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Sample records for health organization recommended

  1. Recommendations by health organizations for pulse consumption.

    PubMed

    Leterme, Pascal

    2002-12-01

    The present paper aims to study why and how health organizations recommend the consumption of pulses such as beans, chickpeas or lentils. Although it is recognized that frequent pulse consumption may reduce serum cholesterol levels and helps reduce risks of coronary heart disease and diabetes, these advantages are scarcely mentioned by health-promoting associations, i.e. vegetarians and organizations helping people to reduce the risks for chronic diseases. Pulses, especially common beans, are rather considered as whole grains that provide plenty of proteins, starch, dietary fibres, minerals and vitamins. Many organizations refer to the food guide pyramid to advise their members, and place beans either in the third part, together with meat, in the second one with fruits and vegetables, or in the bottom part with starchy foods. Whatever their place, they have acquired the status of staple food for anyone who wants to eat a healthy diet. PMID:12498622

  2. The Use of Research Evidence in Two International Organizations' Recommendations about Health Systems

    PubMed Central

    Hoffman, Steven J.; Lavis, John N.; Bennett, Sara

    2009-01-01

    Background: Little is known about the extent to which research evidence informs the development of recommendations by international organizations. Methods: We identified specific World Health Organization (WHO) and World Bank recommendations on five topics (contracting, healthcare financing, health human resources, tuberculosis control and tobacco control), catalogued the related systematic reviews and assessed the recommendations to determine their consistency with the systematic reviews that were available at the time of their formulation. Findings: Only two of the eight publications examined were found to cite systematic reviews, and only five of 14 WHO and two of seven World Bank recommendations were consistent with both the direction and nature of effect claims from systematic reviews. Ten of 14 WHO and five of seven World Bank recommendations were consistent with the direction of effect claims only. Conclusion: WHO and the World Bank – working with donor agencies and national governments – can improve their use of (or at least, their reporting about their use of) research evidence. Decision-makers and clinicians should critically evaluate the quality and local applicability of recommendations from any source, including international organizations, prior to their implementation. PMID:20676252

  3. [Recommendations of the World Health Organization Tobacco Control Research Team regarding electronic nicotine delivery devices].

    PubMed

    Kaleta, Dorota

    2010-01-01

    Negative health, social and economic consequences of smoking tobacco are widely known. Recent years have seen the emergence of many commercially sold appliances for inducing nicotine into the airways, including products such as "e-cigarette", "E-cigar" and "green cigarette". These products are often promoted as potential alternatives to nicotine replacement therapy. It transpires, however, that there is a lack of conclusive evidence concerning the health effects of long-term use of chemical substances applied via those electronic nicotine inhalers. Reliable data on the exact chemical composition of the cartridges used in the inhalers is also missing. The objective was to present the main conclusions and recommendations of the World Health Organization Tobacco Control Research Team regarding electronic nicotine delivery devices, which were formulated against the principles of the WHO Framework Convention on Tobacco Control (FCTC). Based on several analyses, WHO recommends a ban on disseminating information that suggest that electronic nicotine vaporisers are safer than cigarettes, or that they are an effective way of combating nicotine addition, until appropriate evidence can be provided. According to the WHO recommendations, references to efficacy of electronic vaporisers for quitting smoking or to their health effects must be backed by reliable pharmacokinetics studies, safety and efficacy tests and appropriate certification from regulatory bodies. PMID:21360967

  4. Measles eradication: recommendations from a meeting cosponsored by the World Health Organization, the Pan American Health Organization, and CDC.

    PubMed

    1997-06-13

    Recent successes in interrupting indigenous transmission of measles virus in the Americas and in the United Kingdom prompted the World Health Organization (WHO), Pan American Health Organization (PAHO), and CDC to convene a meeting in July, 1996 to consider the feasibility of global measles eradication. Presentations at the meeting included an overview of global measles control and elimination efforts; detailed reviews of successful measles elimination efforts in Latin America, the English-speaking Caribbean, Canada, and the United States; surveillance for clinical disease; laboratory tools for antibody detection and virus identification; and other factors that might influence the feasibility of disease eradication. With this background information, meeting organizers asked participants to address five questions: 1) Is global measles eradication feasible? 2) Is measles eradication feasible with current vaccines? 3) What are the appropriate vaccination strategies for measles eradication? 4) How should surveillance for measles be carried out? 5) What role should outbreak control play in the strategy to eliminate measles? Participants agreed that measles eradication is technically feasible with available vaccines and recommended adoption of the goal of global eradication with a target date during 2005-2010, with the proviso that measles eradication efforts should not interfere with poliomyelitis eradication but should build on the successes of the global Poliomyelitis Eradication Initiative. Although existing vaccines are adequate for eradication, vaccination strategies that rely on administration of a single dose of vaccine are not. In the Americas, sustained interruption of indigenous measles virus transmission has been achieved through a three-tiered vaccination strategy that includes a) "catch-up" vaccination of all persons aged 1-14 years, regardless of disease history or vaccination status; b) "keep-up" vaccination of > or = 90% of children in each successive

  5. Evidence and rationale for the World Health Organization recommended standards for Japanese encephalitis surveillance

    PubMed Central

    2009-01-01

    Background Japanese encephalitis (JE) is the most important form of viral encephalitis in Asia. Surveillance for the disease in many countries has been limited. To improve collection of accurate surveillance data in order to increase understanding of the full impact of JE and monitor control programs, World Health Organization (WHO) Recommended Standards for JE Surveillance have been developed. To aid acceptance of the Standards, we describe the process of development, provide the supporting evidence, and explain the rationale for the recommendations made in the document. Methods A JE Core Working Group was formed in 2002 and worked on development of JE surveillance standards. A series of questions on specific topics was initially developed. A literature review was undertaken and the findings were discussed and documented. The group then prepared a draft document, with emphasis placed on the feasibility of implementation in Asian countries. A field test version of the Standards was published by WHO in January 2006. Feedback was then sought from countries that piloted the Standards and from public health professionals in forums and individual meetings to modify the Standards accordingly. Results After revisions, a final version of the JE surveillance standards was published in August 2008. The supporting information is presented here together with explanations of the rationale and levels of evidence for specific recommendations. Conclusion Provision of the supporting evidence and rationale should help to facilitate successful implementation of the JE surveillance standards in JE-endemic countries which will in turn enable better understanding of disease burden and the impact of control programs. PMID:20038298

  6. [Care in a birth center according to the recommendations of the World Health Organization].

    PubMed

    Barbosa da Silva, Flora Maria; Rego da Paixão, Taís Couto; de Oliveira, Sonia Maria Junqueira Vasconcellos; Leite, Jaqueline Sousa; Riesco, Maria Luiza Gonzalez; Osava, Ruth Hitomi

    2013-10-01

    Birth centers are maternal care models that use appropriate technology when providing care to birthing women. This descriptive study aimed to characterize intrapartum care in a freestanding birth center, in light of the practices recommended by the World Health Organization (WHO), with 1,079 assisted births from 2006 to 2009 in the Sapopemba Birth Center, São Paulo, Brazil. Results included the use of intermittent auscultation (mean=7 controls); maternal positions during delivery: semi-sitting (82.3%), side-lying (16.0%), other positions (1.7%), oral intake (95.6%); companionship (93.3%); exposure to up to three vaginal examinations (85.4%), shower bathing (84.0%), walking (68.0%), massage (60.1%), exercising with a Swiss ball (51.7%); amniotomy (53.4%), oxytocin use during the first (31.0%) and second stages of labor (25.8%), bath immersion (29.3%) and episiotomy (14.1%). In this birth center, care providers used practices recommended by the WHO, although some practices might have been applied less frequently. PMID:24346440

  7. Recommendations from a meeting on health implications of genetically modified organism (GMO).

    PubMed

    Amofah, George

    2014-06-01

    The Ghana Public Health Association organized a scientific seminar to examine the introduction of genetically modified organisms into public use and the health consequences. The seminar was driven by current public debate on the subject. The seminar identified some of the advantages of GMOs and also the health concerns. It is clear that there is the need to enhance local capacity to research the introduction and use of GMOs; to put in place appropriate regulatory mechanisms including particularly the labeling of GMO products and post-marketing surveillance for possible negative health consequences in the long term. Furthermore the appropriate state agency should put in place advocacy strategies to keep the public informed about GMOs. PMID:25667561

  8. [Maternal discharge: conditions and organization for mothers and newborns returning home. The French National Authority for Health recommendations update].

    PubMed

    Hascoët, J-M; Petitprez, K

    2014-09-01

    In light of changes in both medical practices and the organization of medical care, the French National Authority for Health (Haute Autorité de santé, HAS) proposed new recommendations on the discharge of mothers and newborns, updating its 2004 recommendations on early discharge of mothers and newborns. This decision in turn made it necessary to define optimal discharge conditions and accompanying measures for mothers and infants returning home. The problem was approached by adopting the usual HAS methodology for drafting good practice recommendations. This involved establishing a working group bringing together representatives of all medical and care fields related to perinatology as well as patient representatives. This working group submitted draft recommendations, based on updated published references, to a committee. The committee then proposed amendments to the recommendations, which the working group was free to accept or reject. The updated recommendations that emerged from this process apply four essential principles : first, preparing for discharge as early as the prenatal period, ideally during the third trimester of pregnancy, in particular by providing expectant mothers with information on how the discharge will be organized and anticipating problems that might arise; second, ensuring care continuity between hospitalization, discharge to home, and follow-up; third, ensuring optimal conditions for discharge after a maternity stay of 72-96 h for normal delivery or 96-120 h in case of caesarean section (this hospital stay duration allows for neonatal screening); and fourth, defining how mothers and children are to be accompanied during the first postnatal month. In conclusion, these recommendations resulted in an increase in the duration of as well as an improvement in routine newborn surveillance, whether in hospital or after discharge, in what is a critical phase of infant development. They encourage ambulatory postnatal monitoring. The new

  9. Ensuring the Ethical Implementation of the New World Health Organization Pre-Exposure Prophylaxis Recommendations for Men Who Have Sex with Men.

    PubMed

    Arora, Kavita Shah; Streed, Carl G

    2015-03-01

    The World Health Organization's (WHO) new recommendation to encourage pre-exposure prophylaxis in men who have sex with men (MSM) is an important step towards eradicating the HIV epidemic. However, the ethical issues of stigma, privacy and confidentiality, and access must be addressed in order to ensure the optimal implementation of this important recommendation. PMID:26790012

  10. Introduction on health recommender systems.

    PubMed

    Sanchez-Bocanegra, C L; Sanchez-Laguna, F; Sevillano, J L

    2015-01-01

    People are looking for appropriate health information which they are concerned about. The Internet is a great resource of this kind of information, but we have to be careful if we don't want to get harmful info. Health recommender systems are becoming a new wave for apt health information as systems suggest the best data according to the patients' needs.The main goals of health recommender systems are to retrieve trusted health information from the Internet, to analyse which is suitable for the user profile and select the best that can be recommended, to adapt their selection methods according to the knowledge domain and to learn from the best recommendations.A brief definition of recommender systems will be given and an explanation of how are they incorporated in the health sector. A description of the main elementary recommender methods as well as their most important problems will also be made. And, to finish, the state of the art will be described. PMID:25417084

  11. Pilot mental health: expert working group recommendations.

    PubMed

    2012-12-01

    Following a March 27, 2012, incident in which a pilot of a major commercial airline experienced a serious disturbance in his mental health, the Aerospace Medical Association formed an Ad Hoc Working Group on Pilot Mental Health. The working group met several times and analyzed current medical standards for evaluating pilot mental health. The result of the working group was a letter sent to the FAA and other organizations worldwide interested in medical standards. The Committee found that it is neither productive nor cost effective to perform extensive psychiatric evaluations as part of the routine pilot aeromedical assessment. However it did recommend greater attention be given to mental health issues by aeromedical examiners, especially to the more common and detectable mental health conditions and life stressors that can affect pilots and flight performance. They encouraged this through increased education and global recognition of the importance of mental health in aviation safety. PMID:23316549

  12. Prioritizing Sleep Health: Public Health Policy Recommendations.

    PubMed

    Barnes, Christopher M; Drake, Christopher L

    2015-11-01

    The schedules that Americans live by are not consistent with healthy sleep patterns. In addition, poor access to educational and treatment aids for sleep leaves people engaging in behavior that is harmful to sleep and forgoing treatment for sleep disorders. This has created a sleep crisis that is a public health issue with broad implications for cognitive outcomes, mental health, physical health, work performance, and safety. New public policies should be formulated to address these issues. We draw from the scientific literature to recommend the following: establishing national standards for middle and high school start times that are later in the day, stronger regulation of work hours and schedules, eliminating daylight saving time, educating the public regarding the impact of electronic media on sleep, and improving access to ambulatory in-home diagnostic testing for sleep disorders. PMID:26581727

  13. Medicinal Plants Recommended by the World Health Organization: DNA Barcode Identification Associated with Chemical Analyses Guarantees Their Quality

    PubMed Central

    Palhares, Rafael Melo; Gonçalves Drummond, Marcela; dos Santos Alves Figueiredo Brasil, Bruno; Pereira Cosenza, Gustavo; das Graças Lins Brandão, Maria; Oliveira, Guilherme

    2015-01-01

    Medicinal plants are used throughout the world, and the regulations defining their proper use, such as identification of the correct species and verification of the presence, purity and concentration of the required chemical compounds, are widely recognized. Herbal medicines are made from vegetal drugs, the processed products of medicinal species. These processed materials present a number of challenges in terms of botanical identification, and according to the World Health Organization (WHO), the use of incorrect species is a threat to consumer safety. The samples used in this study consisted of the dried leaves, flowers and roots of 257 samples from 8 distinct species approved by the WHO for the production of medicinal herbs and sold in Brazilian markets. Identification of the samples in this study using DNA barcoding (matK, rbcL and ITS2 regions) revealed that the level of substitutions may be as high as 71%. Using qualitative and quantitative chemical analyses, this study identified situations in which the correct species was being sold, but the chemical compounds were not present. Even more troubling, some samples identified as substitutions using DNA barcoding contained the chemical compounds from the correct species at the minimum required concentration. This last situation may lead to the use of unknown species or species whose safety for human consumption remains unknown. This study concludes that DNA barcoding should be used in a complementary manner for species identification with chemical analyses to detect and quantify the required chemical compounds, thus improving the quality of this class of medicines. PMID:25978064

  14. Medicinal plants recommended by the world health organization: DNA barcode identification associated with chemical analyses guarantees their quality.

    PubMed

    Palhares, Rafael Melo; Gonçalves Drummond, Marcela; Dos Santos Alves Figueiredo Brasil, Bruno; Pereira Cosenza, Gustavo; das Graças Lins Brandão, Maria; Oliveira, Guilherme

    2015-01-01

    Medicinal plants are used throughout the world, and the regulations defining their proper use, such as identification of the correct species and verification of the presence, purity and concentration of the required chemical compounds, are widely recognized. Herbal medicines are made from vegetal drugs, the processed products of medicinal species. These processed materials present a number of challenges in terms of botanical identification, and according to the World Health Organization (WHO), the use of incorrect species is a threat to consumer safety. The samples used in this study consisted of the dried leaves, flowers and roots of 257 samples from 8 distinct species approved by the WHO for the production of medicinal herbs and sold in Brazilian markets. Identification of the samples in this study using DNA barcoding (matK, rbcL and ITS2 regions) revealed that the level of substitutions may be as high as 71%. Using qualitative and quantitative chemical analyses, this study identified situations in which the correct species was being sold, but the chemical compounds were not present. Even more troubling, some samples identified as substitutions using DNA barcoding contained the chemical compounds from the correct species at the minimum required concentration. This last situation may lead to the use of unknown species or species whose safety for human consumption remains unknown. This study concludes that DNA barcoding should be used in a complementary manner for species identification with chemical analyses to detect and quantify the required chemical compounds, thus improving the quality of this class of medicines. PMID:25978064

  15. Travelers' Health: Vaccine Recommendations for Infants and Children

    MedlinePlus

    ... before international travel. Country-specific vaccination recommendations and requirements for departure and entry vary over time. For ... Hajj. The World Health Organization issued temporary vaccination requirements for residents of and long-term visitors to ...

  16. Standard method for detecting upper respiratory carriage of Streptococcus pneumoniae: updated recommendations from the World Health Organization Pneumococcal Carriage Working Group.

    PubMed

    Satzke, Catherine; Turner, Paul; Virolainen-Julkunen, Anni; Adrian, Peter V; Antonio, Martin; Hare, Kim M; Henao-Restrepo, Ana Maria; Leach, Amanda J; Klugman, Keith P; Porter, Barbara D; Sá-Leão, Raquel; Scott, J Anthony; Nohynek, Hanna; O'Brien, Katherine L

    2013-12-17

    In 2003 the World Health Organization (WHO) convened a working group and published a set of standard methods for studies measuring nasopharyngeal carriage of Streptococcus pneumoniae (the pneumococcus). The working group recently reconvened under the auspices of the WHO and updated the consensus standard methods. These methods describe the collection, transport and storage of nasopharyngeal samples, as well as provide recommendations for the identification and serotyping of pneumococci using culture and non-culture based approaches. We outline the consensus position of the working group, the evidence supporting this position, areas worthy of future research, and the epidemiological role of carriage studies. Adherence to these methods will reduce variability in the conduct of pneumococcal carriage studies undertaken in the context of pneumococcal vaccine trials, implementation studies, and epidemiology studies more generally so variability in methodology does not confound the interpretation of study findings. PMID:24331112

  17. Effects on instruments of the World Health Organization--recommended protocols for decontamination after possible exposure to transmissible spongiform encephalopathy-contaminated tissue.

