in Afghanistan

    ERIC Educational Resources Information Center

    Babury, Mohammed Osman; Hayward, Fred Manwarren

    2013-01-01

    More than 30 years of war in Afghanistan have resulted in immense policy challenges to address the resulting mental health issues. The purpose of this policy analysis is to examine the potential role of higher education in addressing the pressing mental health problems in Afghanistan's public universities and higher education institutions as…

  4. Addressing maternal and child health in post-conflict Afghanistan: the way forward.

    PubMed

    Singh, P K; Rai, R K; Alagarajan, M

    2013-09-01

    Afghanistan's maternal and child mortality rates are among the highest in the world. The country faces challenges to meet the Millennium Development Goals set for 2015 which can be attributed to multiple causes related to accessibility, affordability and availability of health-care services. This report addresses the challenges in strengthening maternal and child health care in Afghanistan, as well discussing the areas to be prioritized. In order to ensure sound maternal and child health care in Afghanistan, policy-makers must prioritize monitoring and surveillance systems, integrating maternal and child health care with rights-based family planning methods, building human resources, offering incentives (such as the provision of a conditional cash transfer to women) and promoting action-oriented, community-based interventions. On a wider scale, the focus must be to improve the health infrastructure, organizing international collaboration and expanding sources of funding. PMID:24313047

  5. Change and stability in work-family conflict and mothers' and fathers' mental health: Longitudinal evidence from an Australian cohort.

    PubMed

    Cooklin, A R; Dinh, H; Strazdins, L; Westrupp, E; Leach, L S; Nicholson, J M

    2016-04-01

    Work-family conflict (WFC) occurs when work or family demands are 'mutually incompatible', with detrimental effects on mental health. This study contributes to the sparse longitudinal research, addressing the following questions: Is WFC a stable or transient feature of family life for mothers and fathers? What happens to mental health if WFC increases, reduces or persists? What work and family characteristics predict WFC transitions and to what extent are they gendered? Secondary analyses of 5 waves of data (child ages 4-5 to 12-13 years) from employed mothers (n = 2693) and fathers (n = 3460) participating in the Longitudinal Study of Australian Children were conducted. WFC transitions, across four two-year intervals (Waves 1-2, 2-3, 3-4, and 4-5) were classified as never, conscript, exit or chronic. Significant proportions of parents experienced change in WFC, between 12 and 16% of mothers and fathers for each transition 'type'. Parents who remained in chronic WFC reported the poorest mental health (adjusted multiple regression analyses), followed by those who conscripted into WFC. When WFC was relieved (exit), both mothers' and fathers' mental health improved significantly. Predictors of conscript and chronic WFC were somewhat distinct for mothers and fathers (adjusted logit regressions). Poor job quality, a skilled occupation and having more children differentiated chronic fathers' from those who exited WFC. For mothers, work factors only (skilled occupation; work hours; job insecurity) predicted chronic WFC. Findings reflect the persistent, gendered nature of work and care shaped by workplaces, but also offer tailored opportunities to redress WFC for mothers and fathers. We contribute novel evidence that mental health is directly influenced by the WFC interface, both positively and negatively, highlighting WFC as a key social determinant of health. PMID:26986239

  6. Applying total quality management concepts to public health organizations.

    PubMed Central

    Kaluzny, A D; McLaughlin, C P; Simpson, K

    1992-01-01

    Total quality management (TQM) is a participative, systematic approach to planning and implementing a continuous organizational improvement process. Its approach is focused on satisfying customers' expectations, identifying problems, building commitment, and promoting open decision-making among workers. TQM applies analytical tools, such as flow and statistical charts and check sheets, to gather data about activities within an organization. TQM uses process techniques, such as nominal groups, brainstorming, and consensus forming to facilitate communication and decision making. TQM applications in the public sector and particularly in public health agencies have been limited. The process of integrating TQM into public health agencies complements and enhances the Model Standards Program and assessment methodologies, such as the Assessment Protocol for Excellence in Public Health (APEX-PH), which are mechanisms for establishing strategic directions for public health. The authors examine the potential for using TQM as a method to achieve and exceed standards quickly and efficiently. They discuss the relationship of performance standards and assessment methodologies with TQM and provide guidelines for achieving the full potential of TQM in public health organizations. The guidelines include redefining the role of management, defining a common corporate culture, refining the role of citizen oversight functions, and setting realistic estimates of the time needed to complete a task or project. PMID:1594734

  7. Conflict Management.

    ERIC Educational Resources Information Center

    Fisher, William; Koue, Glen

    1991-01-01

    Discusses general issues involved in conflict management and provides more specific examples of conflict management in libraries. Causes of conflict are considered, including organizational structure, departmentalization, performance appraisal, poor communication, and technological change; and methods of dealing with conflict are described,…

  8. Peace-building and reconciliation dividends of integrated health services delivery in post-conflict Burundi: qualitative assessments of providers and community members.

    PubMed

    Christensen, Cathryn; Edward, Anbrasi

    2015-01-01

    While demonstrating causality remains challenging, several 'health-peace' mechanisms have been proposed to describe how health systems contribute to peace-building and stability in post-conflict settings. A qualitative study was undertaken in southern Burundi to identify drivers of social tension and reconciliation in the catchment area of Village Health Works, a health services organisation. Key informant interviews and focus group discussions were conducted in early 2014 with a total of one hundred and twenty community members and staff representing a range of conflict and recovery experience. Themes emerging from these interviews indicated mechanisms at the individual, household, community, and regional levels through which health provision mitigates tensions and promotes social cohesion. This peace dividend was amplified by the clinic's integrated model, which facilitates further community interaction through economic, agricultural and education programmes. Land pressure and the marginalisation of repatriated refugees were cited as drivers of local tension. PMID:25875719

  9. Locating ethnicity and health: exploring concepts and contexts.

    PubMed

    Ahmad, Waqar I U; Bradby, Hannah

    2007-09-01

    With the rapid development of ethnicity and health as a field of sociological research, this paper seeks to re-evaluate the development of ideas around ethnicity, 'race' and culture and consider how they have been applied to the question of health. Ethnicity as a social characteristic is contingent on the situation in which it is manifest. The process of marking 'other' ethnic groups includes stereotyping and racialisation, a process through which 'racial' or ethnic differences predominate to the exclusion of a consideration of social, economic and power relations. In the British context, the history of empire and medicine's justification of racist treatment of enslaved and colonised people, is relevant to understanding how ethnic and cultural differences have come to be essentialised and pathologised. Immigration to Britain only became a mass phenomenon after World War II, with settlement patterns following employment opportunities and kinship alliances. The state has a longstanding history of 'managing' diversity, sometimes essentialising differences between groups, at other times tackling disadvantage and discrimination experiences through policy action. Sociologists of health were slow to study ethnicity, with initial research coming from tropical disease specialists. The tendency of medicine to pathologise minority cultures is explored through case studies of the approach to rickets and the assessment of health risks associated with consanguineous marriage. Anti-racist approaches have encouraged the consideration of discrimination against and socioeconomic position of minorities. The field has developed with work on nomenclature and the operationalisation of ethnic identity, necessary to study health inequalities between ethnic groups and paying due heed to the contribution of socioeconomic position and racism to group experiences. Research into chronic conditions with complex analysis of a number of distinct contributory variables has been published of late

  10. What matters for working fathers? Job characteristics, work-family conflict and enrichment, and fathers' postpartum mental health in an Australian cohort.

    PubMed

    Cooklin, Amanda R; Giallo, Rebecca; Strazdins, Lyndall; Martin, Angela; Leach, Liana S; Nicholson, Jan M

    2015-12-01

    One in ten fathers experience mental health difficulties in the first year postpartum. Unsupportive job conditions that exacerbate work-family conflict are a potential risk to fathers' mental health given that most new fathers (95%) combine parenting with paid work. However, few studies have examined work-family conflict and mental health for postpartum fathers specifically. The aim of the present study was to identify the particular work characteristics (e.g., work hours per week, job quality) associated with work-family conflict and enrichment, and fathers' mental health in the postpartum period. Survey data from 3243 fathers of infants (aged 6-12 months) participating in the Longitudinal Study of Australian Children were analysed via path analysis, considering key confounders (age, education, income, maternal employment, maternal mental health and relationship quality). Long and inflexible work hours, night shift, job insecurity, a lack of autonomy and more children in the household were associated with increased work-family conflict, and this was in turn associated with increased distress. Job security, autonomy, and being in a more prestigious occupation were positively associated with work-family enrichment and better mental health. These findings from a nationally representative sample of Australian fathers contribute novel evidence that employment characteristics, via work-family conflict and work-family enrichment, are key determinants of fathers' postnatal mental health, independent from established risk factors. Findings will inform the provision of specific 'family-friendly' conditions protective for fathers during this critical stage in the family life-cycle, with implications for their wellbeing and that of their families. PMID:26520473

  11. Mental Health Outcomes of Drug Conflict Among University Students at the U.S.–Mexico Border

    PubMed Central

    O’Connor, Kathleen; Vizcaino, Maricarmen; Benavides, Nora A.

    2015-01-01

    The purpose of this cross-sectional study was to investigate to what extent young adults with close ties to Mexico were at greater risk for self-reported negative mental health outcomes than comparison groups during drug-related armed conflict from 2008 through 2012, and the effect of type and number of traumatic events on mental health outcomes. Using the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist, 202 university students living in the El Paso–Ciudad Juárez border region were surveyed for symptoms of depression, anxiety, and posttraumatic stress. Students with close ties to Mexico reported symptoms of anxiety and posttraumatic stress at significantly higher rates compared with those without connection to Mexico, but there was no significant difference in rates of depression. Although more than a third of participants reported experiencing 5 or more traumatic events connected with the drug war, being confined to home had the most significant effect. Frequency of traumatic events reported by students as well as rates of anxiety and posttraumatic stress symptoms were higher among students with greater connection to Mexico. Rates of clinically-significant depressive symptoms among all students were higher than expected for U.S. adults but comparable with all U.S. college students. This study presents important new data on the mental health effects of Mexico’s drug war. PMID:26633944

  12. A mental health needs assessment of children and adolescents in post-conflict Liberia: results from a quantitative key-informant survey

    PubMed Central

    Borba, Christina P.C.; Ng, Lauren C.; Stevenson, Anne; Vesga-Lopez, Oriana; Harris, Benjamin L.; Parnarouskis, Lindsey; Gray, Deborah A.; Carney, Julia R.; Domínguez, Silvia; Wang, Edward K.S.; Boxill, Ryan; Song, Suzan J.; Henderson, David C.

    2016-01-01

    Between 1989 and 2004, Liberia experienced a devastating civil war that resulted in widespread trauma with almost no mental health infrastructure to help citizens cope. In 2009, the Liberian Ministry of Health and Social Welfare collaborated with researchers from Massachusetts General Hospital to conduct a rapid needs assessment survey in Liberia with local key informants (n = 171) to examine the impact of war and post-war events on emotional and behavioral problems of, functional limitations of, and appropriate treatment settings for Liberian youth aged 5–22. War exposure and post-conflict sexual violence, poverty, infectious disease and parental death negatively impacted youth mental health. Key informants perceived that youth displayed internalizing and externalizing symptoms and mental health-related functional impairment at home, school, work and in relationships. Medical clinics were identified as the most appropriate setting for mental health services. Youth in Liberia continue to endure the harsh social, economic and material conditions of everyday life in a protracted post-conflict state, and have significant mental health needs. Their observed functional impairment due to mental health issues further limited their access to protective factors such as education, employment and positive social relationships. Results from this study informed Liberia's first post-conflict mental health policy. PMID:26807147

  13. Secondary Health Project: Concepts Review. Research Report 70.

    ERIC Educational Resources Information Center

    Agency for Instructional Television, Bloomington, IN.

    This report describes a preliminary evaluation in September 1979 of 12 program topics and their stated objectives for an instructional television series, the Secondary School Health Project, which addresses issues relevant to the personal and social growth of adolescents. The study addressed the following questions: (1) How can the series' topics…

  14. Associations between Mental Health and Ebola-Related Health Behaviors: A Regionally Representative Cross-sectional Survey in Post-conflict Sierra Leone

    PubMed Central

    Betancourt, Theresa S.; Vinck, Patrick; VanderWeele, Tyler J.; Spencer-Walters, Dayo; Akinsulure-Smith, Adeyinka M.; Pham, Phuong

    2016-01-01

    Background Little attention has been paid to potential relationships between mental health, trauma, and personal exposures to Ebola virus disease (EVD) and health behaviors in post-conflict West Africa. We tested a conceptual model linking mental health and trauma to EVD risk behaviors and EVD prevention behaviors. Methods and Findings Using survey data from a representative sample in the Western Urban and Western Rural districts of Sierra Leone, this study examines associations between war exposures, post-traumatic stress disorder (PTSD) symptoms, depression, anxiety, and personal EVD exposure (e.g., having family members or friends diagnosed with EVD) and EVD-related health behaviors among 1,008 adults (98% response rate) from 63 census enumeration areas of the Western Rural and Western Urban districts randomly sampled at the height of the EVD epidemic (January–April 2015). Primary outcomes were EVD risk behaviors (14 items, Cronbach’s α = 0.84) and EVD prevention behaviors (16 items, Cronbach’s α = 0.88). Main predictors comprised war exposures (8 items, Cronbach’s α = 0.85), anxiety (10 items, Cronbach’s α = 0.93), depression (15 items, Cronbach’s α = 0.91), and PTSD symptoms (16 items, Cronbach’s α = 0.93). Data were analyzed using two-level, population-weighted hierarchical linear models with 20 multiply imputed datasets. EVD risk behaviors were associated with intensity of depression symptoms (b = 0.05; 95% CI 0.00, 0.10; p = 0.037), PTSD symptoms (b = 0.10; 95% CI 0.03, 0.17; p = 0.008), having a friend diagnosed with EVD (b = −0.04; 95% CI −0.08, −0.00; p = 0.036), and war exposures (b = −0.09; 95% CI −0.17, −0.02; p = 0.013). EVD prevention behaviors were associated with higher anxiety (b = 0.23; 95% CI 0.06, 0.40; p = 0.008), having a friend diagnosed with EVD (b = 0.15; 95% CI 0.04, 0.27; p = 0.011), and higher levels of war exposure (b = 0.45; 95% CI 0.16, 0.74; p = 0.003), independent of mental health. PTSD symptoms

  15. Trends in Sugar-Sweetened Beverages: Are Public Health and the Market Aligned or in Conflict?

    PubMed

    Shrapnel, William

    2015-09-01

    Adverse health consequences of consuming sugar-sweetened beverages are frequently cited as an example of market failure, justifying government intervention in the marketplace, usually in the form of taxation. However, declining sales of sugar-sweetened beverages in Australia and a corresponding increase in sales of drinks containing non-nutritive sweeteners, in the absence of significant government regulation, appear to reflect market forces at work. If so, the public health challenge in relation to sugar-sweetened beverages may have less to do with regulating the market and more to do with harnessing it. Contrary to assertions that consumers fail to appreciate the links between their choice of beverage and its health consequences, the health conscious consumer appears to be driving the changes taking place in the beverage market. With the capacity to meet consumer expectations for convenience and indulgence without unwanted kilojoules, drinks containing non-nutritive sweeteners enable the "small change" in health behaviour that individuals are willing to consider. Despite the low barriers involved in perpetuating the current trend of replacing sugar-sweetened beverages with drinks containing non-nutritive sweeteners, some public health advocates remain cautious about advocating this dietary change. In contrast, the barriers to taxation of sugar-sweetened beverages appear high. PMID:26404369

  16. Trends in Sugar-Sweetened Beverages: Are Public Health and the Market Aligned or in Conflict?

    PubMed Central

    Shrapnel, William

    2015-01-01

    Adverse health consequences of consuming sugar-sweetened beverages are frequently cited as an example of market failure, justifying government intervention in the marketplace, usually in the form of taxation. However, declining sales of sugar-sweetened beverages in Australia and a corresponding increase in sales of drinks containing non-nutritive sweeteners, in the absence of significant government regulation, appear to reflect market forces at work. If so, the public health challenge in relation to sugar-sweetened beverages may have less to do with regulating the market and more to do with harnessing it. Contrary to assertions that consumers fail to appreciate the links between their choice of beverage and its health consequences, the health conscious consumer appears to be driving the changes taking place in the beverage market. With the capacity to meet consumer expectations for convenience and indulgence without unwanted kilojoules, drinks containing non-nutritive sweeteners enable the “small change” in health behaviour that individuals are willing to consider. Despite the low barriers involved in perpetuating the current trend of replacing sugar-sweetened beverages with drinks containing non-nutritive sweeteners, some public health advocates remain cautious about advocating this dietary change. In contrast, the barriers to taxation of sugar-sweetened beverages appear high. PMID:26404369

  17. Prevalence and Health Correlates of Work-Life Conflict among Blue- and White-Collar Workers from Different Economic Sectors

    PubMed Central

    Hämmig, Oliver

    2014-01-01

    The research on work-life conflict (WLC) is largely neglected in occupational medicine and public health and typically limited to white-collar workers and public servants. This study therefore aims to explore possible differences in the prevalence of WLC and its association with health outcomes between white- and blue-collar workers from different work environments in Switzerland. Cross-sectional survey data collected in 2007 in the service sector and in 2010 in the industrial sector were used for statistical analyses. A subsample of university graduates employed by large service companies (N = 1,170) from the first survey’s population was taken and compared with a subsample of low or unskilled industrial and construction workers with no or only compulsory education (N = 489) from the second survey’s population. The results show almost consistently, and particularly in women, a lower prevalence of time- and strain-based forms and both causal directions of WLC in blue-collar workers. However, associations between different WLC measures and general, physical and mental health outcomes were found to be equally strong or even stronger among blue-collar workers compared to white-collar workers. Low or unskilled industrial and construction workers are less frequently affected by higher degrees of WLC but are then at no lower risk of suffering poor self-rated health or severe backaches and sleep disorders than university graduates working in the service sector with comparable exposure to WLC. In conclusion, it can be stated that WLC turned out to be much less prevalent but equally or even more detrimental to health in blue-collar workers, who therefore need to be considered in future studies. PMID:25426483

  18. Analytical concepts for health management systems of liquid rocket engines

    NASA Technical Reports Server (NTRS)

    Williams, Richard; Tulpule, Sharayu; Hawman, Michael

    1990-01-01

    Substantial improvement in health management systems performance can be realized by implementing advanced analytical methods of processing existing liquid rocket engine sensor data. In this paper, such techniques ranging from time series analysis to multisensor pattern recognition to expert systems to fault isolation models are examined and contrasted. The performance of several of these methods is evaluated using data from test firings of the Space Shuttle main engines.

  19. Evaluation of Health in All Policies: concept, theory and application.

    PubMed

    Baum, Fran; Lawless, Angela; Delany, Toni; Macdougall, Colin; Williams, Carmel; Broderick, Danny; Wildgoose, Deborah; Harris, Elizabeth; Mcdermott, Dennis; Kickbusch, Ilona; Popay, Jennie; Marmot, Michael

    2014-06-01

    This article describes some of the crucial theoretical, methodological and practical issues that need to be considered when evaluating Health in All Policies (HiAP) initiatives. The approaches that have been applied to evaluate HiAP in South Australia are drawn upon as case studies, and early findings from this evaluative research are provided. The South Australian evaluation of HiAP is based on a close partnership between researchers and public servants. The article describes the South Australian HiAP research partnership and considers its benefits and drawbacks in terms of the impact on the scope of the research, the types of evidence that can be collected and the implications for knowledge transfer. This partnership evolved from the conduct of process evaluations and is continuing to develop through joint collaboration on an Australian National Health & Medical Research Council grant. The South Australian research is not seeking to establish causality through statistical tests of correlations, but instead by creating a 'burden of evidence' which supports logically coherent chains of relations. These chains emerge through contrasting and comparing findings from many relevant and extant forms of evidence. As such, program logic is being used to attribute policy change to eventual health outcomes. The article presents the preliminary program logic model and describes the early work of applying the program logic approach to HiAP. The article concludes with an assessment of factors that have accounted for HiAP being sustained in South Australia from 2008 to 2013. PMID:25217350

  20. Working together to rebuild health care in post-conflict Somaliland.

    PubMed

    Leather, Andrew; Ismail, Edna Adan; Ali, Roda; Abdi, Yasin Arab; Abby, Mohamed Hussein; Gulaid, Suleiman Ahmed; Walhad, Said Ahmed; Guleid, Suleiman; Ervine, Ian Maxwell; Lowe-Lauri, Malcolm; Parker, Michael; Adams, Sarah; Datema, Marieke; Parry, Eldryd

    2006-09-23

    In 1991, the Somali National Movement fighters recaptured the Somaliland capital city of Hargeisa after a 3-year civil war. The government troops of the dictator General Mohamed Siad Barre fled south, plunging most of Somalia into a state of anarchy that persists to this day. In the north of the region, the redeclaration of independence of Somaliland took place on May 18, 1991. Despite some sporadic civil unrest between 1994 and 1996, and a few tragic killings of members of the international community, the country has enjoyed peace and stability and has an impressive development record. However, Somaliland continues to await international recognition. The civil war resulted in the destruction of most of Somaliland's health-care facilities, compounded by mass migration or death of trained health personnel. Access to good, affordable health care for the average Somali remains greatly compromised. A former medical director of the general hospital of Hargeisa, Abdirahman Ahmed Mohamed, suggested the idea of a link between King's College Hospital in London, UK, and Somaliland. With support from two British colleagues, a fact-finding trip sponsored by the Tropical Health and Education Trust (THET) took place in July, 2000, followed by a needs assessment by a THET programme coordinator. Here, we describe the challenges of health-care reconstruction in Somaliland and the evolving role of the partnership between King's College Hospital, THET, and Somaliland within the context of the growing movement to link UK NHS trusts and teaching institutions with counterparts in developing countries. PMID:16997666

  1. Concepts of Healthful Food among Low-Income African American Women

    ERIC Educational Resources Information Center

    Lynch, Elizabeth B.; Holmes, Shane; Keim, Kathryn; Koneman, Sylvia A.

    2012-01-01

    Objective: Describe beliefs about what makes foods healthful among low-income African American women. Methods: In one-on-one interviews, 28 low-income African American mothers viewed 30 pairs of familiar foods and explained which food in the pair was more healthful and why. Responses were grouped into codes describing concepts of food…

  2. Concept Paper on Health and Safety Issues in Day Care. Final Manuscript.

    ERIC Educational Resources Information Center

    Pizzo, Peggy; Aronson, Susan S.

    This report discusses the existence and prevention of major health and safety risks for children in day care and makes recommendations for the Federal Interagency Day Care requirements (FIDCR) concerning health and safety. Section I describes varying concepts of risk related to probability and to possibility of adverse events, and discusses…

  3. Concepts of Self-Rated Health: Specifying the Gender Difference in Mortality Risk

    ERIC Educational Resources Information Center

    Deeg, Dorly J. H.; Kriegsman, Didi M. W.

    2003-01-01

    Purpose: This study addresses the question of how the relation between self-rated health (SRH) and mortality differs between genders. In addition to the general question, four specific concepts of SRH are distinguished: SRH in comparison with age peers, SRH in comparison with one's own health 10 years ago, and current and future health…

  4. Media Health Literacy (MHL): Development and Measurement of the Concept among Adolescents

    ERIC Educational Resources Information Center

    Levin-Zamir, Diane; Lemish, Dafna; Gofin, Rosa

    2011-01-01

    Increasing media use among adolescents and its significant influence on health behavior warrants in-depth understanding of their response to media content. This study developed the concept and tested a model of Media Health Literacy (MHL), examined its association with personal/socio-demographic determinants and reported sources of health…

  5. Linking Health Concepts in the Assessment and Evaluation of Water Distribution Systems

    ERIC Educational Resources Information Center

    Karney, Bryan W.; Filion, Yves R.

    2005-01-01

    The concept of health is not only a specific criterion for evaluation of water quality delivered by a distribution system but also a suitable paradigm for overall functioning of the hydraulic and structural components of the system. This article views health, despite its complexities, as the only criterion with suitable depth and breadth to allow…

  6. How are Closeness and Conflict in Student-Teacher Relationships Associated with Demographic Factors, School Functioning and Mental Health in Norwegian Schoolchildren Aged 6-13?

    ERIC Educational Resources Information Center

    Drugli, May Britt

    2013-01-01

    This study explored the association between teacher-reported student-teacher relationship quality (closeness and conflict) and demographic factors, school functioning and child mental health in a cross-sectional study. The study was conducted among a national sample of Norwegian school children (N?=?825) in grades 1 to 7. Bivariate analyses and…

  7. Changing concepts in lipid nutrition in health and disease.

    PubMed

    Chandrasekharan, N

    1999-09-01

    Fat remains a hot topic because of concerns over associations between consumption of fats and the incidence of some chronic conditions including coronary artery disease, diabetes, cancer and obesity. Dietary fats serve multiple purposes. The effects of dietary fats generally reflect the collective influences of multiple fatty acids in the diet or food. This presentation highlights some recent developments on the role of dietary fats and oils in health and disease. Debate continues over the role of dietary modification in coronary prevention by lipid lowering. The degree to which a recommended diet will result in health benefits for an individual is difficult to predict, because the outcome will depend on the influence of other factors such as a person's genetic constitution, level of physical activity and total diet composition. There can now be little doubt about the importance of genetic factors in the etiology of cardiovascular disease, diabetes, obesity and cancer. The importance of antioxidant status in the prevention of cardiovascular disease as well as many cancers is being increasingly recognised. It is now evident that not all saturated fatty acids are equally cholesterolemic. Recent accounts evaluating palm oil's effects on blood lipids and lipoproteins suggest that diets incorporating palm oil as the major dietary fat do not raise plasma total and LDL cholesterol levels to the extent expected from its fatty acid composition. Palm oil is endowed with a good mixture of natural antioxidants and together with its balanced composition of the different classes of fatty acids, makes it a safe, stable and versatile edible oil with many positive health and nutritional attributes. In recent times, adverse health concerns from the consumption of trans fatty acids arising from hydrogenation of oils and fats have been the subject of much discussion and controversy. Trans fatty acids when compared with cis fatty acids or unhydrogenated fats have been shown to lower

  8. Conflicts of interest matter and awareness is needed.

    PubMed

    Vineis, Paolo; Saracci, Rodolfo

    2015-10-01

    A conflict of interest arises by having two conflicting goals in one's research. The primary goal of research relevant to public health is to produce impartial evidence on health hazards for humans. Several entities - including industry - may have public health as a goal among others, but this is not their primary goal. Primary goals are in those cases profit or career, that conflict with the goal of health. It is a role of the State to foster research whose primary goal is impartial evidence on factors affecting population health. Disclosure of conflicts of interest is not enough: the view that disclosure solves all problems amounts to say that a declaration of having produced unbiased evidence is a self-fulfilling guarantee that the evidence will not be affected by conflicts of interest. This concept is seriously misleading. A conflict of interest arises from the circumstances in which research occurs and does not exist only in the opinion of some people or groups (or the authors of a paper). PMID:25636323

  9. Managing Conflicts of Interest in the UK National Institute for Health and Care Excellence (NICE) Clinical Guidelines Programme: Qualitative Study

    PubMed Central

    Graham, Tanya; Alderson, Phil; Stokes, Tim

    2015-01-01

    Background There is international concern that conflicts of interest (COI) may bias clinical guideline development and render it untrustworthy. Guideline COI policies exist with the aim of reducing this bias but it is not known how such policies are interpreted and used by guideline producing organisations. This study sought to determine how conflicts of interest (COIs) are disclosed and managed by a national clinical guideline developer (NICE: the UK National Institute for Health and Care Excellence). Methods Qualitative study using semi-structured telephone interviews with 14 key informants: 8 senior staff of NICE’s guideline development centres and 6 chairs of guideline development groups (GDGs). We conducted a thematic analysis. Results Participants regard the NICE COI policy as comprehensive leading to transparent and independent guidance. The application of the NICE COI policy is, however, not straightforward and clarity could be improved. Disclosure of COI relies on self reporting and guideline developers have to take “on trust” the information they receive, certain types of COI (non-financial) are difficult to categorise and manage and disclosed COI can impact on the ability to recruit clinical experts to GDGs. Participants considered it both disruptive and stressful to exclude members from GDG meetings when required by the COI policy. Nonetheless the impact of this disruption can be minimised with good group chairing skills. Conclusions We consider that the successful implementation of a COI policy in clinical guideline development requires clear policies and procedures, appropriate training of GDG chairs and an evaluation of how the policy is used in practice. PMID:25811754

  10. Dynamics of resilience in forced migration: a 1-year follow-up study of longitudinal associations with mental health in a conflict-affected, ethnic Muslim population

    PubMed Central

    Siriwardhana, Chesmal; Abas, Melanie; Siribaddana, Sisira; Sumathipala, Athula; Stewart, Robert

    2015-01-01

    Objective The concept of ‘resilience’ is of increasing interest in studies of mental health in populations facing adversity. However, lack of longitudinal data on the dynamics of resilience and non-usage of resilience-specific measurements have prevented a better understanding of resilience-mental health interactions. Hence, the present study was conducted to investigate the stability of levels of resilience and its associations with sociodemographic and mental health exposures in a conflict-affected internal-migrant population in Sri Lanka. Design A prospective follow-up study of 1 year. Setting Puttalam district of North Western province in postconflict Sri Lanka (baseline in 2011, follow-up in 2012). Participants An ethnic Muslim population internally displaced 20 years ago (in 1990) from Northern Sri Lanka, aged 18 or above and currently in the process of return migration. Measures It was hypothesised that levels of resilience would be associated with mental health outcomes. Resilience was measured on both occasions using the 14-item Resilience Scale (RS-14), social support by the Multidimensional Social Support Scale and Lubben Social Network Scale and common mental disorders by the Patient Health Questionnaire (PHQ). Results Of 450 participants interviewed at baseline in 2011, 338 (75.1%) were re-interviewed in 2012 after a 1-year follow-up. The mean resilience scores measured by RS-14 were 80.2 (95% CI 78.6 to 81.9) at baseline and 84.9 (83.5 to 86.3) at follow-up. At both time points, lower resilience was independently associated with food insecurity, lower social support availability and social isolation. At both time points, there were significant associations with common mental disorders (CMDs) in unadjusted analyses, but they only showed independence at baseline. The CMD prevalence, maintenance and incidence at follow-up was 8.3%, 28.2% and 2.2%, respectively. Conclusions In this displaced population facing a potential reduction in adversity

  11. After the Baby: Work-Family Conflict and Working Mothers' Psychological Health

    ERIC Educational Resources Information Center

    Marshall, Nancy L.; Tracy, Allison J.

    2009-01-01

    This study examines work and family characteristics and depressive symptomatology among over 700 working mothers of infants. Working mothers in poorer quality jobs, as well as working mothers who were single or whose infant's health was poorer than that of other infants, reported greater depressive symptomatology. The effect of job quality on…

  12. [The role of caregivers in health care. Historical backgrounds and current conflict situations].

    PubMed

    Hofmann, I

    2012-09-01

    As a result of recent demographic developments, there has been an increased demand for high-quality health care. Among the various health professions, caregiving represents the largest professional group, numbering approximately 820,000 caregivers. Despite its size, this group is failing to meet basic conditions in line with international standards that secure adequate care. This failing is primarily due to the special path that Germany took regarding healthcare at the end of the nineteenth century and on which it continues to this day. It manifests itself in a heteronomy to which the professional group is permanently subjected by lobbies and policies that view health care from a perspective whose primary aim is to reduce unemployment. The present lack of organization of caregivers has frustrated their political assertiveness; and not least because of this, many caregivers leave the profession early. The profession itself is grappling with its professional identity. The development of expert standards, research into care, ethical reflections, as well as the struggle for common professional training are positive signs in this ongoing debate and are reflected in the positive feedback received from patients. The interdisciplinary dialogue between caregivers and physicians is in need of improvement. The first signs of progress are evident within the framework of health care ethics committees. This dialogue would certainly benefit both the professional group as well as the patients. PMID:22936484

  13. Validation of a Mental Health Assessment in an African Conflict Population

    ERIC Educational Resources Information Center

    Ertl, Verena; Pfeiffer, Anett; Saile, Regina; Schauer, Elisabeth; Elbert, Thomas; Neuner, Frank

    2010-01-01

    We studied the validity of the assessment of posttraumatic stress disorder (PTSD) and depression within the context of an epidemiological mental health survey among war-affected adolescents and young adults in northern Uganda. Local language versions of the Posttraumatic Diagnostic Scale (PDS) and the Depression section of the Hopkins Symptom…

  14. Darfur Refugees in Cairo: Mental Health and Interpersonal Conflict in the Aftermath of Genocide

    ERIC Educational Resources Information Center

    Meffert, Susan M.; Marmar, Charles R.

