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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

    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

  1. 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

  2. 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

  3. 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

  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 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

  14. [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

  15. 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

  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. 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.

  14. 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…

  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. 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...

  10. 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…

  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. 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

  16. 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

  17. 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

  18. 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

  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 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

  5. 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

  6. 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

  7. 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

  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. 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.

  11. 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

  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. 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…

  20. 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…

  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. 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.

  14. 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

  15. 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

  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. 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

  1. 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

  2. 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

  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. 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

  17. 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…

  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. 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

  9. 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

  10. 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

  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. 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

  18. 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

  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. 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…

  4. 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…

  5. 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…

  6. [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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  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. 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

  9. 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

  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