    PubMed

    Brown, Stanley A; Merritt, Katharine; Woods, Terry O; Busick, Deanna N

    2005-01-15

    It has been recommended by the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) that rigorous decontamination protocols be used on surgical instruments that have been exposed to tissue possibly contaminated with Creutzfeldt-Jakob disease (CJD). This study was designed to examine the effects of these protocols on various types of surgical instruments. The most important conclusions are: (1) autoclaving in 1N NaOH will cause darkening of some instruments; (2) soaking in 1N NaOH at room temperature damages carbon steel but not stainless steel or titanium; (3) soaking in chlorine bleach will badly corrode gold-plated instruments and will damage some, but not all, stainless-steel instruments, especially welded and soldered joints. Damage became apparent after the first exposure and therefore long tests are not necessary to establish which instruments will be damaged. PMID:15449256

  18. Pilot Mental Health: Expert Working Group Recommendations - Revised 2015.

    PubMed

    2016-05-01

    In September 2012, the Aerospace Medical Association published and distributed recommendations from its Pilot Mental Health Working Group to improve awareness and identification of pilot mental health issues during the aeromedical assessment of pilots. Following the crash of Germanwings Flight 9525 in March 2015 with pilot suicide as the probable cause, the Pilot Mental Health Working Group reconvened to review their recommendations. As a result, the working group revised the recommendations which are provided here and which were distributed worldwide. The Working Group continues to emphasize the importance of assessing and optimizing pilot mental health, while providing additional recommendations on building trust and rapport between the aeromedical examiner and the pilot, on utilizing aviation mental health and aeromedical specialists, and on the balance between medical confidentiality and risk to public safety. The working group encourages all organizations involved in flight safety to review and consider implementing these recommendations within their usual operations. PMID:27099091

  19. Recommendations for Undergraduate Public Health Education

    ERIC Educational Resources Information Center

    Riegelman, Richard K.; Albertine, Susan

    2008-01-01

    This curriculum guide serves to assist faculty who are developing undergraduate courses in public health as well as educational administrators and faculty curriculum committees who are designing undergraduate public health curricula. The approach outlined in these recommendations focuses on the development of three core courses, each of which is…

  20. The Health Maintenance Organization

    ERIC Educational Resources Information Center

    Lum, Doman

    1973-01-01

    Controversial proposals to establish health organizations could drastically change the delivery of health services. Understanding the issues in this controversy can help professionals in the human services see what is needed in health reform and legislation. (Author)

  1. [Physical activity and public health: recommendations for exercise prescription].

    PubMed

    Mendes, Romeu; Sousa, Nelson; Barata, J L Themudo

    2011-01-01

    During the last half century scientific data have been accumulated, through epidemiological and clinical studies that clearly document the significant health benefits associated with regular physical activity. This paper will analyse the latest recommendations for prescribing exercise in all age groups in healthy subjects and to individuals with chronic non-communicable diseases such as overweight, obesity, diabetes, hypertension, atherosclerotic cardiovascular disease and cancer, that contribute to the leading causes of global mortality. A search in the Pubmed database was performed and were also searched the recommendations of the World Health Organization and scientific organizations in Portugal. Most health benefits occur with at least 150 minutes of aerobic exercise of moderate intensity, accumulated over the week, which can be split into periods of at least 10 minutes. Brisk walking seems to be the preferred aerobic exercise. Vigorous intensity aerobic exercise and resistance exercises for muscle strengthening, at least two days a week are also recommended. Children, youth, older adults and people with overweight have particular needs for physical activity. Additional benefits occur with increasing quantity and quality of physical activity through the proper manipulation of the exercise density (intensity, frequency and duration). However, some physical activity is better than none. The role of health professionals in prescribing appropriate exercise to their patients is fundamental to their involvement in increasing their physical activity levels and thus contributing to their health promotion and prevention and treatment of major non-communicable chronic diseases. PMID:22713198

  2. Pan American Health Organization

    MedlinePlus

    ... international partner organizations are urging strong financial and political support for a medium-term cholera plan recently ... Collaborating Centers IRIS Institutional Repository for Information Sharing Public Health Associations Bulletins Virtual Campus for Public Health ...

  3. To Your Health: NLM update transcript - Healthy international travel recommendations

    MedlinePlus

    ... html To Your Health: NLM update Transcript Healthy international travel recommendations : 08/08/2016 To use the ... on weekly topics. Some specific recommendations on healthy international travel as well as information to take to ...

  4. Policy Recommendations for Health Professions Education. Item #7.

    ERIC Educational Resources Information Center

    Illinois State Board of Higher Education, Springfield.

    This report presents recommendations for Illinois' Board of Higher Education's approval in the areas of: (1) general policies for health professions education, (2) the adoption of immediate program priorities to implement the general policy directions in health education programs, and (3) specific recommendations for adjustments in Health Services…

  5. [Health care levels and minimum recommendations for neonatal care].

    PubMed

    Rite Gracia, S; Fernández Lorenzo, J R; Echániz Urcelay, I; Botet Mussons, F; Herranz Carrillo, G; Moreno Hernando, J; Salguero García, E; Sánchez Luna, M

    2013-07-01

    A policy statement on the levels of care and minimum recommendations for neonatal healthcare was first proposed by the Standards Committee and the Board of the Spanish Society of Neonatology in 2004. This allowed us to define the level of care of each center in our country, as well as the health and technical requirements by levels of care to be defined. This review takes into account changes in neonatal care in the last few years and to optimize the location of resources. Facilities that provide care for newborn infants should be organized within a regionalized system of perinatal care. The functional capabilities of each level of care should be defined clearly and uniformly, including requirements for equipment, facilities, personnel, ancillary services, training, and the organization of services (including transport) needed to cover each level of care. PMID:23266243

  6. Health Care Reform: Recommendations and Analysis.

    ERIC Educational Resources Information Center

    Lewit, Eugene M.; And Others

    1993-01-01

    Health care reform needs to assure coverage to all children regardless of income level or illnesses; address benefits, financing, administration, and delivery systems; provide substantial subsidies to low-income families; be equitable for all people; provide better monitoring of child health; protect and strengthen health providers who assist…

  7. HHS announces Text4Health task force recommendations

    Cancer.gov

    Today, the U.S. Department of Health and Human Services (HHS) announced new recommendations to support health text messaging and mobile health (mHealth) programs. The department has been actively exploring means to capitalize on the rapid proliferation of

  8. 25 CFR 900.174 - If an Indian tribe or tribal organization objects to the recommended decision, what will the...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 2 2011-04-01 2011-04-01 false If an Indian tribe or tribal organization objects to the recommended decision, what will the Secretary of Health and Human Services or the IBIA do? 900.174 Section 900... organization objects to the recommended decision, what will the Secretary of Health and Human Services or...

  9. Evaluation of military field-water quality: Volume 6, Infectious organisms of military concern associated with nonconsumptive exposure: Assessment of health risks and recommendations for establishing related standards

    SciTech Connect

    Cooper, R.C.; Olivieri, A.W.; Danielson, R.E.; Badger, P.G.

    1986-02-01

    This study is an assessment of the risk of illness due to exposure to water-related (i.e., water-based, water-washed) infectious organisms. The organisms under consideration are Aeromonas spp., Leptospira spp., Pseudomonas spp., Staphylococcus spp., non-cholerae Vibrio spp., Acanthamoeba spp., Balantidium coli, Naegleria spp., Ascaris lumbricoides, Dracunculus medinesis, Schistosoma spp., and the agents responsible for cercarial dermatitis (i.e., Trichobilharzia, Gigantobilharzia, and Austrobilharzia). Evaluation of the risk to disease associated with the above pathogens requires information in specific areas such as dose response, concentration of agents in the environment, and environmental persistence. The existing body of knowledge concerning these agents ranges from speculation to established fact. Unfortunately, areas of information critical to risk assessment are frequently unavailable. Because of this lack of data, the risk assessment presented is semiquantitative and limited to the presentation of an environmental classification scheme. 14 refs., 2 figs., 57 tabs.

  10. Wildlife health investigations: needs, challenges and recommendations

    PubMed Central

    2013-01-01

    In a fast changing world with growing concerns about biodiversity loss and an increasing number of animal and human diseases emerging from wildlife, the need for effective wildlife health investigations including both surveillance and research is now widely recognized. However, procedures applicable to and knowledge acquired from studies related to domestic animal and human health can be on partly extrapolated to wildlife. This article identifies requirements and challenges inherent in wildlife health investigations, reviews important definitions and novel health investigation methods, and proposes tools and strategies for effective wildlife health surveillance programs. Impediments to wildlife health investigations are largely related to zoological, behavioral and ecological characteristics of wildlife populations and to limited access to investigation materials. These concerns should not be viewed as insurmountable but it is imperative that they are considered in study design, data analysis and result interpretation. It is particularly crucial to remember that health surveillance does not begin in the laboratory but in the fields. In this context, participatory approaches and mutual respect are essential. Furthermore, interdisciplinarity and open minds are necessary because a wide range of tools and knowledge from different fields need to be integrated in wildlife health surveillance and research. The identification of factors contributing to disease emergence requires the comparison of health and ecological data over time and among geographical regions. Finally, there is a need for the development and validation of diagnostic tests for wildlife species and for data on free-ranging population densities. Training of health professionals in wildlife diseases should also be improved. Overall, the article particularly emphasizes five needs of wildlife health investigations: communication and collaboration; use of synergies and triangulation approaches; investments

  11. Wildlife health investigations: needs, challenges and recommendations.

    PubMed

    Ryser-Degiorgis, Marie-Pierre

    2013-01-01

    In a fast changing world with growing concerns about biodiversity loss and an increasing number of animal and human diseases emerging from wildlife, the need for effective wildlife health investigations including both surveillance and research is now widely recognized. However, procedures applicable to and knowledge acquired from studies related to domestic animal and human health can be on partly extrapolated to wildlife. This article identifies requirements and challenges inherent in wildlife health investigations, reviews important definitions and novel health investigation methods, and proposes tools and strategies for effective wildlife health surveillance programs. Impediments to wildlife health investigations are largely related to zoological, behavioral and ecological characteristics of wildlife populations and to limited access to investigation materials. These concerns should not be viewed as insurmountable but it is imperative that they are considered in study design, data analysis and result interpretation. It is particularly crucial to remember that health surveillance does not begin in the laboratory but in the fields. In this context, participatory approaches and mutual respect are essential. Furthermore, interdisciplinarity and open minds are necessary because a wide range of tools and knowledge from different fields need to be integrated in wildlife health surveillance and research. The identification of factors contributing to disease emergence requires the comparison of health and ecological data over time and among geographical regions. Finally, there is a need for the development and validation of diagnostic tests for wildlife species and for data on free-ranging population densities. Training of health professionals in wildlife diseases should also be improved. Overall, the article particularly emphasizes five needs of wildlife health investigations: communication and collaboration; use of synergies and triangulation approaches; investments

  12. Advancing human health risk assessment: integrating recent advisory committee recommendations.

    PubMed

    Dourson, Michael; Becker, Richard A; Haber, Lynne T; Pottenger, Lynn H; Bredfeldt, Tiffany; Fenner-Crisp, Penelope A

    2013-07-01

    Over the last dozen years, many national and international expert groups have considered specific improvements to risk assessment. Many of their stated recommendations are mutually supportive, but others appear conflicting, at least in an initial assessment. This review identifies areas of consensus and difference and recommends a practical, biology-centric course forward, which includes: (1) incorporating a clear problem formulation at the outset of the assessment with a level of complexity that is appropriate for informing the relevant risk management decision; (2) using toxicokinetics and toxicodynamic information to develop Chemical Specific Adjustment Factors (CSAF); (3) using mode of action (MOA) information and an understanding of the relevant biology as the key, central organizing principle for the risk assessment; (4) integrating MOA information into dose-response assessments using existing guidelines for non-cancer and cancer assessments; (5) using a tiered, iterative approach developed by the World Health Organization/International Programme on Chemical Safety (WHO/IPCS) as a scientifically robust, fit-for-purpose approach for risk assessment of combined exposures (chemical mixtures); and (6) applying all of this knowledge to enable interpretation of human biomonitoring data in a risk context. While scientifically based defaults will remain important and useful when data on CSAF or MOA to refine an assessment are absent or insufficient, assessments should always strive to use these data. The use of available 21st century knowledge of biological processes, clinical findings, chemical interactions, and dose-response at the molecular, cellular, organ and organism levels will minimize the need for extrapolation and reliance on default approaches. PMID:23844697

  13. Advancing human health risk assessment: Integrating recent advisory committee recommendations

    PubMed Central

    Becker, Richard A.; Haber, Lynne T.; Pottenger, Lynn H.; Bredfeldt, Tiffany; Fenner-Crisp, Penelope A.

    2013-01-01

    Over the last dozen years, many national and international expert groups have considered specific improvements to risk assessment. Many of their stated recommendations are mutually supportive, but others appear conflicting, at least in an initial assessment. This review identifies areas of consensus and difference and recommends a practical, biology-centric course forward, which includes: (1) incorporating a clear problem formulation at the outset of the assessment with a level of complexity that is appropriate for informing the relevant risk management decision; (2) using toxicokinetics and toxicodynamic information to develop Chemical Specific Adjustment Factors (CSAF); (3) using mode of action (MOA) information and an understanding of the relevant biology as the key, central organizing principle for the risk assessment; (4) integrating MOA information into dose–response assessments using existing guidelines for non-cancer and cancer assessments; (5) using a tiered, iterative approach developed by the World Health Organization/International Programme on Chemical Safety (WHO/IPCS) as a scientifically robust, fit-for-purpose approach for risk assessment of combined exposures (chemical mixtures); and (6) applying all of this knowledge to enable interpretation of human biomonitoring data in a risk context. While scientifically based defaults will remain important and useful when data on CSAF or MOA to refine an assessment are absent or insufficient, assessments should always strive to use these data. The use of available 21st century knowledge of biological processes, clinical findings, chemical interactions, and dose–response at the molecular, cellular, organ and organism levels will minimize the need for extrapolation and reliance on default approaches. PMID:23844697

  14. Children and Managed Health Care. Analysis and Recommendations.

    ERIC Educational Resources Information Center

    Deal, Lisa W.; Shiono, Patricia H.; Behrman, Richard E.

    1998-01-01

    Reviews the changes managed health care has brought to the delivery and use of medical services and recommends specific steps that will make the existing system more responsive to the needs of children. Systemwide health care reforms must give children stable medical care that emphasizes preventive health and developmental services. (SLD)

  15. Achieving Population Health in Accountable Care Organizations

    PubMed Central

    Walker, Deborah Klein

    2013-01-01

    Although “population health” is one of the Institute for Healthcare Improvement’s Triple Aim goals, its relationship to accountable care organizations (ACOs) remains ill-defined and lacks clarity as to how the clinical delivery system intersects with the public health system. Although defining population health as “panel” management seems to be the default definition, we called for a broader “community health” definition that could improve relationships between clinical delivery and public health systems and health outcomes for communities. We discussed this broader definition and offered recommendations for linking ACOs with the public health system toward improving health for patients and their communities. PMID:23678910

  16. Recommendations for health information technology implementation in rural hospitals.

    PubMed

    Huang, Yuan-Han; Gramopadhye, Anand K

    2016-05-01

    Purpose - The purpose of this paper is to investigate violations against work standards associated with using a new health information technology (HIT) system. Relevant recommendations for implementing HIT in rural hospitals are provided and discussed to achieve meaningful use. Design/methodology/approach - An observational study is conducted to map medication administration process while using a HIT system in a rural hospital. Follow-up focus groups are held to determine and verify potential adverse factors related to using the HIT system while passing drugs to patients. Findings - A detailed task analysis demonstrated several violations, such as only relying on the barcode scanning system to match up with patient and drugs could potentially result in the medical staff forgetting to provide drug information verbally before administering drugs. There was also a lack of regulated and clear work procedure in using the new HIT system. In addition, the computer system controls and displays could not be adjusted so as to satisfy the users' expectations. Nurses prepared medications and documentation in an environment that was prone to interruptions. Originality/value - Recommendations for implementing a HIT system in rural healthcare facilities can be categorized into five areas: people, tasks, tools, environment, and organization. Detailed remedial measures are provided for achieving continuous process improvements at resource-limited healthcare facilities in rural areas. PMID:27142953

  17. 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

  18. Visualization and exploration for recommender systems in enterprise organization

    NASA Astrophysics Data System (ADS)

    Karni, Z.; Shapira, L.

    2013-03-01

    Recommender systems seek to predict the interest a user would find in an item, person or social element they had not yet considered, based upon the properties of the item, the user's past experience and similar users. However, recommended items are often presented to the user with no context and no ability to influence the results. We present a novel visualization technique for recommender systems in which, a user can see the items recommended for him, and understand why they were recommended. Focusing on a user, we render a planar visualization listing a set of recommended items. The items are organized such that similar items reside nearby on the screen, centered around realtime generated categories. We use a combination of iconography, text and tag clouds, with maximal use of screen real estate, and keep items from overlapping to produce our results. We apply our visualization to expert relevance maps in the enterprise and a book recommendation system for consumers. The latter is based on Shelfari, a social network for reading and books.

  19. 25 CFR 900.167 - If an Indian tribe or tribal organization objects to the recommended decision, what will the...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 2 2011-04-01 2011-04-01 false If an Indian tribe or tribal organization objects to the recommended decision, what will the Secretary of Health and Human Services or the IBIA do? 900.167 Section 900... Payment § 900.167 If an Indian tribe or tribal organization objects to the recommended decision, what...

  20. Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations

    PubMed Central

    Greenhalgh, Trisha; Robert, Glenn; Macfarlane, Fraser; Bate, Paul; Kyriakidou, Olivia

    2004-01-01

    This article summarizes an extensive literature review addressing the question, How can we spread and sustain innovations in health service delivery and organization? It considers both content (defining and measuring the diffusion of innovation in organizations) and process (reviewing the literature in a systematic and reproducible way). This article discusses (1) a parsimonious and evidence-based model for considering the diffusion of innovations in health service organizations, (2) clear knowledge gaps where further research should be focused, and (3) a robust and transferable methodology for systematically reviewing health service policy and management. Both the model and the method should be tested more widely in a range of contexts. PMID:15595944

  1. The organization of colposcopy services in Ontario: recommended framework

    PubMed Central

    Murphy, J.; Varela, N.P.; Elit, L.; Lytwyn, A.; Yudin, M.; Shier, M.; Wu, V.; El-Khatib, S.

    2015-01-01

    Objective The purpose of this guideline is to help ensure the provision of high-quality colposcopy practices in the province of Ontario, including those conducted as diagnostic procedures in follow-up to an abnormal cervical screening test. Methods This document updates the recommendations published in the 2008 colposcopy guideline from Cancer Care Ontario, The Optimum Organization for the Delivery of Colposcopy Service in Ontario. A systematic review of guidelines was conducted to evaluate the existing evidence and recommendations concerning these key aspects of colposcopy: □ Training, qualification, accreditation, and maintenance of competence□ Practice setting requirements□ Operational practice□ Quality indicators and outcomes Results This guideline provides recommendations on training and maintenance of competence for colposcopists in the practice settings in which colposcopic evaluation and treatments are conducted. It also provides recommendations on operational issues and quality indicators for colposcopy. Conclusions This updated guideline is intended to support quality improvement for colposcopy for all indications, including the follow-up of an abnormal cervical screening test and work-up for lower genital tract lesions that are not clearly malignant. The recommendations contained in this document are intended for clinicians and institutions performing colposcopy in Ontario, and for policymakers and program planners involved in the delivery of colposcopy services. PMID:26300667

  2. Third Year Trends in Compliance with Recommended Health Seeking Behaviors.

    ERIC Educational Resources Information Center

    Bausell, R. Barker; Soeken, Karen L.