    2009-01-01

    Hundreds of thousands of Darfur people affected by the Sudanese genocide have fled to Cairo, Egypt, in search of assistance. Collaborating with Africa and Middle East Refugee Assistance (AMERA), the authors conducted a mental health care needs assessment among Darfur refugees in Cairo. Information was collected using individual and focus group…

  15. Concept, Components, and Strategies of Soil Health in Agroecosystems

    PubMed Central

    Magdoff, Fred

    2001-01-01

    The terms ''soil health'' or ''soil quality'' as applied to agroecosystems refer to the ability of soil to support and sustain crop growth while maintaining environmental quality. High-quality soils have the following characteristics: (i) a sufficient, but not excess, supply of nutrients; (ii) good structure (tilth); (iii) sufficient depth for rooting and drainage; (iv) good internal drainage; (v) low populations of plant disease and parasitic organisms; (vi) high populations of organisms that promote plant growth; (vii) low weed pressure; (viii) no chemicals that might harm the plant; (ix) resistance to being degraded; and (x) resilience following an episode of degradation. Management intended to improve soil health involves creatively combining a number of practices that enhance the soil's biological, chemical, and physical suitability for crop production. The most important general strategy is to add plentiful quantities of organic matter—including crop and cover crop residues, manures, and composts. Other important strategies include better crop rotations, reducing tillage and keeping the soil surface covered with living and dead residue, reducing compaction by decreasing heavy equipment traffic, and using best nutrient management practices. Practices that enhance soil quality frequently reduce plant pest pressures. PMID:19265876

  16. Health journalism in the service of power: 'moral complacency' and the Hebrew media in the Gaza-Israel conflict.

    PubMed

    Birenbaum-Carmeli, Daphna

    2014-05-01

    The power of health news as a vehicle in the production of meaning in the service of power is the core of this article. Tracking the media coverage of a medical service, it shows how a routine practice can be invoked at a time of armed conflict so as to enhance a benevolent state image. The case at hand is the medical treatment of Gaza children in Israeli hospitals. A series of Internet searches revealed a group of publications on the subject in the Hebrew media, during and shortly after Israel's assault on Gaza in the winter of 2008-2009. In the press articles the treatments were invariably constituted as the epitome of Israel's compassion towards the enemy's children. This image relied, however, on a simultaneous silencing of other aspects of these treatments, which would have challenged this image. The monolithic depictions give rise to the notion of reversed moral panic or 'moral complacency', wherein the media amplifies a little-known social phenomenon into an epitome of societal values and charges it with significance on a national scale. The article ends with considering some features that possibly render health news an especially convenient domain for state-supportive media presentations. PMID:24841223

  17. Inter-group conflict in health care: UK students' experiences of bullying and the need for organisational solutions.

    PubMed

    Stevenson, Keith; Randle, Jacqueline; Grayling, Ian

    2006-05-01

    This paper addresses bullying of United Kingdom (UK) nursing students whilst on work placement as a specific issue of inter-group difficulty that currently affects nurses and students working in the UK National Health Service. The authors begin by discussing the concept of bullying and sharing the types of bullying reported in two recent studies involving UK nursing students. Both studies illustrate the effects that negative workplace experiences can have on new entrants to the profession. After reviewing various individual solutions which have been recommended for reducing bullying, they suggest that the most effective solution is for health care organisations offering placement training to become much more proactive in creating a culture that will not tolerate bullying behaviour by staff at any level. The literature suggests bullying is a phenomenon affecting workplaces in many countries. Thus the issues described in this article, and the solutions offered have relevance to a variety of health care settings. PMID:17201580

  18. Conflict management, Part 1. Conflict management checklist: a diagnostic tool for assessing conflict in organizations.

    PubMed

    Siders, C T; Aschenbrener, C A

    1999-01-01

    Complex interpersonal conflicts are inevitable in the high speed, high stakes, pressured work of health care. Poorly managed, conflict saps productivity, erodes trust, and spawns additional disputes. Well managed, conflict can enhance the self-confidence and self-esteem of the parties, build relationships, and engender creative solutions beyond expectations. Just as thoughtful differential diagnosis precedes optimum treatment in the doctor-patient relationship, management of conflict is greatly enhanced when preceded by careful assessment. In the first of two articles, the authors present a diagnostic approach, the Conflict Management Checklist, to increase self-awareness and decrease anxiety around conflict. PMID:10557482

  19. Stress as a mediator between work-family conflict and psychological health among the nursing staff: Moderating role of emotional intelligence.

    PubMed

    Sharma, Jyoti; Dhar, Rajib Lochan; Tyagi, Akansha

    2016-05-01

    The study examined the extent to which work-family conflicts cause stress among nursing staff and its subsequent impact on their psychological health. It also examined if the emotional intelligence level of the nursing staff acted as a moderator between their level of stress and psychological health. A survey was carried out on 693 nursing staff associated with 33 healthcare institutions in Uttarakhand, India. A hierarchical multiple regression analysis was carried out to understand the relationships shared by independent (work-family conflicts) and dependent (psychological health) constructs with the mediator (stress) as well as the moderator (emotional intelligence). The results revealed that stress acted as a mediator between work-family conflict of the nursing staff and their psychological health. However, their emotional intelligence level acted as a moderator between their stress level and psychological health. To conclude, the crucial roles of emotional intelligence in controlling the impact of stress on psychological health along with the practical as well as theoretical implications are also discussed. PMID:25769936

  20. Building the microbiome in health and disease: niche construction and social conflict in bacteria

    PubMed Central

    McNally, Luke; Brown, Sam P.

    2015-01-01

    Microbes collectively shape their environment in remarkable ways via the products of their metabolism. The diverse environmental impacts of macro-organisms have been collated and reviewed under the banner of ‘niche construction’. Here, we identify and review a series of broad and overlapping classes of bacterial niche construction, ranging from biofilm production to detoxification or release of toxins, enzymes, metabolites and viruses, and review their role in shaping microbiome composition, human health and disease. Some bacterial niche-constructing traits can be seen as extended phenotypes, where individuals actively tailor their environment to their benefit (and potentially to the benefit of others, generating social dilemmas). Other modifications can be viewed as non-adaptive by-products from a producer perspective, yet they may lead to remarkable within-host environmental changes. We illustrate how social evolution and niche construction perspectives offer complementary insights into the dynamics and consequences of these traits across distinct timescales. This review highlights that by understanding the coupled bacterial and biochemical dynamics in human health and disease we can better manage host health. PMID:26150664

  1. Embedding Concepts of Sex and Gender Health Differences into Medical Curricula

    PubMed Central

    Rice, Morrisa; Schiebinger, Londa; Jenkins, Marjorie R.; Werbinski, Janice; Núñez, Ana; Wood, Susan; Viggiano, Thomas R.; Shuster, Lynne T.

    2013-01-01

    Abstract Sex, a biological variable, and gender, a cultural variable, define the individual and affect all aspects of disease prevention, development, diagnosis, progression, and treatment. Sex and gender are essential elements of individualized medicine. However, medical education rarely considers such topics beyond the physiology of reproduction. To reduce health care disparities and to provide optimal, cost-effective medical care for individuals, concepts of sex and gender health need to become embedded into education and training of health professionals. In September 2012, Mayo Clinic hosted a 2-day workshop bringing together leading experts from 13 U.S. schools of medicine and schools of public health, Health Resources and Services Administration Office of Women's Health (HRSA OWH), the National Institutes of Health (NIH) Office of Research on Women's Health (ORWH), and the Canadian Institute of Health and Gender. The purpose of this workshop was to articulate the need to integrate sex- and gender-based content into medical education and training, to identify gaps in current medical curricula, to consider strategies to embed concepts of sex and gender health into health professional curricula, and to identify existing resources to facilitate and implement change. This report summarizes these proceedings, recommendations, and action items from the workshop. PMID:23414074

  2. Environmental Health Disparities: A Framework Integrating Psychosocial and Environmental Concepts

    PubMed Central

    Gee, Gilbert C.; Payne-Sturges, Devon C.

    2004-01-01

    Although it is often acknowledged that social and environmental factors interact to produce racial and ethnic environmental health disparities, it is still unclear how this occurs. Despite continued controversy, the environmental justice movement has provided some insight by suggesting that disadvantaged communities face greater likelihood of exposure to ambient hazards. The exposure–disease paradigm has long suggested that differential “vulnerability” may modify the effects of toxicants on biological systems. However, relatively little work has been done to specify whether racial and ethnic minorities may have greater vulnerability than do majority populations and, further, what these vulnerabilities may be. We suggest that psychosocial stress may be the vulnerability factor that links social conditions with environmental hazards. Psychosocial stress can lead to acute and chronic changes in the functioning of body systems (e.g., immune) and also lead directly to illness. In this article we present a multidisciplinary framework integrating these ideas. We also argue that residential segregation leads to differential experiences of community stress, exposure to pollutants, and access to community resources. When not counterbalanced by resources, stressors may lead to heightened vulnerability to environmental hazards. PMID:15579407

  3. Anthrax as an example of the One Health concept.

    PubMed

    Bengis, R G; Frean, J

    2014-08-01

    Anthrax is a peracute, acute or subacute multispecies bacterial infection that occurs on many continents. It is one of the oldest infectious diseases known; the biblical fifth and sixth plagues (Exodus chapters 7 to 9) that affected first livestock and then humans were probably anthrax. From the earliest historical records until development of an effective vaccine midway through the 20th Century, anthrax was one of the foremost causes of uncontrolled mortality in cattle, sheep, goats, horses and pigs, with 'spill over' into humans, worldwide. With the development of the Sterne spore vaccine, a sharp decline in anthrax outbreaks in livestock occurred during the 1930-1980 era. There were successful national vaccination programmes in many countries during this period, complemented by the liberal use of antibiotics and the implementation of quarantine regulations and carcass disposal. However, a resurgence of this disease in livestock has been reported recently in some regions, where complacency and a false sense of security have hindered vaccination programmes. The epidemiology of anthrax involves an environmental component, as well as livestock, wildlife and human components. This makes anthrax an ideal example for discussion in the One Health context. Many outbreaks of anthrax in wildlife are undetected or unreported, owing to surveillance inadequacies and difficulties. Human disease is generally acquired accidentally during outbreaks of anthrax in domestic livestock and wildlife. The exception is deliberate targeting of humans with anthrax in the course of biowarfare or bioterrorism. PMID:25707186

  4. Teachable moments for health behavior change: a concept analysis

    PubMed Central

    Lawson, Peter J.; Flocke, Susan A.

    2009-01-01

    Objective “Teachable moments” have been proposed as events or circumstances which can lead individuals to positive behavior change. However, the essential elements of teachable moments have not been elucidated. Therefore, we undertook a comprehensive review of the literature to uncover common definitions and key elements of this phenomenon. Methods Using databases spanning social science and medical disciplines, all records containing the search term “teachable moment*” were collected. Identified literature was then systematically reviewed and patterns were derived. Results Across disciplines, ‘teachable moment’ has been poorly developed both conceptually and operationally. Usage of the term falls into three categories: 1) “teachable moment” is synonymous with “opportunity” (81%); 2) a context that leads to a higher than expected behavior change is retrospectively labeled a ‘teachable moment’ (17%); 3) a phenomenon that involves a cueing event that prompts specific cognitive and emotional responses (2%). Conclusion The findings suggest that the teachable moment is not necessarily unpredictable or simply a convergence of situational factors that prompt behavior change but suggest the possible creation of a teachable moment through clinician-patient interaction. Practice Implications Clinician-patient interaction may be central to the creation of teachable moments for health behavior change. PMID:19110395

  5. Alternative dispute resolution: methods to address workplace conflict in health services organizations.

    PubMed

    DeSouza, J R

    1998-01-01

    As healthcare organizations become increasingly complex, healthcare administrators and human resource managers face the cost and challenges of employment-related disputes. Litigation and legal costs associated with employment disputes are escalating at a significant rate. Additionally, litigation procedures are drawn out and damage the employer-employee relationship. Alternative dispute resolution (ADR) programs such as mediation and arbitration alleviate the burden of litigation and preserve positive employment relationships between the organization and its employees. A proposed ADR program is presented is a guideline for health services organizations considering the adoption of such programs. PMID:10182933

  6. Lost in translation: a genealogy of the “social capital” concept in public health

    PubMed Central

    Moore, S; Haines, V; Hawe, P; Shiell, A

    2006-01-01

    Study objective To examine the genealogy of the social capital concept in public health, with attention to the epistemological concerns and academic practices that shaped the way in which this concept was translated into public health. Design A citation‐network path analysis of the public health literature on social capital was used to generate a genealogy of the social capital concept in public health. The analysis identifies the intellectual sources, influential texts, and developments in the conceptualisation of social capital in public health. Participants The population of 227 texts (articles, books, reports) was selected in two phases. Phase 1 texts were articles in the PubMed database with “social capital” in their title published before 2003 (n = 65). Phase 2 texts are those texts cited more than once by phase 1 articles (n = 165). Main results The analysis shows how the scholarship of Robert Putnam has been absorbed into public health research, how three seminal texts appearing in 1996 and 1997 helped shape the communitarian form that the social capital concept has assumed in public health, and how both were influenced by the epistemological context of social epidemiology at the time. Conclusions Originally viewed in public health research as an ecological level, psychosocial mechanism that might mediate the income inequality‐health pathway, the dominance of the communitarian approach to social capital has given disproportionate attention to normative and associational properties of places. Network approaches to social capital were lost in this translation. Recovering them is key to a full translation and conceptualisation of social capital in public health. PMID:16840764

  7. Validation of a mental health assessment in an African conflict population.

    PubMed

    Ertl, Verena; Pfeiffer, Anett; Saile, Regina; Schauer, Elisabeth; Elbert, Thomas; Neuner, Frank

    2010-06-01

    We studied the validity of the assessment of posttraumatic stress disorder (PTSD) and depression within the context of an epidemiological mental health survey among war-affected adolescents and young adults in northern Uganda. Local language versions of the Posttraumatic Diagnostic Scale (PDS) and the Depression section of the Hopkins Symptom Checklist (DHSCL) were administered by trained local interviewers. Correlations with probable predictor variables (i.e., trauma exposure), outcomes (e.g., impaired functioning), and local idioms of distress (i.e., spirit possession) were determined to estimate criterion-related construct validity. To assess convergent validity, expert clinicians reinterviewed a subsample using structured interviews (the Clinician Administered PTSD Scale [CAPS] and the Mini International Neuropsychiatric Interview [MINI]). Depression and PTSD symptoms as assessed by the local interviewers correlated with the context variables as predicted. After optimizing the scoring algorithm, we found good agreement between the PDS-based diagnoses and expert diagnoses. However, the concordance for depression diagnoses was not satisfactory. Results show that mental health assessments in African languages can produce reliable and valid data but that caution is warranted in the unevaluated transfer of cutoff scores and scoring algorithms. PMID:20528059

  8. Healthy plants: necessary for a balanced 'One Health' concept.

    PubMed

    Fletcher, Jacqueline; Franz, David; Leclerc, J Eugene

    2009-01-01

    All life forms depend ultimately upon sunlight to create the energy 'currency' required for the functions of living. Green plants can make that conversion directly but the rest of us would perish without access to foods derived, directly or indirectly, from plants. We also require their fibre which we use for clothing, building and other purposes. However, plants, just as humans and animals, are attacked by pathogens that cause a myriad of symptoms that can lead to reduced yields, lower quality products and diminished nutritional value. Plant pathogens share many features with their human and animal counterparts. Some pathogens - whether of humans, animals, or plants - have nimble genomes or the ability to pirate genes from other organisms via mobile elements. Some have developed the ability to cross kingdoms in their host ranges. Many others share virulence factors, such as the type III secretion system (T3SS) or mechanisms for sensing population density, that work equally well in all kingdoms. Certain pathogens of hosts in all kingdoms rely upon insect vectors and use similar mechanisms to ensure dispersal (and sometimes survival) in this way. Plant-pathogen interactions have more direct consequence for humans when the microbes are human pathogens such as Escherichia coli 0157:H7 and Salmonella spp., which can contaminate fresh produce or when they produce metabolites, such as mycotoxins, which are harmful when consumed. Finally, national biosecurity concerns and the need for prevention, preparedness and forensic capabilities cross all kingdom barriers. Thus, our communities that focus on one of these kingdoms have much to learn from one another and a complete and balanced 'One Health' initiative must be tripartite, embracing the essential components of healthy plants, healthy animals and healthy people. PMID:20391392

  9. Population Health Measurement: Applying Performance Measurement Concepts in Population Health Settings

    PubMed Central

    Stoto, Michael A.

    2014-01-01

    Introduction: Whether the focus of population-health improvement efforts, the measurement of health outcomes, risk factors, and interventions to improve them are central to achieving collective impact in the population health perspective. And because of the importance of a shared measurement system, appropriate measures can help to ensure the accountability of and ultimately integrate the efforts of public health, the health care delivery sector, and other public and private entities in the community to improve population health. Yet despite its importance, population health measurement efforts in the United States are poorly developed and uncoordinated. Collaborative Measurement Development: To achieve the potential of the population health perspective, public health officials, health system leaders, and others must work together to develop sets of population health measures that are suitable for different purposes yet are harmonized so that together they can help to improve a community’s health. This begins with clearly defining the purpose of a set of measures, distinguishing between outcomes for which all share responsibility and actions to improve health for which the health care sector, public health agencies, and others should be held accountable. Framework for Population Health Measurement: Depending on the purpose of the analysis, then, measurement systems should clearly specify what to measure—in particular the population served (the denominator), what the critical health dimensions are in a measurement framework, and how the measures can be used to ensure accountability. Building on a clear understanding of the purpose and dimensions of population health that must be measured, developers can then choose specific measures using existing data or developing new data sources if necessary, with established validity, reliability, and other scientific characteristics. Rather than indiscriminately choosing among the proliferating data streams, this

  10. The global health concept of the German government: strengths, weaknesses, and opportunities.

    PubMed

    Bozorgmehr, Kayvan; Bruchhausen, Walter; Hein, Wolfgang; Knipper, Michael; Korte, Rolf; Razum, Oliver; Tinnemann, Peter

    2014-01-01

    Recognising global health as a rapidly emerging policy field, the German federal government recently released a national concept note for global health politics (July 10, 2013). As the German government could have a significant impact on health globally by making a coherent, evidence-informed, and long-term commitment in this field, we offer an initial appraisal of the strengths, weaknesses, and opportunities for development recognised in this document. We conclude that the national concept is an important first step towards the implementation of a coherent global health policy. However, important gaps were identified in the areas of intellectual property rights and access to medicines. In addition, global health determinants such as trade, economic crises, and liberalisation as well as European Union issues such as the health of migrants, refugees, and asylum seekers are not adequately addressed. Furthermore, little information is provided about the establishment of instruments to ensure an effective inter-ministerial cooperation. Finally, because implementation aspects for the national concept are critical for the success of this initiative, we call upon the newly elected 2013 German government to formulate a global health strategy, which includes a concrete plan of action, a time scale, and measurable goals. PMID:24560258

  11. The global health concept of the German government: strengths, weaknesses, and opportunities

    PubMed Central

    Bozorgmehr, Kayvan; Bruchhausen, Walter; Hein, Wolfgang; Knipper, Michael; Korte, Rolf; Razum, Oliver; Tinnemann, Peter

    2014-01-01

    Recognising global health as a rapidly emerging policy field, the German federal government recently released a national concept note for global health politics (July 10, 2013). As the German government could have a significant impact on health globally by making a coherent, evidence-informed, and long-term commitment in this field, we offer an initial appraisal of the strengths, weaknesses, and opportunities for development recognised in this document. We conclude that the national concept is an important first step towards the implementation of a coherent global health policy. However, important gaps were identified in the areas of intellectual property rights and access to medicines. In addition, global health determinants such as trade, economic crises, and liberalisation as well as European Union issues such as the health of migrants, refugees, and asylum seekers are not adequately addressed. Furthermore, little information is provided about the establishment of instruments to ensure an effective inter-ministerial cooperation. Finally, because implementation aspects for the national concept are critical for the success of this initiative, we call upon the newly elected 2013 German government to formulate a global health strategy, which includes a concrete plan of action, a time scale, and measurable goals. PMID:24560258

  12. Acculturation-based and everyday parent-adolescent conflict among Chinese American adolescents: longitudinal trajectories and implications for mental health.

    PubMed

    Juang, Linda P; Syed, Moin; Cookston, Jeffrey T

    2012-12-01

    The purpose of the study was to examine 2 types of conflict for Chinese American families that have not been integrated in previous literature: everyday conflict and acculturation-based conflict. We explored the relation between the 2 types of conflict over time and their associations with adolescent adjustment (i.e., anxiety/somatization, loneliness, depressive symptoms, and self-esteem). The sample consisted of 316 Chinese American adolescents (M = 14.8 years, SD = .73 at Wave 1) who participated in a 3-wave longitudinal study. The results showed that everyday and acculturation-based conflict are related and change in parallel over time. However, the 2 types of conflict are unique predictors of the 4 different indicators of psychological functioning. Results also suggested that psychological functioning is a better predictor of trajectories of conflict than vice versa. Taken together, the results highlight the importance of considering how the acculturation process contributes to parent-adolescent conflict regarding everyday issues and deeper cultural values. PMID:23088797

  13. Central gender theoretical concepts in health research: the state of the art.

    PubMed

    Hammarström, Anne; Johansson, Klara; Annandale, Ellen; Ahlgren, Christina; Aléx, Lena; Christianson, Monica; Elwér, Sofia; Eriksson, Carola; Fjellman-Wiklund, Anncristine; Gilenstam, Kajsa; Gustafsson, Per E; Harryson, Lisa; Lehti, Arja; Stenberg, Gunilla; Verdonk, Petra

    2014-02-01

    Despite increasing awareness of the importance of gender perspectives in health science, there is conceptual confusion regarding the meaning and the use of central gender theoretical concepts. We argue that it is essential to clarify how central concepts are used within gender theory and how to apply them to health research. We identify six gender theoretical concepts as central and interlinked-but problematic and ambiguous in health science: sex, gender, intersectionality, embodiment, gender equity and gender equality. Our recommendations are that: the concepts sex and gender can benefit from a gender relational theoretical approach (i.e., a focus on social processes and structures) but with additional attention to the interrelations between sex and gender; intersectionality should go beyond additive analyses to study complex intersections between the major factors which potentially influence health and ensure that gendered power relations and social context are included; we need to be aware of the various meanings given to embodiment, which achieve an integration of gender and health and attend to different levels of analyses to varying degrees; and appreciate that gender equality concerns absence of discrimination between women and men while gender equity focuses on women's and men's health needs, whether similar or different. We conclude that there is a constant need to justify and clarify our use of these concepts in order to advance gender theoretical development. Our analysis is an invitation for dialogue but also a call to make more effective use of the knowledge base which has already developed among gender theorists in health sciences in the manner proposed in this paper. PMID:24265394

  14. Involvement in Mental Health and Substance Abuse Work: Conceptions of Service Users

    PubMed Central

    Laitila, Minna; Nikkonen, Merja; Pietilä, Anna-Maija

    2011-01-01

    Service user involvement (SUI) is a principal and a guideline in social and health care and also in mental health and substance abuse work. In practice, however, there are indicators of SUI remaining rhetoric rather than reality. The purpose of this study was to analyse and describe service users' conceptions of SUI in mental health and substance abuse work. The following study question was addressed: what are service users' conceptions of service user involvement in mental health and substance abuse work? In total, 27 users of services participated in the study, and the data was gathered by means of interviews. A phenomenographic approach was applied in order to explore the qualitative variations in participants' conceptions of SUI. As a result of the data analysis, four main categories of description representing service users' conceptions of service user involvement were formed: service users have the best expertise, opinions are not heard, systems make the rules, and courage and readiness to participate. In mental health and substance abuse work, SUI is still insufficiently achieved and there are obstacles to be taken into consideration. Nurses are in a key position to promote and encourage service user involvement. PMID:21994839

  15. Wealth and Health Behavior: Testing the Concept of a Health Cost

    PubMed Central

    Galama, Titus J.

    2014-01-01

    Wealthier individuals engage in healthier behavior. This paper seeks to explain this phenomenon by exploiting both inheritances and lottery winnings to test a theory of health behavior. We distinguish between the direct monetary cost and the indirect health cost (value of health lost) of unhealthy consumption. The health cost increases with wealth and the degree of unhealthiness, leading wealthier individuals to consume more healthy and moderately unhealthy, but fewer severely unhealthy goods. The empirical evidence presented suggests that differences in health costs may indeed partially explain behavioral differences, and ultimately health outcomes, between wealth groups. PMID:25530621

  16. Cannabis, pesticides and conflicting laws: the dilemma for legalized States and implications for public health.

    PubMed

    Stone, Dave

    2014-08-01

    State laws on the legalization of medical and recreational cannabis are rapidly evolving. Similar to other crops, cannabis is susceptible to multiple pests during cultivation. Growers have an economic incentive to produce large yields and high quality plants, and may resort to pesticides to achieve these outcomes. Currently, there are no pesticides registered for cannabis in the United States, given its illegal status by the federal government. This discrepancy creates a regulatory vacuum and dilemma for States with legal medical and recreational cannabis that seek to balance lawful compliance with pesticides and worker or public health. Pesticide use presents occupational safety issues that can be mitigated through established worker protection measures. The absence of approved products for cannabis may result in consumer exposures to otherwise more hazardous pesticides or higher residue levels. While many legal and scientific hurdles exist to register conventional pesticides for use on cannabis, legalized States have explored other opportunities to leverage the present regulatory infrastructure. Stakeholder engagement and outreach to the cannabis industry from credible sources could mitigate pesticide misuse and harm. PMID:24859075

  17. [Conflict and deficit in etiopathogenia].

    PubMed

    Solimano, Alberto Luis

    2010-01-01

    Currently, there is a proliferation of theories and theoretical languages in the field of Mental Health. These different languages, with their accompanying discourse, can be a great source of confusion for the therapist, who is often forced to use them in clinical practice. The purpose of this paper is to describe and compare two principal theories in an attempt to integrate their different theoretical languages and approaches. To this end, two approaches in etiopathogenia, conflict and deficit, characteristic of two principal models, namely the medical-psychiatric model and the psychoanalytic-psychodynamic model, are described and compared. Firstly, deficit and psychic conflict are defined in the context of psychopathology. Secondly, Freud's complemental series is described and suggested as a model to enable the inclusion of both concepts in the etiopathology of mental disease. Thirdly, the diagnostic process is examined to illustrate how each model operates using a different methodology to collect data. In the field of psychiatry, clinical observation involves finding generalities to classify the disease in a nosography. In contrast, psychoanalysis investigates the conflict in the therapeutic relationship, and thus preserves the singularity of the subject. Finally, it is suggested that both models may be necessary and complementary, as they are both instrumental in the treatment of mental illness. PMID:21188311

  18. The concepts of health and preventive health practices of Chinese Australian women in relation to cancer screening.

    PubMed

    Kwok, Cannas; Sullivan, Gerard

    2007-04-01

    Despite an emphasis on mammographic screening in Australia, Chinese Australian women have low participation rates. This qualitative study investigated how concepts of health and health promotion influence Chinese Australian women's decisions to participate in cancer screening, which is an important issue for nurses who work with multicultural populations. In-depth interviews were conducted with 20 Chinese Australian women. Using thematic data analysis, the findings showed that health and illness are taken-for-granted experiences of everyday life. When they were asymptomatic, most informants saw no reason to suspect that they may have diseases. Consistent with these health beliefs, the women focused on preserving and promoting health and overall well-being in everyday life rather than attempting to detect hidden disease by screening. These ideas and practices influenced behavior in relation to cancer diagnosis and in particular toward mammography. PMID:17416713

  19. A window of opportunity for reform in post-conflict settings? The case of Human Resources for Health policies in Sierra Leone, 2002–2012

    PubMed Central

    2014-01-01

    Background It is recognized that decisions taken in the early recovery period may affect the development of health systems. Additionally, some suggest that the immediate post-conflict period may allow for the opening of a political ‘window of opportunity’ for reform. For these reasons, it is useful to reflect on the policy space that exists in this period, by what it is shaped, how decisions are made, and what are their long-term implications. Examining the policy trajectory and its determinants can be helpful to explore the specific features of the post-conflict policy-making environment. With this aim, the study looks at the development of policies on human resources for health (HRH) in Sierra Leone over the decade after the conflict (2002–2012). Methods Multiple sources were used to collect qualitative data on the period between 2002 and 2012: a stakeholder mapping workshop, a document review and a series of key informant interviews. The analysis draws from political economy and policy analysis tools, focusing on the drivers of reform, the processes, the contextual features, and the actors and agendas. Findings Our findings identify three stages of policy-making. At first characterized by political uncertainty, incremental policies and stop-gap measures, the context substantially changed in 2009. The launch of the Free Health Care Initiative provided to be an instrumental event and catalyst for health system, and HRH, reform. However, after the launch of the initiative, the pace of HRH decision-making again slowed down. Conclusions Our study identifies the key drivers of HRH policy trajectory in Sierra Leone: (i) the political situation, at first uncertain and later on more defined; (ii) the availability of funding and the stances of agencies providing such funds; (iii) the sense of need for radical change – which is perhaps the only element related to the post-conflict setting. It also emerges that a ‘windows of opportunity’ for reform did not open

  20. Consumer appeal of nutrition and health claims in three existing product concepts.

    PubMed

    Verbeke, Wim; Scholderer, Joachim; Lähteenmäki, Liisa

    2009-06-01

    This paper reports on consumers' reactions towards calcium-enriched fruit juice, omega-3 enriched spread and fibre-enriched cereals, each with a nutrition claim, health claim and reduction of disease risk claim. Cross-sectional data were collected in April 2006 from a sample of 341 consumers in Belgium. Consumers' reactions to the carrier product, functional ingredient and claim combinations were assessed as perceived convincingness of the claim, credibility of the product, attractiveness of the product, and intention to buy the product, while accounting for differences in product familiarity, attitudinal and demographic characteristics. Generally, health claims outperformed nutrition claims, and both of these claim types outperformed reduction of disease risk claims. Comparing consumer reactions across product concepts revealed clear preferences for fibre-enriched cereals as compared to the other two concepts. The interaction effects between claim type and product concept indicated that reduction of disease risk claims are perceived very well in omega-3 enriched spreads, particularly in terms of perceived convincingness of the claim, while not appealing to consumers in the other product concepts. Positive attitudes towards functional foods and familiarity with the concrete functional product category boosted the claim type and product ratings, whereas perceived control over own health and perceiving functional foods as a marketing scam decreased all product concept's appeal. PMID:19501767

  1. eHealth literacy 2.0: problems and opportunities with an evolving concept.

    PubMed

    Norman, Cameron

    2011-01-01

    As the use of eHealth grows and diversifies globally, the concept of eHealth literacy - a foundational skill set that underpins the use of information and communication technologies (ICT) for health - becomes more important than ever to understand and advance. EHealth literacy draws our collective attention to the knowledge and complex skill set that is often taken for granted when people interact with technology to address information, focusing our attention on learning and usability issues from the clinical through to population health level. Just as the field of eHealth is dynamic and evolving, so too is the context where eHealth literacy is applied and understood. The original Lily Model of eHealth literacy and scale used to assess it were developed at a time when the first generation of web tools gained prominence before the rise of social media. The rapid shifts in the informational landscape created by Web 2.0 tools and environments suggests it might be time to revisit the concept of eHealth Literacy and consider what a second release might look like. PMID:22193243

  2. Community-based delivery of maternal care in conflict-affected areas of eastern Burma: perspectives from lay maternal health workers.