    Beginning in 1983, a national poll has been conducted annually to assess the extent to which the American public engaged in a core of 21 recommended health seeking behaviors. For the third consecutive year a national sample of approximately 1250 adults were interviewed concerning their self-reported compliance with a basic core of 21 health…

  3. Perspective: Conflict of interest and professional organizations: considerations and recommendations.

    PubMed

    Camilleri, Michael; Parke, David W

    2010-01-01

    There are differences in conflicts of interest (COIs) in professional organizations compared with academic medical centers. The authors discuss nine major questions pertaining to industry relationships of professional organizations: (1) What makes COI management different in professional membership organizations? (2) What COI challenges are specific to professional organizations? (3) What are potential impacts of perceived or real COIs involving professional organizations and the management of COIs? (4) Is regulation necessary, or should professional organizations proactively resolve COI issues independently? (5) Are guidelines portable from academic medical centers to professional organizations? (6) What approaches may be considered for managing COIs of the organization's leaders? (7) What approaches are reasonable for managing COI issues at professional meetings? (8) What approaches are important for integrity of educational programs, publications, and products? and (9) What approaches are reasonable for managing and enforcing COI guidelines on an ongoing basis? Responses to these questions focus on four principles: First, a code of ethics governing general behavior of members and safeguarding the interest of patients must be in place; second, the monitoring and management of COI for leadership, including, in some cases, recusal from certain activities; third, the pooling and consistent, transparent management of unrestricted grants from corporate sponsors; and, fourth, the management of industry marketing efforts at membership meetings to ensure their appropriateness. The perspectives offered are intended to encourage individuals and learned bodies to further study and provide commentary and recommendations on managing COIs of a professional organization. PMID:20042830

  4. Recommendations for Health Monitoring and Reporting for Zebrafish Research Facilities.

    PubMed

    Collymore, Chereen; Crim, Marcus J; Lieggi, Christine

    2016-07-01

    The presence of subclinical infection or clinical disease in laboratory zebrafish may have a significant impact on research results, animal health and welfare, and transfer of animals between institutions. As use of zebrafish as a model of disease increases, a harmonized method for monitoring and reporting the health status of animals will facilitate the transfer of animals, allow institutions to exclude diseases that may negatively impact their research programs, and improve animal health and welfare. All zebrafish facilities should implement a health monitoring program. In this study, we review important aspects of a health monitoring program, including choice of agents, samples for testing, available testing methodologies, housing and husbandry, cost, test subjects, and a harmonized method for reporting results. Facilities may use these recommendations to implement their own health monitoring program. PMID:26991393

  5. Organization theory. Analyzing health care organizations.

    PubMed

    Cors, W K

    1997-02-01

    Organization theory (OT) is a tool that can be applied to analyze and understand health care organizations. Transaction cost theory is used to explain, in a unifying fashion, the myriad changes being undertaken by different groups of constituencies in health care. Agency theory is applied to aligning economic incentives needed to ensure Integrated Delivery System (IDS) success. By using tools such as OT, a clearer understanding of organizational changes is possible. PMID:10164970

  6. Recommendations for the school health physical examination in Lebanon.

    PubMed

    Hamadeh, G N; Saab, B R; Adib, S M; Mroueh, S M

    1999-01-01

    School health developed gradually over the years; starting with efforts to keep contagion out of schools to global programs of comprehensive services. One of its components, school medicine, covers screening examinations, record maintenance, emergency care, immunization monitoring and health counseling. This paper proposes the essential health activities to be performed during a screening school examination in Lebanon. The recommendations are based on a combination of international literature review of evidence and the existence of Lebanese epidemiological reports identifying specific problems. Vaccination record review, tuberculin testing, vision, hearing, dental and skin disorders screening procedures are proposed as essential activities of the school physical examination. PMID:10758706

  7. 25 CFR 900.167 - If an Indian tribe or tribal organization objects to the recommended decision, what will the...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false If an Indian tribe or tribal organization objects to the recommended decision, what will the Secretary of Health and Human Services or the IBIA do? 900.167 Section 900.167 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, AND INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN...

  8. 25 CFR 900.174 - If an Indian tribe or tribal organization objects to the recommended decision, what will the...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false If an Indian tribe or tribal organization objects to the recommended decision, what will the Secretary of Health and Human Services or the IBIA do? 900.174 Section 900.174 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, AND INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN...

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

    PubMed

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

    2004-01-01

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

  10. Mental health organizations in transition.

    PubMed

    Guy, B N

    1975-03-01

    Many mental health institutions are changing their traditional treatment policies and practices and their organizational structures. Literature is reviewed which provides a model for changing mental health organizations based in general systems theory. The systems organizational model has empirical support in the growing community mental health movement. The strong interaction of technological and ideological factors determining the nature of the new mental health organizations is stressed. Also considered are some of the problems facing those planning and managing changing mental health organizations. PMID:1057420

  11. Oral health care during pregnancy recommendations for oral health professionals.

    PubMed

    Kumar, Jayanth; Samelson, Renee

    2009-11-01

    Pregnancy is a unique time in a woman's life and is characterized by complex physiological changes. These changes can adversely affect oral health. Pregnancy is also an opportune time to educate women about preventing dental caries in young children, a common childhood problem. Although multiple studies have shown an association between periodontal infection and adverse pregnancy outcomes, such as premature delivery and low birth weight, recent randomized clinical trials conducted in the United States failed to show that treatment of periodontal disease during pregnancy improved birth outcomes. However, the studies confirmed the safety and effectiveness of providing oral health care during pregnancy. Pregnancy by itself is not a reason to defer routine dental care and necessary treatment for oral health problems. Diagnosis and treatment, including needed dental X-rays, can be undertaken safely during the first trimester of pregnancy. Needed treatment can be provided throughout the remainder of the pregnancy; however, the time period between the 14th and 20th week is considered ideal. PMID:20069785

  12. Public health emergencies: nurses' recommendations for effective actions.

    PubMed

    O'Boyle, Carol; Robertson, Cheryl; Secor-Turner, Molly

    2006-08-01

    During a public health emergency such as an influenza pandemic or a bioterrorism attack, nurses may be at risk for exposure to lethal infectious diseases when caring for victims. The aim of this study was to identify interventions nurses believe will support their ability to cope during public health emergencies. A qualitative research design was used with 33 nurses from designated bioterrorism-receiving hospitals. Nurses recommended adequate protective equipment, education, drills, accessible information and available content experts, and available administrators. Other recommendations included increased security to protect nurses, emotional and physical support, communication with nurses' families, and commitment from institutions to care for ill or injured nurses. Preparations for emergencies should include assessments of nurses' and other stakeholders' concerns. These nurses proposed specific measures to improve safety, reduce anxiety, increase trust in hospitals, and provide physical and emotional support. PMID:16921865

  13. The health care learning organization.

    PubMed

    Hult, G T; Lukas, B A; Hult, A M

    1996-01-01

    To many health care executives, emphasis on marketing strategy has become a means of survival in the threatening new environment of cost attainment, intense competition, and prospective payment. This paper develops a positive model of the health care organization based on organizational learning theory and the concept of the health care offering. It is proposed that the typical health care organization represents the prototype of the learning organization. Thus, commitment to a shared vision is proposed to be an integral part of the health care organization and its diagnosis, treatment, and delivery of the health care offering, which is based on the exchange relationship, including its communicative environment. Based on the model, strategic marketing implications are discussed. PMID:10158798

  14. Updating ACSM's Recommendations for Exercise Preparticipation Health Screening.

    PubMed

    Riebe, Deborah; Franklin, Barry A; Thompson, Paul D; Garber, Carol Ewing; Whitfield, Geoffrey P; Magal, Meir; Pescatello, Linda S

    2015-11-01

    The purpose of the American College of Sports Medicine's (ACSM) exercise preparticipation health screening process is to identify individuals who may be at elevated risk for exercise-related sudden cardiac death and/or acute myocardial infarction. Recent studies have suggested that using the current ACSM exercise preparticipation health screening guidelines can result in excessive physician referrals, possibly creating a barrier to exercise participation. In addition, there is considerable evidence that exercise is safe for most people and has many associated health and fitness benefits; exercise-related cardiovascular events are often preceded by warning signs/symptoms; and the cardiovascular risks associated with exercise lessen as individuals become more physically active/fit. Consequently, a scientific roundtable was convened by the ACSM in June 2014 to evaluate the current exercise preparticipation health screening recommendations. The roundtable proposed a new evidence-informed model for exercise preparticipation health screening on the basis of three factors: 1) the individual's current level of physical activity, 2) presence of signs or symptoms and/or known cardiovascular, metabolic, or renal disease, and 3) desired exercise intensity, as these variables have been identified as risk modulators of exercise-related cardiovascular events. Identifying cardiovascular disease risk factors remains an important objective of overall disease prevention and management, but risk factor profiling is no longer included in the exercise preparticipation health screening process. The new ACSM exercise preparticipation health screening recommendations reduce possible unnecessary barriers to adopting and maintaining a regular exercise program, a lifestyle of habitual physical activity, or both, and thereby emphasize the important public health message that regular physical activity is important for all individuals. PMID:26473759

  15. Recommendations for mental health professionals in the NICU

    PubMed Central

    Hynan, M T; Steinberg, Z; Baker, L; Cicco, R; Geller, P A; Lassen, S; Milford, C; Mounts, K O; Patterson, C; Saxton, S; Segre, L; Stuebe, A

    2015-01-01

    This article describes recommended activities of social workers, psychologists and psychiatric staff within the neonatal intensive care unit (NICU). NICU mental health professionals (NMHPs) should interact with all NICU parents in providing emotional support, screening, education, psychotherapy and teleservices for families. NMHPs should also offer educational and emotional support for the NICU health-care staff. NMHPs should function at all levels of layered care delivered to NICU parents. Methods of screening for emotional distress are described, as well as evidence for the benefits of peer-to-peer support and psychotherapy delivered in the NICU. In the ideal NICU, care for the emotional and educational needs of NICU parents are outcomes equal in importance to the health and development of their babies. Whenever possible, NMHPs should be involved with parents from the antepartum period through after discharge. PMID:26597800

  16. Protection of Human Beings Trafficked for the Purpose of Organ Removal: Recommendations.

    PubMed

    Pascalev, Assya; Van Assche, Kristof; Sándor, Judit; Codreanu, Natalia; Naqvi, Anwar; Gunnarson, Martin; Frunza, Mihaela; Yankov, Jordan

    2016-02-01

    This report presents a comprehensive set of recommendations for protection of human beings who are trafficked for the purpose of organ removal or are targeted for such trafficking. Developed by an interdisciplinary group of international experts under the auspices of the project Trafficking in Human Beings for the Purpose of Organ Removal (also known as the HOTT project), these recommendations are grounded in the view that an individual who parts with an organ for money within an illegal scheme is ipso facto a victim and that the crime of trafficking in human beings for the purpose of organ removal (THBOR) intersects with the crime of trafficking in organs. Consequently, the protection of victims should be a priority for all actors involved in antitrafficking activities: those combating organ-related crimes, such as health organizations and survivor support services, and those combating trafficking in human beings, such as the criminal justice sectors. Taking into account the special characteristics of THBOR, the authors identify 5 key stakeholders in the protection of human beings trafficked for organ removal or targeted for such trafficking: states, law enforcement agencies and judiciary, nongovernmental organizations working in the areas of human rights and antitrafficking, transplant centers and health professionals involved in transplant medicine, and oversight bodies. For each stakeholder, the authors identify key areas of concern and concrete measures to identify and protect the victims of THBOR. The aim of the recommendations is to contribute to the development of a nonlegislative response to THBOR, to promote the exchange of knowledge and best practices in the area of victim protection, and to facilitate the development of a policy-driven action plan for the protection of THBOR victims in the European Union and worldwide. PMID:27500252

  17. Protection of Human Beings Trafficked for the Purpose of Organ Removal: Recommendations

    PubMed Central

    Pascalev, Assya; Van Assche, Kristof; Sándor, Judit; Codreanu, Natalia; Naqvi, Anwar; Gunnarson, Martin; Frunza, Mihaela; Yankov, Jordan

    2016-01-01

    Abstract This report presents a comprehensive set of recommendations for protection of human beings who are trafficked for the purpose of organ removal or are targeted for such trafficking. Developed by an interdisciplinary group of international experts under the auspices of the project Trafficking in Human Beings for the Purpose of Organ Removal (also known as the HOTT project), these recommendations are grounded in the view that an individual who parts with an organ for money within an illegal scheme is ipso facto a victim and that the crime of trafficking in human beings for the purpose of organ removal (THBOR) intersects with the crime of trafficking in organs. Consequently, the protection of victims should be a priority for all actors involved in antitrafficking activities: those combating organ-related crimes, such as health organizations and survivor support services, and those combating trafficking in human beings, such as the criminal justice sectors. Taking into account the special characteristics of THBOR, the authors identify 5 key stakeholders in the protection of human beings trafficked for organ removal or targeted for such trafficking: states, law enforcement agencies and judiciary, nongovernmental organizations working in the areas of human rights and antitrafficking, transplant centers and health professionals involved in transplant medicine, and oversight bodies. For each stakeholder, the authors identify key areas of concern and concrete measures to identify and protect the victims of THBOR. The aim of the recommendations is to contribute to the development of a nonlegislative response to THBOR, to promote the exchange of knowledge and best practices in the area of victim protection, and to facilitate the development of a policy-driven action plan for the protection of THBOR victims in the European Union and worldwide. PMID:27500252

  18. 76 FR 10598 - Office of the National Coordinator for Health Information Technology; Recommendations Received...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-25

    ... HUMAN SERVICES Office of the National Coordinator for Health Information Technology; Recommendations... the Public Health Service Act, as amended by the Health Information Technology for Economic and Clinical Health (HITECH) Act, requires the National Coordinator for Health Information Technology...

  19. Toward a 21st-century health care system: recommendations for health care reform.

    PubMed

    Arrow, Kenneth; Auerbach, Alan; Bertko, John; Brownlee, Shannon; Casalino, Lawrence P; Cooper, Jim; Crosson, Francis J; Enthoven, Alain; Falcone, Elizabeth; Feldman, Robert C; Fuchs, Victor R; Garber, Alan M; Gold, Marthe R; Goldman, Dana; Hadfield, Gillian K; Hall, Mark A; Horwitz, Ralph I; Hooven, Michael; Jacobson, Peter D; Jost, Timothy Stoltzfus; Kotlikoff, Lawrence J; Levin, Jonathan; Levine, Sharon; Levy, Richard; Linscott, Karen; Luft, Harold S; Mashal, Robert; McFadden, Daniel; Mechanic, David; Meltzer, David; Newhouse, Joseph P; Noll, Roger G; Pietzsch, Jan B; Pizzo, Philip; Reischauer, Robert D; Rosenbaum, Sara; Sage, William; Schaeffer, Leonard D; Sheen, Edward; Silber, B Michael; Skinner, Jonathan; Shortell, Stephen M; Thier, Samuel O; Tunis, Sean; Wulsin, Lucien; Yock, Paul; Nun, Gabi Bin; Bryan, Stirling; Luxenburg, Osnat; van de Ven, Wynand P M M

    2009-04-01

    The coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a series of workshops during which physicians, health policy experts, health insurance executives, business leaders, hospital administrators, economists, and others who represent diverse perspectives came together. This group agreed that the following 8 recommendations are fundamental to successful reform: 1. Replace the current fee-for-service payment system with a payment system that encourages and rewards innovation in the efficient delivery of quality care. The new payment system should invest in the development of outcome measures to guide payment. 2. Establish a securely funded, independent agency to sponsor and evaluate research on the comparative effectiveness of drugs, devices, and other medical interventions. 3. Simplify and rationalize federal and state laws and regulations to facilitate organizational innovation, support care coordination, and streamline financial and administrative functions. 4. Develop a health information technology infrastructure with national standards of interoperability to promote data exchange. 5. Create a national health database with the participation of all payers, delivery systems, and others who own health care data. Agree on methods to make de-identified information from this database on clinical interventions, patient outcomes, and costs available to researchers. 6. Identify revenue sources, including a cap on the tax exclusion of employer-based health insurance, to subsidize health care coverage with the goal of insuring all Americans. 7. Create state or regional insurance exchanges to pool risk, so that Americans without access to employer-based or other group insurance could obtain a standard benefits package through these exchanges

  20. Natural remedies recommended for the management of oral health.

    PubMed

    Ocasio, N A; Solomowitz, B H; Sher, M R

    1999-01-01

    This paper discusses various practices recommended by homeopaths, herbalists, spiritual and natural healers for the management and maintenance of oral health. It is intended as a partial guide to educate the dental professional on self-administered, over-the-counter remedies that are easily available to the general population. Since few if any clinical studies exist assessing the efficacy or side effects of these ingested products, little is known about the beneficial or potentially harmful course these remedies may take on the human body. PMID:10474992

  1. Children's Health Insurance Program (CHIP): accomplishments, challenges, and policy recommendations.

    PubMed

    Racine, Andrew D; Long, Thomas F; Helm, Mark E; Hudak, Mark; Racine, Andrew D; Shenkin, Budd N; Snider, Iris Grace; White, Patience Haydock; Droge, Molly; Harbaugh, Norman

    2014-03-01

    Sixteen years ago, the 105th Congress, responding to the needs of 10 million children in the United States who lacked health insurance, created the State Children's Health Insurance Program (SCHIP) as part of the Balanced Budget Act of 1997. Enacted as Title XXI of the Social Security Act, the Children's Health Insurance Program (CHIP; or SCHIP as it has been known at some points) provided states with federal assistance to create programs specifically designed for children from families with incomes that exceeded Medicaid thresholds but that were insufficient to enable them to afford private health insurance. Congress provided $40 billion in block grants over 10 years for states to expand their existing Medicaid programs to cover the intended populations, to erect new stand-alone SCHIP programs for these children, or to effect some combination of both options. Congress reauthorized CHIP once in 2009 under the Children's Health Insurance Program Reauthorization Act and extended its life further within provisions of the Patient Protection and Affordable Care Act of 2010. The purpose of this statement is to review the features of CHIP as it has evolved over the 16 years of its existence; to summarize what is known about the effects that the program has had on coverage, access, health status, and disparities among participants; to identify challenges that remain with respect to insuring this group of vulnerable children, including the impact that provisions of the new Affordable Care Act will have on the issue of health insurance coverage for near-poor children after 2015; and to offer recommendations on how to expand and strengthen the national commitment to provide health insurance to all children regardless of means. PMID:24470647

  2. Recommendations

    ERIC Educational Resources Information Center

    Brazelton, G. Blue; Renn, Kristen A.; Stewart, Dafina-Lazarus

    2015-01-01

    In this chapter, the editors provide a summary of the information shared in this sourcebook about the success of students who have minoritized identities of sexuality or gender and offer recommendations for policy, practice, and further research.