    PubMed

    Teela, Katherine C; Mullany, Luke C; Lee, Catherine I; Poh, Eh; Paw, Palae; Masenior, Nicole; Maung, Cynthia; Beyrer, Chris; Lee, Thomas J

    2009-04-01

    In settings where active conflict, resource scarcity, and logistical constraints prevail, provision of maternal health services within health centers and hospitals is unfeasible and alternative community-based strategies are needed. In eastern Burma, such conditions necessitated implementation of the "Mobile Obstetric Maternal Health Worker" (MOM) project, which has employed a community-based approach to increase access to essential maternal health services including emergency obstetric care. Lay Maternal Health Workers (MHWs) are central to the MOM service delivery model and, because they are accessible to both the communities inside Burma and to outside project managers, they serve as key informants for the project. Their insights can facilitate program and policy efforts to overcome critical delays and insufficient management of maternal complications linked to maternal mortality. Focus group discussions (n=9), in-depth interviews (n=18), and detailed case studies (n=14) were collected from MHWs during centralized project management meetings in February and October of 2007. Five case studies are presented to characterize and interpret the realities of reproductive health work in a conflict-affected setting. Findings highlight the process of building supportive networks and staff ownership of the MOM project, accessing and gaining community trust and participation to achieve timely delivery of care, and overcoming challenges to manage and appropriately deliver essential health services. They suggest that some emergency obstetric care services that are conventionally delivered only within healthcare settings might be feasible in community or home-based settings when alternatives are not available. This paper provides an opportunity to hear directly from community-based workers in a conflict setting, perspectives seldom documented in the scientific literature. A rights-based approach to service delivery and its suitability in settings where human rights violations

  3. [Illness concepts of children. Validation of a modified locus of control test in illness and health].

    PubMed

    Schmidt, A; Altmann-Herz, U

    1992-12-01

    We investigated the health and illness concepts of 53 healthy children aged 8 to 14 years using a modified illness and health locus of control scale (KKG, Lohaus and Schmitt, 1989) with the scales internal, external-p (powerful others) and external-c (chance). A comparison of the results with those on self-esteem (FSK 4-6), anxiety (CMAS-R) and hopelessness (HSC) scales showed a decrease in externality, but not an increase in internality, with increasing age and a correlation between self-confidence and a more internal locus of control. The influence of children's health locus of control on treatment compliance is discussed. PMID:1288033

  4. Analysis and implementation of a World Health Organization health report: methodological concepts and strategies.

    PubMed

    von Groote, Per Maximilian; Giustini, Alessandro; Bickenbach, Jerome Edmond

    2014-01-01

    A long-standing scientific discourse on the use of health research evidence to inform policy has come to produce multiple implementation theories, frameworks, models, and strategies. It is from this extensive body of research that the authors extract and present essential components of an implementation process in the health domain, gaining valuable guidance on how to successfully meet the challenges of implementation. Furthermore, this article describes how implementation content can be analyzed and reorganized, with a special focus on implementation at different policy, systems and services, and individual levels using existing frameworks and tools. In doing so, the authors aim to contribute to the establishment and testing of an implementation framework for reports such as the World Health Organization World Report on Disability, the World Health Organization International Perspectives on Spinal Cord Injury, and other health policy reports or technical health guidelines. PMID:24356078

  5. The genetic conception of health: is it as radical as claimed?

    PubMed

    Petersen, Alan

    2006-10-01

    The so-called new genetics is widely predicted to radically transform medicine and public health and deliver considerable benefits in the future. This article argues that, although it is doubtful that many of the promised benefits of genetic research will be delivered, an increasingly pervasive genetic worldview and expectations about future genetic innovations are profoundly shaping conceptions of health and illness and priorities in healthcare. Further, it suggests that debates about the normative and justice implications of new genetic technologies thus far have been constrained by bioethics discourse, which has tended to frame questions narrowly in terms of how best to ensure the protection and promotion of the rights and freedoms of the individual. Sociologists and other social scientists can help broaden debate in this field by exposing the assumptions underlying the genetic conception of health and exploring the implications of associated developments. PMID:16973682

  6. Disclosure of Financial Conflicts of Interests in Interventions to Improve Child Psychosocial Health: A Cross-Sectional Study.

    PubMed

    Eisner, Manuel; Humphreys, David K; Wilson, Philip; Gardner, Frances

    2015-01-01

    Academic journals increasingly request a full disclosure of financial conflict of interest (CoI). The Committee for Publication Ethics provides editors with guidance about the course of action in the case of suspected non-disclosure. No prior study has examined the extent to which journal articles on psychosocial interventions disclose CoI, and how journal editors process requests to examine suspected undisclosed CoI. Four internationally disseminated psychosocial interventions were examined. 136 articles related to an intervention, co-authored by intervention developers and published in health sciences journals were retrieved as requiring a CoI statement. Two editors refused consent to be included in the study. COI disclosures and editor responses were coded for 134 articles. Overall, 92/134 (71%) of all articles were found to have absent, incomplete or partly misleading CoI disclosures. Disclosure rates for the four programs varied significantly between 11% and 73%. Journal editors were contacted about 92 published articles with no CoI disclosure or a disclosure that was considered problematic. In 65/92 (71%) of all cases the editors published an 'erratum' or 'corrigendum'. In 16 of these cases the journal had mishandled a submitted disclosure. The most frequent reason for non-publication of an erratum was that the journal had no disclosure policy at the time of the publication (16 cases). Consumers of research on psychosocial interventions published in peer-reviewed journals cannot currently assume that CoI disclosures are adequate and complete. More efforts are needed to achieve transparency. PMID:26606667

  7. Disclosure of Financial Conflicts of Interests in Interventions to Improve Child Psychosocial Health: A Cross-Sectional Study

    PubMed Central

    Eisner, Manuel; Humphreys, David K.; Wilson, Philip; Gardner, Frances

    2015-01-01

    Academic journals increasingly request a full disclosure of financial conflict of interest (CoI). The Committee for Publication Ethics provides editors with guidance about the course of action in the case of suspected non-disclosure. No prior study has examined the extent to which journal articles on psychosocial interventions disclose CoI, and how journal editors process requests to examine suspected undisclosed CoI. Four internationally disseminated psychosocial interventions were examined. 136 articles related to an intervention, co-authored by intervention developers and published in health sciences journals were retrieved as requiring a CoI statement. Two editors refused consent to be included in the study. COI disclosures and editor responses were coded for 134 articles. Overall, 92/134 (71%) of all articles were found to have absent, incomplete or partly misleading CoI disclosures. Disclosure rates for the four programs varied significantly between 11% and 73%. Journal editors were contacted about 92 published articles with no CoI disclosure or a disclosure that was considered problematic. In 65/92 (71%) of all cases the editors published an ‘erratum’ or ‘corrigendum’. In 16 of these cases the journal had mishandled a submitted disclosure. The most frequent reason for non-publication of an erratum was that the journal had no disclosure policy at the time of the publication (16 cases). Consumers of research on psychosocial interventions published in peer-reviewed journals cannot currently assume that CoI disclosures are adequate and complete. More efforts are needed to achieve transparency. PMID:26606667

  8. [Health, death, illness, and nursing care concepts in Malagasi Antemoro Tribe].

    PubMed

    Gradellini, Martina; Fiaccadori, Cianzia

    2010-01-01

    A collaboration experience with the Fondation Médical d'Ampasimanjeva nurses, in an international cooperation project,permits to analyse the basic nursing concepts, starting from the local cultural approach. Research main outcome is to describe health, death, illness, and nursing care concepts in the Malgasi Antemoro tribe. Closing to the ethnographic research, work has been developed in three different moments: a first job organization starting from a spread literature analysis, the follow work on field about collecting data, and the last data elaboration and discussion Collecting data tool was the focus group which has done with the complete hospital nursing staff, divided by ward places. A fourth one was addressed to a twenty medical patients group. Focus group questions came from the Rising Sun Model guide, by Madeleine Leininger, adapted to the research own needs. Outcomes show an important traditional medicine influence, explained by the way people conceive health, illness, and even life, all elements directly affected the nursing care. It stands out a strong belief that health depends by the ability of person to work. The death concept is saw as a passage's phase to the Razana's spiritual condition. This is the reason supporting fatalism as approach to the death, that appear as an inevitable event managed by God. Disease's concept is related to traditional healers; as a matter of facts, it exists a strong belief that diseases find origin from magician. PMID:20943096

  9. Coming home to Hume: a sociobiological foundation for a concept of 'health' and morality.

    PubMed

    Schaffner, K F

    1999-08-01

    Assessing the normative status of concepts of health and disease involves one in questions regarding the relationship between fact and value. Some have argued that Christopher Boorse's conception of health and disease lacks such a valuational element because it cannot account for types of harms which, while disvalued, do not have evolutionarily dysfunctional consequences. I take Boorse's account and incorporate some Humean-like sociobiological assumptions in order to respond to this challenge. The possession of moral sentiments, I argue, offers an evolutionary advantage (thus falling within Boorse's definition of normal functional abilities). However, this does not amount to emotivism: on the contrary, these sentiments can be the basis of a value system. This value structure introduces the concept of sympathizing with a fellow being's suffering as the basis of a normative dimension to disease. For example, it holds the disvalue of disease to lie in the fact that disease involves suffering and functional limitations. The naturalistic Humean type of account presented here thus jumps the normative-descriptive divide. When Boorse's account is extended to include social sentiments and behaviors, a conception of health emerges which is broader than Boorse's or Kass's, but narrower than the WHO's. PMID:10517299

  10. Post-conflict mental health needs: a cross-sectional survey of trauma, depression and associated factors in Juba, Southern Sudan

    PubMed Central

    Roberts, Bayard; Damundu, Eliaba Yona; Lomoro, Olivia; Sondorp, Egbert

    2009-01-01

    Background The signing of the Comprehensive Peace Agreement in January 2005 marked the end of the civil conflict in Sudan lasting over 20 years. The conflict was characterised by widespread violence and large-scale forced migration. Mental health is recognised as a key public health issue for conflict-affected populations. Studies revealed high levels of post-traumatic stress disorder (PTSD) amongst populations from Southern Sudan during the conflict. However, no studies have been conducted on mental health in post-war Southern Sudan. The objective of this study was to measure PTSD and depression in the population in the town of Juba in Southern Sudan; and to investigate the association ofdemographic, displacement, and past and recent trauma exposure variables, on the outcomes of PTSD and depression. Methods A cross-sectional, random cluster survey with a sample of 1242 adults (aged over 18 years) was conducted in November 2007 in the town of Juba, the capital of Southern Sudan. Levels of exposure to traumatic events and PTSD were measured using the Harvard Trauma Questionnaire (original version), and levels of depression measured using the Hopkins Symptom Checklist-25. Multivariate logistic regression was used to analyse the association ofdemographic, displacement and trauma exposure variables on the outcomes of PTSD and depression. Multivariate logistic regression was also conducted to investigate which demographic and displacement variables were associated with exposure to traumatic events. Results Over one third (36%) of respondents met symptom criteria for PTSD and half (50%) of respondents met symptom criteria for depression. The multivariate logistic regression analysis showed strong associations of gender, marital status, forced displacement, and trauma exposure with outcomes of PTSD and depression. Men, IDPs, and refugees and persons displaced more than once were all significantly more likely to have experienced eight or more traumatic events. Conclusion

  11. Using quantitative and qualitative data in health services research – what happens when mixed method findings conflict? [ISRCTN61522618

    PubMed Central

    Moffatt, Suzanne; White, Martin; Mackintosh, Joan; Howel, Denise

    2006-01-01

    Background In this methodological paper we document the interpretation of a mixed methods study and outline an approach to dealing with apparent discrepancies between qualitative and quantitative research data in a pilot study evaluating whether welfare rights advice has an impact on health and social outcomes among a population aged 60 and over. Methods Quantitative and qualitative data were collected contemporaneously. Quantitative data were collected from 126 men and women aged over 60 within a randomised controlled trial. Participants received a full welfare benefits assessment which successfully identified additional financial and non-financial resources for 60% of them. A range of demographic, health and social outcome measures were assessed at baseline, 6, 12 and 24 month follow up. Qualitative data were collected from a sub-sample of 25 participants purposively selected to take part in individual interviews to examine the perceived impact of welfare rights advice. Results Separate analysis of the quantitative and qualitative data revealed discrepant findings. The quantitative data showed little evidence of significant differences of a size that would be of practical or clinical interest, suggesting that the intervention had no impact on these outcome measures. The qualitative data suggested wide-ranging impacts, indicating that the intervention had a positive effect. Six ways of further exploring these data were considered: (i) treating the methods as fundamentally different; (ii) exploring the methodological rigour of each component; (iii) exploring dataset comparability; (iv) collecting further data and making further comparisons; (v) exploring the process of the intervention; and (vi) exploring whether the outcomes of the two components match. Conclusion The study demonstrates how using mixed methods can lead to different and sometimes conflicting accounts and, using this six step approach, how such discrepancies can be harnessed to interrogate each

  12. Unravelling the concept of consumer preference: implications for health policy and optimal planning in primary care.

    PubMed

    Foster, Michele M; Earl, Peter E; Haines, Terry P; Mitchell, Geoffrey K

    2010-10-01

    Accounting for consumer preference in health policy and delivery system design makes good economic sense since this is linked to outcomes, quality of care and cost control. Probability trade-off methods are commonly used in policy evaluation, marketing and economics. Increasingly applied to health matters, the trade-off preference model has indicated that consumers of health care discriminate between different attributes of care. However, the complexities of the health decision-making environment raise questions about the inherent assumptions concerning choice and decision-making behavior which frame this view of consumer preference. In this article, we use the example of primary care in Australia as a vehicle to examine the concept of 'consumer preference' from different perspectives within economics and discuss the significance of how we model preferences for health policy makers. In doing so, we question whether mainstream thinking, namely that consumers are capable of deliberating between rival strategies and are willing to make trade-offs, is a reliable way of thinking about preferences given the complexities of the health decision-making environment. Alternative perspectives on preference can assist health policy makers and health providers by generating more precise information about the important attributes of care that are likely to enhance consumer engagement and optimise acceptability of health care. PMID:20466449

  13. The association between armed conflict, violence and mental health: a cross sectional study comparing two populations in Cundinamarca department, Colombia

    PubMed Central

    2012-01-01

    Background Exposure to violence in general and to armed conflict in particular has been consistently associated with an increased prevalence of mental illness. Colombia has sustained an internal armed conflict for decades and is considered one of the most violent countries in the world. However, certain areas have been more exposed to the conflict than others. Methods This is a cross sectional study comparing two communities from different villages in the department of Cundinamarca, Colombia. One, Guasca, was directly impacted by armed conflict. The other one; Guatavita has never been affected by armed conflict. We applied two different instruments: the PHQ scale and a short standardized interview in order to estimate the prevalence of major psychiatric disorders and their link to violent events. Forty-two volunteers from each village were evaluated through a personal interview using these two instruments. Findings Of the population surveyed in Guatavita, 2.4% reported direct exposure to violence compared to 23.8% from Guasca. In the population exposed directly to violent events, the prevalence of all disorders was greater than in the non-exposed population with an OR of 1.46 (95% CI 0.3809 - 5.5989) for anxiety; 4.54 (95% CI 1.1098 - 18.5984) for depression; 6.0 (95% CI 1.2298 - 30.2263) for somatization disorder; and 4.4 (95% CI 1.2037 - 16.0842) for alcohol abuse. Interpretation There is a statistically significant association between the history of armed conflict, violence and the presence of mental illnesses, particularly depression, somatization disorder and alcohol abuse. Special attention should be paid to the detection, prevention and treatment of these disorders when dealing with populations exposed to violence and to armed conflict in particular. PMID:23244206

  14. [The concept of social marketing--potential and limitations for health promotion and prevention in Germany].

    PubMed

    Loss, J; Lang, K; Ultsch, S; Eichhorn, C; Nagel, E

    2006-07-01

    "Social marketing" is the use of marketing principles to design and implement programmes to promote socially beneficial behaviour changes. In the field of health promotion and prevention, the systematic planning process of social marketing can offer new ideas and perspectives to the traditions of social science. Major characteristics of social marketing encompass continuous market research focussing on attitudes, motives and behavioural patterns of the target group, an integrated mix of strategic key elements, and the perpetual evaluation of all procedures. So far, however, it is unclear in how far social marketing is actually more effective than other concepts of programme planning. Furthermore, it has to be discussed whether the underlying philosophy of social marketing and its implicit understanding of relationships to the public are reconcilable with health promotion principles. In Anglo-Saxon countries, the social marketing concept has achieved widespread application and is subject to controversial scientific discussions, whereas this approach is hardly considered in German health promotion research and practice. Given the increasing call for quality management and evaluation of health promotion interventions, the social marketing concept may contribute useful insights at an operational level and thus add to a discussion on effective approaches for programme planning. PMID:16868866

  15. A formal concept analysis and semantic query expansion cooperation to refine health outcomes of interest

    PubMed Central

    2015-01-01

    Background Electronic Health Records (EHRs) are frequently used by clinicians and researchers to search for, extract, and analyze groups of patients by defining Health Outcome of Interests (HOI). The definition of an HOI is generally considered a complex and time consuming task for health care professionals. Methods In our clinical note-based pharmacovigilance research, we often operate upon potentially hundreds of ontologies at once, expand query inputs, and we also increase the search space over clinical text as well as structured data. Such a method implies to specify an initial set of seed concepts, which are based on concept unique identifiers. This paper presents a novel method based on Formal Concept Analysis (FCA) and Semantic Query Expansion (SQE) to assist the end-user in defining their seed queries and in refining the expanded search space that it encompasses. Results We evaluate our method over a gold-standard corpus from the 2008 i2b2 Obesity Challenge. This experimentation emphasizes positive results for sensitivity and specificity measures. Our new approach provides better recall with high precision of the obtained results. The most promising aspect of this approach consists in the discovery of positive results not present our Obesity NLP reference set. Conclusions Together with a Web graphical user interface, our FCA and SQE cooperation end up being an efficient approach for refining health outcome of interest using plain terms. We consider that this approach can be extended to support other domains such as cohort building tools. PMID:26043839

  16. [The role of health education in promotion of health-related fitness concept].

    PubMed

    Brudecki, Janusz

    2010-01-01

    One of the most important objectives of health education is to shape the habits of attention to positive physical health, which determines the low risk of health problems, particularly in later life. Therefore, an important indicator of correct pro-health behaviors is to maintain an appropriate ratio between body weight and height, as well as maintaining fat distribution indices (BMI, WHR) at the appropriate level. Aim of this paper is to attempt a synthetic view of the health-related fineness--its development, and maintenance level for life in the context of the objectives of health education. The results of children and adolescents and the population of adult males from Cracow indicate that the percentage of children with elevated values of the fat distribution indices (BMI, WHR) between 8 and 19 years is systematically reduced in relation to international standards. At the same time in the adult male population dramatically increased to almost 50% in the group of men after the age of 50. This implies that educational activities related to the promotion of healthy lifestyle and maintain appropriate physical activity can not be finished at the stage of school education, but must also continue at a later date. PMID:21446123

  17. Conceptions of Mental Illness: Attitudes of Mental Health Professionals and the General Public

    PubMed Central

    Stuber, Jennifer P.; Rocha, Anita; Christian, Ann; Link, Bruce G.

    2014-01-01

    Objectives The authors compared attitudes of the U.S. general public and of mental health professionals about the competence and perceived dangerousness of people with mental health problems and the desire for social distance from them. Factors related to negative attitudes and the desire for social distance also were examined. Methods Vignettes describing individuals meeting DSM-IV criteria for major depression and schizophrenia were included in the 2006 General Social Survey (GSS) and a 2009 study of mental health professionals, and responses were descriptively compared (GSS, N=397 responses to depression vignette, N=373 responses to schizophrenia vignette; 731 mental health professionals responded to both vignettes). Regression analyses examined whether demographic and provider characteristics were associated with perceptions of less competence and perceived dangerousness of the vignette character and with respondents’ desire for social distance. Results Compared with the American public, mental health professionals had significantly more positive attitudes toward people with mental health problems. However, some providers’ conceptions about the dangerousness of people with schizophrenia and provider desire for social distance from clients in work and personal situations were concerning. Younger age, self-identifying as non-Hispanic white, being female, having at least a four-year college degree, being familiar with mental illness, and certain job titles and more years of experience in the mental health field were predictive of more positive conceptions. Conclusions Although mental health professionals held more positive attitudes than the general public about people with mental health problems, strong stereotypes persisted in both groups, especially concerning schizophrenia. This study identified several demographic and provider characteristics that can inform intervention strategies in both groups. PMID:24430508

  18. The influence of demographic characteristics, living conditions, and trauma exposure on the overall health of a conflict-affected population in Southern Sudan

    PubMed Central

    2010-01-01

    Background There remains limited evidence on how armed conflict affects overall physical and mental well-being rather than specific physical or mental health conditions. The aim of this study was to investigate the influence of demographic characteristics, living conditions, and violent and traumatic events on general physical and mental health in Southern Sudan which is emerging from 20 years of armed conflict. Methods A cross-sectional survey of 1228 adults was conducted in November 2007 in the town of Juba, the capital of Southern Sudan. Multivariate linear regression analysis was used to investigate the associations and relative influence of variables in three models of demographic characteristics, living conditions, and trauma exposure, on general physical and mental health status. These models were run separately and also as a combined model. Data quality and the internal consistency of the health status instrument (SF-8) were assessed. Results The variables in the multivariate analysis (combined model) with negative coefficients of association with general physical health and mental health (i.e. worse health), respectively, were being female (coef. -2.47; -2.63), higher age (coef.-0.16; -0.17), absence of soap in the household (physical health coef. -2.24), and experiencing within the past 12 months a lack of food and/or water (coef. -1.46; -2.27) and lack of medical care (coef.-3.51; -3.17). A number of trauma variables and cumulative exposure to trauma showed an association with physical and mental health (see main text for data). There was limited variance in results when each of the three models were run separately and when they were combined, suggesting the pervasive influence of these variables. The SF-8 showed good data quality and internal consistency. Conclusions This study provides evidence on the pervasive influence of demographic characteristics, living conditions, and violent and traumatic events on the general physical and mental health of a

  19. [Medications and financing of health systems in Third World countries. Cost recovery: a concept to review].

    PubMed

    Velasquez, G

    1989-01-01

    During the 1960s most African countries declared that health care would be free in their newly independent countries. Unfortunately, the health care systems inherited from colonial days were hospital based and emphasized curative rather than preventive care, and were too expensive for most countries to maintain. As the quality and availability of health services have deteriorated, the concept of free care has been questioned. At the same time, the number of countries involved in programs of structural adjustment imposed by the International Monetary Fund has grown steadily since the early 1980s, and some countries have drastically restricted public expenditures for health care. IN the search for new sources of financing, the concept of recovery of costs has become prominent. Various attempts have been made to "recover costs" even before the costs have been assessed. Financing of health care by governments, besides being insufficient, has impeded analysis of health care costs in most African countries. The World Bank proposes that the price of each medical product or service should be equal to the cost of providing it. UNICEF proposals stress the need to rationalize expenses and to defend vulnerable population groups during application of adjustment measures. The World Health Organization approach is geared toward attaining the objective of health for all by the year 2000. The basic question is still how to finance quality health care with reasonable participation of users without impeding access of the population to needed health services. An objective of 100% cost recovery will seriously compromise access for the large number of persons without purchasing power to pay the real price of health care. The term "recovery of costs" is inappropriate; the problem is to achieve a balance between participation of the population and government resources for the health system. Health services are not completely self-financing in any developed country and it appears

  20. Conflict Activity Cards. Grades 9-12.

    ERIC Educational Resources Information Center

    Webb, Farren; Thomas, Cynthia; Bohan, Bridget; O'Hotto, Twila

    These activity cards represent a way for teachers to supplement the content of the curriculum with activities that address the concept of conflict. Students become aware of conflicts in their lives and discover individual methods for coping with those conflicts. The cards contain action-oriented activities to enable students to learn through…

  1. [Using the health literacy concept to promote self-management in a chronic kidney disease patient].

    PubMed

    Sun, Jia-Hui; Lin, Chiu-Chu

    2014-02-01

    Patients with chronic kidney disease (CKD) must learn and use self-management skills to control their disease and delay disease progression. Comprehension of instructions is thus critical to integrating self-management principles into daily life. In this case report, the client had difficulty implementing the behavioral changes necessary to control diet and blood sugar due to the lack of proper and sufficient information. The authors applied health literacy concepts to assess the client's knowledge and skills related to disease control and then provided health teaching at a level appropriate to the client's health literacy level. This individualized care enhanced the client's confidence and motivation to implement self-care activities. Healthcare professionals should help patients overcome barriers to reading and verbal communication to help low-health-literacy patients successfully self-manage their chronic disease. Clients may thus learn to report their symptoms clearly and accurately. PMID:24519350

  2. What Causes Environmental Inequalities and Related Health Effects? An Analysis of Evolving Concepts

    PubMed Central

    Kruize, Hanneke; Droomers, Mariël; van Kamp, Irene; Ruijsbroek, Annemarie

    2014-01-01

    Early environmental justice studies were exposure-oriented, lacked an integrated approach, and did not address the health impact of environmental inequalities. A coherent conceptual framework, needed to understand and tackle environmental inequalities and the related health effects, was lacking. We analyzed the more recent environmental justice literature to find out how conceptual insights have evolved. The conceptual framework of the WHO Commission on Social Determinants of Health (CSDH) was analyzed for additional explanations for environmental inequalities and the related health effects. This paper points out that recent environmental justice studies have broadened their scope by incorporating a broader set of physical and social environmental indicators, and by focusing on different geographic levels and on health impacts of environmental inequalities. The CSDH framework provided additional elements such as the role of structural determinants, the role of health-related behavior in relation to the physical and social environment, access to health care, as well as the life course perspective. Incorporating elements of the CSDH framework into existing environmental justice concepts, and performing more empirical research on the interactions between the different determinants at different geographical levels would further improve our understanding of environmental inequalities and their health effects and offer new opportunities for policy action. PMID:24886752

  3. On the concept of a socialist health system: a question of Marxist epistemology.

    PubMed

    Segall, M

    1983-01-01

    This paper concerns the best approach to the concept of a socialist health system. It first criticizes a narrow empiricism, which reduces the subject to a phenomenalistic study of existing health systems in socialist countries, paying insufficient attention to historical contexts and developments and to the worldwide evolution of socialist ideas. Such a rightist empiricism, separating practice from theory, is then contrasted with a leftist idealism, which separates theory from practice. The latter approach entails abstract models of an ideal socialist health system with many characteristics, without specifying which are the necessary and sufficient ones for applying the global designation "socialist." This leads to epistemological confusion and a deterministic view of the relation of the social formation to the health system, which is in fact complex. A socialist health system is best seen as an aspect of socialist theory rather than as an actual social entity. Viewed this way, it can act as a continuing guide to social practice and be enriched by that practice. Taking an appropriate class standpoint, socialist health theory should relate to social factors in the causation of disease and in the capacity of peoples to undertake health-related activities and to the social control of health care services and related industries. PMID:6853001

  4. Integrating health education and physical activity programming for cardiovascular health promotion among female inmates: A proof of concept study.

    PubMed

    Nair, Uma S; Jordan, Jeremy S; Funk, Daniel; Gavin, Kristin; Tibbetts, Erica; Collins, Bradley N

    2016-05-01

    Female inmate populations in the United States tend to be overweight, physically inactive, experience high stress, and have a history of nicotine and other drug dependence. Thus, they bear an elevated risk of cardiovascular (CV) disease than the general population. However, few evidence-based health interventions exist for this population. This study will test proof of concept, feasibility, and potential efficacy of a multiple health behavior change intervention that integrates CV-health promotion education delivered during a physical activity (PA) program (indoor cycling) tailored to this population. This study uses a quasi-experimental 2-group design with two measurement time-points: baseline and 8-week end of treatment. N=120 incarcerated women (18-59years of age) who are medically cleared for participation in PA will be enrolled. Indoor cycling instructors will be trained to deliver five health education topics over an 8-week period during twice-weekly cycling classes. Topics match the American Heart Association recommendations for CV health: (a) nutrition, (b) PA promotion, (c) weight management, (d) stress management, and (e) smoking cessation and relapse prevention. Modes of intervention include instructor advice, written materials and audio/video clips reviewed during class. CV-related and mental health measures will be assessed at both time-points. Results will guide a full scale efficacy study. Future research in this area has potential to impact the health of female inmates, a high-risk population. Moreover, this multiple health behavior change intervention model represents a community approach to health promotion that could generalize to other underserved populations who may benefit most from similar intervention efforts. PMID:27020419

  5. [Regional integration, population health needs, and human resources for health systems and services: an approach to the concept of health care gap].

    PubMed

    Schweiger, Arturo Luis Francisco; Alvarez, Daniela Teresita

    2007-01-01

    The existence of gaps between the population's health needs and the human resources available for meeting them, as well as limitations in the methods to estimate such needs, constitute key factors to be tackled in the development and integration of health systems in Latin America. This aim of this study was to conduct an initial literature review on the tools and procedures used to estimate and plan human resources allocation in health and to use this review as the basis for identifying the advantages, limitations, and complementary characteristics of these tools, subsequently proposing the need for more in-depth studies on their applicability for designing regional health policies. The article then presents the concept of global public health goods, the generation and use of which results in a strategic alternative for improving both health systems integration in the region and quality of life for the population covered by such services. PMID:17625647

  6. 45 CFR 73.735-903 - Action if conflicts of interest or possible conflicts are noted.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Action if conflicts of interest or possible conflicts are noted. 73.735-903 Section 73.735-903 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION STANDARDS OF CONDUCT Reporting Financial Interests § 73.735-903 Action if conflicts of interest or possible conflicts are...

  7. [Developmental origins of adult health and disease: an important concept for social inequalities in health].

    PubMed

    Charles, M-A

    2013-08-01

    According to the theory of the developmental origins of adult health and disease, development in utero and in the first years of life are critical phases during which susceptibility to many chronic diseases is set. Diseases eventually occur only if the environment and lifestyle in later life is favorable. Exposure to chemicals (environmental or drug), to infectious agents, unbalanced nutrition, or psychosocial stress prenatally or in the first months/years of life are all factors which have been shown to impact long-term health of individuals. The consequences, however, are not limited to health. A demonstrative example was provided by the study of the influenza epidemic of 1918-1919 in the United States. Nationwide, it was estimated that the loss of income over a lifetime for individuals exposed during fetal life to this epidemic amounted to 14 billion dollars. This example demonstrates that an exposure during fetal life, which is not socially differentiated, may affect the social situation of individuals in adulthood. In many situations, it is much more difficult to separate the specific effect of a given exposure from the overall effect of the social environment. Indeed, it has been shown that socioeconomic status in childhood is associated with increased risk of mortality in adulthood, even after accounting for the socioeconomic status and risky behaviors in adulthood. Among the explanations, the theory of developmental origins of health credits of biological plausibility the model of critical periods early in which the individual is particularly vulnerable to certain exposures. Thus, ensuring the best conditions for the biological, physical, emotional and cognitive development of children in early life will enable them to reach their potential in terms of health and socioeconomic return to society. Investment in this period also brings the hope of reducing the perpetuation of social inequalities and health from generation to generation. PMID:23845205

  8. Trauma and mental health of medics in eastern Myanmar’s conflict zones: a cross-sectional and mixed methods investigation

    PubMed Central

    2013-01-01

    Background In conflict and disaster settings, medical personnel are exposed to psychological stressors that threaten their wellbeing and increase their risk of developing burnout, depression, anxiety, and PTSD. As lay medics frequently function as the primary health providers in these situations, their mental health is crucial to the delivery of services to afflicted populations. This study examines a population of community health workers in Karen State, eastern Myanmar to explore the manifestations of health providers’ psychological distress in a low-resource conflict environment. Methods Mental health screening surveys were administered to 74 medics, incorporating the 12-item general health questionnaire (GHQ-12) and the posttraumatic checklist for civilians (PCL-C). Semi-structured qualitative interviews were conducted with 30 medics to investigate local idioms of distress, sources of distress, and the support and management of medics’ stressors. Results The GHQ-12 mean was 10.7 (SD 5.0, range 0–23) and PCL-C mean was 36.2 (SD 9.7, range 17–69). There was fair internal consistency for the GHQ-12 and PCL-C (Cronbach’s alpha coeffecients 0.74 and 0.80, respectively) and significant correlation between the two scales (Pearson’s R-correlation 0.47, P<0.001). Qualitative results revealed abundant evidence of stressors, including perceived inadequacy of skills, transportation barriers, lack of medical resources, isolation from family communities, threats of military violence including landmine injury, and early life trauma resulting from conflict and displacement. Medics also discussed mechanisms to manage stressors, including peer support, group-based and individual forms of coping. Conclusions The results suggest significant sources and manifestations of mental distress among this under-studied population. The discrepancy between qualitative evidence of abundant stressors and the comparatively low symptom scores may suggest marked mental resilience

  9. [The effectiveness of community volunteers in counting populations and assessing their nutritional vulnerability during armed conflict: district health in D.R. Congo, Central Africa].

    PubMed

    Bisimwa, B G; Mambo, M T; Mitangala, N P; Schirvel, C; Porignon, D; Dramaix, W M; Donnen, P

    2009-01-01

    The study assessed the ability of community volunteers, working with district health officials, to conduct a local census to count the population in their villages and assess their nutritional vulnerability. The study involved organizing community volunteers in village nutrition committee and assigning them to count the village population in a Kivu rural health district (D.R.Congo) and assess their vulnerability in terms of nutrition. The study took place in March and April 2003, during armed conflict in the region. Community volunteers supervised by district health officials collected data, presented here as median proportions (with their Max and Min), by age category. The results show that community volunteers were able to conduct this census with reliable results. The population distribution by age category was similar to the national model from a survey by experts. The community volunteers estimated a median of 22.2 % (6.2-100 %) of households in each village in the eastern DR Congo were vulnerable and required foreign aid. Community volunteers can contribute accurately to the collection of demographic data to be used in health programme planning, thus allowing these data to be followed even during instability and armed conflicts. PMID:20031515

  10. The exposome concept: a challenge and a potential driver for environmental health research.

    PubMed

    Siroux, Valérie; Agier, Lydiane; Slama, Rémy

    2016-06-01

    The exposome concept was defined in 2005 as encompassing all environmental exposures from conception onwards, as a new strategy to evidence environmental disease risk factors. Although very appealing, the exposome concept is challenging in many respects. In terms of assessment, several hundreds of time-varying exposures need to be considered, but increasing the number of exposures assessed should not be done at the cost of increased exposure misclassification. Accurately assessing the exposome currently requires numerous measurements, which rely on different technologies; resulting in an expensive set of protocols. In the future, high-throughput 'omics technologies may be a promising technique to integrate a wide range of exposures from a small numbers of biological matrices. Assessing the association between many exposures and health raises statistical challenges. Due to the correlation structure of the exposome, existing statistical methods cannot fully and efficiently untangle the exposures truly affecting the health outcome from correlated exposures. Other statistical challenges relate to accounting for exposure misclassification or identifying synergistic effects between exposures. On-going exposome projects are trying to overcome technical and statistical challenges. From a public health perspective, a better understanding of the environmental risk factors should open the way to improved prevention strategies. PMID:27246588

  11. 42 CFR 421.312 - Conflict of interest resolution.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Conflict of interest resolution. 421.312 Section... Conflict of interest resolution. (a) Review Board. CMS may establish and convene a Conflicts of Interest...) Resolution—(1) Pre-award conflicts. Resolution of an organizational conflict of interest is a...

  12. Advancing One Health Policy and Implementation Through the Concept of One Medicine One Science

    PubMed Central

    Cardona, Carol; Travis, Dominic A.; Berger, Kavita; Coat, Gwenaële; Kennedy, Shaun; Steer, Clifford J.; Murtaugh, Michael P.

    2015-01-01

    Numerous interspecies disease transmission events, Ebola virus being a recent and cogent example, highlight the complex interactions between human, animal, and environmental health and the importance of addressing medicine and health in a comprehensive scientific manner. The diversity of information gained from the natural, social, behavioral, and systems sciences is critical to developing and sustainably promoting integrated health approaches that can be implemented at the local, national, and international levels to meet grand challenges. The Concept of One Medicine One Science (COMOS) as outlined herein describes the interplay between scientific knowledge that underpins health and medicine and efforts toward stabilizing local systems using 2 linked case studies: the food system and emerging infectious disease. Forums such as the International Conference of One Medicine One Science (iCOMOS), where science and policy can be debated together, missing pieces identified, and science-based collaborations formed among industry, governmental, and nongovernmental policy makers and funders, is an essential step in addressing global health. The expertise of multiple disciplines and research foci to support policy development is critical to the implementation of one health and the successful achievement of global health security goals. PMID:26421234

  13. The Concept of Sasang Health Index and Constitution-Based Health Assessment: An Integrative Model with Computerized Four Diagnosis Methods

    PubMed Central

    Kim, Jaeuk U.; Ku, Boncho; Kim, Young-Min; Do, Jun-Hyeong; Jang, Eunsu; Jeon, Young Ju; Kim, Keun Ho; Kim, Jong Yeol

    2013-01-01

    Sasang constitutional medicine (SCM) shares its philosophy with that of personalized medicine: it provides constitution-specific treatment and healthcare individualized for each patient. In this work, we propose the concept of the Sasang Health Index (SHI) as an attempt to assess the individualized health status in the framework of SCM. From the target population of females in their fifties and older, we recruited 298 subjects and collected their physiological data, including complexion, radial pulse, and voice, and their questionnaire responses. The health status of each subject was evaluated by two Korean medical doctors independently, and the SHI model was obtained by combining all the integrative features of the phenotype data using a regression technique. As a result, most subjects belonged to either the healthy, subhealthy, or slightly diseased group, and the intraclass correlation coefficient between the two doctors' health scoring reached 0.95. We obtained an SHI model for each constitution type with adjusted R-squares of 0.50, 0.56, and 0.30, for the TE, SE, and SY constitution types, respectively. In the proposed SHI model, the significant characteristics used in the health assessment consisted of constitution-specific features in accordance with the classic literature and features common to all the constitution types. PMID:23843888

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

    PubMed

    Blanchet, Karl

    2015-05-01

    International health is still highly dominated by equilibrium approaches. The emergence of systems thinking in international health provides a great avenue to develop innovative health interventions adapted to changing contexts. The public health community, nevertheless, has the responsibility to translate concepts related to systems thinking and complexity into concrete research methods and interventions. One possibility is to consider the properties of systems such as resilience and adaptability as entry points to better understand how health systems react to shocks. PMID:25905481

  15. Diarrheal illnesses on the Ecuadorian coast: socio-environmental changes and health concepts

    PubMed Central

    Trostle, James A.; Yépez-Montufar, Jeanneth Alexandra; Corozo-Angulo, Betty; Rodríguez, Marylin

    2013-01-01

    The authors present an ethnoepidemiological study of diarrheal illnesses in 21 communities on the northern coast of Ecuador, where numerous social and environmental changes have taken place since 2001 due to a new highway. As communities realize that nature itself is changing, changes occur in their interpretations of health and disease, which the authors present through a taxonomic classification of diarrheal illnesses. Given the high incidence of diarrheal diseases, alternative concepts have emerged (as compared to those of biomedicine) in relation to causes, symptoms, and treatments. The non-biomedical and biomedical systems overlap, with mixtures of coexistence and resistance. Recognizing this reality means understanding a series of challenges for the official health system, including the indiscriminate use of antibiotics, non-use of health services for some diseases, and perceived relations between environmental contamination and the efficacy of modern and traditional medicines. PMID:20694359

  16. Chemical Pesticides and Human Health: The Urgent Need for a New Concept in Agriculture.

    PubMed

    Nicolopoulou-Stamati, Polyxeni; Maipas, Sotirios; Kotampasi, Chrysanthi; Stamatis, Panagiotis; Hens, Luc

    2016-01-01

    The industrialization of the agricultural sector has increased the chemical burden on natural ecosystems. Pesticides are agrochemicals used in agricultural lands, public health programs, and urban green areas in order to protect plants and humans from various diseases. However, due to their known ability to cause a large number of negative health and environmental effects, their side effects can be an important environmental health risk factor. The urgent need for a more sustainable and ecological approach has produced many innovative ideas, among them agriculture reforms and food production implementing sustainable practice evolving to food sovereignty. It is more obvious than ever that the society needs the implementation of a new agricultural concept regarding food production, which is safer for man and the environment, and to this end, steps such as the declaration of Nyéléni have been taken. PMID:27486573

  17. Chemical Pesticides and Human Health: The Urgent Need for a New Concept in Agriculture

    PubMed Central

    Nicolopoulou-Stamati, Polyxeni; Maipas, Sotirios; Kotampasi, Chrysanthi; Stamatis, Panagiotis; Hens, Luc

    2016-01-01

    The industrialization of the agricultural sector has increased the chemical burden on natural ecosystems. Pesticides are agrochemicals used in agricultural lands, public health programs, and urban green areas in order to protect plants and humans from various diseases. However, due to their known ability to cause a large number of negative health and environmental effects, their side effects can be an important environmental health risk factor. The urgent need for a more sustainable and ecological approach has produced many innovative ideas, among them agriculture reforms and food production implementing sustainable practice evolving to food sovereignty. It is more obvious than ever that the society needs the implementation of a new agricultural concept regarding food production, which is safer for man and the environment, and to this end, steps such as the declaration of Nyéléni have been taken. PMID:27486573

  18. Adjustment of Siblings of Children with Mental Health Problems: Behaviour, Self-Concept, Quality of Life and Family Functioning

    ERIC Educational Resources Information Center

    Barnett, R. A.; Hunter, M.

    2012-01-01

    This study examined the adjustment of siblings of children with mental health problems. The participants had brothers or sisters receiving treatment at a Child and Adolescent Mental Health Service within the Hunter New England Health Service, New South Wales, Australia. Seventy-five siblings completed questionnaires on their self-concept, quality…

  19. Sexual and gender-based violence in areas of armed conflict: a systematic review of mental health and psychosocial support interventions

    PubMed Central

    2013-01-01

    Background Sexual and other forms of gender-based violence are common in conflict settings and are known risk factors for mental health and psychosocial wellbeing. We present findings from a systematic review of the academic and grey literature focused on the effectiveness of mental health and psychosocial support interventions for populations exposed to sexual and other forms of gender-based violence in the context of armed conflicts. Methods We searched the Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, PubMed/ Medline, psycINFO, and PILOTS, as well as grey literature to search for evaluations of interventions, without date limitations. Results Out of 5,684 returned records 189 full text papers were assessed for eligibility. Seven studies met inclusion criteria: 1 non-randomized controlled study; 3 non-controlled pre- post-test designs; 1 retrospective cohort with a matched comparison group; and 2 case studies. Studies were conducted in West and Central Africa; Albania; UK and USA, included female participants, and focused on individual and group counseling; combined psychological, medical, social and economic interventions; and cognitive behavioral therapy (two single case studies). Conclusions The seven studies, while very limited, tentatively suggest beneficial effects of mental health and psychosocial interventions for this population, and show feasibility of evaluation and implementation of such interventions in real-life settings through partnerships with humanitarian organizations. Robust conclusions on the effectiveness of particular approaches are not possible on the basis of current evidence. More rigorous research is urgently needed. PMID:23915821

  20. General practitioners' and district nurses' conceptions of the encounter with obese patients in primary health care

    PubMed Central

    2011-01-01

    Background Primary health care specialists have a key role in the management of obesity. Through understanding how they conceive the encounter with patients with obesity, treatment may be improved. The aim of this study was thus to explore general practitioners' and district nurses' conceptions of encountering patients with obesity in primary health care. Method Data were collected through semi-structured interviews, and analysed using a phenomenographic approach. The participants were 10 general practitioners (6 women, 4 men) and 10 district nurses (7 women, 3 men) from 19 primary health care centres within a well-defined area of Sweden. Results Five descriptive categories were identified: Adequate primary health care, Promoting lifestyle change, Need for competency, Adherence to new habits and Understanding patient attitudes. All participants, independent of gender and profession, were represented in the descriptive categories. Some profession and gender differences were, however, found in the underlying conceptions. The general staff view was that obesity had to be prioritised. However, there was also the contradictory view that obesity is not a disease and therefore not the responsibility of primary health care. Despite this, staff conceived it as important that patients were met with respect and that individual solutions were provided which could be adhered to step-by-step by the patient. Patient attitudes, such as motivation to change, evasive behaviour, too much trust in care and lack of self-confidence, were, however, conceived as major barriers to a fruitful encounter. Conclusions Findings from this study indicate that there is a need for development and organisation of weight management in primary health care. Raising awareness of staff's negative views of patient attitudes is important since it is likely that it affects the patient-staff relationship and staff's treatment efforts. More research is also needed on gender and profession differences in this

  1. Stakeholders understanding of the concept of benefit sharing in health research in Kenya: a qualitative study

    PubMed Central

    2011-01-01

    Background The concept of benefit sharing to enhance the social value of global health research in resource poor settings is now a key strategy for addressing moral issues of relevance to individuals, communities and host countries in resource poor settings when they participate in international collaborative health research. The influence of benefit sharing framework on the conduct of collaborative health research is for instance evidenced by the number of publications and research ethics guidelines that require prior engagement between stakeholders to determine the social value of research to the host communities. While such efforts as the production of international guidance on how to promote the social value of research through such strategies as benefit sharing have been made, the extent to which these ideas and guidelines have been absorbed by those engaged in global health research especially in resource poor settings remains unclear. We examine this awareness among stakeholders involved in health related research in Kenya. Methods We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups. Results Our study suggests that although people have a sense of justice and the moral aspects of research, this was not articulated in terms used in the literature and the guidelines on the ethics of global health research. Conclusion This study demonstrates that while in theory several efforts can be made to address the moral issues of concern to research participants and their communities in resource poor settings, quick fixes such as benefit sharing are not going to be straightforward. We suggest a need to pay closer attention to the processes through which ethical principles are enacted in

  2. [Evolution of the climate change concept and its impact in the public health of Peru].

    PubMed

    Sánchez Zavaleta, Carlos A

    2016-03-01

    The term "climate change" is not a new concept but its impact on public health is under constant review. We know that climate has already changed and will continue to change for centuries with the rise in average global temperature, and the associated rise in sea level. This fact makes mitigation efforts relevant only in the very long term and for generations of humans whose parents have not yet been born. When we talk about public health in the context of climate change, we are talking about adaptation. In the present, countries that are currently the most affected by climate change are precisely countries like Peru, without a significant carbon footprint at the global level but that are highly sensitive to the effects of climate. Without reliable climate projections, the health impact of climate change can be uncertain and complicated. Nevertheless, at the local level, every district can identify its vulnerabilities and define priorities to protect the health of its population. There are, and it can also be developed, environmental health indicators that can help monitor how well we are adapting and how prepared we are for changes in the climate. Adaptation to climate change implies improving living conditions, enhancing epidemiological surveillance systems and extending access to healthcare. The fight against the effects of climate change in public health is a fight against poverty and inequality, and that is nothing new in Peru. PMID:27384632

  3. Tools for integrating women's health into medical education: clinical cases and concept mapping.

    PubMed

    Weiss, L B; Levison, S P

    2000-11-01

    The authors describe two teaching tools, case-based learning and concept mapping, and how they support cross-disciplinary, multidisciplinary, and interdisciplinary learning, use a biopsychosocial model, and promote the integration of sex- and gender-based science into the medical curriculum. The process of case development at MCP Hahnemann University (MCPHU) is outlined in detail for a specific case. That case, which integrates three different components of women's health, is then presented in full. The authors then provide an example of a concept map dealing with women and alcohol use; the map defines current knowledge and serves as a blueprint for developing curricular goals and learning objectives for the topic. Properly constructed concept maps and cases help teach patient-centered approaches to problem solving, address sex- and gender-based differences in disease as well as in pathophysiology and pharmacology, integrate psychosocial issues-such as family dynamics, environmental stressors, access to health care, effective gender-based communication between patient and provider, and cultural variations-along with biomedical ones, and encourage a multidisciplinary approach to patient care. The authors maintain that these tools might be used to transform medical education by making it more integrated and interdisciplinary. PMID:11078666

  4. Conflicts about Conflict of Interest.

    PubMed

    Kelly, Terrence

    2016-07-01

    Pharmaceutical representatives use detailing, gift giving, and the donation of free samples as a means to gain access to and influence over physicians. In biomedical ethics, there has been an ongoing debate as to whether these practices constitute an unethical conflict of interest (COI) on the part of the physician. Underlying this debate are the following antecedent questions: (1) what counts as a conflict of interest, (2) when are such conflicts unethical, and (3) how should the ethical physician respond to conflicts? This article distinguishes between two perspectives that have been developed on these issues: a reliable performance model (PM) and a trustworthiness model (TM). PM advocates argue that a conflict of interest can only be established by demonstrating that a particular influence is undermining the reliability of the physician's judgment, and this requires empirical evidence of negative patient outcomes. TM advocates, on the other hand, argue that because of the fiduciary nature of the patient-physician relationship, physicians have an obligation to develop and be worthy of patient trust. A COI, on this view, is a condition that undermines the warrant for patients to judge a physician as trustworthy. Although there is much that is right in the PM, it is argued that the TM does a better job of responsibly addressing the unique vulnerabilities of the patient. The TM is then applied to the practices of detailing, gift giving, and sample donation. It is concluded that these practices constitute an unethical conflict of interest. PMID:27348838

  5. Contamination, misuse and abuse of the global oceans leading to ecosystem damage and destruction, health consequences and international conflict

    NASA Technical Reports Server (NTRS)

    1975-01-01

    Unregulated uses of the oceans may threaten the global ecological balance, alter plant and animal life and significantly impact the global climatic systems. Recent plans to locate large scale structures on the oceans and to exploit the mineral riches of the seas pose even greater risk to the ecological system. Finally, increasing use of the oceans for large scale transport greatly enhances the probability of collision, polluting spills and international conflict.

  6. A Concept of Operations for an Integrated Vehicle Health Assurance System

    NASA Technical Reports Server (NTRS)

    Hunter, Gary W.; Ross, Richard W.; Berger, David E.; Lekki, John D.; Mah, Robert W.; Perey, Danie F.; Schuet, Stefan R.; Simon, Donald L.; Smith, Stephen W.

    2013-01-01

    This document describes a Concept of Operations (ConOps) for an Integrated Vehicle Health Assurance System (IVHAS). This ConOps is associated with the Maintain Vehicle Safety (MVS) between Major Inspections Technical Challenge in the Vehicle Systems Safety Technologies (VSST) Project within NASA s Aviation Safety Program. In particular, this document seeks to describe an integrated system concept for vehicle health assurance that integrates ground-based inspection and repair information with in-flight measurement data for airframe, propulsion, and avionics subsystems. The MVS Technical Challenge intends to maintain vehicle safety between major inspections by developing and demonstrating new integrated health management and failure prevention technologies to assure the integrity of vehicle systems between major inspection intervals and maintain vehicle state awareness during flight. The approach provided by this ConOps is intended to help optimize technology selection and development, as well as allow the initial integration and demonstration of these subsystem technologies over the 5 year span of the VSST program, and serve as a guideline for developing IVHAS technologies under the Aviation Safety Program within the next 5 to 15 years. A long-term vision of IVHAS is provided to describe a basic roadmap for more intelligent and autonomous vehicle systems.

  7. Operationalizing the new concept of sexual and reproductive health in Indonesia.

    PubMed

    Ford, N J; Siregar, K N

    1998-03-01

    The new politics of family planning in the 1990s has involved the articulation of a comprehensive concept of sexual and reproductive health (SRH). Following the ratification of the SRH concept and goals at recent international conferences, one major issue is how governments translate the broad statements into operational policies and programs. The authors consider the ways in which the process is occurring in Indonesia, defining SRH, and reviewing the levels of its attainment in 8 of its components in Indonesia. The policy process in Indonesia is explored with regard to pre-existing reassessments, setting important priorities and moralistic and pragmatic policy orientations. The following SRH components are discussed: family planning, infertility, maternal and child health, HIV/AIDS, sexually transmitted diseases, adolescents' needs, sexual health, and gender issues. In terms of SRH, Indonesia has achieved considerable success in addressing family planning and infant and child mortality, limited success in addressing maternal mortality and HIV/AIDS, and very little progress in addressing STDs, adolescent needs, and positive sexuality. There are few data on gender issues. PMID:12293590

  8. Continual Screening of Patients Using mHealth: The Rolling Score Concept Applied to Sleep Medicine.

    PubMed

    Zluga, Claudio; Modre-Osprian, Robert; Kastner, Peter; Schreier, Günter

    2016-01-01

    Continual monitoring of patients utilizing mHealth-based telemonitoring applications are more and more used for individual management of patients. A new approach in risk assessment called Rolling Score Concept uses standardized questionnaires for continual scoring of individuals' health state through electronic patient reported outcome (ePRO). Using self-rated questionnaires and adding a specific Time Schedule to each question result in a movement of the questionnaires' scores over time, the Rolling Score. A text-processing pipeline was implemented with KNIME analytics platform to extract a Score Mapping Rule Set for three standardized screening questionnaires in the field of sleep medicine. A feasibility study was performed in 10 healthy volunteers equipped with a mHealth application on a smartphone and a sleep tracker. Results show that the proposed Rolling Score Concept is feasible and deviations of scores are in a reasonable range (< 7%), sustaining the new approach. However, further studies are required for verification. In addition, parameter quantification could avoid incorrect subjective evaluation by substitution of questions with sensor data. PMID:27139409

  9. TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo

    PubMed Central

    Kaboru, Berthollet Bwira; Ogwang, Brenda. A.; Namegabe, Edmond Ntabe; Mbasa, Ndemo; Kabunga, Deka Kambale; Karafuli, Kambale

    2013-01-01

    Background: HIV/AIDS and Tuberculosis (TB) are major contributors to the burden of disease in sub-Saharan Africa. The two diseases have been described as a harmful synergy as they are biologically and epidemiologically linked. Control of TB/HIV co-infection is an integral and most challenging part of both national TB and national HIV control programmes, especially in contexts of instability where health systems are suffering from political and social strife. This study aimed at assessing the provision of HIV/TB co-infection services in health facilities in the conflict-ridden region of Goma in Democratic Republic of Congo. Methods: A cross-sectional survey of health facilities that provide either HIV or TB services or both was carried out. A semi-structured questionnaire was used to collect the data which was analysed using descriptive statistics. Results: Eighty facilities were identified, of which 64 facilities were publicly owned. TB care was more available than HIV care (in 61% vs. 9% of facilities). Twenty-three facilities (29%) offered services to co-infected patients. TB/HIV co-infection rates among patients were unknown in 82% of the facilities. Only 19 facilities (24%) reported some coordination with and support from concerned diseases’ control programmes. HIV and TB services are largely fragmented, indicating imbalances and poor coordination by disease control programmes. Conclusion: HIV and TB control appear not to be the focus of health interventions in this crisis affected region, despite the high risks of TB and HIV infection in the setting. Comprehensive public health response to this setting calls for reforms that promote joint TB/HIV co-infection control, including improved leadership by the HIV programmes that accuse weaknesses in this conflict-ridden region. PMID:24596866

  10. Integration of primary health care concepts in a children's hospital with limited resources.

    PubMed

    Anh, N N; Tram, T T

    1995-08-12

    After nearly 30 years of war, health services in Vietnam were devastated. Pediatric Hospital Number 1 (PH1) in Ho Chi Minh City was severely overloaded, mortality rates for readily treatable diseases were high, and staff competence and motivation were low. In 1988, PH1 introduced primary health care (PHC) concepts into the policy of the hospital. The approach included identification of priority diseases that are most easily treatable (diarrhoea, acute respiratory infections, Dengue haemorrhagic fever, malnutrition, and common paediatric emergencies including malaria); establishment of training programmes through paediatric priority training units for medical staff of PH1 and health centres (district and commune services), and health education for the patients' carers; promotion of outpatient treatment to avoid unnecessary admissions; use of appropriate technology such as essential drugs and application of WHO guidelines; support for health centres; transfer of responsibility for decision-making from one central authority to each department; and community participation, by which we sought small contributions from families who could afford to pay. Since the new approach was implemented, the numbers of admissions have fallen substantially. Mortality rates have decreased greatly (diarrhoea by 80%, Dengue fever by 64%, and acute respiratory infections by 41%). Support from foreign non-governmental organisations has enabled training and research to enhance staff skill and knowledge and supply of necessary equipment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7623575

  11. Taking a value network from concept to reality: Canadian Health Leadership Network (a case study).

    PubMed

    Tholl, Bill

    2014-01-01

    This article describes, in a step-by-step way, how the value network concept has been put to work to increase leadership capacity through the Canadian Health Leadership Network (CHLNet). The three phases in evolving the network are described: startup, value creation, and consolidation phases. This is a case study that underscores the fact that networks are best facilitated rather than administered; that trust and reciprocity are the twin pillars for sustaining any network; and that leadership without ownership can be a driving force behind the success of a value network. PMID:25518145

  12. The concept of skin bleaching in Africa and its devastating health implications.

    PubMed

    de Souza, Melanie Miyanji

    2008-01-01

    Africa is considered a continent of mystery and intrigue with absurd concepts and beliefs. Cosmetic dermatology is no less intriguing than other issues. While quick judgement may be passed condemning attitudes and misconceptions in this field, we need to analyze factors that contribute to such ideas. Acquiring a lighter skin forms the basis of Skin Care and Cosmetology in dark skinned people. This regrettably has far reaching devastating effects on health and individual finances. This in return has enriched unscrupulous stake holders. Help from the international medical fraternity and the pharmaceutical/cosmetology industry is required to end this evil. PMID:18280901

  13. Proof-of-Concept Application of Impedance-Based Health Monitoring on Space Shuttle Ground Structures

    NASA Technical Reports Server (NTRS)

    Peairs, Daniel M.; Grisso, Benjamin; Inman, Daniel J.; Page, Kenneth R.; Athman, Robert; Margasahayam, Ravi N.

    2003-01-01

    Many of the structures responsible for the launch, ground systems and support operations of the space shuttle are still being used well past their nominal expected design life. This has led to an increased interest in monitoring these structures in order to decrease the risk of eventual breakdown or structural failure. One monitoring method, which has shown promising results for such applications, is the impedance-based structural health monitoring technique. This paper presents results from proof-of-concept tests on the launch pad's orbiter access arm bolted connection, solid rocket booster hold down post, mobile launch platform heat shield and crawler transporter bearing. Modification for future tests are suggested.

  14. Conflict Management: Difficult Conversations with Difficult People

    PubMed Central

    Overton, Amy R.; Lowry, Ann C.

    2013-01-01

    Conflict occurs frequently in any workplace; health care is not an exception. The negative consequences include dysfunctional team work, decreased patient satisfaction, and increased employee turnover. Research demonstrates that training in conflict resolution skills can result in improved teamwork, productivity, and patient and employee satisfaction. Strategies to address a disruptive physician, a particularly difficult conflict situation in healthcare, are addressed. PMID:24436688

  15. Conflict management: difficult conversations with difficult people.

    PubMed

    Overton, Amy R; Lowry, Ann C

    2013-12-01

    Conflict occurs frequently in any workplace; health care is not an exception. The negative consequences include dysfunctional team work, decreased patient satisfaction, and increased employee turnover. Research demonstrates that training in conflict resolution skills can result in improved teamwork, productivity, and patient and employee satisfaction. Strategies to address a disruptive physician, a particularly difficult conflict situation in healthcare, are addressed. PMID:24436688

  16. Exploring International Views on Key Concepts for Mass-gathering Health through a Delphi Process.

    PubMed

    Steenkamp, Malinda; Hutton, Alison E; Ranse, Jamie C; Lund, Adam; Turris, Sheila A; Bowles, Ron; Arbuthnott, Katherine; Arbon, Paul A

    2016-08-01

    Introduction The science underpinning mass-gathering health (MGH) is developing rapidly. However, MGH terminology and concepts are not yet well defined or used consistently. These variations can complicate comparisons across settings. There is, therefore, a need to develop consensus and standardize concepts and data points to support the development of a robust MGH evidence-base for governments, event planners, responders, and researchers. This project explored the views and sought consensus of international MGH experts on previously published concepts around MGH to inform the development of a transnational minimum data set (MDS) with an accompanying data dictionary (DD). Report A two-round Delphi process was undertaken involving volunteers from the World Health Organization (WHO) Virtual Interdisciplinary Advisory Group (VIAG) on Mass Gatherings (MGs) and the MG section of the World Association for Disaster and Emergency Medicine (WADEM). The first online survey tested agreement on six key concepts: (1) using the term "MG HEALTH;" (2) purposes of the proposed MDS and DD; (3) event phases; (4) two MG population models; (5) a MGH conceptual diagram; and (6) a data matrix for organizing MGH data elements. Consensus was defined as ≥80% agreement. Round 2 presented five refined MGH principles based on Round 1 input that was analyzed using descriptive statistics and content analysis. Thirty-eight participants started Round 1 with 36 completing the survey and 24 (65% of 36) completing Round 2. Agreement was reached on: the term "MGH" (n=35/38; 92%); the stated purposes for the MDS (n=38/38; 100%); the two MG population models (n=31/36; 86% and n=30/36; 83%, respectively); and the event phases (n=34/36; 94%). Consensus was not achieved on the overall conceptual MGH diagram (n=25/37; 67%) and the proposed matrix to organize data elements (n=28/37; 77%). In Round 2, agreement was reached on all the proposed principles and revisions, except on the MGH diagram (n=18/24; 75

  17. Physicians' Self-Conceptions of Their Expertise in Statutory Health Insurance and Social Security Systems.

    PubMed

    Seger, Wolfgang; Nüchtern, Elisabeth

    2015-07-01

    Medical experts who practice social medicine have a strong ethical approach for their professional positions. Their reports must reflect an objective, independent, high-quality assessment of interactions between health status and the disability of individuals. However, they must simultaneously consider the societal involvement of these individuals when determining the framework of the Statutory Health Insurance and Social Security Systems. Their task is to recommend sociomedical benefits that are tailored to suit personal needs and that respect the individual life situations of the persons involved, thus complementing the efforts of healthcare professionals in clinical settings. The editorial describes the self-conception of this medical specialty on behalf of the German Society of Social Medicine and Prevention (DGSMP). Policy makers in social insurances and social security systems generally must respect independent sociomedical recommendations as a crucial point for further realistic development activities. PMID:26388973

  18. Physicians’ Self-Conceptions of Their Expertise in Statutory Health Insurance and Social Security Systems

    PubMed Central

    Seger, Wolfgang; Nüchtern, Elisabeth

    2015-01-01

    Medical experts who practice social medicine have a strong ethical approach for their professional positions. Their reports must reflect an objective, independent, high-quality assessment of interactions between health status and the disability of individuals. However, they must simultaneously consider the societal involvement of these individuals when determining the framework of the Statutory Health Insurance and Social Security Systems. Their task is to recommend sociomedical benefits that are tailored to suit personal needs and that respect the individual life situations of the persons involved, thus complementing the efforts of healthcare professionals in clinical settings. The editorial describes the self-conception of this medical specialty on behalf of the German Society of Social Medicine and Prevention (DGSMP). Policy makers in social insurances and social security systems generally must respect independent sociomedical recommendations as a crucial point for further realistic development activities. PMID:26388973

  19. Bartonella spp. - a chance to establish One Health concepts in veterinary and human medicine.

    PubMed

    Regier, Yvonne; O Rourke, Fiona; Kempf, Volkhard A J

    2016-01-01

    Infectious diseases remain a remarkable health threat for humans and animals. In the past, the epidemiology, etiology and pathology of infectious agents affecting humans and animals have mostly been investigated in separate studies. However, it is evident, that combined approaches are needed to understand geographical distribution, transmission and infection biology of "zoonotic agents". The genus Bartonella represents a congenial example of the synergistic benefits that can arise from such combined approaches: Bartonella spp. infect a broad variety of animals, are linked with a constantly increasing number of human diseases and are transmitted via arthropod vectors. As a result, the genus Bartonella is predestined to play a pivotal role in establishing a One Health concept combining veterinary and human medicine. PMID:27161111

  20. Risk selection in a regulated health insurance market: a review of the concept, possibilities and effects.

    PubMed

    van Kleef, Richard C; van de Ven, Wynand P M M; van Vliet, René C J A

    2013-12-01

    The Dutch basic health insurance is based on the principles of regulated competition. This implies that insurers and providers compete on price and quality while the regulator sets certain rules to achieve public objectives such as solidarity. Two regulatory aspects of this scheme are that insurers are not allowed to risk rate their premiums and are compensated for predictable variation in individual medical expenses (i.e., risk equalization). Research, however, indicates that the current risk equalization is imperfect, which confronts insurers and consumers with incentives for risk selection. The goal of this paper is to review the concept, possibilities and potential effects of risk selection in the Dutch basic health insurance. We conclude that the possibilities for risk selection are numerous and a potential threat to solidarity, efficiency and quality of care. Regulators should be aware that measurement of risk selection is a methodological and data-demanding challenge. PMID:24219050

  1. Conflict and Conflict Resolution: A Bibliography.

    ERIC Educational Resources Information Center

    Edney, C.W.; Barker, Randolph T.