  3. Health policy and exercise: a brief BRFSS study and recommendations.

    PubMed

    Larson, James S; Winn, Mylon

    2010-03-01

    The Behavioral Risk Factor Surveillance Survey is used to compare three predictors of self-rated health, specifically exercise, tobacco smoking, and a diagnosis of diabetes (a proxy for obesity). Exercise is found to be the best predictor, and the remainder of the article discusses the role of exercise in disease prevention and the all-important concept of exercise adherence. Government policy in the future needs to promote exercise adherence in a more rigorous way, because it is a key to both individual and societal health. Exercise habits need to be instilled from youth, and physical education requirements in school need to be re-established at all levels through high school. Adults also need encouragement with better neighborhood planning of exercise trails for walking and biking, as well as planned community activities to encourage fitness through one's lifetime. The article concludes with six recommendations for formal government action to encourage exercise adherence. PMID:18490485

  4. Patient Accessible Electronic Health Records: Exploring Recommendations for Successful Implementation Strategies

    PubMed Central

    Urowitz, Sara; Apatu, Emma; DeLenardo, Claudette; Eysenbach, Gunther; Harth, Tamara; Pai, Howard; Leonard, Kevin J

    2008-01-01

    Background Providing patients with access to their electronic health records offers great promise to improve patient health and satisfaction with their care, as well to improve professional and organizational approaches to health care. Although many benefits have been identified, there are many questions about best practices for the implementation of patient accessible Electronic Health Records (EHRs). Objectives To develop recommendations to assist health care organizations in providing patients with access to EHRs in a meaningful, responsible, and responsive manner. Methods A Patient Accessible Electronic Health Record (PAEHR) Workshop was held with nationally and internationally renowned experts to explore issues related to providing patient access to the EHR and managing institutional change. Results The PAEHR Workshop was attended by 45 participants who discussed recommendations for the implementation of patient accessible EHRs. Recommendations were discussed under four subject domains: (1) providing patient access to the EHR, (2) maintaining privacy and confidentiality related to the PAEHR, (3) patient education and navigation of the PAEHR, and (4) strategies for managing institutional change. The discussion focused on the need for national infrastructure, clear definitions for privacy, security and confidentiality, flexible, interoperable solutions, and patient and professional education. In addition, there was a strong call for research into all domains of patient accessible EHRs to ensure the adoption of evidence-based practices. Conclusions Patient access to personal health information is a fundamental issue for patient engagement and empowerment. Health care professionals and organizations should consider the potential benefits and risks of patient access when developing EHR strategies. Flexible, standardized, and interoperable solutions must be integrated with outcomes-based research to activate effectively patients as partners in their health care

  5. Democratizing the world health organization.

    PubMed

    van de Pas, R; van Schaik, L G

    2014-02-01

    A progressive erosion of the democratic space appears as one of the emerging challenges in global health today. Such delimitation of the political interplay has a particularly evident impact on the unique public interest function of the World Health Organization (WHO). This paper aims to identify some obstacles for a truly democratic functioning of the UN specialized agency for health. The development of civil society's engagement with the WHO, including in the current reform proposals, is described. The paper also analyses how today's financing of the WHO--primarily through multi-bi financing mechanisms--risks to choke the agency's role in global health. Democratizing the public debate on global health, and therefore the role of the WHO, requires a debate on its future role and engagement at the country level. This desirable process can only be linked to national debates on public health, and the re-definition of health as a primary political and societal concern. PMID:24417900

  6. Empirically based recommendations to support parents facing the dilemma of paediatric cadaver organ donation.

    PubMed

    Bellali, T; Papazoglou, I; Papadatou, D

    2007-08-01

    The aim of the study was to describe the challenges donor and non-donor parents encounter before, during, and after the organ donation decision, and to identify parents' needs and expectations from health care professionals. A further aim was to propose evidence-based recommendations for effectively introducing the option of donation, and supporting families through the grieving process. This study was undertaken as part of a larger research project investigating the experiences of Greek parents who consented or declined organ and tissue donation, using a qualitative methodology for data collection and analysis. The experiences of 22 Greek bereaved parents of 14 underage brain dead children were studied through semi-structured interviews. Parents' decision-making process was described as challenging and fraught with difficulties both before and after the donation period. Identified challenges were clustered into: (a) personal challenges, (b) conditions of organ request, and (c) interpersonal challenges. Parents' main concern following donation was the lack of information about transplantation outcomes. Findings led to a list of recommendations for nurses and other health professionals for approaching and supporting parents in making choices about paediatric organ donation that are appropriate to them, and for facilitating their adjustment to the sudden death of their underage child. PMID:17475498

  7. Vietnamese Health Care Providers' Preferences Regarding Recommendation of HPV Vaccines.

    PubMed

    Asiedu, Gladys B; Breitkopf, Carmen Radecki; Kremers, Walter K; Ngo, Quang V; Nguyen, Nguyen V; Barenberg, Benjamin J; Tran, Vinh D; Dinh, Tri A

    2015-01-01

    Physician recommendation is an important predictor of HPV vaccine acceptance; however, physician willingness and preferences regarding HPV vaccination may be influenced by factors including patient age, vaccine type, and cost. A cross-sectional survey was administered to a convenience sample of health care providers in Da Nang, Vietnam, to evaluate awareness, perceptions about HPV and HPV vaccines, and willingness to vaccinate a female patient. Willingness to vaccinate was evaluated using a full-factorial presentation of scenarios featuring the following factors: vaccine cost (free vs 1,000,000 VND), patient age (12, 16, or 22 years), and HPV vaccine type (bivalent vs quadrivalent). Responses from 244 providers were analyzed; providers had a mean age of 34±11.9 years; a majority were female, married, and had children of their own. Thirty-six percent specialized in obstetrics/gynecology and 24% were providers in family medicine. Of the three factors considered in conjoint analysis, vaccine cost was the most important factor in willingness to vaccinate, followed by patient age, and vaccine type. The most favorable scenario for vaccinating a female patient was when the vaccine was free, the patient was 22 years of age, and the HPV4 vaccine was described. In multivariable analysis, older age, being a physician, being married, and having children were all associated with increased willingness to recommend HPV vaccination (p<0.05). Provider willingness is an important aspect of successful HPV vaccination programs; identifying preferences and biases in recommendation patterns will highlight potential areas for education and intervention. PMID:26163611

  8. Recommendations for evaluation of health care improvement initiatives.

    PubMed

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

    2013-01-01

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

  9. 78 FR 9397 - International Drug Scheduling; Convention on Psychotropic Substances; World Health Organization...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-08

    ... June 2012. In the Federal Register of September 05, 2008 (73 FR 51823), FDA announced the WHO ECDD... Substances; World Health Organization Scheduling Recommendations for Gamma-hydroxybutyric Acid AGENCY: Food... public meeting concerning recommendations by the World Health Organization (WHO) to impose...

  10. Guidelines and Recommendations for Developing Interactive eHealth Apps for Complex Messaging in Health Promotion

    PubMed Central

    Heffernan, Kayla Joanne; Maclean, Skye Tamara; Callegari, Emma Teresa; Garland, Suzanne Marie; Reavley, Nicola Jane; Varigos, George Andrew; Wark, John Dennis

    2016-01-01

    Background The now ubiquitous catchphrase, “There’s an app for that,” rings true owing to the growing number of mobile phone apps. In excess of 97,000 eHealth apps are available in major app stores. Yet the effectiveness of these apps varies greatly. While a minority of apps are developed grounded in theory and in conjunction with health care experts, the vast majority are not. This is concerning given the Hippocratic notion of “do no harm.” There is currently no unified formal theory for developing interactive eHealth apps, and development is especially difficult when complex messaging is required, such as in health promotion and prevention. Objective This paper aims to provide insight into the creation of interactive eHealth apps for complex messaging, by leveraging the Safe-D case study, which involved complex messaging required to guide safe but sufficient UV exposure for vitamin D synthesis in users. We aim to create recommendations for developing interactive eHealth apps for complex messages based on the lessons learned during Safe-D app development. Methods For this case study we developed an Apple and Android app, both named Safe-D, to safely improve vitamin D status in young women through encouraging safe ultraviolet radiation exposure. The app was developed through participatory action research involving medical and human computer interaction researchers, subject matter expert clinicians, external developers, and target users. The recommendations for development were created from analysis of the development process. Results By working with clinicians and implementing disparate design examples from the literature, we developed the Safe-D app. From this development process, recommendations for developing interactive eHealth apps for complex messaging were created: (1) involve a multidisciplinary team in the development process, (2) manage complex messages to engage users, and (3) design for interactivity (tailor recommendations, remove barriers to

  11. Inadequacies in Health Recommendations Provided for International Travelers by North American Travel Health Advisors.

    PubMed

    Keystone; Dismukes; Sawyer; Kozarsky

    1994-06-01

    The rise of international travel has increased the need for more, improved travel advice from physicians and public health facilities. The quality of the health information given has not been examined on a large-scale basis by many studies, however. Surveys in Canada, Switzerland, and the United States, for example, report that only 20% to 50% of practitioners could give accurate information regarding immunization and prophylaxis about travel-related disease. Anonymous surveys were sent to 1165 American and 96 Canadian public health units and travel clinics. Using five scenarios on travel to developing countries, each source was asked to complete a standardized form giving their recommendations for immunization, antimalarials, travelers' diarrhea, and other travel issues. Of the American respondents, 60% were physicians equally distributed among private practice, university, and corporate clinics; nurses comprised 75% of the Canadian respondents, primarily from public health clinics. The number of travelers counseled per year ranged from 3 to 40,000 (American mean, 448; Canadian mean, 2180). Depending on the scenario, 20 to 75% of the immunization groups recommended were inadequate or inappropriate: most frequently, lack of tetanus/polio boosters; indiscriminant use of yellow fever/cholera vaccines; haphazard advice about meningococcal, rabies, and typhoid vaccines; and a lack of consideration of measles in young adults. Of the antimalarial recommendations given, 20 to 60% were incorrect, including prescribing medication for nonrisk areas, failure to recognize chloroquine-resistant areas, and failure to understand the use of, or contraindications to, mefloquine. Frequently, acclimatization, altitude sickness, sunscreens, and safe-sex issues were omitted. The prevention and treatment of travelers' diarrhea were adequately covered, however. Pre-travel advice given by North American health advisors shows a considerable variability in the accuracy and extent necessary

  12. Moderate leisure-time physical activity: who is meeting the public health recommendations? A national cross-sectional study.

    PubMed

    Jones, D A; Ainsworth, B E; Croft, J B; Macera, C A; Lloyd, E E; Yusuf, H R

    1998-01-01

    We identified the prevalence of adults who met the 1993 Centers for Disease Control and Prevention and the American College of Sports Medicine moderate physical activity recommendation and the 1996 Surgeon General's Report on Physical Activity and Health energy expenditure guideline for leading a moderately active lifestyle. Participants were 16,890 women and 12,272 men at least 18 years old who were asked in the 1990 National Health Interview Survey about their leisure-time physical activities. About one third of US adults met either recommendation for moderate activity; 32% met the Centers for Disease Control and Prevention and the American Association of Sports Medicine recommendation and 38% met the surgeon general's guideline. Women, ethnic minorities, adults with lower educational attainment, and older adults were least active. Public health efforts are needed to address the issues related to physical inactivity and to provide organized programs to increase moderate physical activity levels in US adults. PMID:9596466

  13. Public health and the anticorporate movement: rationale and recommendations.

    PubMed

    Wiist, William H

    2006-08-01

    Institutions and informal networks have formed a movement that is challenging the growing power and pervasive influence of large corporations. The movement's analyses show that the historical development and current function of the corporate entity requires production of a profit regardless of consequences to health, society, or the environment. As a result, public health professionals frequently address health problems related to products, services, or practices of corporations. There are possibilities for links between public health and the anticorporate movement. Public health research and the professional preparation curriculum should focus on the corporate entity as a social structural determinant of disease. PMID:16809584

  14. Public Health and the Anticorporate Movement: Rationale and Recommendations

    PubMed Central

    Wiist, William H.

    2006-01-01

    Institutions and informal networks have formed a movement that is challenging the growing power and pervasive influence of large corporations. The movement’s analyses show that the historical development and current function of the corporate entity requires production of a profit regardless of consequences to health, society, or the environment. As a result, public health professionals frequently address health problems related to products, services, or practices of corporations. There are possibilities for links between public health and the anticorporate movement. Public health research and the professional preparation curriculum should focus on the corporate entity as a social structural determinant of disease. PMID:16809584

  15. Overview to Health Professions Education: Health Education Commission Recommendations for Use in Developing the Illinois Master Plan--Phase IV.

    ERIC Educational Resources Information Center

    McGill, J. T.

    Recommendations for the preparation of health professionals in Illinois are made in order to: (1) ensure that an adequate number of health professionals are educated to meet the needs of Illinois citizens; (2) improve the distribution of available health manpower within the State; (3) enhance the access to health professions education programs for…

  16. Organic foods: health and environmental advantages and disadvantages.

    PubMed

    Forman, Joel; Silverstein, Janet

    2012-11-01

    The US market for organic foods has grown from $3.5 billion in 1996 to $28.6 billion in 2010, according to the Organic Trade Association. Organic products are now sold in specialty stores and conventional supermarkets. Organic products contain numerous marketing claims and terms, only some of which are standardized and regulated. In terms of health advantages, organic diets have been convincingly demonstrated to expose consumers to fewer pesticides associated with human disease. Organic farming has been demonstrated to have less environmental impact than conventional approaches. However, current evidence does not support any meaningful nutritional benefits or deficits from eating organic compared with conventionally grown foods, and there are no well-powered human studies that directly demonstrate health benefits or disease protection as a result of consuming an organic diet. Studies also have not demonstrated any detrimental or disease-promoting effects from an organic diet. Although organic foods regularly command a significant price premium, well-designed farming studies demonstrate that costs can be competitive and yields comparable to those of conventional farming techniques. Pediatricians should incorporate this evidence when discussing the health and environmental impact of organic foods and organic farming while continuing to encourage all patients and their families to attain optimal nutrition and dietary variety consistent with the US Department of Agriculture's MyPlate recommendations. This clinical report reviews the health and environmental issues related to organic food production and consumption. It defines the term "organic," reviews organic food-labeling standards, describes organic and conventional farming practices, and explores the cost and environmental implications of organic production techniques. It examines the evidence available on nutritional quality and production contaminants in conventionally produced and organic foods. Finally, this

  17. Capitated contracting of integrated health provider organizations.

    PubMed

    Bazzoli, G J; Dynan, L; Burns, L R

    This paper examines global capitation of integrated health provider organizations that link physicians and hospitals, such as physician-hospital organizations and management service organizations. These organizations have proliferated in recent years, but their contracting activity has not been studied. We develop a conceptual model to understand the capitated contracting bargaining process. Exploratory multivariate analysis suggests that global capitation of these organizations is more common in markets with high health maintenance organization (HMO) market share, greater numbers of HMOs, and fewer physician group practices. Additionally, health provider organizations with more complex case mix, nonprofit status, more affiliated physicians, health system affiliations, and diversity in physician organizational arrangements are more likely to have global capitation. Finally, state regulation of provider contracting with self-insured employers appears to have spillover effects on health plan risk contracting with health providers. PMID:10711318

  18. Health IT success and failure: recommendations from literature and an AMIA workshop.

    PubMed

    Kaplan, Bonnie; Harris-Salamone, Kimberly D

    2009-01-01

    With the United States joining other countries in national efforts to reap the many benefits that use of health information technology can bring for health care quality and savings, sobering reports recall the complexity and difficulties of implementing even smaller-scale systems. Despite best practice research that identified success factors for health information technology projects, a majority, in some sense, still fail. Similar problems plague a variety of different kinds of applications, and have done so for many years. Ten AMIA working groups sponsored a workshop at the AMIA Fall 2006 Symposium. It was entitled "Avoiding The F-Word: IT Project Morbidity, Mortality, and Immortality" and focused on this under-addressed problem. PARTICIPANTS discussed communication, workflow, and quality; the complexity of information technology undertakings; the need to integrate all aspects of projects, work environments, and regulatory and policy requirements; and the difficulty of getting all the parts and participants in harmony. While recognizing that there still are technical issues related to functionality and interoperability, discussion affirmed the emerging consensus that problems are due to sociological, cultural, and financial issues, and hence are more managerial than technical. Participants drew on lessons from experience and research in identifying important issues, action items, and recommendations to address the following: what "success" and "failure" mean, what contributes to making successful or unsuccessful systems, how to use failure as an enhanced learning opportunity for continued improvement, how system successes or failures should be studied, and what AMIA should do to enhance opportunities for successes. The workshop laid out a research agenda and recommended action items, reflecting the conviction that AMIA members and AMIA as an organization can take a leadership role to make projects more practical and likely to succeed in health care settings. PMID

  19. Job satisfaction in health-care organizations

    PubMed Central

    Bhatnagar, Kavita; Srivastava, Kalpana

    2012-01-01

    Job satisfaction among health-care professionals acquires significance for the purpose of maximization of human resource potential. This article is aimed at emphasizing importance of studying various aspects of job satisfaction in health-care organizations. PMID:23766585

  20. Improving Health Care Globally: A Critical Review of the Necessity of Family Medicine Research and Recommendations to Build Research Capacity

    PubMed Central

    van Weel, Chris; Rosser, Walter W.

    2004-01-01

    An invitational conference led by the World Organization of Family Doctors (Wonca) involving selected delegates from 34 countries was held in Kingston, Ontario, Canada, March 8 to12, 2003. The conference theme was “Improving Health Globally: The Necessity of Family Medicine Research.” Guiding conference discussions was the value that to improve health care worldwide, strong, evidence-based primary care is indispensable. Eight papers reviewed before the meeting formed the basic material from which the conference developed 9 recommendations. Wonca, as an international body of family medicine, was regarded as particularly suited to pursue these conference recommendations: Research achievements in family medicine should be displayed to policy makers, health (insurance) authorities, and academic leaders in a systematic way. In all countries, sentinel practice systems should be developed to provide surveillance reports on illness and diseases that have the greatest impact on the population’s health and wellness in the community. A clearinghouse should be organized to provide a central repository of knowledge about family medicine research expertise, training, and mentoring. National research institutes and university departments of family medicine with a research mission should be developed. Practice-based research networks should be developed around the world. Family medicine research journals, conferences, and Web sites should be strengthened to disseminate research findings internationally, and their use coordinated. Improved representation of family medicine research journals in databases, such as Index Medicus, should be pursued. Funding of international collaborative research in family medicine should be facilitated. International ethical guidelines, with an international ethical review process, should be developed in particular for participatory (action) research, where researchers work in partnership with communities. When implementing these recommendations

  1. Recommendations for Evaluating Temporal Trends of Persistent Organic Pollutants in Breast Milk

    PubMed Central

    Gyalpo, Tenzing; Scheringer, Martin; Hungerbühler, Konrad

    2015-01-01

    Background: Biomonitoring data of persistent organic pollutants (POPs) in breast milk are increasingly collected and available for quantitative analysis of levels and time trends. A common approach is to apply log-linear regression to calculate doubling and halving times of the POP concentrations based on the temporal trend observed in breast milk. However, there are different, sometimes conflicting interpretations of these doubling and halving times. Objectives: We provide a mechanistic understanding of doubling and halving times where possible. Five recommendations are proposed for dealing with POP concentration trends in breast milk during three distinct periods (pre-ban, transition, post-ban period). Discussion: Using temporal trends of BDE-47 and PCB-153 in breast milk data, we show which information can be gained from the time-trend data. To this end, we analyzed time trends of hypothetical POPs for different periods with time-variant exposure and different intrinsic elimination half-lives, using a dynamic population-based pharmacokinetic model. Different pieces of information can be extracted from time-trend data from different periods. The analysis of trends of short-lived POPs is rather straightforward and facilitates extraction of the intrinsic elimination half-lives from the breast milk data. However, trends of slowly eliminated POPs only provide indications for the exposure time trend. Conclusions: Time-trend data of rapidly eliminated POPs provide information on exposure time trends and elimination half-lives. Temporal trends of slowly eliminated POPs are more complicated to interpret, and the extraction of exposure time trends and elimination half-lives require data sets covering several decades. Citation: Gyalpo T, Scheringer M, Hungerbühler K. 2016. Recommendations for evaluating temporal trends of persistent organic pollutants in breast milk. Environ Health Perspect 124:881–885; http://dx.doi.org/10.1289/ehp.1510219 PMID:26672061

  2. Recommendations: Health Professions Education. A Report to the Southern Regional Education Board by Its Commission on Health and Human Services.

    ERIC Educational Resources Information Center

    Southern Regional Education Board, Atlanta, GA.

    Problems facing health professions schools and academic health centers that can damage health were identified by the Southern Regional Education Board, along with recommendations for action within the states. Nine problems for these schools and centers concern: declining applications and enrollments for dental schools and many schools of pharmacy,…

  3. Improving Health (Majority Recommendations.) Next Steps for Children and Families. Implementation Guide Series.

    ERIC Educational Resources Information Center

    National Commission on Children, Washington, DC.

    Based on the assumption that all American children deserve an opportunity to be born healthy and to grow up healthy, this guide presents the recommendations approved by the majority of the National Commission on Children for improving the health of the nation's pregnant women and children. The Commission's five recommendations are: (1) provide…

  4. The Hague Recommendations: Improving Nonlegislative Responses to Trafficking in Human Beings for the Purpose of Organ Removal.

    PubMed

    Ambagtsheer, Frederike; Weimar, Willem

    2016-02-01

    Over the years, the trade in human organs has become an object of international concern. Since the 1980s, antiorgan trade initiatives have mainly involved the strengthening of legislative responses. Little attention however is given to nonlegislative responses by law enforcement authorities. The HOTT project is a European Union-funded research project titled "trafficking in human beings for the purpose of organ removal." Its objectives are to increase knowledge, raise awareness, and improve the nonlegislative response to the crime. Its consortium organized a "Writers' Conference" in The Hague, The Netherlands at Europol's Headquarters where a group of 40 experts, consisting of transplant professionals, law enforcement officials, and policy makers, formulated recommendations to improve nonlegislative responses. These recommendations, presented hereafter, address the ethical and legal obligations of health care providers, the protection of persons trafficked for the purpose of organ removal, strengthening cross-border collaboration in criminal cases, and stimulating partnerships between transplant professionals and law enforcement. These recommendations offer ways in which transplant professionals can contribute to improving the nonlegislative response to trafficking in human beings for the purpose of organ removal. PMID:27500254

  5. The Hague Recommendations: Improving Nonlegislative Responses to Trafficking in Human Beings for the Purpose of Organ Removal

    PubMed Central

    Ambagtsheer, Frederike; Weimar, Willem

    2016-01-01

    Abstract Over the years, the trade in human organs has become an object of international concern. Since the 1980s, antiorgan trade initiatives have mainly involved the strengthening of legislative responses. Little attention however is given to nonlegislative responses by law enforcement authorities. The HOTT project is a European Union-funded research project titled “trafficking in human beings for the purpose of organ removal.” Its objectives are to increase knowledge, raise awareness, and improve the nonlegislative response to the crime. Its consortium organized a “Writers' Conference” in The Hague, The Netherlands at Europol's Headquarters where a group of 40 experts, consisting of transplant professionals, law enforcement officials, and policy makers, formulated recommendations to improve nonlegislative responses. These recommendations, presented hereafter, address the ethical and legal obligations of health care providers, the protection of persons trafficked for the purpose of organ removal, strengthening cross-border collaboration in criminal cases, and stimulating partnerships between transplant professionals and law enforcement. These recommendations offer ways in which transplant professionals can contribute to improving the nonlegislative response to trafficking in human beings for the purpose of organ removal. PMID:27500254

  6. Health Maintenance Organization (HMO) Plan

    MedlinePlus

    ... up/change plans About Medicare health plans Medicare Advantage Plans + Share widget - Select to show Subcategories Getting ... plan? About Medicare health plans , current subcategory Medicare Advantage Plans , current page Medicare Medical Savings Account (MSA) ...

  7. Biodiversity and health: Lessons and recommendations from an interdisciplinary conference to advise Southeast Asian research, society and policy.

    PubMed

    Walther, Bruno Andreas; Boëte, Christophe; Binot, Aurélie; By, Youlet; Cappelle, Julien; Carrique-Mas, Juan; Chou, Monidarin; Furey, Neil; Kim, Sothea; Lajaunie, Claire; Lek, Sovan; Méral, Philippe; Neang, Malyne; Tan, Boon-Huan; Walton, Catherine; Morand, Serge

    2016-06-01

    Southeast Asia is an economic, biodiverse, cultural and disease hotspot. Due to rapid socio-economic and environmental changes, the role of biodiversity and ecosystems for human health ought to be examined and communicated to decision-makers and the public. We therefore summarized the lessons and recommendations from an interdisciplinary conference convened in Cambodia in 2014 to advise Southeast Asian societies on current research efforts, future research needs, and to provide suggestions for improved education, training and science-policy interactions. First, we reviewed several examples of the important role of ecosystems as 'sentinels' in the sense that potentially harmful developments for human health become first apparent in ecosystem components. Other ecosystem services which also benefit human well-being are briefly summarized. Second, we summarized the recommendations of the conference's roundtable discussions and added recent developments in the science-policy interface. The recommendations were organized along five themes: Ethical and legal considerations; implementation of the One Health approach; education, training, and capacity building; future research priorities; and potential science-policy interactions. While the role of biodiversity for human health needs further research, especially for zoonoses and emerging diseases, many direct and indirect benefits to human health are already apparent, but have yet to filter down to the science-policy interface in order to influence legislation and enforcement. Therefore, efforts to strengthen the interface in Southeast Asia should become a high priority in order to strengthen the health and resilience of Southeast Asian societies. PMID:26903421

  8. The case for the World Health Organization's Commission on Social Determinants of Health to address gender identity.

    PubMed

    Pega, Frank; Veale, Jaimie F

    2015-03-01

    We analyzed the case of the World Health Organization's Commission on Social Determinants of Health, which did not address gender identity in their final report. We argue that gender identity is increasingly being recognized as an important social determinant of health (SDH) that results in health inequities. We identify right to health mechanisms, such as established human rights instruments, as suitable policy tools for addressing gender identity as an SDH to improve health equity. We urge the World Health Organization to add gender identity as an SDH in its conceptual framework for action on the SDHs and to develop and implement specific recommendations for addressing gender identity as an SDH. PMID:25602894

  9. Recommendation for Center-Based Early Childhood Education to Promote Health Equity.

    PubMed

    2016-01-01

    The Community Preventive Services Task Force recommends early childhood education programs based on strong evidence of effectiveness in improving educational outcomes associated with long-term health and sufficient evidence of effectiveness in improving social- and health-related outcomes. When provided to low-income or racial and ethnic minority communities, early childhood education programs are likely to reduce educational achievement gaps, improve the health of low-income student populations, and promote health equity. PMID:26672408

  10. Consumers’ intention to use health recommendation systems to receive personalized nutrition advice

    PubMed Central

    2013-01-01

    Background Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We examine consumers' intention to use such a health recommendation system as a function of options related to the underlying system (e.g. the type of company that generates the advice) as well as intermediaries (e.g. general practitioner) that might assist in using the system. We further explore if the effect of both the system and intermediaries on intention to use a health recommendation system are mediated by consumers' perceived effort, privacy risk, usefulness and enjoyment. Methods 204 respondents from a consumer panel in the Netherlands participated. The data were collected by means of a questionnaire. Each respondent evaluated three hypothetical health recommendation systems on validated multi-scale measures of effort, privacy risk, usefulness, enjoyment and intention to use the system. To test the hypothesized relationships we used regression analyses. Results We find evidence that the options related to the underlying system as well as the intermediaries involved influence consumers' intention to use such a health recommendation system and that these effects are mediated by perceptions of effort, privacy risk, usefulness and enjoyment. Also, we find that consumers value usefulness of a system more and enjoyment less when a general practitioner advices them to use a health recommendation system than if they use it out of their own curiosity. Conclusions We developed and tested a model of consumers' intention to use a health recommendation system. We found that intermediaries play an important role in how consumers evaluate such a system over and above options of the underlying system that is used to generate the recommendation. Also, health-related information services seem to

  11. Towards Collaborative Filtering Recommender Systems for Tailored Health Communications

    PubMed Central

    Marlin, Benjamin M.; Adams, Roy J.; Sadasivam, Rajani; Houston, Thomas K.

    2013-01-01

    The goal of computer tailored health communications (CTHC) is to promote healthy behaviors by sending messages tailored to individual patients. Current CTHC systems collect baseline patient “profiles” and then use expert-written, rule-based systems to target messages to subsets of patients. Our main interest in this work is the study of collaborative filtering-based CTHC systems that can learn to tailor future message selections to individual patients based explicit feedback about past message selections. This paper reports the results of a study designed to collect explicit feedback (ratings) regarding four aspects of messages from 100 subjects in the smoking cessation support domain. Our results show that most users have positive opinions of most messages and that the ratings for all four aspects of the messages are highly correlated with each other. Finally, we conduct a range of rating prediction experiments comparing several different model variations. Our results show that predicting future ratings based on each user’s past ratings contributes the most to predictive accuracy. PMID:24551430

  12. Towards collaborative filtering recommender systems for tailored health communications.

    PubMed

    Marlin, Benjamin M; Adams, Roy J; Sadasivam, Rajani; Houston, Thomas K

    2013-01-01

    The goal of computer tailored health communications (CTHC) is to promote healthy behaviors by sending messages tailored to individual patients. Current CTHC systems collect baseline patient "profiles" and then use expert-written, rule-based systems to target messages to subsets of patients. Our main interest in this work is the study of collaborative filtering-based CTHC systems that can learn to tailor future message selections to individual patients based explicit feedback about past message selections. This paper reports the results of a study designed to collect explicit feedback (ratings) regarding four aspects of messages from 100 subjects in the smoking cessation support domain. Our results show that most users have positive opinions of most messages and that the ratings for all four aspects of the messages are highly correlated with each other. Finally, we conduct a range of rating prediction experiments comparing several different model variations. Our results show that predicting future ratings based on each user's past ratings contributes the most to predictive accuracy. PMID:24551430

  13. Understanding the Mental Health Needs of American Muslims: Recommendations and Considerations for Practice

    ERIC Educational Resources Information Center

    Ahmed, Sameera; Reddy, Linda A.

    2007-01-01

    American Muslims represent a heterogeneous population that is underserved by the mental health community, despite increased psychological distress reported since 9/11. This article offers professionals an understanding of the mental health needs of American Muslims. Recommendations for conducting culturally responsive assessments and treatment are…

  14. An informatics agenda for public health: summarized recommendations from the 2011 AMIA PHI Conference

    PubMed Central

    Goodman, Kenneth W; Gotham, Ivan J; Holmes, John H; Lang, Lisa; Miner, Kathleen; Potenziani, David D; Richards, Janise; Turner, Anne M; Fu, Paul C

    2012-01-01

    The AMIA Public Health Informatics 2011 Conference brought together members of the public health and health informatics communities to revisit the national agenda developed at the AMIA Spring Congress in 2001, assess the progress that has been made in the past decade, and develop recommendations to further guide the field. Participants met in five discussion tracks: technical framework; research and evaluation; ethics; education, professional training, and workforce development; and sustainability. Participants identified 62 recommendations, which clustered into three key themes related to the need to (1) enhance communication and information sharing within the public health informatics community, (2) improve the consistency of public health informatics through common public health terminologies, rigorous evaluation methodologies, and competency-based training, and (3) promote effective coordination and leadership that will champion and drive the field forward. The agenda and recommendations from the meeting will be disseminated and discussed throughout the public health and informatics communities. Both communities stand to gain much by working together to use these recommendations to further advance the application of information technology to improve health. PMID:22395299

  15. Recommendations for the School Health Nurse in Addressing HIV/AIDS with Adolescents.

    ERIC Educational Resources Information Center

    Uris, Patricia

    The school is a defined setting where health issues can be addressed. School nurses providing health care to adolescents who are infected or affected by HIV/AIDS need strong policies and good training to make their efforts effective. the goal of these recommendations is to strengthen adolescent HIV programs in schools and to improve standards of…

  16. Ground-Based Facilities for Simulation of Microgravity: Organism-Specific Recommendations for Their Use, and Recommended Terminology

    PubMed Central

    Anken, Ralf; Boonstra, Johannes; Braun, Markus; Christianen, Peter C.M.; de Geest, Maarten; Hauslage, Jens; Hilbig, Reinhard; Hill, Richard J.A.; Lebert, Michael; Medina, F. Javier; Vagt, Nicole; Ullrich, Oliver

    2013-01-01

    Abstract Research in microgravity is indispensable to disclose the impact of gravity on biological processes and organisms. However, research in the near-Earth orbit is severely constrained by the limited number of flight opportunities. Ground-based simulators of microgravity are valuable tools for preparing spaceflight experiments, but they also facilitate stand-alone studies and thus provide additional and cost-efficient platforms for gravitational research. The various microgravity simulators that are frequently used by gravitational biologists are based on different physical principles. This comparative study gives an overview of the most frequently used microgravity simulators and demonstrates their individual capacities and limitations. The range of applicability of the various ground-based microgravity simulators for biological specimens was carefully evaluated by using organisms that have been studied extensively under the conditions of real microgravity in space. In addition, current heterogeneous terminology is discussed critically, and recommendations are given for appropriate selection of adequate simulators and consistent use of nomenclature. Key Words: 2-D clinostat—3-D clinostat—Gravity—Magnetic levitation—Random positioning machine—Simulated microgravity—Space biology. Astrobiology 13, 1–17. PMID:23252378

  17. Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments

    PubMed Central

    Kazantzis, Nikolaos; Rickwood, Debra; Rickard, Nikki

    2016-01-01

    Background The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available. Objective To guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps. Methods A literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design. Results Sixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp. Conclusions Randomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems. PMID:26932350

  18. Challenges and opportunities of using recommender systems for personalized health education.

    PubMed

    Fernandez-Luque, Luis; Karlsen, Randi; Vognild, Lars K

    2009-01-01

    The use of computers in health education started more than a decade ago, mainly for tailoring health educational resources. Nowadays, many of the computer-tailoring health education systems are using the Internet for delivering different types of health education. Traditionally, these systems are designed for a specific health problem, with a predefined library of educational resources. These systems do not take advantage of the increasing amount of educational resources available on the Internet. One of the reasons is that the high availability of content is making it more difficult to find the relevant one. The problem of information overload has been addressed for many years in the field of recommender systems. This paper is focused on the challenges and opportunities of merging recommender systems with personalized health education. It also discusses the usage of social networks and semantic technologies within this approach. PMID:19745443

  19. Commentary Considerations for Recommending Extended Use and Limited Reuse of Filtering Facepiece Respirators in Health Care Settings

    PubMed Central

    Fisher, Edward M.; Shaffer, Ronald E.

    2015-01-01

    Public health organizations, such as the Centers for Disease Control and Prevention (CDC), are increasingly recommending the use of N95 filtering facepiece respirators (FFRs) in health care settings. For infection control purposes, the usual practice is to discard FFRs after close contact with a patient (“single use”). However, in some situations, such as during contact with tuberculosis patients, limited FFR reuse (i.e., repeated donning and doffing of the same FFR by the same person) is practiced. A related practice, extended use, involves wearing the same FFR for multiple patient encounters without doffing. Extended use and limited FFR reuse have been recommended during infectious disease outbreaks and pandemics to conserve FFR supplies. This commentary examines CDC recommendations related to FFR extended use and limited reuse and analyzes available data from the literature to provide a relative estimate of the risks of these practices compared to single use. Analysis of the available data and the use of disease transmission models indicate that decisions regarding whether FFR extended use or reuse should be recommended should continue to be pathogen- and event-specific. Factors to be included in developing the recommendations are the potential for the pathogen to spread via contact transmission, the potential that the event could result in or is currently causing a FFR shortage, the protection provided by FFR use, human factors, potential for self-inoculation, the potential for secondary exposures, and government policies and regulations. While recent findings largely support the previous recommendations for extended use and limited reuse in certain situations, some new cautions and limitations should be considered before issuing recommendations in the future. In general, extended use of FFRs is preferred over limited FFR reuse. Limited FFR reuse would allow the user a brief respite from extended wear times, but increases the risk of self-inoculation and

  20. Strong Public Health Recommendations from Weak Evidence? Lessons Learned in Developing Guidance on the Public Health Management of Meningococcal Disease.