    The role of communication in conflict and conflict resolution is the focus of the items listed in this two-part extensive bibliography. Entries are arranged alphabetically and are listed under the following five categories in each section: intrapersonal and interpersonal conflict, group and societal conflict, organizational conflict, political and…

  2. How do patients expect the mental health service system to act? Testing the WHO responsiveness concept for its appropriateness in mental health care.

    PubMed

    Bramesfeld, Anke; Klippel, Ulrike; Seidel, Gabriele; Schwartz, Friedrich W; Dierks, Marie-Luise

    2007-09-01

    The World Health Organisation (WHO) concept of responsiveness has been defined as a measure of how well the health system responds to the population's legitimate expectations of non-health aspects of health care provision. It comprises eight domains: dignity, prompt attention, autonomy, choice of health care provider, clear communication, confidentiality, quality of basic amenities, and access to social support networks. The concept is of particular relevance to mental health care systems because of the specific dependency and vulnerability of their users. We tested its applicability to mental health care with five focus groups of experienced mental health care users in Hannover, Germany. The focus groups revealed 492 statements about users' expectations in mental health care. Most concerned attention (115), dignity (108) and autonomy (86). The quotations were assigned to the eight responsiveness domains. In addition, the domain of prompt attention was extended and renamed attention, and the new domain continuity was created. The findings correspond with the literature on health care expectations of non-mental health patients, but differ slightly from the results of a WHO study on overall health care responsiveness. The need for widening the concept of continuity and extending the attention domain reflects the nature of mental health care of providing predominately long-term care. Our analysis indicates the feasibility of the responsiveness concept (if altered as proposed) as a tool for assessing the quality of mental health service from the users' point of view. It should also be further developed to quantitatively evaluate mental health care systems and to benchmark system performance. PMID:17493723

  3. Locating Relevant Patient Information in Electronic Health Record Data Using Representations of Clinical Concepts and Database Structures

    PubMed Central

    Pan, Xuequn; Cimino, James J.

    2014-01-01

    Clinicians and clinical researchers often seek information in electronic health records (EHRs) that are relevant to some concept of interest, such as a disease or finding. The heterogeneous nature of EHRs can complicate retrieval, risking incomplete results. We frame this problem as the presence of two gaps: 1) a gap between clinical concepts and their representations in EHR data and 2) a gap between data representations and their locations within EHR data structures. We bridge these gaps with a knowledge structure that comprises relationships among clinical concepts (including concepts of interest and concepts that may be instantiated in EHR data) and relationships between clinical concepts and the database structures. We make use of available knowledge resources to develop a reproducible, scalable process for creating a knowledge base that can support automated query expansion from a clinical concept to all relevant EHR data. PMID:25954405

  4. The Indian concepts of lifestyle and mental health in old age.

    PubMed

    Tiwari, S C; Pandey, Nisha M

    2013-01-01

    Lifestyle is the perception of a particular person or entire society towards life and it is the way people live, think and behave. In Indian lifestyle, principles of Karma (action) and dharma (the righteous way to perform the work) are given significant value. In India, earlier, the life of an individual was being regulated harmoniously according to the stages (Ashrams) of life, i.e., studentship (Brahmcharya); householder (Grihstha); forest dweller (Vanprasth); ascetic (Sanyas) and was meant to maintain the discipline, peace and harmony in the family and society. However, revolution in the social milieu and political scenario changed the patterns of religious beliefs and lifestyle of individuals. And thus, the Indian lifestyle got colored with shadows of cults and cultures. The lifestyle affects the longevity and health in old age. Lifestyles also have role in developing cognitive disorders like Alzheimer's disease (AD). AD found to be more common in socially isolated older adults. Deteriorations in health (especially mental health) are often the results of faulty lifestyles like smoking, alcohol intake, improper diet and lack of exercise as well as an adverse psycho-social milieu. Adopting the advocated principles of Indian concepts of lifestyle and paying proper attention to mental illnesses of older adults and recognizing their problems may preserve mental health in old age. PMID:23858270

  5. The Indian concepts of lifestyle and mental health in old age

    PubMed Central

    Tiwari, S. C.; Pandey, Nisha M.

    2013-01-01

    Lifestyle is the perception of a particular person or entire society towards life and it is the way people live, think and behave. In Indian lifestyle, principles of Karma (action) and dharma (the righteous way to perform the work) are given significant value. In India, earlier, the life of an individual was being regulated harmoniously according to the stages (Ashrams) of life, i.e., studentship (Brahmcharya); householder (Grihstha); forest dweller (Vanprasth); ascetic (Sanyas) and was meant to maintain the discipline, peace and harmony in the family and society. However, revolution in the social milieu and political scenario changed the patterns of religious beliefs and lifestyle of individuals. And thus, the Indian lifestyle got colored with shadows of cults and cultures. The lifestyle affects the longevity and health in old age. Lifestyles also have role in developing cognitive disorders like Alzheimer's disease (AD). AD found to be more common in socially isolated older adults. Deteriorations in health (especially mental health) are often the results of faulty lifestyles like smoking, alcohol intake, improper diet and lack of exercise as well as an adverse psycho-social milieu. Adopting the advocated principles of Indian concepts of lifestyle and paying proper attention to mental illnesses of older adults and recognizing their problems may preserve mental health in old age. PMID:23858270

  6. [Occupational health service management--the concept and application of lean management].

    PubMed

    Sobczak, Alicja; Rydlewska-Liszkowska, Izabela

    2012-01-01

    One of the most effective management systems is the so-called lean management (LM) aimed at loss minimization of institutions' activities while maximizing value and satisfaction to the clients. The system implementation comprises not only typical business areas but also health care sectors. The aim of the article is to present the concept and opportunity of improving the management of occupational health units. Due to its multi-profile nature of tasks and diverse relations with the environment occupational health could be a good institutional example of LM implementation. Operational perspective consists of five guidelines: describing values expected by final clients, setting value flow eliminating needless elements, creating the integrated, coherent and smooth sequence of valuable activities, offering the values to clients, and aiming at continuing improvement. LM could be implemented in occupational health units in the following areas: timing and tasks coordination, leaning some tasks and expanding others in order to maximize clients' value, cost rationalizing, improving the quality of services by eliminating mistakes, avoiding repetition of activities. PMID:23373329

  7. Adjustment Disorders Are Uniquely Suited for eHealth Interventions: Concept and Case Study

    PubMed Central

    Bachem, Rahel C; Lorenz, Louisa; Moser, Christian T; Berger, Thomas

    2015-01-01

    Background Adjustment disorders (also known as mental distress in response to a stressor) are among the most frequently diagnosed mental disorders in psychiatry and clinical psychology worldwide. They are also commonly diagnosed in clients engaging in deliberate self-harm and in those consulting general practitioners. However, their reputation in research-oriented mental health remains weak since they are largely underresearched. This may change when the International Statistical Classification of Diseases-11 (ICD-11) by the World Health Organization is introduced, including a new conceptualization of adjustment disorders as a stress-response disorder with positively defined core symptoms. Objective This paper provides an overview of evidence-based interventions for adjustment disorders. Methods We reviewed the new ICD-11 concept of adjustment disorder and discuss the the rationale and case study of an unguided self-help protocol for burglary victims with adjustment disorder, and its possible implementation as an eHealth intervention. Results Overall, the treatment with the self-help manual reduced symptoms of adjustment disorder, namely preoccupation and failure to adapt, as well as symptoms of depression, anxiety, and stress. Conclusions E-mental health options are considered uniquely suited for offering early intervention after the experiences of stressful life events that potentially trigger adjustment disorders. PMID:26543920

  8. Towards a ‘patient-centred’ operationalisation of the new dynamic concept of health: a mixed methods study

    PubMed Central

    Huber, M; van Vliet, M; Giezenberg, M; Winkens, B; Heerkens, Y; Dagnelie, P C; Knottnerus, J A

    2016-01-01

    Objective To evaluate among stakeholders the support for the new, dynamic concept of health, as published in 2011: ‘Health as the ability to adapt and to self-manage’, and to elaborate perceived indicators of health in order to make the concept measurable. Design A mixed methods study: a qualitative first step with interviews and focus groups, followed by a quantitative survey. Participants Representatives of seven healthcare stakeholder domains, for example, healthcare providers, patients with a chronic condition and policymakers. The qualitative study involved 140 stakeholders; the survey 1938 participants. Results The new concept was appreciated, as it addresses people as more than their illness and focuses on strengths rather than weaknesses. Caution is needed as the concept requires substantial personal input of which not everyone is capable. The qualitative study identified 556 health indicators, categorised into six dimensions: bodily functions, mental functions and perception, spiritual/existential dimension, quality of life, social and societal participation, and daily functioning, with 32 underlying aspects. The quantitative study showed all stakeholder groups considering bodily functions to represent health, whereas for other dimensions there were significant differences between groups. Patients considered all six dimensions almost equally important, thus preferring a broad concept of health, whereas physicians assessed health more narrowly and biomedically. In the qualitative study, 78% of respondents considered their health indicators to represent the concept. Conclusions To prevent confusion with health as ‘absence of disease’, we propose the use of the term ‘positive health’ for the broad perception of health with six dimensions, as preferred by patients. This broad perception deserves attention by healthcare providers as it may support shared decision-making in medical practice. For policymakers, the broad perception of

  9. [The role of workplace health promotion in the concept of corporate social responsibility].

    PubMed

    Wojtaszczyk, Patrycja

    2008-01-01

    Workplace health promotion (WHP) is an idea that was conceived over 25 years ago. At its very core is the wellbeing of employees. The development and dissemination of this notion, as well as the implementation of its basic principles have always been challenged by various theories and practices derived from the field of human resources management. The corporate social responsibility (CSR) is one of such new concepts promulgated within the European Union Based on the literature review, especially European Commission documents, articles retrieved in the EBSCO database, guidelines and guidebooks published by the CSR Forum, other NGOs active in the field, and the publications of the Nofer Institute of Occupational Medicine, the author makes an attempt to compare these two ideas and discuss the coherence between their assumptions. The primary hypothesis was that WHP is an element of CSR. The comparison between CSR and WHP concepts confirm a hypothesis that the latter is an element of the former, which means that activities aimed at taking care of health and well-being of employees contribute to the creation of a socially responsible company. It indicates that the implementation of both ideas requires multidisciplinary and holistic approach. In addition, the role of social dialog and workers' participation in the company management are strongly emphasized. PMID:18846997

  10. Politics and Power in Global Health: The Constituting Role of Conflicts: Comment on "Navigating Between Stealth Advocacy and Unconscious Dogmatism: The Challenge of Researching the Norms, Politics and Power of Global Health".

    PubMed

    Askheim, Clemet; Heggen, Kristin; Engebretsen, Eivind

    2016-02-01

    In a recent article, Gorik Ooms has drawn attention to the normative underpinnings of the politics of global health. We claim that Ooms is indirectly submitting to a liberal conception of politics by framing the politics of global health as a question of individual morality. Drawing on the theoretical works of Chantal Mouffe, we introduce a conflictual concept of the political as an alternative to Ooms' conception. Using controversies surrounding medical treatment of AIDS patients in developing countries as a case we underline the opportunity for political changes, through political articulation of an issue, and collective mobilization based on such an articulation. PMID:26927399

  11. Reflections on the concept of basic needs and primary health care.

    PubMed

    Quenum, C A

    1981-01-01

    The notion or concept of need has different meanings according to the individual groups or ages to which it is applied. A need is something which man subjectively feels an urge to satisfy. Basic or primary needs are the minimum vital requirements which must be met to ensure dignified human existence. Basic needs relate both to individuals and communities. Although the needs of individuals and communities are contingent, they are not necessarily in harmony. One of the principal goals of socioeconomic development in general and health care development in particular is the satisfaction of the basic needs of the greatest number of people. Growth-oriented strategies have so far failed to reduce inequalities and physical, mental, and social destitution. Development strategies focusing on basic needs must: 1) eliminate social inequalities; 2) include coherent programs of activities relating to basic needs; and 3) undergo radical structural changes (a social revolution in community health). Promotion of health care for the most underprivileged segments of society necessitate: 1) production of goods necessary for the satisfaction of basic needs such as building materials or essential medicines; 2) construction of country roads; and 3) development of programs of rural health, water supply, literacy, and housing. Primary health care is essential care which is fundamental to basic needs. Policies, strategies, and plans of action should be formulated in order to develop primary health care. An excellent means of implementing primary health care is the choice of appropriate technology for health care. Choosing the appropriate technology for development entails finding the right balance between labor-intensive and capital-intensive technology; it should be the result of combining knowledge and practices which help improve the physical, mental, and social well-being of individuals, families, and communities. In most rural populations of the world, infections and epidemic and

  12. Disruptive staff interactions: a serious source of inter-provider conflict and stress in health care settings.

    PubMed

    Stecker, Mona; Stecker, Mark M

    2014-07-01

    This study sought to explore the prevalence of workplace stress, gender differences, and the relationship of workplace incivility to the experience of stress. Effects of stress on performance have been explored for many years. Work stress has been at the root of many physical and psychological problems and has even been linked to medical errors and suboptimal patient outcomes. In this study, 617 respondents completed a Provider Conflict Questionnaire (PCQ) as well as a ten-item stress survey. Work was the main stressor according to 78.2% of respondents. The stress index was moderately high, ranging between 10 and 48 (mean = 25.5). Females demonstrated a higher stress index. Disruptive behavior showed a significant positive correlation with increased stress. This study concludes that employees of institutions with less disruptive behavior exhibited lower stress levels. This finding is important in improving employee satisfaction and reducing medical errors. It is difficult to retain experienced nurses, and stress is a significant contributor to job dissatisfaction. Moreover, workplace conflict and its correlation to increased stress levels must be managed as a strategy to reduce medical errors and increase job satisfaction. PMID:24963854

  13. Everyday life and health concepts among blue-collar female workers in Denmark: implications for health promotion aiming at reducing health inequalities.

    PubMed

    Jensen, Jeanette Magne

    2013-06-01

    This article introduces a perspective on the health of women with low levels of education in terms of organisation of their everyday life. The aim is to demonstrate the ways in which the women's concept of health is contingent on the conditions encountered in everyday life. A qualitative study based on interviews with the women forms the basis for the discussion. The analysis shows that the women find it difficult to adopt the official discourse on health and its foundation in a biomedical tradition. The article argues that it is necessary to move away from the educational approach focusing on risk and lifestyle with the goal of regulating individual behaviour. Instead, an approach is suggested which can provide the women with the opportunity to gain control of the everyday health determinants which are normally beyond their immediate reach. This is based on the argument that it is necessary to work with a health promotion and education strategy capable of operating within the various interactive patterns between 'environment' and 'individual' which form the foundation for health. PMID:23797936

  14. Using Organization Development Concept to Conduct Administrative Assessment of Health Promoting Schools in Taiwan--A Preliminary Study

    ERIC Educational Resources Information Center

    Huang, Jen-Jen; Yeh, Gwo-Liang; Tseng, Chie-Chien; Chen, Wei William; Hwu, Yin-Jinn; Jiang, Donald Dah-Shyong

    2009-01-01

    The Health Promoting School (HPS) programs in Taiwan were initiated and implemented with funding from Department of Health and Ministry of Education during the initial phase. The purpose of this article was to describe the application of organization development (OD) concept in the administrative assessment of HPS programs and to present results…

  15. Lay Concepts of the Relative Importance of Different Influences on Health; Are There Major Socio-Demographic Variations?

    ERIC Educational Resources Information Center

    Macintyre, Sally; McKay, Laura; Ellaway, Anne

    2006-01-01

    There is an extensive literature within anthropology, sociology and psychology about lay concepts of determinants of health and illness. Many of these studies have used single sex or social class samples, often in narrow age bands, and many are qualitative in approach. We asked respondents in a health survey to say how important (on a five-point…

  16. Identifying Multi-Level Culturally Appropriate Smoking Cessation Strategies for Aboriginal Health Staff: A Concept Mapping Approach

    ERIC Educational Resources Information Center

    Dawson, Anna P.; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

    2013-01-01

    Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco…

  17. Intergenerational cultural conflict, mental health, and educational outcomes among Asian and Latino/a Americans: Qualitative and meta-analytic review.

    PubMed

    Lui, P Priscilla

    2015-03-01

    Among immigrant Asian and Latino groups, the contrast between collectivism in traditional heritage and individualism in the mainstream American cultures presents unique challenges for their family relationships. This systematic review was designed to answer 3 fundamental questions: to what extent do(es) (a) acculturation mismatch (AM) correlate with intergenerational cultural conflict (ICC); (b) ICC correlate with offspring's mental health and educational outcomes; and (c) demographic and study characteristics moderate these relationships. Sixty-one research reports were reviewed, with 68 independent study samples (N = 14,453; 41 and 27 Asian and Latino/a samples, respectively) subjected to 3 meta-analyses. AM positively correlated with ICC (r = .23), which in turn negatively correlated with offspring mental health (r = -.20) and educational outcomes (r = -.09). Findings provided support for acculturation gap-distress theory. While these effect size estimates were small, participant and methodological variables affected their magnitude. Contrary to findings on intergenerational conflict within mainstream non-immigrant families, the relationships among AM, ICC, and mental health were larger in young adult than adolescent groups within immigrant families. ICC significantly correlated with internalizing problems and adaptive functioning, but not externalizing problems. AM was more closely related to ICC among women and second-generation immigrant offspring. AM and ICC were more problematic among offspring who were low-risk and lived in less ethnically disperse regions, particularly when studied in cross-sectional studies. Effect sizes also differed significantly across measurement tools for the key constructs. Limitations to generalizability (few studies on educational outcomes, relative under-representation of Latino/a to Asian American samples), and implications for intervention and future research are discussed. PMID:25528344

  18. Exploring areas of consensus and conflict around values underpinning public involvement in health and social care research: a modified Delphi study

    PubMed Central

    Snape, D; Kirkham, J; Preston, J; Popay, J; Britten, N; Collins, M; Froggatt, K; Gibson, A; Lobban, F; Wyatt, K; Jacoby, A

    2014-01-01

    Objective There is growing interest in the potential benefits of public involvement (PI) in health and social care research. However, there has been little examination of values underpinning PI or how these values might differ for different groups with an interest in PI in the research process. We aimed to explore areas of consensus and conflict around normative, substantive and process-related values underpinning PI. Design Mixed method, three-phase, modified Delphi study, conducted as part of a larger multiphase project. Setting The UK health and social care research community. Participants Stakeholders in PI in research, defined as: clinical and non-clinical academics, members of the public, research managers, commissioners and funders; identified via research networks, online searches and a literature review. Results We identified high levels of consensus for many normative, substantive and process-related issues. However, there were also areas of conflict in relation to issues of bias and representativeness, and around whether the purpose of PI in health and social care research is to bring about service change or generate new knowledge. There were large differences by group in the percentages endorsing the ethical justification for PI and the argument that PI equalises power imbalances. With regard to practical implementation of PI, research support infrastructures were reported as lacking. Participants reported shortcomings in the uptake and practice of PI. Embedding PI practice and evaluation in research study designs was seen as fundamental to strengthening the evidence base. Conclusions Our findings highlight the extent to which PI is already embedded in research. However, they also highlight a need for ‘best practice’ standards to assist research teams to understand, implement and evaluate PI. These findings have been used in developing a Public Involvement Impact Assessment Framework (PiiAF), which offers guidance to researchers and members of the

  19. Health and healthy human being in Islamic thought: Reflection on application for the nursing concept – A philosophical inquiry

    PubMed Central

    Alimohammadi, Nasrollah; Taleghani, Fariba

    2015-01-01

    Introduction: Health and healthy human being as a core concept of nursing have attracted considerable attention in the Western literature but have received less attention in the context of Eastern philosophy contexts. Methods: This study was done based on philosophical inquiry; this method could be accomplished by means of different approaches like philosophical analysis through concept analysis. There are different methods for concept analysis. Mors's method was employed to analyze the concept of health and healthy human being, we sought to clarify them according to ideas deriving from the Islamic thought. To achieve the research objective, Islamic texts were studied and analyzed based on the criteria of concept analysis (definition, attributes/characteristics, and beaneries). Results: Our analysis revealed in the Islamic thought human being is an integrated entity. Therefore, his health not only consists of each single dimension, but also the full health together with the health of society gets meaning in a balanced and coordinated set. Conclusion: Based on the results, in this study, there are a series of similarities and differences with the perspectives of health in Islamic thought and holism paradigm available in nursing. PMID:27462615

  20. Equity and health policy in Africa: Using concept mapping in Moore (Burkina Faso)

    PubMed Central

    Ridde, Valéry

    2008-01-01

    Background This methodological article is based on a health policy research project conducted in Burkina Faso (West Africa). Concept mapping (CM) was used as a research method to understand the local views of equity among stakeholders, who were concerned by the health policy under consideration. While this technique has been used in North America and elsewhere, to our knowledge it has not yet been applied in Africa in any vernacular language. Its application raises many issues and certain methodological limitations. Our objective in this article is to present its use in this particular context, and to share a number of methodological observations on the subject. Methods Two CMs were done among two different groups of local stakeholders following four steps: generating ideas, structuring the ideas, computing maps using multidimensional scaling and cluster analysis methods, and interpreting maps. Fifteen nurses were invited to take part in the study, all of whom had undergone training on health policies. Of these, nine nurses (60%) ultimately attended the two-day meeting, conducted in French. Of 45 members of village health committees who attended training on health policies, only eight were literate in the local language (Moore). Seven of these (88%) came to the meeting. Results The local perception of equity seems close to the egalitarian model. The actors are not ready to compromise social stability and peace for the benefit of the worst-off. The discussion on the methodological limitations of CM raises the limitations of asking a single question in Moore and the challenge of translating a concept as complex as equity. While the translation of equity into Moore undoubtedly oriented the discussions toward social relations, we believe that, in the context of this study, the open-ended question concerning social justice has a threefold relevance. At the same time, those limitations were transformed into strengths. We understand that it was essential to resort to the

  1. Interventions for Children Affected by Armed Conflict: a Systematic Review of Mental Health and Psychosocial Support in Low- and Middle-Income Countries.

    PubMed

    Jordans, Mark J D; Pigott, Hugo; Tol, Wietse A

    2016-01-01

    Over one billion children under the age of 18 live in countries affected by armed conflict. This systematic review replicates an earlier study, aiming to provide a comprehensive update of the most current developments in interventions for children affected by armed conflict. For the period 2009-2015, a total of 1538 records were collected from PubMed, PsycINFO, and PILOTS. Twenty-four studies met the inclusion criteria, and the included interventions involve data from 4858 children. Although the number of publications and level of evidence has improved since the previous review, there is still a general lack of rigor and clarity in study design and reported results. Overall, interventions appeared to show promising results demonstrating mostly moderate effect sizes on mental health and psychosocial well-being. However, these positive intervention benefits are often limited to specific subgroups. There is a need for increased diversification in research focus, with more attention to interventions that focus at strengthening community and family support, and to young children, and improvements in targeting and conceptualizing of interventions. PMID:26769198

  2. The new brain: concepts, challenges, and opportunities for mental health nursing.

    PubMed

    Buchanan, David Andrew

    2012-04-01

    The new paradigm that the brain is able change itself (neuroplasticity) is acknowledged and teased out in terms of the ramifications for mental illnesses. Parallel studies in pain (central sensitization) and mirror neurones are examined to conceptually clarify these ramifications in relation to mental health, and to expand our understanding of empathy and social inclusion beyond good ideas to being a part of our nature. The paper then focuses on making clear what the concepts, challenges, and opportunities for mental health nursing might be; even advancing possibilities for recovery through better understanding the third space or intersubjective. What ramifications this has for mental health nursing is reviewed in terms of a paradigm change and the necessity for conceptual clarity, as it relates to the uniqueness of the person right before our very eyes. The author contends that to embrace this new paradigm is not only necessary but ethically obligatory, as it opens up new possibilities for understanding ourselves and this changeable person. PMID:22251880

  3. Conflict engagement: workplace dynamics.

    PubMed

    Gerardi, Debra

    2015-04-01

    This article is one in a series on conflict. It is part of an ongoing series on leadership coordinated by the American Organization of Nurse Executives (AONE), highlighting topics of interest to nurse managers and emerging nurse leaders. The AONE provides leadership, professional development, advocacy, and research to advance nursing practice and patient care, promote nursing leadership excellence, and shape public policy for health care. PMID:25811527

  4. Conflict engagement: collaborative processes.

    PubMed

    Gerardi, Debra

    2015-05-01

    This article is one in a series on conflict. It is part of an ongoing series on leadership coordinated by the American Organization of Nurse Executives (AONE; www.aone.org), highlighting topics of interest to nurse managers and emerging nurse leaders. The AONE provides leadership, professional development, advocacy, and research to advance nursing practice and patient care, promote nursing leadership excellence, and shape public policy for health care. PMID:25906208

  5. Research Priorities for Fertility and Conception Research as Identified by Multidisciplinary Health Care Practitioners and Researchers

    PubMed Central

    Moran, Lisa J.; Spencer, Laura; Russell, Darryl L.; Hull, Mary Louise; Robertson, Sarah A.; Varcoe, Tamara J.; Davies, Michael J.; Brown, Hannah M.; Rodgers, Raymond J.

    2016-01-01

    The Robinson Research Institute of the University of Adelaide convened a multidisciplinary group of n = 33 clinicians, researchers and representatives of government organisations on the 2 October 2014 for a workshop entitled “Promoting fertility and healthy conception. How do we generate greater reproductive health awareness?” The key aim of the workshop was to assess the body of knowledge that informs clinical practice and government policy, and to identify questions and additional information needed by health practitioners and government representatives working in the field of reproductive health and to frame future research and policy. The workshop identified topics that fell mostly into three categories: lifestyle-related, societal and biological factors. The lifestyle topics included nutrition and diet, exercise, obesity, shift work and other factors deemed to be modifiable at the level of the individual. The societal topics included discussions of matters that are structural, and resistant to change by individuals, including specific ethical issues, social disadvantage, government and educational policies. The biological factors are intrinsic physical states of the individual, and included many factors where there is a dense body of scientific knowledge which may not be readily accessible in less academic language. This workshop thus provided an opportunity to identify further actions that could be undertaken to meet the needs of diverse organisations and groups of professionals with an interest in human fertility. Since so many factors in our social and biological environment can impact fertility and preconception health, it is imperative to involve many disciplines or levels of government or societal organisations that have not traditionally been involved in this area. PMID:26771633

  6. Research Priorities for Fertility and Conception Research as Identified by Multidisciplinary Health Care Practitioners and Researchers.

    PubMed

    Moran, Lisa J; Spencer, Laura; Russell, Darryl L; Hull, Mary Louise; Robertson, Sarah A; Varcoe, Tamara J; Davies, Michael J; Brown, Hannah M; Rodgers, Raymond J

    2016-01-01

    The Robinson Research Institute of the University of Adelaide convened a multidisciplinary group of n = 33 clinicians, researchers and representatives of government organisations on the 2 October 2014 for a workshop entitled "Promoting fertility and healthy conception. How do we generate greater reproductive health awareness?" The key aim of the workshop was to assess the body of knowledge that informs clinical practice and government policy, and to identify questions and additional information needed by health practitioners and government representatives working in the field of reproductive health and to frame future research and policy. The workshop identified topics that fell mostly into three categories: lifestyle-related, societal and biological factors. The lifestyle topics included nutrition and diet, exercise, obesity, shift work and other factors deemed to be modifiable at the level of the individual. The societal topics included discussions of matters that are structural, and resistant to change by individuals, including specific ethical issues, social disadvantage, government and educational policies. The biological factors are intrinsic physical states of the individual, and included many factors where there is a dense body of scientific knowledge which may not be readily accessible in less academic language. This workshop thus provided an opportunity to identify further actions that could be undertaken to meet the needs of diverse organisations and groups of professionals with an interest in human fertility. Since so many factors in our social and biological environment can impact fertility and preconception health, it is imperative to involve many disciplines or levels of government or societal organisations that have not traditionally been involved in this area. PMID:26771633

  7. From sociocultural disintegration to community connectedness dimensions of local community concepts and their effects on psychological health of its residents.

    PubMed

    Sørensen, Tom; Kleiner, Robert; Ngo, Paul; Sørensen, Andreas; Bøe, Nils

    2013-01-01

    In a series of community mental health promotion studies in Lofoten, Norway, the concept of sociocultural integration is used to describe properties of a local community that are related to people's psychological health. Starting with Durkheim's description of a cohesive society, we compare different concepts that are related to sociocultural integration, for example, sense of community, social capital, and social cohesion. We then examine the relationship of various individual oriented social psychological concepts to sociocultural integration. These concepts often share theoretical and operational definitions. The concept of sociocultural integration in the Lofoten studies was proved to be very valuable in understanding how the properties of a community can affect people's mental health and their social psychological properties. It has also shown its value in the planning of mental health services and demonstrating its success in concrete community-based mental health promotion projects. Thus they could make important contributions to further studies and actions in local communities where the intersection between the individual, their social network, and their local community occurs. PMID:24236288

  8. From Sociocultural Disintegration to Community Connectedness Dimensions of Local Community Concepts and Their Effects on Psychological Health of Its Residents

    PubMed Central

    Sørensen, Tom; Kleiner, Robert; Ngo, Paul; Sørensen, Andreas; Bøe, Nils

    2013-01-01

    In a series of community mental health promotion studies in Lofoten, Norway, the concept of sociocultural integration is used to describe properties of a local community that are related to people's psychological health. Starting with Durkheim's description of a cohesive society, we compare different concepts that are related to sociocultural integration, for example, sense of community, social capital, and social cohesion. We then examine the relationship of various individual oriented social psychological concepts to sociocultural integration. These concepts often share theoretical and operational definitions. The concept of sociocultural integration in the Lofoten studies was proved to be very valuable in understanding how the properties of a community can affect people's mental health and their social psychological properties. It has also shown its value in the planning of mental health services and demonstrating its success in concrete community-based mental health promotion projects. Thus they could make important contributions to further studies and actions in local communities where the intersection between the individual, their social network, and their local community occurs. PMID:24236288

  9. Using Concept Mapping in the Development of a School of Public Health

    PubMed Central

    Hsu, Laura J; Pacheco, Misty Y; Crabtree, Christopher

    2015-01-01

    Schools of Public Health have a wide variety of essential stakeholders. Broad input in program planning should assist in ensuring well-developed plans and strong community buy-in. The planning of a school can better address the needs of multiple stakeholders from systematic broad-based input from these constituents using concept mapping. In this study, we used concept mapping to prioritize a set of recommendations from diverse stakeholders to assist in the process of planning a school. A set of statements was generated on essential elements for the proposed school from a broad group of stakeholders. The statements were then distilled into unique themes, which were then rated on importance and feasibility. Cluster maps and pattern matches were used to analyze the ratings. Unique themes (N = 147) were identified and grouped into 12 clusters. Cluster themes included leadership, faculty, culture, school, and curriculum. Pattern matches revealed a significant, modest correlation between importance and feasibility (r = 0.27). A broad range of perspectives was used to identify relevant areas to address in the development of a school. PMID:26225267

  10. International Consensus on Key Concepts and Data Definitions for Mass-gathering Health: Process and Progress.

    PubMed

    Turris, Sheila A; Steenkamp, Malinda; Lund, Adam; Hutton, Alison; Ranse, Jamie; Bowles, Ron; Arbuthnott, Katherine; Anikeeva, Olga; Arbon, Paul

    2016-04-01

    Mass gatherings (MGs) occur worldwide on any given day, yet mass-gathering health (MGH) is a relatively new field of scientific inquiry. As the science underpinning the study of MGH continues to develop, there will be increasing opportunities to improve health and safety of those attending events. The emerging body of MG literature demonstrates considerable variation in the collection and reporting of data. This complicates comparison across settings and limits the value and utility of these reported data. Standardization of data points and/or reporting in relation to events would aid in creating a robust evidence base from which governments, researchers, clinicians, and event planners could benefit. Moving towards international consensus on any topic is a complex undertaking. This report describes a collaborative initiative to develop consensus on key concepts and data definitions for a MGH "Minimum Data Set." This report makes transparent the process undertaken, demonstrates a pragmatic way of managing international collaboration, and proposes a number of steps for progressing international consensus. The process included correspondence through a journal, face-to-face meetings at a conference, then a four-day working meeting; virtual meetings over a two-year period supported by online project management tools; consultation with an international group of MGH researchers via an online Delphi process; and a workshop delivered at the 19thWorld Congress on Disaster and Emergency Medicine held in Cape Town, South Africa in April 2015. This resulted in an agreement by workshop participants that there is a need for international consensus on key concepts and data definitions. PMID:26843271

  11. A strategy for teaching students concepts of population-based health care for older persons.

    PubMed

    Xakellis, George C; Robinson, Mark

    2003-08-01

    The authors present a strategy for organizing and teaching the concepts of population-based health care for patients over the age of 65. The key ingredients are a case study based on a representative sample of 5,000 Medicare recipients and a student guide containing the sample group's demographics, clinical characteristics, and utilization patterns. As part of the case study, three subgroups within the sample are described: the basically healthy 50% that consume only 3% of medical resources, the most severely ill 10% that consume 70% of medical resources, and the moderately ill 40% that consume the remaining 27% of medical resources. These categories introduce the concepts of severity of illness, highlight the clinical challenges facing providers of care to the elderly, and contrast the divergent needs of individual health care consumers in an aging population. Armed with this succinct and manageable information packet, students are asked to play the role of an interdisciplinary team that is responsible for effectively managing the care of this population of 5,000 lives. Included in this article is a description of learning resources provided; sample group discussion questions; one strategy for caring for the population developed by a faculty-student group; and a brief description of the educational implications of the model. At the end of the article the reader is provided a Web address containing a description of the case and supporting materials (http://healthyaging.ucdavis.edu/education/continuing/ManagedMedicareTeachingCase.pdf). Readers are invited to view, print, and/or utilize the case in their own academic settings. PMID:12915368

  12. 42 CFR 455.240 - Conflict of interest resolution.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... though the conflict of interest exists and a request for waiver is approved in accordance with 48 CFR 9... 42 Public Health 4 2011-10-01 2011-10-01 false Conflict of interest resolution. 455.240 Section... § 455.240 Conflict of interest resolution. (a) Review Board: CMS may establish a Conflicts of...