    PubMed

    Hanquet, Germaine; Stefanoff, Pawel; Hellenbrand, Wiebke; Heuberger, Sigrid; Lopalco, Pierluigi; Stuart, James M

    2015-01-01

    The evidence underpinning public health policy is often of low quality, leading to inconsistencies in recommended interventions. One example is the divergence in national policies across Europe for managing contacts of invasive meningococcal disease. Aiming to develop consistent guidance at the European level, a group of experts reviewed the literature and formulated recommendations. The group defined eight priority research questions, searched the literature, and formulated recommendations using GRADE methodology. Five of the research questions are discussed in this paper. After taking into account quality of evidence, benefit, harm, value, preference, burden on patient of the intervention, and resource implications, we made four strong recommendations and five weak recommendations for intervention. Strong recommendations related not only to one question with very low quality of evidence as well as to two questions with moderate to high quality of evidence. The weak recommendations related to two questions with low and very low quality of evidence but also to one question with moderate quality of evidence. GRADE methodology ensures a transparent process and explicit recognition of additional factors that should be considered when making recommendations for policy. This approach can be usefully applied to many areas of public health policy where evidence quality is often low. PMID:26693485

  1. Strong Public Health Recommendations from Weak Evidence? Lessons Learned in Developing Guidance on the Public Health Management of Meningococcal Disease

    PubMed Central

    Hanquet, Germaine; Stefanoff, Pawel; Hellenbrand, Wiebke; Heuberger, Sigrid; Lopalco, Pierluigi; Stuart, James M.

    2015-01-01

    The evidence underpinning public health policy is often of low quality, leading to inconsistencies in recommended interventions. One example is the divergence in national policies across Europe for managing contacts of invasive meningococcal disease. Aiming to develop consistent guidance at the European level, a group of experts reviewed the literature and formulated recommendations. The group defined eight priority research questions, searched the literature, and formulated recommendations using GRADE methodology. Five of the research questions are discussed in this paper. After taking into account quality of evidence, benefit, harm, value, preference, burden on patient of the intervention, and resource implications, we made four strong recommendations and five weak recommendations for intervention. Strong recommendations related not only to one question with very low quality of evidence as well as to two questions with moderate to high quality of evidence. The weak recommendations related to two questions with low and very low quality of evidence but also to one question with moderate quality of evidence. GRADE methodology ensures a transparent process and explicit recognition of additional factors that should be considered when making recommendations for policy. This approach can be usefully applied to many areas of public health policy where evidence quality is often low. PMID:26693485

  2. Closing the loop from continuous M-health monitoring to fuzzy logic-based optimized recommendations.

    PubMed

    Benharref, Abdelghani; Serhani, Mohamed Adel; Nujum, Al Ramzana

    2014-01-01

    Continuous sensing of health metrics might generate a massive amount of data. Generating clinically validated recommendations, out of these data, to patients under monitoring is of prime importance to protect them from risk of falling into severe health degradation. Physicians also can be supported with automated recommendations that gain from historical data and increasing learning cycles. In this paper, we propose a Fuzzy Expert System that relies on data collected from continuous monitoring. The monitoring scheme implements preprocessing of data for better data analytics. However, data analytics implements the loopback feature in order to constantly improve fuzzy rules, knowledge base, and generated recommendations. Both techniques reduced data quantity, improved data quality and proposed recommendations. We evaluate our solution through a series of experiments and the results we have obtained proved that our fuzzy expert system combined with the intelligent monitoring and analytic techniques provide a high accuracy of collected data and valid advices. PMID:25570547

  3. The Future of Public Health Informatics: Alternative Scenarios and Recommended Strategies

    PubMed Central

    Edmunds, Margo; Thorpe, Lorna; Sepulveda, Martin; Bezold, Clem; Ross, David A.

    2014-01-01

    Background: In October 2013, the Public Health Informatics Institute (PHII) and Institute for Alternative Futures (IAF) convened a multidisciplinary group of experts to evaluate forces shaping public health informatics (PHI) in the United States, with the aim of identifying upcoming challenges and opportunities. The PHI workshop was funded by the Robert Wood Johnson Foundation as part of its larger strategic planning process for public health and primary care. Workshop Context: During the two-day workshop, nine experts from the public and private sectors analyzed and discussed the implications of four scenarios regarding the United States economy, health care system, information technology (IT) sector, and their potential impacts on public health in the next 10 years, by 2023. Workshop participants considered the potential role of the public health sector in addressing population health challenges in each scenario, and then identified specific informatics goals and strategies needed for the sector to succeed in this role. Recommendations and Conclusion: Participants developed recommendations for the public health informatics field and for public health overall in the coming decade. These included the need to rely more heavily on intersectoral collaborations across public and private sectors, to improve data infrastructure and workforce capacity at all levels of the public health enterprise, to expand the evidence base regarding effectiveness of informatics-based public health initiatives, and to communicate strategically with elected officials and other key stakeholders regarding the potential for informatics-based solutions to have an impact on population health. PMID:25848630

  4. DOE organization and management approach in responding to recommendation 94-2 - The implementation plan

    SciTech Connect

    Widmayer, D.

    1995-12-31

    In March, the Department of Energy (DOE) submitted the Implementation Plan in response to the Defense Nuclear Facilities Safety Board (DNFSB) Recommendation 94-2, {open_quotes}Conformance with Safety Standards at Department of Energy Low-Level Nuclear Waste and Disposal Sites.{close_quotes} This paper discusses the management organization and interactions established to accomplish the tasks developed to respond to the DNFSB Recommendation. The organization of the tasks into six technical areas and the interfaces and connections between the tasks are briefly described. A summary of how each significant part of the DNFSB Recommendation is being addressed is presented. This paper provides a brief introduction to the remaining presentations in this session.

  5. New systems of work organization and workers' health.

    PubMed

    Kompier, Michiel A J

    2006-12-01

    This paper aims at identifying major changes in and around work organizations, their effects upon job characteristics and the health and well-being of today's employees, and related research challenges. Increased internationalization and competition, increased utilization of information and communication technology, the changing workforce configuration, and flexibility and new organizational practices are considered. As work has changed from physical to mental in nature, job characteristics have changed significantly. Meanwhile work and family life have blended. New systems of work organization have become more prevalent, but they do not represent a radical change across the whole economy. New practices may have an adverse impact upon job characteristics, but their effects depend on their design, implementation, and management. Research recommendations include improved monitoring of changes in work organization and studies into their health and safety consequences, intervention studies, studies into the motivating potential of modern work practices, studies of marginalized workers and workers in less developed countries, and "mechanism studies". PMID:17173199

  6. Health care facilities' "war on terrorism": a deliberate process for recommending personal protective equipment.

    PubMed

    Koenig, Kristi L; Boatright, Connie J; Hancock, John A; Denny, Frank J; Teeter, David S; Kahn, Christopher A; Schultz, Carl H

    2007-02-01

    The protection of health care facility (HCF) staff from the effects of weapons of mass destruction has gained heightened attention since the 9-11 terrorist attacks. One critical component of protection is personal protective equipment (PPE). No universal standard exists for an "essential" level of PPE for HCF staff. The absence of such a standard raises the need for development of national policy for PPE levels, particularly in HCFs. We describe a process used by the Veterans Health Administration for recommending policy for "essential" PPE levels. Although the recommendations are specific for Veterans Health Administration, the process, findings, and applications may be useful to other institutions as they attempt to resolve this critical issue. This descriptive account will serve to generate practical scientific debate in the academic community and lead to definitive public policy recommendations for the Nation's HCFs in executing their roles in the event of a terrorist attack. PMID:17276809

  7. [Methodological limitations and recommendations in publications on migrant population health in Spain].

    PubMed

    Monge, Susana; Ronda, Elena; Pons-Vigués, Mariona; Vives Cases, Carmen; Malmusi, Davide; Gil-González, Diana

    2015-01-01

    Our objective was to describe the methodological limitations and recommendations identified by authors of original articles on immigration and health in Spain. A literature review was conducted of original articles published in Spanish or English between 1998 and 2012 combining keywords on immigration and health. A total of 311 articles were included; of these, 176 (56.6%) mentioned limitations, and 15 (4.8%) made recommendations. The most frequently mentioned limitations included the following: reduced sample sizes; internal validity and sample representativeness issues, with under- or overrepresentation of specific groups; problems of validity of the collected information and missing data mostly related to measurement tools; and absence of key variables for adjustment or stratification. Based on these results, a series of recommendations are proposed to minimise common limitations and advance the quality of scientific production on immigration and health in our setting. PMID:26387460

  8. Reducing Health Inequities in the U.S.: Recommendations From the NHLBI's Health Inequities Think Tank Meeting.

    PubMed

    Sampson, Uchechukwu K A; Kaplan, Robert M; Cooper, Richard S; Diez Roux, Ana V; Marks, James S; Engelgau, Michael M; Peprah, Emmanuel; Mishoe, Helena; Boulware, L Ebony; Felix, Kaytura L; Califf, Robert M; Flack, John M; Cooper, Lisa A; Gracia, J Nadine; Henderson, Jeffrey A; Davidson, Karina W; Krishnan, Jerry A; Lewis, Tené T; Sanchez, Eduardo; Luban, Naomi L; Vaccarino, Viola; Wong, Winston F; Wright, Jackson T; Meyers, David; Ogedegbe, Olugbenga G; Presley-Cantrell, Letitia; Chambers, David A; Belis, Deshirée; Bennett, Glen C; Boyington, Josephine E; Creazzo, Tony L; de Jesus, Janet M; Krishnamurti, Chitra; Lowden, Mia R; Punturieri, Antonello; Shero, Susan T; Young, Neal S; Zou, Shimian; Mensah, George A

    2016-08-01

    The National, Heart, Lung, and Blood Institute convened a Think Tank meeting to obtain insight and recommendations regarding the objectives and design of the next generation of research aimed at reducing health inequities in the United States. The panel recommended several specific actions, including: 1) embrace broad and inclusive research themes; 2) develop research platforms that optimize the ability to conduct informative and innovative research, and promote systems science approaches; 3) develop networks of collaborators and stakeholders, and launch transformative studies that can serve as benchmarks; 4) optimize the use of new data sources, platforms, and natural experiments; and 5) develop unique transdisciplinary training programs to build research capacity. Confronting health inequities will require engaging multiple disciplines and sectors (including communities), using systems science, and intervening through combinations of individual, family, provider, health system, and community-targeted approaches. Details of the panel's remarks and recommendations are provided in this report. PMID:27470459

  9. Physician Incentives in Health Maintenance Organizations

    ERIC Educational Resources Information Center

    Gaynor, Martin; Rebitzer, James B.; Taylor, Lowell J.

    2004-01-01

    Managed care organizations rely on incentives that encourage physicians to limit medical expenditures, but little is known about how physicians respond to these incentives. We address this issue by analyzing the physician incentive contracts in use at a health maintenance organization. By combining knowledge of the incentive contracts with…

  10. Collecting Comparative Data on Farmworker Housing and Health: Recommendations for Collecting Housing and Health Data Across Places and Time.

    PubMed

    Arcury, Thomas A; Gabbard, Susan; Bell, Bryan; Casanova, Vanessa; Flocks, Joan D; Swanberg, Jennifer E; Wiggins, Melinda F

    2015-11-01

    The substandard nature of the housing in which most farmworkers live has detrimental effects on their health, as well as on their children's health and development. However, little research has directly documented associations between farmworker housing and health; existing research is not always comparable due to differences in design and measurement. Comparative data can help determine actual causal links between housing characteristics and farmworker health and help to evaluate the efficacy of current housing policy. The goal of this paper is to provide guidelines promoting comparable research on farmworker housing and the association of this housing with health. This paper reviews general concepts relevant to measuring farmworker housing and health, issues that should be considered in designing farmworker housing and health research, data collection methods, and measures. It concludes with recommendations for a research agenda on farmworker housing and health. PMID:26315035

  11. Applying the WHO recommendations on health-sector response to violence against women to assess the Spanish health system. A mixed methods approach.

    PubMed

    Goicolea, Isabel; Vives-Cases, Carmen; Minvielle, Fauhn; Briones-Vozmediano, Erica; Ohman, Ann

    2014-01-01

    This methodological note describes the development and application of a mixed-methods protocol to assess the responsiveness of Spanish health systems to violence against women in Spain, based on the World Health Organization (WHO) recommendations. Five areas for exploration were identified based on the WHO recommendations: policy environment, protocols, training, accountability/monitoring, and prevention/promotion. Two data collection instruments were developed to assess the situation of 17 Spanish regional health systems (RHS) with respect to these areas: 1) a set of indicators to guide a systematic review of secondary sources, and 2) an interview guide to be used with 26 key informants at the regional and national levels. We found differences between RHSs in the five areas assessed. The progress of RHSs on the WHO recommendations was notable at the level of policies, moderate in terms of health service delivery, and very limited in terms of preventive actions. Using a mixed-methods approach was useful for triangulation and complementarity during instrument design, data collection and interpretation. PMID:24440120

  12. 76 FR 787 - Notice of Availability of the Recommended Toxicity Equivalence Factors (TEFs) for Human Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-06

    ...The U.S. Environmental Protection Agency (EPA) is announcing the availability of the final ``Recommended Toxicity Equivalence Factors (TEFs) for Human Health Risk Assessments of 2,3,7,8- Tetrachlorodibenzo-p-dioxin and Dioxin-Like Compounds'' (EPA/100/R-10/ 005). The purpose of this document is to assist EPA scientists in using the toxicity equivalence methodology to assess health risks from......

  13. Recommendations of the International Medical Informatics Association (IMIA) on education in health and medical informatics.

    PubMed

    2000-08-01

    The International Medical Informatics Association (IMIA) agreed on international recommendations in health informatics/medical informatics education. These should help to establish courses, course tracks or even complete programs in this field, to further develop existing educational activities in the various nations and to support international initiatives concerning education in health and medical informatics (HMI), particularly international activities in educating HMI specialists and the sharing of courseware. The IMIA recommendations centre on educational needs for healthcare professionals to acquire knowledge and skills in information processing and information and communication technology. The educational needs are described as a three-dimensional framework. The dimensions are: 1) professionals in healthcare (physicians, nurses, HMI professionals, ...), 2) type of specialisation in health and medical informatics (IT users, HMI specialists) and 3) stage of career progression (bachelor, master, ...). Learning outcomes are defined in terms of knowledge and practical skills for healthcare professionals in their role (a) as IT user and (b) as HMI specialist. Recommendations are given for courses/course tracks in HMI as part of educational programs in medicine, nursing, healthcare management, dentistry, pharmacy, public health, health record administration, and informatics/computer science as well as for dedicated programs in HMI (with bachelor, master or doctor degree). To support education in HMI, IMIA offers to award a certificate for high quality HMI education and supports information exchange on programs and courses in HMI through a WWW server of its Working Group on Health and Medical Informatics Education (http:www.imia.org/wg1). PMID:10992757

  14. Human Papillomavirus (HPV) Vaccine Availability, Recommendations, Cost, and Policies Among Health Departments in Seven Appalachian States

    PubMed Central

    Katz, Mira L.; Reiter, Paul L.; Kluhsman, Brenda C.; Kennedy, Stephenie; Dwyer, Sharon; Schoenberg, Nancy; Johnson, Andy; Ely, Gretchen; Roberto, Karen A.; Lengerich, Eugene J.; Brown, Pamela; Paskett, Electra D.; Dignan, Mark

    2009-01-01

    Telephone interviews of health department personnel in six states and review of an immunization database from one state were conducted to assess human papillomavirus (HPV) vaccine availability, recommendations, cost, policies, and educational materials in health departments in seven Appalachian states. Most (99.1%) health departments (n=234) reported receiving patient requests for the HPV vaccine, and only two (1%) health departments reported that they did not provide the vaccine for patients. HPV vaccine supply was reported to not meet demand in 10.5% (24/228) of health departments due to high costs. Level (state, region, county) at which policy about the HPV vaccine was determined, vaccine recommendations, costs, and available educational materials varied among states. This study documented variation in vaccine availability, recommendations, cost, policies, and educational materials in Appalachian health departments that could significantly affect vaccine distribution. Findings highlight the need for more comprehensive and consistent policies that maximize accessibility of the HPV vaccine to women, especially those in underserved areas. PMID:19446191

  15. A Systematic Review of Public Health-Aligned Recommendations for Preparing Physical Education Teacher Candidates

    ERIC Educational Resources Information Center

    Webster, Collin A.; Webster, Liana; Russ, Laura; Molina, Sergio; Lee, Heesu; Cribbs, Jason

    2015-01-01

    Purpose: Since Sallis and McKenzie's seminal article in 1991 outlining physical education's role in public health, increased attention has been given to promoting youth physical activity in schools. The present study systematically reviewed the literature from 1991 to 2013 to identify recommendations for the preparation of physical…

  16. A Health Website Recommendation from Gold Coast General Practitioners to Their Patients: A Mixed Method Approach

    ERIC Educational Resources Information Center

    Usher, Wayne

    2011-01-01

    Introduction: To identify health website recommendation trends by Gold Coast (Australia) general practitioners (GPs) to their patients. Method: A mixed method approach to data collection and analysis was employed. Quantitative data were collected using a prepaid postal survey, consisting of 17 questions, mailed to 250 (61 per cent) of 410 GPs on…

  17. Women's Health in the Baccalaureate Nursing School Curriculum: Report of a Survey and Recommendations.

    ERIC Educational Resources Information Center

    National Inst. of Nursing Research (NIH), Bethesda, MD.

    This report presents the analytical results of a survey of U.S. baccalaureate nursing schools conducted during 1999 by the American Colleges of Nursing with a description of the extent of women's health content in the curriculum and selected recommendations designed to strengthen this content. Additional resources are included that describe the…

  18. Recommendations of the International Medical Informatics Association (IMIA) on education in health and medical informatics.

    PubMed

    2004-01-01

    The International Medical Informatics Association (IMIA) agreed on international recommendations in health informatics / medical informatics education. These should help to establish courses, course tracks or even complete programs in this field, to further develop existing educational activities in the various nations and to support international initiatives concerning education in health and medical informatics (HMI), particularly international activities in educating HMI specialists and the sharing of courseware. The IMIA recommendations centre on educational needs for health care professionals to acquire knowledge and skills in information processing and information and communication technology. The educational needs are described as a three-dimensional framework. The dimensions are: 1) professionals in health care (physicians, nurses, HMI professionals, ...), 2) type of specialisation in health and medical informatics (IT users, HMI specialists) and 3) stage of career progression (bachelor, master, ...). Learning outcomes are defined in terms of knowledge and practical skills for health care professionals in their role (a) as IT user and (b) as HMI specialist. Recommendations are given for courses/course tracks in HMI as part of educational programs in medicine, nursing, health care management, dentistry, pharmacy, public health, health record administration, and informatics/computer science as well as for dedicated programs in HMI (with bachelor, master or doctor degree). To support education in HMI, IMIA offers to award a certificate for high quality HMI education and supports information exchange on programs and courses in HMI through a WWW server of its Working Group on Health and Medical Informatics Education (http://www.imia.org/wg1). PMID:15718686

  19. The World Health Organization and Global Health Governance: post-1990.

    PubMed

    Lidén, J

    2014-02-01

    This article takes a historical perspective on the changing position of WHO in the global health architecture over the past two decades. From the early 1990s a number of weaknesses within the structure and governance of the World Health Organization were becoming apparent, as a rapidly changing post Cold War world placed more complex demands on the international organizations generally, but significantly so in the field of global health. Towards the end of that decade and during the first half of the next, WHO revitalized and played a crucial role in setting global health priorities. However, over the past decade, the organization has to some extent been bypassed for funding, and it lost some of its authority and its ability to set a global health agenda. The reasons for this decline are complex and multifaceted. Some of the main factors include WHO's inability to reform its core structure, the growing influence of non-governmental actors, a lack of coherence in the positions, priorities and funding decisions between the health ministries and the ministries overseeing development assistance in several donor member states, and the lack of strong leadership of the organization. PMID:24388640

  20. Managing diversity in health services organizations.

    PubMed

    Muller, H J; Haase, B E

    1994-01-01

    The changing ethnic, racial, and gender workforce characteristics require innovations in management philosophy and practice. Valuing employees' differences is believed to be a competitive advantage in many modern corporations. This article offers recommendations to health care managers for rethinking and improving the management of their heterogeneous workforces. A conceptual framework and evaluative criteria are developed in an attempt to better understand the factors that influence effective diversity management. The experiences of health services institutions in the Southwest (already a multicultural region) are studied to illustrate various approaches to diversity management. Leader philosophy and support, organizational policies and programs, workforce composition, structural integration, and organizational type constitute the main elements in this study. As the nation debates restructuring the health industry, it should also take the opportunity to integrate a management philosophy that values diversity and its practice. PMID:10138715

  1. Management of cytomegalovirus infection in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations.

    PubMed

    Torre-Cisneros, J; Aguado, J M; Caston, J J; Almenar, L; Alonso, A; Cantisán, S; Carratalá, J; Cervera, C; Cordero, E; Fariñas, M C; Fernández-Ruiz, M; Fortún, J; Frauca, E; Gavaldá, J; Hernández, D; Herrero, I; Len, O; Lopez-Medrano, F; Manito, N; Marcos, M A; Martín-Dávila, P; Monforte, V; Montejo, M; Moreno, A; Muñoz, P; Navarro, D; Pérez-Romero, P; Rodriguez-Bernot, A; Rumbao, J; San Juan, R; Vaquero, J M; Vidal, E

    2016-07-01

    Cytomegalovirus (CMV) infection remains a major complication of solid organ transplantation. Because of management of CMV is variable among transplant centers, in 2011 the Spanish Transplantation Infection Study Group (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) developed consensus guidelines for the prevention and treatment of CMV infection in solid organ transplant recipients. Since then, new publications have clarified or questioned the aspects covered in the previous document. For that reason, a panel of experts revised the evidence on CMV management, including immunological monitoring, diagnostics, prevention, vaccines, indirect effects, treatment, drug resistance, immunotherapy, investigational drugs, and pediatric issues. This document summarizes the recommendations. PMID:27132815

  2. Improving Clinical Workflow in Ambulatory Care: Implemented Recommendations in an Innovation Prototype for the Veteran’s Health Administration

    PubMed Central

    Patterson, Emily S.; Lowry, Svetlana Z.; Ramaiah, Mala; Gibbons, Michael C.; Brick, David; Calco, Robert; Matton, Greg; Miller, Anne; Makar, Ellen; Ferrer, Jorge A.

    2015-01-01

    Introduction: Human factors workflow analyses in healthcare settings prior to technology implemented are recommended to improve workflow in ambulatory care settings. In this paper we describe how insights from a workflow analysis conducted by NIST were implemented in a software prototype developed for a Veteran’s Health Administration (VHA) VAi2 innovation project and associated lessons learned. Methods: We organize the original recommendations and associated stages and steps visualized in process maps from NIST and the VA’s lessons learned from implementing the recommendations in the VAi2 prototype according to four stages: 1) before the patient visit, 2) during the visit, 3) discharge, and 4) visit documentation. NIST recommendations to improve workflow in ambulatory care (outpatient) settings and process map representations were based on reflective statements collected during one-hour discussions with three physicians. The development of the VAi2 prototype was conducted initially independently from the NIST recommendations, but at a midpoint in the process development, all of the implementation elements were compared with the NIST recommendations and lessons learned were documented. Findings: Story-based displays and templates with default preliminary order sets were used to support scheduling, time-critical notifications, drafting medication orders, and supporting a diagnosis-based workflow. These templates enabled customization to the level of diagnostic uncertainty. Functionality was designed to support cooperative work across interdisciplinary team members, including shared documentation sessions with tracking of text modifications, medication lists, and patient education features. Displays were customized to the role and included access for consultants and site-defined educator teams. Discussion: Workflow, usability, and patient safety can be enhanced through clinician-centered design of electronic health records. The lessons learned from implementing

  3. EU Country Specific Recommendations for health systems in the European Semester process: trends, discourse and predictors.

    PubMed

    Azzopardi-Muscat, Natasha; Clemens, Timo; Stoner, Deborah; Brand, Helmut

    2015-03-01

    In the framework of "Europe 2020", European Union Member States are subject to a new system of economic monitoring and governance known as the European Semester. This paper seeks to analyse the way in which national health systems are being influenced by EU institutions through the European Semester. A content analysis of the Country Specific Recommendations (CSRs) for the years 2011, 2012, 2013 and 2014 was carried out. This confirmed an increasing trend for health systems to feature in CSRs which tend to be framed in the discourse on sustainability of public finances rather than that of social inclusion with a predominant focus on the policy objective of sustainability. The likelihood of obtaining a health CSRs was tested against a series of financial health system performance indicators and general government finance indicators. The odds ratio of obtaining a health CSR increased slightly with the increase in level of general Government debt, with an OR 1.02 (CI: 1.01, 1.03; p=0.007) and decreased with an increased public health expenditure/total health expenditure ratio, with an OR 0.89 (CI: 0.84, 0.96; p=0.001). The European Semester process is a relatively new process that is influencing health systems in the European Union. The effect of this process on health systems merits further attention. Health stakeholders should seek to engage more closely with this process which if steered appropriately could also present opportunities for health system reform. PMID:25650138

  4. Can Plan Recommendations Improve the Coverage Decisions of Vulnerable Populations in Health Insurance Marketplaces?

    PubMed Central

    Barnes, Andrew J.; Hanoch, Yaniv; Rice, Thomas

    2016-01-01

    Objective The Affordable Care Act’s marketplaces present an important opportunity for expanding coverage but consumers face enormous challenges in navigating through enrollment and re-enrollment. We tested the effectiveness of a behaviorally informed policy tool—plan recommendations—in improving marketplace decisions. Study Setting Data were gathered from a community sample of 656 lower-income, minority, rural residents of Virginia. Study Design We conducted an incentive-compatible, computer-based experiment using a hypothetical marketplace like the one consumers face in the federally-facilitated marketplaces, and examined their decision quality. Participants were randomly assigned to a control condition or three types of plan recommendations: social normative, physician, and government. For participants randomized to a plan recommendation condition, the plan that maximized expected earnings, and minimized total expected annual health care costs, was recommended. Data Collection Primary data were gathered using an online choice experiment and questionnaire. Principal Findings Plan recommendations resulted in a 21 percentage point increase in the probability of choosing the earnings maximizing plan, after controlling for participant characteristics. Two conditions, government or providers recommending the lowest cost plan, resulted in plan choices that lowered annual costs compared to marketplaces where no recommendations were made. Conclusions As millions of adults grapple with choosing plans in marketplaces and whether to switch plans during open enrollment, it is time to consider marketplace redesigns and leverage insights from the behavioral sciences to facilitate consumers’ decisions. PMID:27028008

  5. Towards universal health coverage for reproductive health services in Ethiopia: two policy recommendations.

    PubMed

    Onarheim, Kristine Husøy; Taddesse, Mieraf; Norheim, Ole Frithjof; Abdullah, Muna; Miljeteig, Ingrid

    2015-01-01

    Reproductive health services are crucial for maternal and child health, but universal health coverage is still not within reach in most societies. Ethiopia's goal of universal health coverage promises access to all necessary services for everyone while providing protection against financial risk. When moving towards universal health coverage, health plans and policies require contextualized knowledge about baseline indicators and their distributions. To understand more about the factors that explain coverage, we study the relationship between socioeconomic and geographic factors and the use of reproductive health services in Ethiopia, and further explore inequalities in reproductive health coverage. Based on these findings, we discuss the normative implications of these findings for health policy. Using population-level data from the Ethiopian Demographic and Health Survey (2011) in a multivariate logistic model, we find that family planning and use of antenatal care are associated with higher wealth, higher education and being employed. Skilled attendance at birth is associated with higher wealth, higher education, and urban location. There is large variation between Addis Ababa (the capital) and other administrative regions. Concentration indices show substantial inequalities in the use of reproductive health services. Decomposition of the concentration indices indicates that difference in wealth is the most important explanatory factor for inequality in reproductive health coverage, but other factors, such as urban setting and previous health care use, are also associated with inequalities. When aiming for universal health coverage, this study shows that different socioeconomic factors as well as health-sector factors should be addressed. Our study re-confirms the importance of a broader approach to reproductive health, and in particular the importance of inequality in wealth and geography. Poor, non-educated, non-employed women in rural areas are

  6. [Organizing health care: an ethical perspective].

    PubMed

    2013-06-01

    Health care at population level is a complex problem. Having this in mind, the purpose of this paper is to focus on the goods that are ethically relevant in the process of caring for health at this level. We briefly analyze some of the Chilean health statistics that, although they show important improvements along the years, demonstrate that certain conditions are to be deemed as inadequate by both healthcare providers and patients. Ethics is a central component to determine how to structure and organize health care systems and how they should operate. We emphasize human dignity as an ethical corner stone of the health care system, along with other important values such as justice and humanization, under the scope of the ends of medicine, and other components such as technical competence of providers and the financing of the whole process. We conclude that as far as a health care system is organized in a way that medical practice is well ordered, primarily and fundamentally according the ends of medicine and the good of persons, such a health care system is ethically adequate. PMID:24121582

  7. Improving Immigrant Populations' Access to Mental Health Services in Canada: A Review of Barriers and Recommendations.

    PubMed

    Thomson, Mary Susan; Chaze, Ferzana; George, Usha; Guruge, Sepali

    2015-12-01

    This article emerges from a scoping review of over two decades of relevant literature on immigrants' access to mental health services in Canada. Key online databases were searched to explore the gaps and opportunities for improving access to mental health services using a review framework provided by Arksey and O'Malley (Int J Soc Res Methodol 8:19-32, 2005). Immigrants and refugees came from diverse religious and cultural backgrounds and had complex mental health-related concerns that were not currently being adequately addressed by existing services. The major barriers to the utilization of mental health services included: those related to the uptake of existing health information and services; those that were related to the process of immigrant settlement; and barriers related to availability of appropriate services. A thematic analysis of the range of recommendations that emerge from these studies for improvement of research, practice and policy is provided. PMID:25742880

  8. [Healthy life years (HLY) comprehensive indicator of health situation--recommended by European Union].

    PubMed

    Gromulska, Lucyna; Wysocki, Mirosław J; Goryński, Paweł

    2008-01-01

    This article presents Healthy Life Years (HLY) indicator of functional health status, its application in the field of public health research and monitoring, method of calculation, idea of its construction and relation of HLY to other health status indicators e.g. life expectancy, quality adjusted life years. Current data on HLY in the EU member states are also presented. HLY indicator is one of structural indicators, recommended by European Council to deliver information on the progress of implementation of the Lisbon Strategy resolutions, which main principle is development of knowledge-based economy characterised by growth, social cohesion and respect for environment. HLY shifts the focus from quantity of years of life to its quality, full-productivity health of the population, thus conveying information not only on health status but also referring to the fields--other than medicine or social sciences--such as: finances, economy, politics, development. PMID:19209744

  9. [Ethical dilemmas in public health care organizations].

    PubMed

    Pereda Vicandi, M

    2014-01-01

    Today you can ask if you can apply ethics to organizations because much of the greater overall impact decisions are not made by private individuals, are decided by organizations. Any organization is legitimate because it satisfies a need of society and this legitimacy depends if the organization does with quality. To offer a good service, quality service, organizations know they need to do well, but seem to forget that should do well not only instrumental level, must also make good on the ethical level. Public health care organizations claim to promote attitudes and actions based on ethics, level of their internal functioning and level of achievement of its goals, but increased awareness and analysis of its inner workings can question it. Such entities, for its structure and procedures, may make it difficult for ethical standards actually govern its operation, also can have negative ethical consequences at the population level. A healthcare organization must not be organized, either structurally or functionally, like any other organization that offers services. In addition, members of the organization can not simply be passive actors. It is necessary that operators and users have more pro-ethical behaviors. Operators from the professionalism and users from liability. PMID:25467632

  10. Health-care providers' perceptions, attitudes towards and recommendation practice of cervical cancer screening.

    PubMed

    Hweissa, N Ab; Lim, J N W; Su, T T

    2016-09-01

    In Libya, cervical cancer is ranked third as the most frequent cancer among women with early diagnosis being shown to reduce morbidity and mortality. Health-care providers can influence women's screening behaviours, and their lack of recommendations for screening can be one of the barriers that affect women's participation in screening programmes. This study aims to assess the health-care provider's perception around cervical cancer screening. In-depth, face-to-face interviews were conducted with 16 health-care providers, from both public and private sectors in Az-Zawiya city, Libya, between February and July of 2014. The interviews were recorded and transcribed, then analysed using thematic analysis. Our findings suggest that health-care providers did not provide sufficient information regarding cervical cancer screening for women who attend health-care facilities. The results highlight the role played by health-care professionals in motivating women to attend cervical cancer screening programs, and the need for health education of health-care providers to offer a precious advice regarding the screening. On the other hand, health-care providers highlighted that implementation of reminding system of cervical cancer screening will support them to improve screening attendance. In addition, health-care providers stressed the necessity for educational and awareness campaigns of cervical cancer screening among Libyan women. PMID:27350095

  11. Emergency care and health systems: consensus-based recommendations and future research priorities.

    PubMed

    Calvello, Emilie J B; Broccoli, Morgan; Risko, Nicholas; Theodosis, Christian; Totten, Vicken Y; Radeos, Michael S; Seidenberg, Phil; Wallis, Lee

    2013-12-01

    The theme of the 14th annual Academic Emergency Medicine consensus conference was "Global Health and Emergency Care: A Research Agenda." The goal of the conference was to create a robust and measurable research agenda for evaluating emergency health care delivery systems. The concept of health systems includes the organizations, institutions, and resources whose primary purpose is to promote, restore, and/or maintain health. This article further conceptualizes the vertical and horizontal delivery of acute and emergency care in low-resource settings by defining specific terminology for emergency care platforms and discussing how they fit into broader health systems models. This was accomplished through discussion surrounding four principal questions touching upon the interplay between health systems and acute and emergency care. This research agenda is intended to assist countries that are in the early stages of integrating emergency services into their health systems and are looking for guidance to maximize their development and health systems planning efforts. PMID:24341583

  12. HEALTH ASSESSMENT DOCUMENT FOR POLYCYCLIC ORGANIC MATTER

    EPA Science Inventory

    The document responds to Section 122 of the Clean Air Act as Amended August 1977, which requires the Administrator to decide whether atmospheric emissions of polycyclic organic matter (POM) potentially endanger public health. This document reviews POM data on chemical and physica...

  13. Problem solving in health services organizations.

    PubMed

    Rakich, J S; Krigline, A B

    1996-01-01

    Health services organization managers at all levels are constantly confronted with problems. Conditions encountered that initiate the need for problem solving are opportunity, threat, crisis, deviation, and improvement. A general problem-solving model presenting an orderly process by which managers can approach this important task is described. An example of the model applied to the current strategic climate is presented. PMID:10158720

  14. Practice recommendations for the monitoring of renal function in pediatric non-renal organ transplant recipients.

    PubMed

    Filler, Guido; Melk, Anette; Marks, Stephen D

    2016-05-01

    The management of non-renal pediatric solid organ transplant recipients has become complex over the last decade with innovations in immunosuppression and surgical techniques. Post-transplantation follow-up is essential to ensure that children have functioning allografts for as long as possible. CKD is highly prevalent in these patients, often under recognized, and has a profound impact on patient survival. These practice recommendations focus on the early detection and management of hypertension, proteinuria, and renal dysfunction in non-renal pediatric solid organ transplant recipients. We present seven practice recommendations. Renal function should be monitored regularly in organ transplant recipients, utilizing assessment of serum creatinine and cystatin C. GFR should be calculated using the new Schwartz formula. Transplant physicians should also monitor blood pressure using automated oscillometric devices and confirm repeated abnormal measures with manual blood pressure readings and ambulatory 24-h blood pressure monitoring. Proteinuria and microalbuminuria should also be assessed regularly. Referrals to a pediatric nephrologist should be made for non-renal organ transplant recipients with repeated blood pressures >95th percentile using the Fourth Task Force reference intervals, microalbumin/creatinine ratio >32.5 mg/g (3.7 mg/mmol) creatinine on repeated testing and/or GFR <90 mL/min/1.73 m(2) . PMID:26917052

  15. New Summary Measures of Population Health and Well-Being for Implementation by Health Plans and Accountable Care Organizations

    PubMed Central

    Gallagher, Jason M.; Rauri, Sachin; Tillema, Juliana O.; Pronk, Nicolaas P.; Knudson, Susan M.

    2016-01-01

    Health plans and accountable care organizations measure many indicators of patient health, with standard metrics that track factors such as patient experience and cost. They lack, however, a summary measure of the third leg of the Triple Aim, population health. In response, HealthPartners has developed summary measures that align with the recommendations of the For the Public’s Health series of reports from the Institute of Medicine. (The series comprises the following 3 reports: For the Public’s Health: Investing in a Healthier Future, For the Public’s Health: Revitalizing Law and Policy to Meet New Challenges, and For the Public’s Health: The Role of Measurement in Action and Accountability.) The summary measures comprise 3 components: current health, sustainability of health, and well-being. The measure of current health is disability-adjusted life years (DALYs) calculated from health care claims and death records. The sustainability of health measure comprises member reporting of 6 behaviors associated with health plus a clinical preventive services index that indicates adherence to evidence-based preventive care guidelines. Life satisfaction represents the summary measure of subjective well-being. HealthPartners will use the summary measures to identify and address conditions and factors that have the greatest impact on the health and well-being of its patients, members, and community. The method could easily be implemented by other institutions and organizations in the United States, helping to address a persistent need in population health measurement for improvement. PMID:27390075

  16. New Summary Measures of Population Health and Well-Being for Implementation by Health Plans and Accountable Care Organizations.