  13. 42 CFR 455.240 - Conflict of interest resolution.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... though the conflict of interest exists and a request for waiver is approved in accordance with 48 CFR 9... 42 Public Health 4 2010-10-01 2010-10-01 false Conflict of interest resolution. 455.240 Section... § 455.240 Conflict of interest resolution. (a) Review Board: CMS may establish a Conflicts of...

  14. Evaluation of Meta-Concepts for Information Retrieval in a Quality-Controlled Health Gateway

    PubMed Central

    Gehanno, Jean-François; Thirion, Benoit

    2007-01-01

    Background: CISMeF is a French quality-controlled health gateway that uses the MeSH thesaurus. We introduced two new concepts, metaterms (medical specialty which has semantic links with one or more MeSH terms, subheadings and resource types) and resource types. Objective: evaluate precision and recall of metaterms. Methods: We created 16 pairs of queries. Each pair concerned the same topic, but one used metaterms and one MeSH terms. To assess precision, each document retrieved by the query was classified as irrelevant, partly relevant or fully relevant. Results: the 16 queries yielded 943 documents for metaterm queries and 139 for MeSH term queries. The recall of MeSH term queries was 0.44 (compared to 1 for metaterm queries) and the precision were identical for MeSH term and metaterm queries. Conclusion: Metaconcept such as CISMeF metaterms allows a better recall with a similar precision that MeSH terms in a quality controlled health gateway. PMID:18693840

  15. Battlefield analgesia: a brief review of current trends and concepts in the treatment of pain in US military casualties from the conflicts in Iraq and Afghanistan.

    PubMed

    Plunkett, Anthony; Turabi, Ali; Wilkinson, Indy

    2012-05-01

    SUMMARY Battlefield analgesia and post-injury pain management is a high priority within the military medical community. The combined military services of the USA have developed a Pain Task Force and clinical practice guidelines to ensure that adequate analgesia is provided to our wounded soldiers as far forward as the point of injury on the battlefield. As a result of this emphasis, novel analgesic techniques and equipment have led to improved pain management. Continuous peripheral nerve blocks, intranasal ketamine, battlefield acupuncture and other adjuncts have all been utilized safely and successfully. The ability to provide rapid analgesia as early in the course of injury as possible not only helps with the immediate pain of the soldier, but potentially minimizes the risk of developing chronic postinjury pain. During the long medical evacuation system the risks of both undertreatment and overtreatment of pain are very real. Future studies and observation will help to delineate best treatment regimens and pave the way for the next generation of medical providers to positively impact a soldier's recovery. This article is written from the perspective of the USA with a focus on the conflicts in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom). PMID:24654665

  16. Learning outcomes for health professions: the concept of the swiss competencies framework.

    PubMed

    Sottas, Beat

    2011-01-01

    Modern conceptions of education are based on normative goals concerning learning outcomes in terms of competencies to acquire. The objective of the Swiss competencies framework was to define general and profession-specific learning outcomes for Bachelor's and Master's degree programmes in nursing, physiotherapy, occupational therapy (ergotherapy), midwifery, nutrition counselling, and technicians in medical radiology. In addition, national authorities needed an instrument that allowed the integration of the old professional trainings into a nationally-harmonised education system and that showed the specificities of the levels (higher vocational education; bachelor and master degree at university level). While the general learning outcomes were derived from legal bases, the profession-specific learning outcomes are elaborated according to the competency-based CanMEDS framework. In the CanMEDS framework, knowledge, skills, and attitudes are condensed into meta-competencies which in turn are divided into seven roles, including the medical expert (central role). Taxonomic characteristics and indicators were elaborated in an iterative process that involved regulators, the universities of applied sciences and professional organisations. For the degree programmes mentioned above, the framework developed focuses not only on professional expertise, but also on collaboration with other health professions. Moreover, the interface-management in care taking processes is a critical success factor. Based on this conception, three levels of objectives were identified: general competencies, profession-specific learning outcomes and learning objectives to be implemented in the universities of applied sciences. The general competencies are composed of four dimensions and apply to all health professionals. The profession-specific learning outcomes for the Bachelor's and Master's degree programmes are outlined with 3 to 5 indicators each in all seven professions concerned. The

  17. C-PHIS: a concept map-based knowledge base framework to develop personal health information systems.

    PubMed

    Karla, Pramukh R; Gurupur, Varadraj P

    2013-10-01

    In this paper we describe the development of a Personal Health Information System using a knowledge base developed using concept maps. Here we describe a solution for providing the critical need to develop an information capturing system that helps domain experts in developing a graphical representation of the aforementioned knowledge base which can then be converted to a machine-actable form of information. A prototype application has been developed using this information capturing system that clearly demonstrates the use of the knowledge base framework using concept maps to develop Personal Health Information System for lung cancer patients. PMID:24014254

  18. More of the same? Conflicting perspectives of obesity causation and intervention amongst overweight people, health professionals and policy makers.

    PubMed

    Greener, Joe; Douglas, Flora; van Teijlingen, Edwin

    2010-04-01

    This paper presents the findings of a qualitative study conducted in the United Kingdom of the perceptions of overweight individuals, as well as health professionals and policy makers working in the area of obesity prevention and weight management. In 2006-2007, we conducted interviews with 34 men and women (18-50 years old) who self identified as being overweight; 20 health professionals; and 9 policy makers. We explored their understandings of the causes of obesity/overweight; beliefs about factors that enabled or inhibited weight loss/gain; and opinions regarding effective obesity/overweight interventions. We found a range of views, which corresponded with biomedical and socio-ecological perspectives of health and disease. The lay overweight respondents viewed the problem of obesity arising from their personal shortcomings (i.e. motivational and physical), juxtaposed to blame-absolving accounts often involving specific challenges associated with day-to-day living. All respondents presented personal stories of complex battles of short-term weight loss and longer-term weight gain, usually characterised by a sense of failure. All expressed a strong sense of personal responsibility to overcome their weight problems, and looked to another not-yet-tried, technocratic weight loss programme to address the problem, despite all reporting past failures. Health professionals and policy makers on the other hand viewed obesity as a socio-ecologically determined problem, detailing social and environmental explanations. Health professionals were more inclined towards individual-orientated weight management interventions as effective responses. Policy makers considered environmental and social policy changes as most likely to make a substantial difference to current obesity trends, but considered it unlikely that such policies would be implemented without the political will and popular support. Our data highlight dissonance between policy maker, health professional and public

  19. Timing of cyber conflict

    PubMed Central

    Axelrod, Robert; Iliev, Rumen

    2014-01-01

    Nations are accumulating cyber resources in the form of stockpiles of zero-day exploits as well as other novel methods of engaging in future cyber conflict against selected targets. This paper analyzes the optimal timing for the use of such cyber resources. A simple mathematical model is offered to clarify how the timing of such a choice can depend on the stakes involved in the present situation, as well as the characteristics of the resource for exploitation. The model deals with the question of when the resource should be used given that its use today may well prevent it from being available for use later. The analysis provides concepts, theory, applications, and distinctions to promote the understanding strategy aspects of cyber conflict. Case studies include the Stuxnet attack on Iran’s nuclear program, the Iranian cyber attack on the energy firm Saudi Aramco, the persistent cyber espionage carried out by the Chinese military, and an analogous case of economic coercion by China in a dispute with Japan. The effects of the rapidly expanding market for zero-day exploits are also analyzed. The goal of the paper is to promote the understanding of this domain of cyber conflict to mitigate the harm it can do, and harness the capabilities it can provide. PMID:24474752

  20. Timing of cyber conflict.

    PubMed

    Axelrod, Robert; Iliev, Rumen

    2014-01-28

    Nations are accumulating cyber resources in the form of stockpiles of zero-day exploits as well as other novel methods of engaging in future cyber conflict against selected targets. This paper analyzes the optimal timing for the use of such cyber resources. A simple mathematical model is offered to clarify how the timing of such a choice can depend on the stakes involved in the present situation, as well as the characteristics of the resource for exploitation. The model deals with the question of when the resource should be used given that its use today may well prevent it from being available for use later. The analysis provides concepts, theory, applications, and distinctions to promote the understanding strategy aspects of cyber conflict. Case studies include the Stuxnet attack on Iran's nuclear program, the Iranian cyber attack on the energy firm Saudi Aramco, the persistent cyber espionage carried out by the Chinese military, and an analogous case of economic coercion by China in a dispute with Japan. The effects of the rapidly expanding market for zero-day exploits are also analyzed. The goal of the paper is to promote the understanding of this domain of cyber conflict to mitigate the harm it can do, and harness the capabilities it can provide. PMID:24474752

  1. Conflict and Compromise in Public Health Policy: Analysis of Changes Made to Five Competitive Food Legislative Proposals Prior to Adoption

    ERIC Educational Resources Information Center

    Dinour, Lauren M.

    2015-01-01

    Competitive foods in schools have historically been scrutinized for their ubiquity and poor nutritional quality, leading many states to enact legislation limiting the availability and accessibility of these items. Evaluations of these policy approaches show their promise in improving the healthfulness of school food environments, considered an…

  2. Conflict and compromise in public health policy: analysis of changes made to five competitive food legislative proposals prior to adoption.

    PubMed

    Dinour, Lauren M

    2015-04-01

    Competitive foods in schools have historically been scrutinized for their ubiquity and poor nutritional quality, leading many states to enact legislation limiting the availability and accessibility of these items. Evaluations of these policy approaches show their promise in improving the healthfulness of school food environments, considered an important strategy for reducing childhood obesity. Yet little is known about the decision-making processes by which such legislation is formed and adopted. Using a comparative case study design, this study describes and analyzes the policy formation processes surrounding five state-level competitive food bills introduced in 2009-2010. Data for each case were drawn from multiple key informant interviews and document reviews. Case studies were conducted, analyzed, and written independently using a standard protocol and were subsequently compared for recurring and unique themes. Abbreviated case studies and summary tables are provided. Results indicate that bill cost is a major barrier to achieving strong, health-promoting policy change. Additionally, findings reveal that supporters of stronger competitive food policies often concede to changes that weaken a bill in order to neutralize opposition and achieve stakeholder buy-in. These challenges suggest that continued research on the development, implementation, and evaluation of public health policies can contribute to the advancement of new strategies for effective health promotion. PMID:25829121

  3. Interparental Conflict and Adolescents' Romantic Relationship Conflict.

    PubMed

    Simon, Valerie A; Furman, Wyndol

    2010-01-01

    This study examined associations between interparental conflict and adolescents' romantic relationship conflict. High school seniors (N=183) who lived with married parents completed questionnaires about their parents' marriage and their own romantic relationships. A subset of 88 adolescents was also observed interacting with their romantic partners. Adolescents' perceptions and appraisals of interparental conflict were related to the amount of conflict in romantic relationship and adolescents' conflict styles. Adolescents' appraisals of interparental conflict (i.e., self-blame, perceived threat) moderated many of the associations between interparental conflict and conflict behavior with romantic partners. The patterns of moderated effects differed by gender. These findings suggest that the meanings boys and girls ascribe to interparental conflict are important for understanding how family experiences contribute to the development of romantic relationships. PMID:20186259

  4. Interparental Conflict and Adolescents’ Romantic Relationship Conflict

    PubMed Central

    Simon, Valerie A.; Furman, Wyndol

    2009-01-01

    This study examined associations between interparental conflict and adolescents’ romantic relationship conflict. High school seniors (N=183) who lived with married parents completed questionnaires about their parents’ marriage and their own romantic relationships. A subset of 88 adolescents was also observed interacting with their romantic partners. Adolescents’ perceptions and appraisals of interparental conflict were related to the amount of conflict in romantic relationship and adolescents’ conflict styles. Adolescents’ appraisals of interparental conflict (i.e., self-blame, perceived threat) moderated many of the associations between interparental conflict and conflict behavior with romantic partners. The patterns of moderated effects differed by gender. These findings suggest that the meanings boys and girls ascribe to interparental conflict are important for understanding how family experiences contribute to the development of romantic relationships. PMID:20186259

  5. Mental health services for children exposed to armed conflict: Médecins Sans Frontières’ experience in the Democratic Republic of Congo, Iraq and the occupied Palestinian territory

    PubMed Central

    Lokuge, K; Shah, T; Pintaldi, G; Thurber, K; Martínez-Viciana, C; Cristobal, M; Palacios, L; Dear, K; Banks, E

    2013-01-01

    Background: Armed conflict has broad-ranging impacts on the mental health and wellbeing of children and adolescents. Mental health needs greatly exceed service provision in conflict settings, particularly for these age groups. The provision and targeting of appropriate services requires better understanding of the characteristics and requirements of children and adolescents exposed to armed conflict. Methods: Routine patient and programme monitoring data were analysed for patients <20 years of age attending mental health services provided by Médecins Sans Frontières (MSF) in three countries affected by armed conflict: the Democratic Republic of Congo (DRC), Iraq and the occupied Palestinian territory (oPt). The demographic characteristics, presenting mental health complaint, attributed precipitating event, services provided and short-term outcomes for mental health services users in each country are described. Results: Between 2009 and 2012, 3025 individuals <20 years of age presented for care in DRC and Iraq, and in 2012 in oPt, constituting 14%, 17·5% and 51%, respectively, of all presentations to MSF mental health services in those three countries. The most common precipitating event was sexual violence in DRC (36·5%), domestic violence in Iraq (17·8%) and incarceration or detention in oPt (33%). Armed conflict-related precipitants were reported by 25·9%, 55·0% and 76·4% of youths in DRC, Iraq and oPt, respectively. The most common presenting complaints in children and adolescents were anxiety-related, followed by mood-related, behaviour-related and somatisation problems; these varied according to country and precipitating event. Although a high proportion (45·7%) left programmes early, 97% of those who completed care self-reported improvement in their presenting complaint. Conclusions: Brief trauma-focused therapy, the current MSF mental health therapeutic intervention, appears to be effective in reducing symptoms arising from the experience of trauma

  6. Designing health care environments: Part I. Basic concepts, principles, and issues related to evidence-based design.

    PubMed

    Cesario, Sandra K

    2009-06-01

    A 2001 Institute of Medicine report captured the nation's attention regarding the dangers that can result from the health care environment. This report, fueled by the need for new facilities to be constructed, led to an explosion of research that now links the physical structure and design of health care facilities to the health and well-being of patients, nurses, other health care workers, and visitors. Continuing nursing education that highlights the importance of evidence-based design has been associated with measurable improvement in health care facilities' clinical outcomes, economic performance, employee productivity, customer satisfaction, and cultural congruency. Three major categories of outcomes can be impacted by evidence-based design: stress reduction, safety, and overall health care quality and ecology. In this article, Part I of a two-part series, the basic concepts, principles, and issues related to evidence-based design are introduced. Part II will describe continuing education programs available for nurses. PMID:19639918

  7. Building primary care practitioners' attitudes and confidence in mental health skills in a post-conflict society: a Cambodian example.

    PubMed

    Henderson, David C; Mollica, Richard F; Tor, Svang; Lavelle, James; Culhane, Melissa A; Hayden, Doug

    2005-08-01

    Our program attempted to integrate community mental health in primary care settings in Cambodia and to evaluate the effects of training on local providers. The training program underwent an extensive evaluation to determine its impact on the mental health knowledge, confidence in performing medical and psychiatric procedures, skills and attitudes of its trainees. One hundred four Cambodian primary care practitioners (PCPs) were trained in a primary care setting in Siem Reap, Cambodia, over a 2-year period. There was a significant improvement in PCPs' confidence in all clusters of medical and psychiatric procedures (counseling, medical evaluation, prescribing medications, psychiatric diagnosis, assessing risk for violence, traditional treatments, and treating trauma victims) comparing baseline to posttraining and baseline to 2-year follow-up (p < 0.05). Only confidence in prescribing psychotropic medications improved from posttraining to 2-year follow-up. This study supports the feasibility of training PCPs in a culturally effective manner in a postconflict society. PMID:16082300

  8. Ethics, morality, and conflicting interests: how questionable professional integrity in some scientists supports global corporate influence in public health

    PubMed Central

    Baur, Xaver; Budnik, Lygia Therese; Ruff, Kathleen; Egilman, David S; Lemen, Richard A; Soskolne, Colin L

    2015-01-01

    Clinical and public health research, education, and medical practice are vulnerable to influence by corporate interests driven by the for-profit motive. Developments over the last 10 years have shown that transparency and self-reporting of corporate ties do not always mitigate bias. In this article, we provide examples of how sound scientific reasoning and evidence-gathering are undermined through compromised scientific enquiry resulting in misleading science, decision-making, and policy intervention. Various medical disciplines provide reference literature essential for informing public, environmental, and occupational health policy. Published literature impacts clinical and laboratory methods, the validity of respective clinical guidelines, and the development and implementation of public health regulations. Said literature is also used in expert testimony related to resolving tort actions on work-related illnesses and environmental risks. We call for increased sensitivity, full transparency, and the implementation of effective ethical and professional praxis rules at all relevant regulatory levels to rout out inappropriate corporate influence in science. This is needed because influencing the integrity of scientists who engage in such activities cannot be depended upon. PMID:25730664

  9. Ethics, morality, and conflicting interests: how questionable professional integrity in some scientists supports global corporate influence in public health.

    PubMed

    Baur, Xaver; Budnik, Lygia Therese; Ruff, Kathleen; Egilman, David S; Lemen, Richard A; Soskolne, Colin L

    2015-03-01

    Clinical and public health research, education, and medical practice are vulnerable to influence by corporate interests driven by the for-profit motive. Developments over the last 10 years have shown that transparency and self-reporting of corporate ties do not always mitigate bias. In this article, we provide examples of how sound scientific reasoning and evidence-gathering are undermined through compromised scientific enquiry resulting in misleading science, decision-making, and policy intervention. Various medical disciplines provide reference literature essential for informing public, environmental, and occupational health policy. Published literature impacts clinical and laboratory methods, the validity of respective clinical guidelines, and the development and implementation of public health regulations. Said literature is also used in expert testimony related to resolving tort actions on work-related illnesses and environmental risks. We call for increased sensitivity, full transparency, and the implementation of effective ethical and professional praxis rules at all relevant regulatory levels to rout out inappropriate corporate influence in science. This is needed because influencing the integrity of scientists who engage in such activities cannot be depended upon. PMID:25730664

  10. Staff Perspectives on the Use of a Computer-Based Concept for Lifestyle Intervention Implemented in Primary Health Care

    ERIC Educational Resources Information Center

    Carlfjord, Siw; Johansson, Kjell; Bendtsen, Preben; Nilsen, Per; Andersson, Agneta

    2010-01-01

    Objective: The aim of this study was to evaluate staff experiences of the use of a computer-based concept for lifestyle testing and tailored advice implemented in routine primary health care (PHC). Design: The design of the study was a cross-sectional, retrospective survey. Setting: The study population consisted of staff at nine PHC units in the…

  11. Effects of a Unit in Mental Health on Rural Adolescents' Attitudes about Seeking Help and Concepts of Mental Illness.

    ERIC Educational Resources Information Center

    Esters, Irvin G.; And Others

    One factor thought to contribute to the underutilization of mental health services, especially among rural Americans, is the stigma attached to mental illness and the associated help seeking process. This study investigated the effects of an instructional unit on mental illness and related issues on rural adolescents' concept of mental illness and…

  12. The Effect of Educational Disequilibrium in Field Work on Graduate Social Work Students' Self-Concept and Mental Health

    ERIC Educational Resources Information Center

    Ying, Yu-Wen

    2011-01-01

    The author used a mixed methods design to assess field work-related educational disequilibrium and its effect on the self-concept and mental health of MSW students. Twenty-eight advanced, fourth-semester MSW students were compared with 37 entering, first-semester MSW students in practice-related sense of accomplishment. Compared with first-year…

  13. Rhazes’ concepts and manuscripts on nutrition in treatment and health care

    PubMed Central

    Nikaein, Farzad; Zargaran, Arman; Mehdizadeh, Alireza

    2012-01-01

    The use of nutrition in medical practice has a long history dating back to 6000 years. The great Persian chemist, physician, and philosopher, Rhazes (865-925 AD), wrote over 200 books in different branches of science. Some of his work drew attention to the notion that nutrition is an important part of treating diseases and health care procedures. Rhazes formulated highly developed concepts of nutrition and wrote several special books about food and diet such as manfe’ al aghzie va mazareha (Benefits of Food and its Harmfulness), teb al moluki (Medicine for Kings), and Ata’me al marza (Food for Patients). His writing included detailed guidance about eating fruit ma iaghdam men al favakeh va al aghzieh va ma yoakhar (Fruit Before or After Meal), and other food types keifiat al eghteza (Temperament and Quality of Foods) and al aghziat al mokhtasareh (Brief Facts about Food). Considering the time that these books were written, they have had a great influence on approaches to nutrition in the history of medicine, so Rhazes can be considered as a pioneer in the scientific field of nutrition. PMID:23661862

  14. Conflict Resolution Automation and Pilot Situation Awareness

    NASA Technical Reports Server (NTRS)

    Dao, Arik-Quang V.; Brandt, Summer L.; Bacon, Paige; Kraut, Josh; Nguyen, Jimmy; Minakata, Katsumi; Raza, Hamzah; Rozovski, David; Johnson, Walter W.

    2010-01-01

    This study compared pilot situation awareness across three traffic management concepts. The Concepts varied in terms of the allocation of traffic avoidance responsibility between the pilot on the flight deck, the air traffic controllers, and a conflict resolution automation system. In Concept 1, the flight deck was equipped with conflict resolution tools that enable them to fully handle the responsibility of weather avoidance and maintaining separation between ownship and surrounding traffic. In Concept 2, pilots were not responsible for traffic separation, but were provided tools for weather and traffic avoidance. In Concept 3, flight deck tools allowed pilots to deviate for weather, but conflict detection tools were disabled. In this concept pilots were dependent on ground based automation for conflict detection and resolution. Situation awareness of the pilots was measured using online probes. Results showed that individual situation awareness was highest in Concept 1, where the pilots were most engaged, and lowest in Concept 3, where automation was heavily used. These findings suggest that for conflict resolution tasks, situation awareness is improved when pilots remain in the decision-making loop.

  15. Who Can Afford Health Care? Evaluating the Socio-Economic Conditions and the Ability to Contribute to Health Care in a Post-Conflict Area in DR Congo

    PubMed Central

    Gerstl, Sibylle; Sauter, Justin; Kasanda, Joseph; Kinzelbach, Alfred

    2013-01-01

    Introduction The Democratic Republic of the Congo is today one of the poorest countries in the world; the health status of the population ranks among the worst in Sub-Saharan Africa. Public health services charge user fees and drug prices. Since 2008, north-eastern Congo is facing a guerrilla war. Malteser International is assisting with free health care for internally displaced persons as well as the general population. Before the incursion the health system was based on user fees. The aim of this study was to determine the socio-economic conditions of the population and to assess their ability to contribute to health care. Methodology Heads of 552 randomly selected households in 23 clusters in two health zones were interviewed using a standardised questionnaire. Findings The demographic description and socio-economic conditions of the study population were homogenous. Major source of income was agriculture (57%); 47% of the households earned less than US$ 5.5/week. Ninety-two percent of the interviewed households estimated that they would be able to contribute to consultation fees (maximum amount of US$ 0.27) and 79% to the drug prices (maximum amount of US$ 1.10). Six percent opted for free consultations and 19% for free drugs. Conclusions Living conditions were very basic; the estimated income of the study population was low. Almost half of the population perceived their current living situation as fairly good/good. More than 90% of the study population estimated to be able to contribute to consultation fees and 80% to drug prices. As a result Malteser International suggested introducing flat-rates for health care services. Once the project ends, the population will have to pay again for their health service. One solution would be the introduction of a health care financing system with the goal to reach universal coverage to health care. PMID:24204819

  16. Sexual Self-Concept and General Health in Rheumatoid Arthritis Patients

    PubMed Central

    Saadat, Seyed Hassan; Ramezani, Arash; Ahmadi, Khodabakhsh

    2015-01-01

    Background: There are several studies regarding sexual dysfunction in chronic diseases such as diabetes and renal failure; however, no significant study has been done on Iranian rheumatoid arthritis (RA) patients. Objectives: In this study, we aimed to identify and compare sexual dysfunction between RA patients and the normal population. Patients and Methods: In this case-control study, two groups of females (87 RA patients and 89 controls) were randomly selected from the rheumatology clinic of Baqiyatallah Hospital, Tehran, Iran. General health questionnaire (GHQ-28) and multidimensional sexual self-concept questionnaire (MSSCQ) were used to evaluate RA patients. We used SPSS for statistical analysis mainly by the t-test and chi-square test. P values less than 0.05 were considered significant. Results: In the GHQ-28 evaluation, RA patients had lower social function; however somatization rated higher in normal patients (P < 0.05). Sexual health was lower in the RA population (P < 0.05). No significant difference was found in sexual desire. Except sexual pain, other sexual health parameters were lower in RA patients. The scores were as follow: sensation 13.6 ± 4.4 vs. 12.2 ± 4.5, P = 0.024; lubrication 6.9 ± 2.1 vs. 6.2 ± 2.1, P = 0.017; orgasm 10.4 ± 2.8 vs. 9.5 ± 3.2, P = 0.37; pain 10.1 ± 2.2 vs. 10.8 ± 1.9, P = 0.013; enjoyment 23.8 ± 5.8 vs. 21.3 ± 7.5, P = 0.009 and partner related 8.5 ± 1.7 vs. 7.6 ± 2.4, P = 0.005. Furthermore, the concern of losing their sexual partner was higher in the normal population. Conclusions: Our study demonstrated that almost all GHQ and MSSCQ parameters were lower in RA patients, which indicates lower quality sexual life in RA patients. We recommend further consideration for the treatment and care of these patients. PMID:26568849

  17. Health Service Utilization for Mental, Behavioural and Emotional Problems among Conflict-Affected Population in Georgia: A Cross-Sectional Study

    PubMed Central

    Gotsadze, George; Patel, Vikram; McKee, Martin; Uchaneishvili, Maia; Rukhadze, Natia

    2015-01-01

    Background There is large gap in mental illness treatment globally and potentially especially so in war-affected populations. The study aim was to examine health care utilization patterns for mental, behavioural and emotional problems among the war-affected adult population in the Republic of Georgia. Methods A cross-sectional household survey was conducted among 3600 adults affected by 1990s and 2008 armed conflicts in Georgia. Service use was measured for the last 12 months for any mental, emotional or behavioural problems. TSQ, PHQ-9 and GAD-7 were used to measure current symptoms of PTSD, depression and anxiety. Descriptive and regression analyses were used. Results Respondents were predominantly female (65.0%), 35.8% were unemployed, and 56.0% covered by the government insurance scheme. From the total sample, 30.5% had symptoms of at least one current mental disorder. Among them, 39.0% sought care for mental problems, while 33.1% expressed facing barriers to accessing care and so did not seek care. General practitioners (29%) and neurologists (26%) were consulted by the majority of those with a current mental disorder who accessed services, while use of psychiatric services was far more limited. Pharmacotherapy was the predominant type of care (90%). Female gender (OR 1.50, 95% CI: 1.25, 1.80), middle-age (OR 1.83, 95% CI: 1.48, 2.26) and older-age (OR 1.62, 95% CI: 1.19, 2.21), possession of the state insurance coverage (OR 1.55, 95% CI: 1.30, 1.86), current PTSD symptoms (OR 1.56, 95% CI: 1.29, 1.90) and depression (OR 2.12, 95% CI: 1.70, 2.65) were associated with higher rates of health service utilization, while employed were less likely to use services (OR 0.71, 95% CI: 0.55, 0.89). Conclusions Reducing financial access barriers and increasing awareness and access to local care required to help reduce the burden of mental disorders among conflict-affected persons in Georgia. PMID:25853246

  18. The best of two worlds: how the Greenland Board of Nutrition has handled conflicting evidence about diet and health.

    PubMed

    Bjerregaard, Peter; Mulvad, Gert

    2012-01-01

    The traditional diet in Greenland consists to a large extent of meat and organs of seal and other marine mammals, which is polluted by POPs and mercury. These substances are present in the blood of Greenlanders in concentrations well above international guidelines, and as these contaminants are suspected of having negative impacts on health, some action should be taken. On the other hand, traditional food is also an important source of health promoting micronutrients that are not provided by imported food in sufficient quantities, for example vitamin D, long chain n-3 fatty acids, and selenium, not to mention the traditional diet's function as a social glue that is perceived as important for Inuit identity in Greenland. The proportion of the total diet that comes from marine mammals is on a constant decrease, and especially children and young adults consume rather little seal and whale. The traditional food items are consequently being replaced by imported food, and among the imported food items several rather unhealthy items are popular, that is carbonated soft drinks with sugar, sweets, chips and farmed (red) meat with a high content of saturated fat. Together with a decrease in physical activity, this dietary transition has resulted in a severe epidemic of overweight and diabetes. In giving advice to the public, the Greenland Board of Nutrition was therefore faced with the challenge to retain the benefits of the traditional diet while minimizing the contaminant exposure, and at the same time to counteract the effects of poor quality imported food. The Board tried to balance the known and suspected positive and negative aspects of the total diet in relation not only to physical health but to general wellbeing, and decided on 10 simple recommendations. As the consumption of traditional food becomes less prominent and as the consumption of food rich in empty calories increases, the guidelines are continuously revised and updated. PMID:22789516

  19. The best of two worlds: how the Greenland Board of Nutrition has handled conflicting evidence about diet and health

    PubMed Central

    Bjerregaard, Peter; Mulvad, Gert

    2012-01-01

    The traditional diet in Greenland consists to a large extent of meat and organs of seal and other marine mammals, which is polluted by POPs and mercury. These substances are present in the blood of Greenlanders in concentrations well above international guidelines, and as these contaminants are suspected of having negative impacts on health, some action should be taken. On the other hand, traditional food is also an important source of health promoting micronutrients that are not provided by imported food in sufficient quantities, for example vitamin D, long chain n-3 fatty acids, and selenium, not to mention the traditional diet’s function as a social glue that is perceived as important for Inuit identity in Greenland. The proportion of the total diet that comes from marine mammals is on a constant decrease, and especially children and young adults consume rather little seal and whale. The traditional food items are consequently being replaced by imported food, and among the imported food items several rather unhealthy items are popular, that is carbonated soft drinks with sugar, sweets, chips and farmed (red) meat with a high content of saturated fat. Together with a decrease in physical activity, this dietary transition has resulted in a severe epidemic of overweight and diabetes. In giving advice to the public, the Greenland Board of Nutrition was therefore faced with the challenge to retain the benefits of the traditional diet while minimizing the contaminant exposure, and at the same time to counteract the effects of poor quality imported food. The Board tried to balance the known and suspected positive and negative aspects of the total diet in relation not only to physical health but to general wellbeing, and decided on 10 simple recommendations. As the consumption of traditional food becomes less prominent and as the consumption of food rich in empty calories increases, the guidelines are continuously revised and updated. PMID:22789516

  20. Another Wrinkle in the Debate about Successful Aging: The Undervalued Concept of Resilience and the Lived Experience of Dementia

    ERIC Educational Resources Information Center

    Harris, Phyllis Braudy

    2008-01-01

    The concept of "successful aging" is a contested discourse in gerontology. Two conflicting paradigms dominate the discussion: a health promotion activity model, and a model critical of the concept of successful aging. However, this study takes a different perspective and proposes that perhaps we have been striving for the wrong goal. The true…

  1. Health Human Capital in Sub-Saharan Africa: Conflicting Evidence from Infant Mortality Rates and Adult Heights

    PubMed Central

    Akachi, Yoko; Canning, David

    2011-01-01

    We investigate trends in cohort infant mortality rates and adult heights in 39 developing countries since 1960. In most regions of the world improved nutrition, and reduced childhood exposure to disease, have lead to improvements in both infant mortality and adult stature. In Sub-Saharan Africa, however, despite declining infant mortality rates, adult heights have not increased. We argue that in Sub-Saharan Africa the decline in infant mortality may have been due to interventions that prevent infant deaths rather than improved nutrition and childhood morbidity. Despite declining infant mortality, Sub-Saharan Africa may not be experiencing increases in health human capital. PMID:20634153

  2. Varieties of Organizational Conflict

    ERIC Educational Resources Information Center

    Pondy, Louis R.

    1969-01-01

    The viewpoints and findings of the seven empirical studies of organizational conflict contained in this issue are compared and contrasted. A distinction is made between conflict within a stable organization structure and conflict aimed at changing the organization structure. (Author)

  3. Scarcity, Conflict, and Equity in Allocating Public Recreation Resources.

    ERIC Educational Resources Information Center

    Shelby, Bo; Danley, Mark

    The conflict between the interests of commercial outfitters and private boaters in the use of whitewater rivers is examined. A discussion is presented on the literature on scarcity, allocation, and conflict among groups. These concepts are applied to the allocation of public resources on whitewater rivers. The conflicting interest groups are…

  4. Non-Residential Father-Child Involvement, Interparental Conflict and Mental Health of Children Following Divorce: A Person-Focused Approach.

    PubMed

    Elam, Kit K; Sandler, Irwin; Wolchik, Sharlene; Tein, Jenn-Yun

    2016-03-01

    Variable-centered research has found complex relationships between child well-being and two critical aspects of the post-divorce family environment: the level of non-residential father involvement (i.e., contact and supportive relationship) with their children and the level of conflict between the father and mother. However, these analyses fail to capture individual differences based on distinct patterns of interparental conflict, father support and father contact. Using a person-centered latent profile analysis, the present study examined (1) profiles of non-residential father contact, support, and interparental conflict in the 2 years following divorce (N = 240), when children (49 % female) were between 9 and 12 years of age and (2) differences across profiles in concurrent child adjustment outcomes as well as outcomes 6 years later. Four profiles of father involvement were identified: High Contact-Moderate Conflict-Moderate Support, Low Contact-Moderate Conflict-Low Support, High Conflict-Moderate Contact-Moderate Support, and Low Conflict-Moderate Contact-Moderate Support. Concurrently, children with fathers in the group with high conflict were found to have significantly greater internalizing and externalizing problems compared to all other groups. Six years later, children with fathers in the group with low contact and low support were found to have greater internalizing and externalizing problems compared to children with fathers in the high conflict group, and also greater internalizing problems compared to children with fathers in the low conflict group. These results provide insight into the complex relationship among non-residential fathers' conflict, contact, and support in child adjustment within divorcing families. PMID:26692236

  5. [Developmental origin of health and adult diseases (DOHaD): evolution of a concept over three decades].

    PubMed

    Charles, Marie-Aline; Delpierre, Cyrille; Bréant, Bernadette

    2016-01-01

    In the 1980s, D. Barker and his team proposed the hypothesis of a fetal origin of adult diseases. The concept subsequently evolved into the developmental origins of health and diseases. Progresses in various domains such as social epidemiology, neuroscience, toxicology have contributed to establish the early years of life as a key period for future health. Finally, epigenetics has provided biological plausibility to long-term programming of health by early exposures. The convergence of all these currents has led to conceptualize human health in a complex and dynamic continuum, the Lifecourse Health Development, beginning in the prenatal period and covering the whole life. Many animal models have been developed to try to unravel the mechanisms involved. Their contributions are described in this paper with the example of type 2 diabetes. PMID:26850602

  6. Chemistry for Health-Science Students: What Is an Appropriate Balance between Basic Chemical Concepts and Health-Related Applications?

    ERIC Educational Resources Information Center

    Genyea, Julien; Callewaert, Denis M.

    1983-01-01

    Suggests general chemistry, organic chemistry, and biochemistry content for a two-semester, health-related, chemistry course sequence. Indicates that basic principles should be emphasized and that (when appropriate) these principles should be discussed with applications to health care. Other issues related to chemistry for health-related programs…

  7. Conflicts Between Parents and Health Professionals About a Child's Medical Treatment: Using Clinical Ethics Records to Find Gaps in the Bioethics Literature.

    PubMed

    McDougall, Rosalind; Notini, Lauren; Phillips, Jessica

    2015-09-01

    Clinical ethics records offer bioethics researchers a rich source of cases that clinicians have identified as ethically complex. In this paper, we suggest that clinical ethics records can be used to point to types of cases that lack attention in the current bioethics literature, identifying new areas in need of more detailed bioethical work. We conducted an analysis of the clinical ethics records of one paediatric hospital in Australia, focusing specifically on conflicts between parents and health professionals about a child's medical treatment. We identified, analysed, and compared cases of this type from the clinical ethics records with cases of this type discussed in bioethics journals. While the cases from journals tended to describe situations involving imminent risk to the child's life, a significant proportion of the clinical ethics records cases involved different stakes for the child involved. These included distress, poorer functional outcome, poorer psychosocial outcome, or increased risk of surgical complications. Our analysis suggests that one type of case that warrants more detailed ethics research is parental refusal of recommended treatment, where the refusal does not endanger the child's life but rather some other aspect of the child's well-being. PMID:26133890

  8. Freedom of conscience and health care in the United States of america: the conflict between public health and religious liberty in the patient protection and affordable care act.

    PubMed

    West-Oram, Peter

    2013-09-01

    The recent confirmation of the constitutionality of the Obama administration's Patient Protection and Affordable Care Act (PPACA) by the US Supreme Court has brought to the fore long-standing debates over individual liberty and religious freedom. Advocates of personal liberty are often critical, particularly in the USA, of public health measures which they deem to be overly restrictive of personal choice. In addition to the alleged restrictions of individual freedom of choice when it comes to the question of whether or not to purchase health insurance, opponents to the PPACA also argue that certain requirements of the Act violate the right to freedom of conscience by mandating support for services deemed immoral by religious groups. These issues continue the long running debate surrounding the demands of religious groups for special consideration in the realm of health care provision. In this paper I examine the requirements of the PPACA, and the impacts that religious, and other ideological, exemptions can have on public health, and argue that the exemptions provided for by the PPACA do not in fact impose unreasonable restrictions on religious freedom, but rather concede too much and in so doing endanger public health and some important individual liberties. PMID:23539432

  9. Concept proposal for a detachable exoskeleton-wheelchair to improve mobility and health.

    PubMed

    Borisoff, Jaimie F; Mattie, Johanne; Rafer, Vince

    2013-06-01

    Wheelchair use has consequences to quality of life in at least two areas: 1) health issues such as pressure sores and chronic overuse injury; and 2) access problems due to the inaccessible nature of the built and natural environments that are most amenable to upright postures. Even with these concerns, wheelchairs are still the best form of mobility for many people (e.g. they are relatively easy to transfer into and propel). However, wheelchairs are simply not transformative, i.e. they do not allow a person with a disability to attain a level of mobility performance that approaches that of their non-disabled peers, nor do they typically allow for face to face interactions and full participation in the community. Wheelchairs also do not typically support ongoing therapeutic benefits for the user. To address the inadequacy of existing wheelchairs, we are merging two evolving technologies into a coherent new mobility device. The first is dynamic wheeled mobility, which adds significant functionality to conventional wheelchairs through the use of on-the-fly adjustable positioning. The second is powered walking exoskeletons, which enable highly desired standing and walking functions, as well as therapeutic benefits associated with rehabilitation gait training. Unfortunately, exoskeletons have significant usability concerns such as slow speed, limited range, potential to cause skin issues, and difficult transfers. A new concept of docking a detachable exoskeleton to a wheeled frame has been developed to address these issues. The design goal is a single mobility device that not only optimizes daily activities (i.e. wheelchair seating and propulsion with dynamic positioning), but also serves as an easy-to-use rehabilitation tool for therapeutic benefits (i.e. a detachable powered exoskeleton for walking sojourns). This has significant potential benefits for the lives of people with mobility impairments. PMID:24187215

  10. What could a strengthened right to health bring to the post-2015 health development agenda?: interrogating the role of the minimum core concept in advancing essential global health needs

    PubMed Central

    2013-01-01

    Background Global health institutions increasingly recognize that the right to health should guide the formulation of replacement goals for the Millennium Development Goals, which expire in 2015. However, the right to health’s contribution is undercut by the principle of progressive realization, which links provision of health services to available resources, permitting states to deny even basic levels of health coverage domestically and allowing international assistance for health to remain entirely discretionary. Discussion To prevent progressive realization from undermining both domestic and international responsibilities towards health, international human rights law institutions developed the idea of non-derogable “minimum core” obligations to provide essential health services. While minimum core obligations have enjoyed some uptake in human rights practice and scholarship, their definition in international law fails to specify which health services should fall within their scope, or to specify wealthy country obligations to assist poorer countries. These definitional gaps undercut the capacity of minimum core obligations to protect essential health needs against inaction, austerity and illegitimate trade-offs in both domestic and global action. If the right to health is to effectively advance essential global health needs in these contexts, weaknesses within the minimum core concept must be resolved through innovative research on social, political and legal conceptualizations of essential health needs. Summary We believe that if the minimum core concept is strengthened in these ways, it will produce a more feasible and grounded conception of legally prioritized health needs that could assist in advancing health equity, including by providing a framework rooted in legal obligations to guide the formulation of new health development goals, providing a baseline of essential health services to be protected as a matter of right against governmental claims of

  11. 42 CFR 50.605 - Management of conflicting interests.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Management of conflicting interests. 50.605 Section 50.605 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS POLICIES... PHS Funding Is Sought § 50.605 Management of conflicting interests. (a) The designated...

  12. An insight into the drinking-water access in the health institutions at the Saharawi refugee camps in Tindouf (Algeria) after 40years of conflict.

    PubMed

    Vivar, M; Pichel, N; Fuentes, M; Martínez, F

    2016-04-15

    Drinking water access in the Saharawi refugee camps located in the Algerian desert is a challenge that is still an on-going problem after 40years of conflict. This work presents an analysis of the situation with emphasis on the water supply in health institutions (quantity and quality) including both sanitary inspections and a comprehensive water quality study. Results from sanitary inspections show that only half of the water supply installations at the hospitals are in adequate conditions and the rest present high risk of microbiological contamination. Water access in small medical community centres on the other hand present issues related to the non-availability of food-grade water tanks for the institutions (70%), the use of small 10l containers as the main water supply (40%), poor maintenance (60% under antihygienic conditions and 30% with damaged covers), and insufficient chlorine levels that prevent microbiological contamination. Regarding water quality analyses, raw water supply in Smara, El Aiun and Awserd camps present high conductivity and high levels of fluoride, chloride, nitrate and sulphate, but dropping to normal levels within the drinking-water standards after water treatment via reverse osmosis plants. But for the case of El Aiun and Awserd, the reverse osmosis plant only provides treated water to the population each 20days, so the population receives raw water directly and health risks should be evaluated. Finally, Dakhla water supply is the best in terms of physico-chemical parameters quality, currently providing safe drinking water after a chlorination stage. In summary, drinking water access has improved dramatically in the last years due to the efforts of local and international authorities but several issues remain to be solved: access to treated water for all the population, improved water quality controls (especially in Dakhla), expansion of distribution networks, and adequate storage systems and maintenance. PMID:26845189

  13. Assessing the Health of Individuals and Populations in Surveys of the Elderly: Some Concepts and Approaches.

    ERIC Educational Resources Information Center

    Wallace, Robert B.

    1994-01-01

    Health survey research assesses health of individuals in population. Measures include prevalence/incidence of diseases, signs/symptoms, functional states, and health services utilization. Although assessing individual biologic robustness can be problematic, testable approaches do exist. Characteristics of health of populations/communities, not…

  14. Identifying multi-level culturally appropriate smoking cessation strategies for Aboriginal health staff: a concept mapping approach.

    PubMed

    Dawson, Anna P; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

    2013-02-01

    Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco control personnel. Smoking cessation strategies (n = 74) were brainstormed using 34 interviews, 3 focus groups and a stakeholder workshop. Stakeholders sorted strategies into meaningful groups and rated them on perceived importance and feasibility. A concept map was developed using multi-dimensional scaling and hierarchical cluster analyses. Ten unique clusters of smoking cessation strategies were depicted that targeted individuals, family and peers, community, workplace and public policy. Smoking cessation resources and services were represented in addition to broader strategies addressing social and environmental stressors that perpetuate smoking and make quitting difficult. The perceived importance and feasibility of clusters were rated differently by participants working in health services that were government-coordinated compared with community-controlled. For health service workers within vulnerable populations, these findings clearly implicate a need for contextualized strategies that mitigate social and environmental stressors in addition to conventional strategies for tobacco control. The concept map is being applied in knowledge translation to guide development of smoking cessation programs for AHWs. PMID:23221591

  15. Child Emotional Security and Interparental Conflict.

    ERIC Educational Resources Information Center

    Davies, Patrick T.; Harold, Gordon T.; Goeke-Morey, Marcie C.; Cummings, E. Mark

    2002-01-01

    Four studies tested a theory that high interparental conflict increases child mental health risk by shaking children's sense of security in the family. Findings showed that children's fear, avoidance, and involvement were prominent responses, especially relative to reactions predicted by other theories. Interparental conflict related to greater…

  16. 42 CFR 35.46 - Conflicting claims.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Conflicting claims. 35.46 Section 35.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS... the interest of persons who may be ultimately entitled thereto, delivery may be withheld from...

  17. 42 CFR 35.46 - Conflicting claims.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Conflicting claims. 35.46 Section 35.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS... the interest of persons who may be ultimately entitled thereto, delivery may be withheld from...

  18. 42 CFR 35.46 - Conflicting claims.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Conflicting claims. 35.46 Section 35.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS... the interest of persons who may be ultimately entitled thereto, delivery may be withheld from...

  19. 42 CFR 35.46 - Conflicting claims.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Conflicting claims. 35.46 Section 35.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS... the interest of persons who may be ultimately entitled thereto, delivery may be withheld from...

  20. 42 CFR 35.46 - Conflicting claims.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Conflicting claims. 35.46 Section 35.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS... the interest of persons who may be ultimately entitled thereto, delivery may be withheld from...

  1. Conflicting Interpretations of Scientific Pedagogy

    NASA Astrophysics Data System (ADS)

    Galamba, Arthur

    2016-05-01

    Not surprisingly historical studies have suggested that there is a distance between concepts of teaching methods, their interpretations and their actual use in the classroom. This issue, however, is not always pitched to the personal level in historical studies, which may provide an alternative insight on how teachers conceptualise and engage with concepts of teaching methods. This article provides a case study on this level of conceptualisation by telling the story of Rómulo de Carvalho, an educator from mid-twentieth century Portugal, who for over 40 years engaged with the heuristic and Socratic methods. The overall argument is that concepts of teaching methods are open to different interpretations and are conceptualised within the melting pot of external social pressures and personal teaching preferences. The practice and thoughts of Carvalho about teaching methods are scrutinised to unveil his conflicting stances: Carvalho was a man able to question the tenets of heurism, but who publicly praised the heurism-like "discovery learning" method years later. The first part of the article contextualises the arrival of heurism in Portugal and how Carvalho attacked its philosophical tenets. In the second part, it dwells on his conflicting positions in relation to pupil-centred approaches. The article concludes with an appreciation of the embedded conflicting nature of the appropriation of concepts of teaching methods, and of Carvalho's contribution to the development of the philosophy of practical work in school science.

  2. Automated conflict resolution issues

    NASA Technical Reports Server (NTRS)

    Wike, Jeffrey S.

    1991-01-01

    A discussion is presented of how conflicts for Space Network resources should be resolved in the ATDRSS era. The following topics are presented: a description of how resource conflicts are currently resolved; a description of issues associated with automated conflict resolution; present conflict resolution strategies; and topics for further discussion.

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

    PubMed

    Fotaki, Marianna

    2014-11-01

    Trust has long been regarded as a vitally important aspect of the relationship between health service providers and patients. Recently, consumer choice has been increasingly advocated as a means of improving the quality and effectiveness of health service provision. However, it is uncertain how the increase of information necessary to allow users of health services to exercise choice, and the simultaneous introduction of markets in public health systems, will affect various dimensions of trust, and how changing relations of trust will impact upon patients and services. This article employs a theory-driven approach to investigate conceptual and material links between choice, trust and markets in health care in the context of the National Health Service in England. It also examines the implications of patient choice on systemic, organisational and interpersonal trust. The article is divided into two parts. The first argues that the shift to marketisation in public health services might lead to an over-reliance on rational-calculative aspects of trust at the expense of embodied, relational and social attributes. The second develops an alternative psychosocial conception of trust: it focuses on the central role of affect and accounts for the material and symbolic links between choice, trust and markets in health care. PMID:25470326

  4. Can the concept of Health Promoting Schools help to improve students' health knowledge and practices to combat the challenge of communicable diseases: Case study in Hong Kong?

    PubMed Central

    Lee, Albert; Wong, Martin CS; Keung, Vera MW; Yuen, Hilda SK; Cheng, Frances; Mok, Jennifer SY

    2008-01-01

    Background The growing epidemics of emerging infectious diseases has raised the importance of a setting approach and include the Health Promoting School (HPS) framework to promote better health and hygiene. Built on the concept of 'the' HPS framework, the Hong Kong Healthy Schools Award scheme includes "Personal Health Skills" as one of its key aspects to improve student hygiene knowledge and practices. This study examines the differences in student perceptions, knowledge and health behaviours between those schools that have adopted the HPS framework and those that have not adopted. Methods A cross-sectional study using multi-stage random sampling was conducted among schools with awards (HSA) and those schools not involved in the award scheme nor adopting the concept of HPS (non-HPS). For HSA group, 5 primary schools and 7 secondary schools entered the study with 510 students and 789 students sampled respectively. For the 'Non-HPS' group, 8 primary schools and 7 secondary schools entered the study with 676 students and 725 students sampled respectively. A self-administered questionnaire was used as the measuring instrument. Results Students in the HSA category were found to be better with statistical significance in personal hygiene practice, knowledge on health and hygiene, as well as access to health information. HSA schools were reported to have better school health policy, higher degrees of community participation, and better hygienic environment. Conclusion Students in schools that had adopted the HPS framework had a more positive health behaviour profile than those in non-HPS schools. Although a causal relationship is yet to be established, the HPS appears to be a viable approach for addressing communicable diseases. PMID:18234083

  5. Integrating the disaster cycle model into traditional disaster diplomacy concepts.

    PubMed

    Callaway, David W; Yim, Eugene S; Stack, Colin; Burkle, Frederick M

    2012-03-01

    Disaster diplomacy is an evolving contemporary model that examines how disaster response strategies can facilitate cooperation between parties in conflict. The concept of disaster diplomacy has emerged during the past decade to address how disaster response can be leveraged to promote peace, facilitate communication, promote human rights, and strengthen intercommunity ties in the increasingly multipolar modern world. Historically, the concept has evolved through two camps, one that focuses on the interactions between national governments in conflict and another that emphasizes the grassroots movements that can promote change. The two divergent approaches can be reconciled and disaster diplomacy further matured by contextualizing the concept within the disaster cycle, a model well established within the disaster risk management community. In particular, access to available health care, especially for the most vulnerable populations, may need to be negotiated. As such, disaster response professionals, including emergency medicine specialists, can play an important role in the development and implementation of disaster diplomacy concepts. PMID:22490937

  6. Refocusing and prioritizing HIV programmes in conflict and post-conflict settings: funding recommendations

    PubMed Central

    Hanson, Brent W.; Wodak, Alex; Fiamma, Agnès; Coates, Thomas J.

    2010-01-01

    Conflict and post-conflict settings pose specific challenges to HIV prevention and care efforts. Whereas armed conflicts have decreased very considerably in number, the interactions between HIV epidemiology and conflict remain problematic. This review describes factors that affect HIV in conflict and post-conflict settings, identifies challenges to addressing HIV, and presents actionable and measurable programming and funding recommendations that can be implemented immediately. Funding priorities include prevention and care efforts such as the provision and monitoring of universal precautions for HIV infection, health services for sexual violence and antiretroviral therapy. Policy efforts should prioritize enforcing appropriate conduct by peacekeepers and aid workers, interventions targeted at specific phases and contexts of conflicts, supporting the continuity of programmes from emergency to post emergency and reconstruction efforts and simplifying and accelerating funding mechanisms. PMID:18641476

  7. Conflict and Emerging Infectious Diseases

    PubMed Central

    Legros, Dominique; Formenty, Pierre; Connolly, Maire A.

    2007-01-01

    Detection and control of emerging infectious diseases in conflict situations are major challenges due to multiple risk factors known to enhance emergence and transmission of infectious diseases. These include inadequate surveillance and response systems, destroyed infrastructure, collapsed health systems and disruption of disease control programs, and infection control practices even more inadequate than those in resource-poor settings, as well as ongoing insecurity and poor coordination among humanitarian agencies. This article outlines factors that potentiate emergence and transmission of infectious diseases in conflict situations and highlights several priority actions for their containment and control. PMID:18217543

  8. Evaluating a Proof-of-Concept Approach of the German Health Telematics Infrastructure in the Context of Discharge Management.

    PubMed

    Hübner, Ursula; Schulte, Georg; Sellemann, Björn; Quade, Matthias; Rottmann, Thorsten; Fenske, Matthias; Egbert, Nicole; Kuhlisch, Raik; Rienhoff, Otto

    2015-01-01

    Although national eHealth strategies have existed now for more than a decade in many countries, they have been implemented with varying success. In Germany, the eHealth strategy so far has resulted in a roll out of electronic health cards for all citizens in the statutory health insurance, but in no clinically meaningful IT-applications. The aim of this study was to test the technical and organisation feasibility, usability, and utility of an eDischarge application embedded into a laboratory Health Telematics Infrastructure (TI). The tests embraced the exchange of eDischarge summaries based on the multiprofessional HL7 eNursing Summary standard between a municipal hospital and a nursing home. All in all, 36 transmissions of electronic discharge documents took place. They demonstrated the technical-organisation feasibility and resulted in moderate usability ratings. A comparison between eDischarge and paper-based summaries hinted at higher ratings of utility and information completeness for eDischarges. Despite problems with handling the electronic health card, the proof-of-concept for the first clinically meaningful IT-application in the German Health TI could be regarded as successful. PMID:26262099

  9. Concepts and trends in the preparation of health educators in the US.

    PubMed

    Hamburg, M V

    1980-01-01

    Traditionally, health educators in the United States were categorized as either school or community-based and were prepared separately in two kinds of institutions: schools of education and schools of public health. The standards for the two kinds of health education preparation were established by two separate agencies: State Education Departments and the American Public Health Association. In the past decade, schools of education have begun to offer training for community health educators as well as for teachers of health. Where this has occurred, programmes have many similarities, but the field work differs. Also a new type of health education specialist has emerged: one who works with patients. The field work for this category of health educator is usually in a health care institution. This situation has made it important to develop standards for professional preparation and practice that can be applied to all types of health educators. A group of professionals have reached agreement that a common core curriculum should be established for the entry level, and guidelines developed for specialized preparation at the advanced levels. A national study is underway to delineate roles of health educators. The future will probably bring competency-based curricula with unified standards for the profession as a whole. There will be more institutions of higher education offering community health education programmes and they can be expected to develop concentrations on special topics such as occupational health or patient education according to their resources. A viable accrediting system can be expected to be developed and widely used. However, the number of students will remain stable until the job market for health educators expands. PMID:7456675

  10. Conflicts and conflict management in the collaboration between nurses and physicians - a qualitative study.

    PubMed

    Leever, A M; Hulst, M V D; Berendsen, A J; Boendemaker, P M; Roodenburg, J L N; Pols, J

    2010-11-01

    In health care, optimal collaboration between nurses and physicians is crucial in the quality of the care process – but not self-generating. Little is known about how health-care professionals cope with conflicts within their collaboration. This qualitative study investigates the way nurses and physicians cope with conflict and clarifies the determinants of conflict management styles. All respondents formulate clear expectations which in their opinion are essential to collaboration. When collaboration leads to disagreement, physicians and nurses choose between ignoring the conflict or engaging in it. Choice is determined by five factors: the influence of oneself, the influence of the other, the nature of the conflict, the context of conflict, and personal motives. PMID:20919957

  11. Helping Kids Deal with Conflict. An Everyday Resource for All Teachers and Parents.

    ERIC Educational Resources Information Center

    Sheanh, Gerry

    Divided into five parts, this book examines some of the conflicts that Canadian children face on a daily basis and explores ways that adults can help children address these challenges. Chapter 1 looks at the causes behind conflicts, and examines some of the concepts concerning conflict and conflict resolution. Chapter 2 discusses self-esteem, what…

  12. To Track or Not to Track: User Reactions to Concepts in Longitudinal Health Monitoring

    PubMed Central

    Intille, Stephen S; Morris, Margaret E

    2006-01-01

    Background Advances in ubiquitous computing, smart homes, and sensor technologies enable novel, longitudinal health monitoring applications in the home. Many home monitoring technologies have been proposed to detect health crises, support aging-in-place, and improve medical care. Health professionals and potential end users in the lay public, however, sometimes question whether home health monitoring is justified given the cost and potential invasion of privacy. Objective The aim of the study was to elicit specific feedback from health professionals and laypeople about how they might use longitudinal health monitoring data for proactive health and well-being. Methods Interviews were conducted with 8 health professionals and 26 laypeople. Participants were asked to evaluate mock data visualization displays that could be generated by novel home monitoring systems. The mock displays were used to elicit reactions to longitudinal monitoring in the home setting as well as what behaviors, events, and physiological indicators people were interested in tracking. Results Based on the qualitative data provided by the interviews, lists of benefits of and concerns about health tracking from the perspectives of the practitioners and laypeople were compiled. Variables of particular interest to the interviewees, as well as their specific ideas for applications of collected data, were documented. Conclusions Based upon these interviews, we recommend that ubiquitous “monitoring” systems may be more readily adopted if they are developed as tools for personalized, longitudinal self-investigation that help end users learn about the conditions and variables that impact their social, cognitive, and physical health. PMID:17236264

  13. Perinatal health care in a conflict-affected setting: evaluation of health-care services and newborn outcomes at a regional medical centre in Iraq.

    PubMed

    Ahamadani, F A B; Louis, H; Ugwi, P; Hines, R; Pomerleau, M; Ahn, R; Burke, T F; Nelson, B D

    2014-12-01

    A field-based assessment was conducted to assess maternal and newborn health-care services, perinatal and newborn outcomes and associated risk factors at Bint Al-Huda Maternal and Newborn Teaching Hospital, a large referral hospital in southern Iraq. The multi-method approach used interviews, discussions, observation and review of perinatal and newborn outcome data. There is limited assessment of maternal vital signs, labour pattern, fetal response, and complications during pregnancy and labour. Perinatal and neonatal mortality rates are 27.4/1000 births and 30.9/1000 live births respectively. Associated neonatal mortality factors were gestational age < 37 weeks, male sex, birth weight < 2.5 kg, maternal age > 35 years, rural maternal residence and vaginal delivery. Improving birth outcomes in southern Iraq requires evidence-based clinical guidelines, additional supplies and equipment, quality improvement initiatives and in-service training. PMID:25664517

  14. Prototype Conflict Alerting Logic for Free Flight

    NASA Technical Reports Server (NTRS)

    Yang, Lee C.; Kuchar, James K.

    1997-01-01

    This paper discusses the development of a prototype alerting system for a conceptual Free Flight environment. The concept assumes that datalink between aircraft is available and that conflicts are primarily resolved on the flight deck. Four alert stages are generated depending on the likelihood of a conflict. If the conflict is not resolved by the flight crews, Air Traffic Control is notified to take over separation authority. The alerting logic is based on probabilistic analysis through modeling of aircraft sensor and trajectory uncertainties. Monte Carlo simulations were used over a range of encounter situations to determine conflict probability. The four alert stages were then defined based on probability of conflict and on the number of avoidance maneuvers available to the flight crew. Preliminary results from numerical evaluations and from a piloted simulator study at NASA Ames Research Center are summarized.

  15. 42 CFR 421.310 - Conflict of interest requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... (FAR) organizational conflict of interest guidance specified under 48 CFR subpart 9.5. (b) The... 42 Public Health 3 2010-10-01 2010-10-01 false Conflict of interest requirements. 421.310 Section... Conflict of interest requirements. Offerors for MIP contracts and MIP contractors are subject to...

  16. 42 CFR 51.26 - Conflicts of interest.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Conflicts of interest. 51.26 Section 51.26 Public... Priorities § 51.26 Conflicts of interest. The P&A system must develop appropriate policies and procedures to avoid actual or apparent conflict of interest involving clients, employees, contractors...

  17. 42 CFR 438.58 - Conflict of interest safeguards.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Conflict of interest safeguards. 438.58 Section 438... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE State Responsibilities § 438.58 Conflict of interest... safeguards against conflict of interest on the part of State and local officers and employees and agents...

  18. 42 CFR 414.912 - Conflicts of interest

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Conflicts of interest 414.912 Section 414.912... Biologicals Under Part B § 414.912 Conflicts of interest (a) Approved CAP vendors and applicants that bid to participate in the CAP are subject to the following: (1) The conflict of interest standards and...

  19. 42 CFR 421.312 - Conflict of interest resolution.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... government to award a contract to the offeror (in accordance with 48 CFR subpart 9.503) even though a... 42 Public Health 3 2010-10-01 2010-10-01 false Conflict of interest resolution. 421.312 Section... Conflict of interest resolution. (a) Review Board. CMS may establish and convene a Conflicts of...

  20. Unconsciously triggered conflict adaptation.

    PubMed

    van Gaal, Simon; Lamme, Victor A F; Ridderinkhof, K Richard

    2010-01-01

    In conflict tasks such as the Stroop, the Eriksen flanker or the Simon task, it is generally observed that the detection of conflict in the current trial reduces the impact of conflicting information in the subsequent trial; a phenomenon termed conflict adaptation. This higher-order cognitive control function has been assumed to be restricted to cases where conflict is experienced consciously. In the present experiment we manipulated the awareness of conflict-inducing stimuli in a metacontrast masking paradigm to directly test this assumption. Conflicting response tendencies were elicited either consciously (through primes that were weakly masked) or unconsciously (strongly masked primes). We demonstrate trial-by-trial conflict adaptation effects after conscious as well as unconscious conflict, which could not be explained by direct stimulus/response repetitions. These findings show that unconscious information can have a longer-lasting influence on our behavior than previously thought and further stretch the functional boundaries of unconscious cognition. PMID:20634898

  1. Associations of Conflict-Related Trauma and Ongoing Stressors with the Mental Health and Functioning of West Papuan Refugees in Port Moresby, Papua New Guinea (PNG)

    PubMed Central

    Tay, Alvin Kuowei; Rees, Susan; Chen, Jack; Kareth, Moses; Lahe, Sylvester; Kitau, Russell; David, Kura; Sonoling, Joyce; Silove, Derrick

    2015-01-01

    Documentation is limited in relation to the mental health of the people of West Papua, a territory that has been exposed to decades-long political persecution. We examined associations of traumatic events (TEs) and current stressors with mental disorder and functioning, amongst 230 West Papuan refugees residing in six settlements in Port Morseby, Papua New Guinea (PNG). We used culturally adapted modules to assess exposure to TEs and mental disorders. Current stressors and functioning were assessed using modifications of measures developed by the World Health Organization (WHO). 129 of 230 respondents (56%) reported exposure to at least one traumatic event (TE), including: political upheaval (36.5%), witnessing or hearing about family members tortured and murdered (33.9%), and not being able to access medical care for family members (33%). One fifth of respondents (47, 20.4%) experienced exposure to high levels of TEs (16 to 23). 211 (91.7%) endorsed at least one or more ongoing stressors, including: exposure to illicit substance use in the community (91.7%), problems with safety and the protection of women (89.6%), no access to legal rights and citizenship (88.3%), and lack of adequate shelter and facilities (85.2%). A quarter (26.9%) met criteria for one or more current mental disorder, and 69.1% reported functional impairment ranging from mild to extreme. Mental disorder was associated with being male (adjusted odds ratio=2.00; 95% CI=1.01-3.97), and exposure to the highest category of ongoing stressors (AOR=2.89; 95% CI=1.08-7.72). The TE count showed a dose-response pattern in its relationship with functional impairment, the greatest risk (AOR=11.47; 95% CI=2.11-62.37) being for those experiencing the highest level of TE exposure (16-23 events). West Papuans living in settlements in Port Moresby reported a range of TEs, ongoing stressors and associated mental disorders characteristic of populations exposed to mass conflict and persecution, prolonged

  2. Associations of Conflict-Related Trauma and Ongoing Stressors with the Mental Health and Functioning of West Papuan Refugees in Port Moresby, Papua New Guinea (PNG).

    PubMed

    Tay, Alvin Kuowei; Rees, Susan; Chen, Jack; Kareth, Moses; Lahe, Sylvester; Kitau, Russell; David, Kura; Sonoling, Joyce; Silove, Derrick

    2015-01-01

    Documentation is limited in relation to the mental health of the people of West Papua, a territory that has been exposed to decades-long political persecution. We examined associations of traumatic events (TEs) and current stressors with mental disorder and functioning, amongst 230 West Papuan refugees residing in six settlements in Port Morseby, Papua New Guinea (PNG). We used culturally adapted modules to assess exposure to TEs and mental disorders. Current stressors and functioning were assessed using modifications of measures developed by the World Health Organization (WHO). 129 of 230 respondents (56%) reported exposure to at least one traumatic event (TE), including: political upheaval (36.5%), witnessing or hearing about family members tortured and murdered (33.9%), and not being able to access medical care for family members (33%). One fifth of respondents (47, 20.4%) experienced exposure to high levels of TEs (16 to 23). 211 (91.7%) endorsed at least one or more ongoing stressors, including: exposure to illicit substance use in the community (91.7%), problems with safety and the protection of women (89.6%), no access to legal rights and citizenship (88.3%), and lack of adequate shelter and facilities (85.2%). A quarter (26.9%) met criteria for one or more current mental disorder, and 69.1% reported functional impairment ranging from mild to extreme. Mental disorder was associated with being male (adjusted odds ratio=2.00; 95% CI=1.01-3.97), and exposure to the highest category of ongoing stressors (AOR=2.89; 95% CI=1.08-7.72). The TE count showed a dose-response pattern in its relationship with functional impairment, the greatest risk (AOR=11.47; 95% CI=2.11-62.37) being for those experiencing the highest level of TE exposure (16-23 events). West Papuans living in settlements in Port Moresby reported a range of TEs, ongoing stressors and associated mental disorders characteristic of populations exposed to mass conflict and persecution, prolonged

  3. Setting objectives for community and systems change: an application of concept mapping for planning a statewide health improvement initiative.

    PubMed

    Trochim, William M K; Milstein, Bobby; Wood, Betty J; Jackson, Susan; Pressler, Virginia

    2004-01-01

    The Hawaii Department of Health (HDOH) used concept mapping techniques to engage local stakeholders and national subject area experts in defining the community and system factors that affect individuals' behaviors related to tobacco, nutrition, and physical activity. Over eight working days, project participants brainstormed 496 statements (edited to a final set of 90), which were then sorted and rated for their importance and feasibility. A sequence of multivariate statistical analyses, including multidimensional scaling and hierarchical cluster analysis, generated maps and figures that were then interpreted by project stakeholders. The results were immediately incorporated into an official plan, approved by the governor and state legislature, recommending how Hawaii's tobacco settlement resources could be used to create sustainable changes in population health. The results also provide empirical support for the premise that both community and systems factors ought to be considered when planning comprehensive health improvement initiatives. PMID:14965431

  4. Is Health Care a Right? Health Reforms in the USA and their Impact Upon the Concept of Care.

    PubMed

    Maruthappu, Mahiben; Ologunde, Rele; Gunarajasingam, Ayinkeran

    2013-01-01

    In 2008 United States President Barack Obama declared that health care "should be a right for every American".(1) This statement, although noble, does not reflect US healthcare statistics in recent times, with the number of uninsured reaching over 50 million in 2010.(2) Such disparity has sparked a political drive towards change, and the introduction of the Patient Protection and Affordable Care Act (PPACA).(3) These changes have been highly polemical, raising the fundamental question of whether health care is a right; a contract between the nation and its inhabitants granted at birth, or an entitlement; a privilege that must be earned as opposed to universally provided. Access to healthcare in the US is mediated by insurance coverage, either in the form of private or employer based cover, which may be government based for public sector employees or private for private sector employees. The majority of spending on healthcare however, comes from government expenditure on health programs such as Medicare, Medicaid, Tricare, and the State Children's Health Insurance Program (SCHIP).(4) Medicare is a federal government funded social insurance program that provides health insurance to people aged 65 and older, younger people with disabilities, and those with end stage renal failure requiring dialysis. Medicaid is a means tested insurance coverage program for individuals with low incomes and their families, and is jointly funded by state and federal governments. Tricare is a healthcare program that provides healthcare insurance for military personnel, retirees, and their dependents. The SCHIP provides states with federal government funding to provide health insurance to children from families with modest incomes that do not qualify for Medicaid. As such, although the majority of the US population is insured by federal, state, employer, or private health insurance, the remainders go uninsured. PMID:25973184

  5. Functional Validity of a Judgment Skills Measure within the Concept of Health Literacy for Sleeping Disorder Patients

    PubMed Central

    Dubowicz, Arthur; Schulz, Peter J.

    2014-01-01

    The concept of health literacy has been widened to include higher order aspects such as patient decision-making skills while its measurement continued to rely narrowly on reading and numeracy skills, known as functional health literacy. We developed a Judgment Skills measure, designed to assess patients’ ability to make appropriate decisions with regard to their condition. The measure offers scenarios with answer options ranked for biomedical adequacy. This study aims to examine the psychometric properties and the functional validity of the Judgment Skills measure. A self-administered survey among 87 primary insomnia patients in the Italian-speaking part of Switzerland was conducted. The extensive path model included variables such as functional health literacy, coping with the medical condition, experience of the scenario, sleep quality, duration suffering, education, and age. Correlation analyses were conducted to link the variables. The Judgment Skills measure showed the expected significant correlations. In general, higher Judgment Skills were related to coping strategies leading to better health outcomes. Functional health literacy correlated highly with education, while Judgment Skills did not, which confirmed the conceptual difference of these skills. The findings propose a model for conducting research that does embrace the broader conceptualization of health literacy. PMID:25329537

  6. Health Care Students' Differing Conceptions of Expertise: A Challenge for Inter-Professional Care

    ERIC Educational Resources Information Center

    Makinen, Jarkko; Petersson, Gunilla; Nurmi, Raija; Lonka, Kirsti

    2007-01-01

    The aim of the study was to examine do health care students, who study at different programs, value similar expert qualities. To investigate this issue, a questionnaire was administered among health care students in a Finnish polytechnic (two cohorts, total n = 466), consisting of a scale for rating the importance of different expert qualities.…

  7. Public health and vector-borne diseases - a new concept for risk governance.

    PubMed

    Schmidt, K; Dressel, K M; Niedrig, M; Mertens, M; Schüle, S A; Groschup, M H

    2013-12-01

    Public Health is defined as an interdisciplinary multilevel approach that deals with questions of preventing diseases at the population level. In this context, this paper focuses on vector-borne diseases as an important threat with an increasing impact on human and animal health. Emphasis is laid on an integrated health approach ('One-Health' initiative) as it recognizes the interrelated nature of both human and animal health. The importance of vector-borne diseases to new and emerging diseases in Europe was demonstrated, for example, by the recent outbreak of West Nile virus infections in Greece, Northern Italy and Hungary; the spread of Crimean-Congo haemorrhagic fever virus across Turkey, south-western countries of the former USSR and the Balkans; the dramatic increase in hantavirus infections in Germany in 2012; and the dengue virus outbreak in Portugal in the same year. This paper provides a systematic approach for the analysis, assessment and governance of emerging health risks attributed to vector-borne diseases by using a holistic approach developed by the International Risk Governance Council (IRGC), called the 'IRGC Risk Governance Framework'. It can be used by decision-makers and general Public Health authorities in order to evaluate the situation regarding any specific pathogen or Public Health risk and to decide if additional measures should be implemented. PMID:23480672

  8. Health Care Policy and Part H Services: Early Intervention as a Concept (Not a Separate Program).

    ERIC Educational Resources Information Center

    Shonkoff, Jack P.

    This paper argues that there is a critical need to reframe the fundamental policy questions which fragment early childhood intervention services and health care, in order to construct an integrated system of comprehensive services that includes basic health care and developmental support for all children and their families and that provides…

  9. Concept of Ahara in relation to Matra, Desha, Kala and their effect on Health.

    PubMed

    Dangayach, Rohit; Vyas, Mahesh; Dwivedi, R R

    2010-01-01

    For evaluation of the effect of Ahara on Health in relation to Matra, Desha and Kala, an interview based survey study was carried out by simple randomized selection of healthy and unhealthy individuals. It was found that consideraton of Matra, Desha and Kala in aspect of Ahara taking were found beneficial for health. PMID:22131693

  10. Concept of Ahara in relation to Matra, Desha, Kala and their effect on Health

    PubMed Central

    Dangayach, Rohit; Vyas, Mahesh; Dwivedi, R. R.

    2010-01-01

    For evaluation of the effect of Ahara on Health in relation to Matra, Desha and Kala, an interview based survey study was carried out by simple randomized selection of healthy and unhealthy individuals. It was found that consideraton of Matra, Desha and Kala in aspect of Ahara taking were found beneficial for health. PMID:22131693

  11. Prophetic Pragmatism? Post-Conflict Educational Development in Aceh and Mindanao

    ERIC Educational Resources Information Center

    Milligan, Jeffrey Ayala

    2009-01-01

    This essay critically examines the relevance of Cornel West's (1989) conception of "prophetic pragmatism" as a theoretical framework for educational development in post-conflict settings torn by religious, socioeconomic, and cultural tensions. It examines the concept through the conflict and post-conflict experiences of the Indonesian province of…

  12. Mobile Integrated Health Care and Community Paramedicine: An Emerging Emergency Medical Services Concept.

    PubMed

    Choi, Bryan Y; Blumberg, Charles; Williams, Kenneth

    2016-03-01

    Mobile integrated health care and community paramedicine are models of health care delivery that use emergency medical services (EMS) personnel to fill gaps in local health care infrastructure. Community paramedics may perform in an expanded role and require additional training in the management of chronic disease, communication skills, and cultural sensitivity, whereas other models use all levels of EMS personnel without additional training. Currently, there are few studies of the efficacy, safety, and cost-effectiveness of mobile integrated health care and community paramedicine programs. Observations from existing program data suggest that these systems may prevent congestive heart failure readmissions, reduce EMS frequent-user transports, and reduce emergency department visits. Additional studies are needed to support the clinical and economic benefit of mobile integrated health care and community paramedicine. PMID:26169927

  13. Reflections on the UK's approach to the 2009 swine flu pandemic: conflicts between national government and the local management of the public health response.

    PubMed

    Chambers, Jacky; Barker, Kezia; Rouse, Andrew

    2012-07-01

    The first cases of swine flu in the UK were detected on 27th April 2009. Two weeks later Birmingham became a "hotspot" for the HIN1 pandemic in England. This paper describes the experiences of local public health agencies during the pandemic and the problems encountered when trying to work within a hierarchical and hermetic system of national policy making. We argue that over reliance on the speculative logic of modellers, together with a failure to adapt swiftly the nation's preparedness plans and public health apparatus created in readiness for a serious and fatal disease, led to an institutional void of policy making during the pandemic, where new rules and concepts emerged about what constituted scientifically acceptable and politically legitimate interventions. The imposition of a single national approach to managing the pandemic and a disregard for the role of local authorities seriously impaired the ability of local agencies to respond in a flexible, timely and pragmatic way to the rapidly emerging situation. Future planning for pandemics must recognise that global epidemics are curbed at the local level, and ensure that any response is proportionate, flexible and effective. PMID:22682089

  14. Interparental Conflict and Adolescents' Romantic Relationship Conflict

    ERIC Educational Resources Information Center

    Simon, Valerie A.; Furman, Wyndol

    2010-01-01

    This study examined associations between interparental conflict and adolescents' romantic relationship conflict. High school seniors (N = 183) who lived with married parents completed questionnaires about their parents' marriage and their own romantic relationships. A subset of 88 adolescents was also observed interacting with their romantic…

  15. An Exploration of Conflict and Conflict Management.

    ERIC Educational Resources Information Center

    Trusty, Francis M.

    The study reported on was conducted to study aspects of conflict and conflict management that might have implications for the fields of education and educational administration. The five phases of the study include a review of the literature, a series of interviews, a synthesis of ideas, the dissemination of findings, and a concluding research…

  16. The Concept of Mothercraft as Related to Infant Health in Urban and Rural Settings.

    ERIC Educational Resources Information Center

    Slesinger, Doris P.

    The concept of "mothercraft" can be influenced by the sociocultural environment and the individual mother and her attributes. This study examined the differences in mothering between those who live in urban areas and those who live in rural areas. Although the study drew on work currently in progress on the relationship between mothering and…

  17. Caring Disposition and Subordination. Swedish Health and Social Care Teachers' Conceptions of Important Vocational Knowledge

    ERIC Educational Resources Information Center

    Rehn, Helena; Eliasson, Eva

    2015-01-01

    Based on the increasing demands for vocational training in upper secondary school to adapt to workplace conditions, the aim of this article is to explore vocational teachers' conceptions regarding vocational knowledge. Drawing on a social constructionist perspective, this study analysed data from 17 interviews. The study showed how power dynamics,…

  18. Public Health Aspects of the Family Medicine Concepts in South Eastern Europe

    PubMed Central

    Masic, Izet; Hadziahmetovic, Miran; Donev, Doncho; Pollhozani, Azis; Ramadani, Naser; Skopljak, Amira; Pasagic, Almir; Roshi, Enver; Zunic, Lejla; Zildzic, Muharem

    2014-01-01

    Introduction: Family medicine as a part of the primary health care is devoted to provide continuous and comprehensive health care to the individuals and families regardless of age, gender, types of diseases and affected system or part of the body. Special emphasis in such holistic approach is given to the prevention of diseases and health promotion. Family Medicine is the first step/link between doctors and patients within patients care as well as regular inspections/examinations and follow-up of the health status of healthy people. Most countries aspire to join the European Union and therefore adopting new regulations that are applied in the European Union. Aim: The aim of this study is to present the role and importance of family medicine, or where family medicine is today in 21 Century from the beginning of development in these countries. The study is designed as a descriptive epidemiological study with data from 10 countries of the former Communist bloc, Slovenia, Croatia, Bosnia and Herzegovina, Serbia, Montenegro, Macedonia, Kosovo, Albania, Bulgaria, Romania, Czech Republic, Slovakia and Hungary, just about half of them are members of the EU. We examined the following variables: socio-organizational indicators, health and educational indicators and health indicators. The data used refer to 2002 and as a source of data are used official data from reference WebPages of family medicine doctors associations, WONCA website (EURACT, EQuiP, EGPRN), WebPages of Bureau of Statistics of the countries where the research was conducted as well as the Ministries of Health. Results: Results indicates that the failures and shortcomings of health care organizations in Southeast Europe. Lack of money hinders the implementation of health care reform in all mentioned countries, the most of them that is more oriented to Bismarck financing system. Problems in the political, legal and economic levels are obstacles for efficient a problem reconstructing health care system toward

  19. The utilisation of health research in policy-making: concepts, examples and methods of assessment

    PubMed Central

    Hanney, Stephen R; Gonzalez-Block, Miguel A; Buxton, Martin J; Kogan, Maurice

    2003-01-01

    The importance of health research utilisation in policy-making, and of understanding the mechanisms involved, is increasingly recognised. Recent reports calling for more resources to improve health in developing countries, and global pressures for accountability, draw greater attention to research-informed policy-making. Key utilisation issues have been described for at least twenty years, but the growing focus on health research systems creates additional dimensions. The utilisation of health research in policy-making should contribute to policies that may eventually lead to desired outcomes, including health gains. In this article, exploration of these issues is combined with a review of various forms of policy-making. When this is linked to analysis of different types of health research, it assists in building a comprehensive account of the diverse meanings of research utilisation. Previous studies report methods and conceptual frameworks that have been applied, if with varying degrees of success, to record utilisation in policy-making. These studies reveal various examples of research impact within a general picture of underutilisation. Factors potentially enhancing utilisation can be identified by exploration of: priority setting; activities of the health research system at the interface between research and policy-making; and the role of the recipients, or 'receptors', of health research. An interfaces and receptors model provides a framework for analysis. Recommendations about possible methods for assessing health research utilisation follow identification of the purposes of such assessments. Our conclusion is that research utilisation can be better understood, and enhanced, by developing assessment methods informed by conceptual analysis and review of previous studies. PMID:12646071

  20. UICC International Session: What are the implications of sharing the concept of Universal Health Coverage for cancer in Asia?

    PubMed

    Akaza, Hideyuki; Roh, Jae Kyung; Hao, Xishan; Wibulpolprasert, Suwit; Nozaki, Shinjiro; Park, Eun-Cheol; Fukuda, Takashi; Sonoda, Shigeto; Kawahara, Norie

    2016-04-01

    The Japan National Committee for the Union for International Cancer Control (UICC) and UICC - Asia Regional Office organized an international session as part of the 74th Annual Meeting of the Japanese Cancer Association on the topic "What are the implications of sharing the concept of Universal Health Coverage for cancer in Asia?" Universal Health Coverage (UHC) is included in the United Nations' Sustainable Development Goals and aims to ensure that all people can receive high-quality medical services, are protected from public health risks, and are prevented from falling into poverty due to medical costs or loss of income arising from illness. The session discussed the growing cost of cancer and the challenges that this poses to the establishment and deployment of UHC in the Asian region, where countries face budgetary and other systemic constraints in tackling and controlling cancer. It was noted how sharing concepts on UHC will assist mutual learning among Asian countries and help in the formation of guidelines that can be adapted to national and regional realities. Presentations included a status report on UHC for cancer control in Thailand, and a report from the WHO Kobe Centre concerning prospects for collaborative research on UHC. Also discussed were the current status of cancer burden and control in China and Korea and Japan's progress in systemizing cost-effectiveness evaluation. The final presentation highlighted the importance of gathering social and economic data across Asia in order to build a picture of commonalities and differences in the region. PMID:27079441

  1. Community concepts of poverty: an application to premium exemptions in Ghana’s National Health Insurance Scheme

    PubMed Central

    2013-01-01

    Background Poverty is multi dimensional. Beyond the quantitative and tangible issues related to inadequate income it also has equally important social, more intangible and difficult if not impossible to quantify dimensions. In 2009, we explored these social and relativist dimension of poverty in five communities in the South of Ghana with differing socio economic characteristics to inform the development and implementation of policies and programs to identify and target the poor for premium exemptions under Ghana’s National Health Insurance Scheme. Methods We employed participatory wealth ranking (PWR) a qualitative tool for the exploration of community concepts, identification and ranking of households into socioeconomic groups. Key informants within the community ranked households into wealth categories after discussing in detail concepts and indicators of poverty. Results Community defined indicators of poverty covered themes related to type of employment, educational attainment of children, food availability, physical appearance, housing conditions, asset ownership, health seeking behavior, social exclusion and marginalization. The poverty indicators discussed shared commonalities but contrasted in the patterns of ranking per community. Conclusion The in-depth nature of the PWR process precludes it from being used for identification of the poor on a large national scale in a program such as the NHIS. However, PWR can provide valuable qualitative input to enrich discussions, development and implementation of policies, programs and tools for large scale interventions and targeting of the poor for social welfare programs such as premium exemption for health care. PMID:23497484

  2. Application of a marketing concept to patient-centered care: co-producing health with heart failure patients.

    PubMed

    Leone, Robert P; Walker, Charles A; Curry, Linda Cox; Agee, Elizabeth J

    2012-05-01

    Increasing numbers of patients are being treated for heart failure each year. One out of four of the heart failure patients who receives care in a hospital is readmitted to the hospital within 30 days of discharge. Effective discharge instruction is critical to prevent these patient readmissions. Co-production is a marketing concept whereby the customer is a partner in the delivery of a good or service. For example, a patient and nurse may partner to co-produce a patient-centered health regimen to improve patient outcomes. In this article we review the cost of treating heart failure patients and current strategies to decrease hospital readmissions for these patients along with the role of the nurse and the concept of co-producing health as related to heart failure patients. Next we describe our study assessing the degree to which discharge processes were co-produced on two hospital units having a preponderance of heart failure patients, and present our findings indicating minimal evidence of co-production. A discussion of our findings, along with clinical implications of these findings, recommendations for change, and suggestions for future research are offered. We conclude that standardized discharge plans lead to a mindset of 'one size fits all,' a mindset inconsistent with the recent call for patient-centered care. We offer co-production as a patient-centered strategy for customizing discharge teaching and improving health outcomes for heart failure patients. PMID:22686115

  3. Conflict Resolution Communications.

    ERIC Educational Resources Information Center

    Lincoln, Melinda G.

    2002-01-01

    Suggests that, due to escalating violence in contemporary society, community colleges should offer certificate or degree programs in conflict resolution. Describes a conflict resolution communication program, which teaches communication skills, mediation processes, and coping strategies to prospective mediators. (NB)

  4. 45 CFR 73.735-903 - Action if conflicts of interest or possible conflicts are noted.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Action if conflicts of interest or possible conflicts are noted. 73.735-903 Section 73.735-903 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES... and the time by which it must be submitted. (b) If the reviewing official is of the opinion that,...

  5. 45 CFR 73.735-903 - Action if conflicts of interest or possible conflicts are noted.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Action if conflicts of interest or possible conflicts are noted. 73.735-903 Section 73.735-903 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES... and the time by which it must be submitted. (b) If the reviewing official is of the opinion that,...

  6. 45 CFR 73.735-903 - Action if conflicts of interest or possible conflicts are noted.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Action if conflicts of interest or possible conflicts are noted. 73.735-903 Section 73.735-903 Public Welfare Department of Health and Human Services... and the time by which it must be submitted. (b) If the reviewing official is of the opinion that,...

  7. Advanced Airspace Concept

    NASA Technical Reports Server (NTRS)

    Erzberger, Heinz

    2002-01-01

    A general overview of the Advanced Airspace Concept (AAC) is presented. The topics include: 1) Limitations of the existing system; 2) The Advanced Airspace Concept; 3) Candidate architecture for the AAC; 4) Separation assurance and conflict avoidance system (TSAFE); and 5) Ground-Air Interactions. This paper is in viewgraph form.

  8. Local concepts of anemia-related illnesses and public health implications in the Taabo health demographic surveillance system, Côte d’Ivoire

    PubMed Central

    2013-01-01

    Background A 14-month prospective longitudinal study conducted in the Taabo health demographic surveillance system (HDSS), south-central Côte d’Ivoire, revealed high prevalence of anemia in different population groups in three types of settings (i.e., small town, village, and hamlet). Demographic parameters and several variables related to parasitic infections, micronutrient status, and inflammation were significantly associated with higher odds of anemia. However, cultural concepts and knowledge of various anemia-related illnesses and their relation with people’s behaviors have not been investigated. Methods Sixteen focus group discussions and six key informant interviews were performed with village authorities, health workers, and traditional healers. Questionnaires were administrated to 200 school-aged children and 115 young women. Of these individuals, 206 participated in the preceding longitudinal study, whereas the remaining 109 people were not exposed to prior research, but had similar age and sex profiles. Mean prominence of participants’ responses was compared between groups of participants and across study settings. Results Local concepts of anemia-related illnesses referred to its perceived causes based on two logical frameworks – biomedical and sociocultural – although a clear distinction was often blurred. We found few differences in knowledge, beliefs, and behaviors across study settings and between participants who were exposed to prior research and newly recruited ones. Malaria und nutritional issues as understood and managed by the population differed from definitions and recommendations provided by the health system. Malaria was not acknowledged as an exclusive mosquito-transmitted disease and participants referred to the quantity, rather than the quality, of food when talking about nutritional issues. Conclusions Local concepts and ideas about anemia have public health implications, inasmuch as they are related to people’s attitudes

  9. Intraorganizational Conflict in Schools.

    ERIC Educational Resources Information Center

    Wynn, Richard

    1978-01-01

    There are no simple answers to the tricky business of managing conflict within organizations. Almost every conflict is a unique case with its own issues, participants, dynamics, and consequences. Still, it appears possible to differentiate between organizations that handle conflict productively and those that do not. Successful organizations view…

  10. Administrative Response to Conflict.

    ERIC Educational Resources Information Center

    Wynn, Richard

    Enduring resolution of conflict is not so much the result of clever tricks as of the state of mind of superintendents, school boards, teachers, students, and citizens and of the organizational climate of the schools and the community. It is important to view conflict in neutral terms, realizing that conflict may be good or bad. Effective…

  11. Strategies for Resolving Conflicts.

    ERIC Educational Resources Information Center

    Ragin, Nancy W.; And Others

    Conflict is a phenomenon of human relationships that occurs when an individual's needs are not being satisfied. This paper explains why it is crucial to recognize and deal with conflict on different levels of education. Chapter 1 discusses coping with conflict. It describes several management styles (competition; collaboration; avoidance;…

  12. Capitalizing on Conflict.

    ERIC Educational Resources Information Center

    Haggstrom, Tim; Rubenstein, Cynthia

    High performance teams allow conflict to surface and then work toward understanding and resolution. Often when teams are in conflict, they appear to be in chaos. What may be occurring is that the conflict has allowed the team to access new information, and what appears to be chaos is actually reorganization around a new perspective. Capitalizing…

  13. Conflict Resolution Bibliography.

    ERIC Educational Resources Information Center

    Charnofsky, Norene M., Comp.

    Various theories and approaches to conflict resolution and peace education are presented in the 31 resources listed in this annotated bibliography. It is divided into two sections. Section 1 contains materials designed to help adults become more effective role models for the peaceful resolution of conflict. Topics include parent/child conflicts,…

  14. Teaching Conflict Resolution Simulations.

    ERIC Educational Resources Information Center

    Hare, Mark A.

    The use of simulation in teaching conflict can be an effective way to promote student involvement. The role of the classroom teacher is to deal with actual student conflict while facilitating the development of communication skills which will aid in the resolustion of conflict. This paper suggests one classroom model which utilizes a combination…

  15. From Conflict to Congruence.

    ERIC Educational Resources Information Center

    Michlowski, Aida A.

    1999-01-01

    Conflict resolution has moved into the classroom. Peaceful conflict resolution includes negotiation, peer mediation, and arbitration. Data on conflict-resolution programs have turned up interesting objectives and outcomes. Curriculum approaches include classroom discipline, peace education, multicultural perspective, and just community. Teaching…

  16. Exploring the concept of user involvement in mental health through a participation continuum.

    PubMed

    Hickey, G; Kipping, C

    1998-01-01

    Although recent years have seen an increased emphasis on involving service users in decisions about their care, there has been limited exploration of the theories and ideologies underpinning the concept. This paper identifies two approaches to user involvement, each with implications for the extent to which users can be involved in decisions about their care. The approaches are linked through a 'participation continuum' which is a framework through which the concept of user involvement can be explored, and against which practice can be assessed. The framework must be seen within the context of constraints to user involvement. A more realistic assessment of the extent to which users can be involved in decisions can then be made and the risks of raising unrealistic expectations avoided. PMID:9510712

  17. Concepts of illness causation and attitudes to health care among older people in the Republic of Ireland.

    PubMed

    MacFarlane, Anne; Kelleher, Cecily

    2002-05-01

    Fifty-one older people (26 of them women) in the Republic of Ireland were interviewed using a semi-structured schedule on their health and illness experiences at three different time points in their lives; as children, as young adults and presently. Of particular interest were their views about the causes of heart disease, cancer and tuberculosis and their experiences of the prevailing health care system during their lifetime. Participants were recruited by letter from a database of respondents to a previous national quantitative survey of older people. Of 247 people originally contacted 127 (51%) responded by letter and 51 of these took part in the interview study. Data were analysed according to principles of content analysis using NUDIST software. Reported ideas about causes of illnesses were multicausal. These were categorised as behavioural, biological, psychosocial or other explanations. While respondents placed most emphasis on behavioural explanations, this was accompanied by more complex views and critical questioning of formal health education messages. There was a strong allegiance to current biomedical concepts and practices. This appeared to be explained in part by reported negative experiences of health care treatments during childhood, particularly in hospitals, now perceived to be much improved. Advances in biomedicine were discussed with accounts of benefits received or observed by participants. An analysis of the history of health services in Ireland suggests that some of the attitudes reported reflect the experiences of the respondents as a generation rather than as older people per se and hence highlights the impact of public policy on people's experiences of and attitudes toward health and health care systems. PMID:12058855

  18. Demystifying Concepts of Epidemic and Causal Association for Public Health Students--A Pedagogical Approach to Promote Critical and Analytical Thinking

    ERIC Educational Resources Information Center

    Patil, Rajan R.

    2011-01-01

    Epidemiology is a difficult but an important subject in public health curriculum. As teachers, we need to be very innovative in teaching the core concepts in epidemiology since it is basically a research oriented subject that calls for enormous application of logic and mathematical skills. Very often, complex epidemiological concepts need to be…

  19. Marital Conflict, Depressive Symptoms, and Functional Impairment

    PubMed Central

    Choi, Heejeong; Marks, Nadine F.

    2008-01-01

    Guided by a stress process perspective, we investigated (a) whether marital conflict might directly lead to changes in depression and functional impairment, (b) whether marital conflict might indirectly lead to changes in functional impairment via depression, and (c) whether marital conflict might indirectly lead to changes in depression via functional impairment. We estimated a latent variable causal model using 3 waves of data from the National Survey of Families and Households (N = 1,832). Results indicated that marital conflict directly led to increases in depression and functional impairment and indirectly led to a rise in depression via functional impairment. Overall, findings suggest marital conflict is a significant risk factor for psychological and physical health among midlife and older adults. PMID:18698378

  20. Environmental assessment for the satellite power system concept development and evaluation program: nonmicrowave health and ecological effects

    SciTech Connect

    White, M R

    1980-11-01

    A Concept Development and Evaluation Program is being carried out for a proposed Satellite Power System (SPS). For purposes of this evaluation, a preliminary reference system has been developed. SPS, as described in the reference system, would collect solar energy on satellites in geosychronous orbit in space. The energy would be converted to microwaves and beamed to an earth-receiving antenna (rectenna). One task in the environmental part of the program is the assessment of the nonmicrowave effects on health and the environment. These effects would result from all phases of SPS development and operation. This report covers the current knowledge regarding these effects, and is based on the reference system. The assessment is summarized as to scope, methodology, impacts of terrestrial development, launch and recovery of spacecraft, space activities (including health effects of the space environment, ionizing radiation, electromagnetic exposure, spacecraft charging and environmental interactions, occupational hazards, etc.) and construction and operation of rectenna (ground receiving station).