    PubMed

    Kottke, Thomas E; Gallagher, Jason M; Rauri, Sachin; Tillema, Juliana O; Pronk, Nicolaas P; Knudson, Susan M

    2016-01-01

    Health plans and accountable care organizations measure many indicators of patient health, with standard metrics that track factors such as patient experience and cost. They lack, however, a summary measure of the third leg of the Triple Aim, population health. In response, HealthPartners has developed summary measures that align with the recommendations of the For the Public's Health series of reports from the Institute of Medicine. (The series comprises the following 3 reports: For the Public's Health: Investing in a Healthier Future, For the Public's Health: Revitalizing Law and Policy to Meet New Challenges, and For the Public's Health: The Role of Measurement in Action and Accountability.) The summary measures comprise 3 components: current health, sustainability of health, and well-being. The measure of current health is disability-adjusted life years (DALYs) calculated from health care claims and death records. The sustainability of health measure comprises member reporting of 6 behaviors associated with health plus a clinical preventive services index that indicates adherence to evidence-based preventive care guidelines. Life satisfaction represents the summary measure of subjective well-being. HealthPartners will use the summary measures to identify and address conditions and factors that have the greatest impact on the health and well-being of its patients, members, and community. The method could easily be implemented by other institutions and organizations in the United States, helping to address a persistent need in population health measurement for improvement. PMID:27390075

  17. Organ Procurement Organizations and the Electronic Health Record.

    PubMed

    Howard, R J; Cochran, L D; Cornell, D L

    2015-10-01

    The adoption of electronic health records (EHRs) has adversely affected the ability of organ procurement organizations (OPOs) to perform their federally mandated function of honoring the donation decisions of families and donors who have signed the registry. The difficulties gaining access to potential donor medical record has meant that assessment, evaluation, and management of brain dead organ donors has become much more difficult. Delays can occur that can lead to potential recipients not receiving life-saving organs. For over 40 years, OPO personnel have had ready access to paper medical records. But the widespread adoption of EHRs has greatly limited the ability of OPO coordinators to readily gain access to patient medical records and to manage brain dead donors. Proposed solutions include the following: (1) hospitals could provide limited access to OPO personnel so that they could see only the potential donor's medical record; (2) OPOs could join with other transplant organizations to inform regulators of the problem; and (3) hospital organizations could be approached to work with Center for Medicare and Medicaid Services (CMS) to revise the Hospital Conditions of Participation to require OPOs be given access to donor medical records. PMID:26138032

  18. Meeting the public health challenge of protecting private wells: Proceedings and recommendations from an expert panel workshop.

    PubMed

    Fox, Mary A; Nachman, Keeve E; Anderson, Breeana; Lam, Juleen; Resnick, Beth

    2016-06-01

    Private wells serving fewer than 25 people are federally unregulated, and their users may be exposed to naturally occurring agents of concern such as arsenic and radionuclides, as well as anthropogenic contaminants. The Centers for Disease Control and Prevention's Clean Water for Health Program works to protect private wells and prevent adverse health outcomes for the roughly 15% of Americans who rely on them. To understand current and emerging challenges to the private drinking water supply, an interdisciplinary expert panel workshop on "Future and Emerging Issues for Private Wells" was organized to inform strategic planning for the Clean Water for Health Program. The panel assessed current conditions of ground water as a source for private wells, identified emerging threats, critical gaps in knowledge, and public health needs, and recommended strategies to guide future activities to ensure the safety of private drinking water wells. These strategies addressed topics of broad interest to the environmental public health community including: development of new methods to support citizen science; addressing contaminant mixtures; expanding capacity for well testing; evaluating treatment technologies; building an evidence base on best practices on well owner outreach and stewardship; and research and data needs. PMID:26950625

  19. Communicating with Public Health Organizations: Technical Solution

    NASA Astrophysics Data System (ADS)

    Mihai, Alexandru; Catalan, Daniel; Kurapkiene, Skaidra; Felfly, Wadih

    By working with experts throughout Europe, ECDC pools Europe's health knowledge, so as to develop authoritative scientific opinions about the risks posed by current and emerging infectious diseases. Difficulties rose in the management of competent bodies' lists and the information was duplicated several times across the organization. ECDC started implementing a CRM system to organize the information in a structured data model, track the history of communication, provide contact information to application in house and support the nomination process and the user identity management for these applications.

  20. Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA

    PubMed Central

    Middleton, Blackford; Bloomrosen, Meryl; Dente, Mark A; Hashmat, Bill; Koppel, Ross; Overhage, J Marc; Payne, Thomas H; Rosenbloom, S Trent; Weaver, Charlotte; Zhang, Jiajie

    2013-01-01

    In response to mounting evidence that use of electronic medical record systems may cause unintended consequences, and even patient harm, the AMIA Board of Directors convened a Task Force on Usability to examine evidence from the literature and make recommendations. This task force was composed of representatives from both academic settings and vendors of electronic health record (EHR) systems. After a careful review of the literature and of vendor experiences with EHR design and implementation, the task force developed 10 recommendations in four areas: (1) human factors health information technology (IT) research, (2) health IT policy, (3) industry recommendations, and (4) recommendations for the clinician end-user of EHR software. These AMIA recommendations are intended to stimulate informed debate, provide a plan to increase understanding of the impact of usability on the effective use of health IT, and lead to safer and higher quality care with the adoption of useful and usable EHR systems. PMID:23355463

  1. Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA.

    PubMed

    Middleton, Blackford; Bloomrosen, Meryl; Dente, Mark A; Hashmat, Bill; Koppel, Ross; Overhage, J Marc; Payne, Thomas H; Rosenbloom, S Trent; Weaver, Charlotte; Zhang, Jiajie

    2013-06-01

    In response to mounting evidence that use of electronic medical record systems may cause unintended consequences, and even patient harm, the AMIA Board of Directors convened a Task Force on Usability to examine evidence from the literature and make recommendations. This task force was composed of representatives from both academic settings and vendors of electronic health record (EHR) systems. After a careful review of the literature and of vendor experiences with EHR design and implementation, the task force developed 10 recommendations in four areas: (1) human factors health information technology (IT) research, (2) health IT policy, (3) industry recommendations, and (4) recommendations for the clinician end-user of EHR software. These AMIA recommendations are intended to stimulate informed debate, provide a plan to increase understanding of the impact of usability on the effective use of health IT, and lead to safer and higher quality care with the adoption of useful and usable EHR systems. PMID:23355463

  2. Pregnancy and oral health: a review and recommendations to reduce gaps in practice and research.

    PubMed

    Russell, Stefanie L; Mayberry, Linda J

    2008-01-01

    This article presents a review of the research relevant to oral health during pregnancy and includes nursing practice recommendations for referral of women to a dentist for safe and effective dental care during pregnancy. In recent years, research linking periodontitis to the risk for adverse birth outcomes has resulted in increased interest in the topic of oral health during pregnancy. The achievement of optimal oral health in pregnant women as its own benefit, however, has in the past been hampered by myths surrounding the safety of dental care during pregnancy. Many women also lack access to dental care and dental insurance, which interferes with their ability to receive adequate oral care during pregnancy. Intraoral changes that occur with pregnancy because of hormonal changes, combined with lack of routine exams and delays in treatment for oral disease, place pregnant women at higher risk for dental infections. PMID:18158525

  3. Supporting public health priorities: recommendations for physical education and physical activity promotion in schools.

    PubMed

    Hills, Andrew P; Dengel, Donald R; Lubans, David R

    2015-01-01

    Physical activity (PA) provides numerous physiological and psychosocial benefits. However, lifestyle changes, including reduced PA opportunities in multiple settings, have resulted in an escalation of overweight and obesity and related health problems. Poor physical and mental health, including metabolic and cardiovascular problems is seen in progressively younger ages, and the systematic decline in school PA has contributed to this trend. Of note, the crowded school curriculum with an intense focus on academic achievement, lack of school leadership support, funding and resources, plus poor quality teaching are barriers to PA promotion in schools. The school setting and physical educators in particular, must embrace their role in public health by adopting a comprehensive school PA program. We provide an overview of key issues and challenges in the area plus best bets and recommendations for physical education and PA promotion in the school system moving forward. PMID:25269062

  4. [Food, health claims and drugs. Conclusions - recommendations. The National Academy of Pharmacy].

    PubMed

    Bourlioux, P

    2008-01-01

    Even if the activity of health claim foods is not relevant to the activity of drugs, we are just at the frontier of two fields which needs the greatest attention. Since foods and drugs are present in the same domain of prevention, the French Academy of Pharmacy draws attention on the necessary relevant and scientifically proven demonstration of the health claims using the same quality standard than those used for drugs (good clinical practises, methodologies correspondent to the current requirement, etc.). It is why the Academy wishes to express five recommendations fearing that the risks of confusion and abuse prevail on the possibilities of information and control. Make sure that foods are not mistaken with drugs; largely spread the lists of authorised claims; introduce the new notion of "nutrivigilance"; make sure that the only authorised health claims use advertising; reject the terms "alicaments" and "nutraceuticals" which are confusing with drugs. PMID:19061723

  5. The World Health Organization Health and Work Performance Questionnaire (HPQ).

    PubMed

    Kessler, Ronald C; Barber, Catherine; Beck, Arne; Berglund, Patricia; Cleary, Paul D; McKenas, David; Pronk, Nico; Simon, Gregory; Stang, Paul; Ustun, T Bedirhan; Wang, Phillip

    2003-02-01

    This report describes the World Health Organization Health and Work Performance Questionnaire (HPQ), a self-report instrument designed to estimate the workplace costs of health problems in terms of reduced job performance, sickness absence, and work-related accidents-injuries. Calibration data are presented on the relationship between individual-level HPQ reports and archival measures of work performance and absenteeism obtained from employer archives in four groups: airline reservation agents (n = 441), customer service representatives (n = 505), automobile company executives (n = 554), and railroad engineers (n = 850). Good concordance is found between the HPQ and the archival measures in all four occupations. The paper closes with a brief discussion of the calibration methodology used to monetize HPQ reports and of future directions in substantive research based on the HPQ. PMID:12625231

  6. Health policy and systems research training: global status and recommendations for action

    PubMed Central

    Tancred, Tara M; Schleiff, Meike; Peters, David H

    2016-01-01

    Abstract Objective To investigate the characteristics of health policy and systems research training globally and to identify recommendations for improvement and expansion. Methods We identified institutions offering health policy and systems research training worldwide. In 2014, we recruited participants from identified institutions for an online survey on the characteristics of the institutions and the courses given. Survey findings were explored during in-depth interviews with selected key informants. Findings The study identified several important gaps in health policy and systems research training. There were few courses in central and eastern Europe, the Middle East, North Africa or Latin America. Most (116/152) courses were instructed in English. Institutional support for courses was often lacking and many institutions lacked the critical mass of trained individuals needed to support doctoral and postdoctoral students. There was little consistency between institutions in definitions of the competencies required for health policy and systems research. Collaboration across disciplines to provide the range of methodological perspectives the subject requires was insufficient. Moreover, the lack of alternatives to on-site teaching may preclude certain student audiences such as policy-makers. Conclusion Training in health policy and systems research is important to improve local capacity to conduct quality research in this field. We provide six recommendations to improve the content, accessibility and reach of training. First, create a repository of information on courses. Second, establish networks to support training. Third, define competencies in health policy and systems research. Fourth, encourage multidisciplinary collaboration. Fifth, expand the geographical and language coverage of courses. Finally, consider alternative teaching formats. PMID:27429488

  7. The Global Commission on HIV and the Law: recommendations for legal reform to promote sexual and reproductive health and rights.

    PubMed

    El Feki, Shereen; Avafia, Tenu; Fidalgo, Tania Martins; Divan, Vivek; Chauvel, Charles; Dhaliwal, Mandeep; Cortez, Clifton

    2014-11-01

    The Global Commission on HIV and the Law was established in 2010 to identify and analyse the complex framework of international, national, religious and customary law shaping national responses to HIV and the well-being of people living with HIV and key populations. Two years of deliberation, based on an exhaustive review of international public health and human rights scholarship, as well as almost 700 testimonials from individuals and organizations in more than 130 countries, informed the Commission's recommendations on reform to laws and practices that criminalize those living with and vulnerable to HIV, sustain or mitigate violence and discrimination lived by women, facilitate or impede access to HIV-related treatment, and/or pertain to children and young people in the context of HIV. This paper presents the Commission's findings and recommendations as they relate to sexual and reproductive health and rights, and examines how the Commission's work intersects with strategic litigation on forced sterilization of women living with HIV, legal reform on the status of transgender individuals, initiatives to improve police treatment of female sex workers, and equal property rights for women living with HIV in sub-Saharan Africa and Latin America. PMID:25555770

  8. Dietary Fats and Health: Dietary Recommendations in the Context of Scientific Evidence1

    PubMed Central

    Lawrence, Glen D.

    2013-01-01

    Although early studies showed that saturated fat diets with very low levels of PUFAs increase serum cholesterol, whereas other studies showed high serum cholesterol increased the risk of coronary artery disease (CAD), the evidence of dietary saturated fats increasing CAD or causing premature death was weak. Over the years, data revealed that dietary saturated fatty acids (SFAs) are not associated with CAD and other adverse health effects or at worst are weakly associated in some analyses when other contributing factors may be overlooked. Several recent analyses indicate that SFAs, particularly in dairy products and coconut oil, can improve health. The evidence of ω6 polyunsaturated fatty acids (PUFAs) promoting inflammation and augmenting many diseases continues to grow, whereas ω3 PUFAs seem to counter these adverse effects. The replacement of saturated fats in the diet with carbohydrates, especially sugars, has resulted in increased obesity and its associated health complications. Well-established mechanisms have been proposed for the adverse health effects of some alternative or replacement nutrients, such as simple carbohydrates and PUFAs. The focus on dietary manipulation of serum cholesterol may be moot in view of numerous other factors that increase the risk of heart disease. The adverse health effects that have been associated with saturated fats in the past are most likely due to factors other than SFAs, which are discussed here. This review calls for a rational reevaluation of existing dietary recommendations that focus on minimizing dietary SFAs, for which mechanisms for adverse health effects are lacking. PMID:23674795

  9. [Who can be a sex therapist? Ministry of Health Committee recommendations].

    PubMed

    Lotan, Yoram

    2009-09-01

    The question of who is authorized to conduct sexual therapy and sexual rehabilitation is a complicated issue which has concerned the Ministry of Health (MOH) and professionals in this area for many years. T.V. Channel 2 presented a program regarding surrogates in sexual treatment. Following this program and due to the lack of clear definitions, the Director General of the MOH appointed a committee assigned to define "sexual treatment" and determine who is considered to be a sex therapist. The members of the committee represented various relevant professions. The recommendations of the committee are still being discussed and no final decisions have yet been made. However, the committee defined "sexual treatment" as professional interventions aiming to treat sexual dysfunctions in men and women as defined in the ICD-10 classification. These dysfunctions could be a result of physical, mental or combined causes". The committee recommended that sex therapists should only be those who are already licensed in one of the following professions: Social work [MSW] with proven experience in individual and family therapy. Clinical Psychology. Medicine--specializing in one of the following fields-Psychiatry, Urology, Gynecology, Family Medicine, Pediatrics or Endocrinology. In addition, the committee recommended a syllabus which aims to train these professionals following the recommendations of the European Academy of Sexual Medicine which are attached to the proposal of the committee. The committee also calls to initiate academic programs which will be accompanied by supervised practical training. Furthermore, the committee recommended acknowledging professionals who will be considered as the founders of sexual therapy in Israel. PMID:20070059

  10. Active Commuting Behaviors in a Nordic Metropolitan Setting in Relation to Modality, Gender, and Health Recommendations

    PubMed Central

    Stigell, Erik; Schantz, Peter

    2015-01-01

    Active commuting between home and place of work or study is often cited as an interesting source of physical activity in a public health perspective. However, knowledge about these behaviors is meager. This was therefore studied in adult active commuters (n = 1872) in Greater Stockholm, Sweden, a Nordic metropolitan setting. They received questionnaires and individually adjusted maps to draw their normal commuting route. Three different modality groups were identified in men and women: single-mode cyclists and pedestrians (those who only cycle or walk, respectively) and dual-mode commuters (those who alternately walk or cycle). Some gender differences were observed in trip distances, frequencies, and velocities. A large majority of the commuting trip durations met the minimum health recommendation of at least 10-minute-long activity bouts. The median single-mode pedestrians and dual-mode commuters met or were close to the recommended weekly physical activity levels of at least 150 minutes most of the year, whereas the single-mode cyclists did so only during spring–mid-fall. A high total number of trips per year (range of medians: 231–389) adds to the value in a health perspective. To fully grasp active commuting behaviors in future studies, both walking and cycling should be assessed over different seasons and ideally over the whole year. PMID:26690193

  11. Tweeting as Health Communication: Health Organizations' Use of Twitter for Health Promotion and Public Engagement.

    PubMed

    Park, Hyojung; Reber, Bryan H; Chon, Myoung-Gi

    2016-01-01

    This study examined how major health organizations use Twitter for disseminating health information, building relationships, and encouraging actions to improve health. The sampled organizations were the American Heart Association, American Cancer Society, and American Diabetes Association. A content analysis was conducted on 1,583 tweets to examine these organizations' use of Twitter's interactive features and to understand the message functions and topics of their tweets. The numbers of retweets and favorites were also measured as engagement indicators and compared by different message functions. The results revealed that all of the organizations posted original tweets most, but they differed in the degree to which they used the retweet and reply functions. Hashtags and hyperlinks were the most frequently used interactive tools. The majority of the tweets were about organization-related topics, whereas personal health-related tweets represented a relatively small portion of the sample. Followers were most likely to like and retweet personal health action-based messages. PMID:26716546

  12. Improving Indoor Environmental Quality for Public Health: Impediments and Policy Recommendations

    PubMed Central

    Wu, Felicia; Jacobs, David; Mitchell, Clifford; Miller, David; Karol, Meryl H.

    2007-01-01

    Background People in modern societies spend more than 90% of their time indoors. Hence, indoor environmental quality (IEQ) has a significant impact on public health. In this article we describe health risks associated with indoor environments, illuminate barriers to overcoming these risks, and provide policy recommendations to achieve healthier indoor environments. Objectives The weight of evidence suggests that indoor environmental contaminants pose significant public health risks, particularly among children and the poor, and the societal costs of illnesses related to indoor environments are considerable. Despite the evidence of harm to human health, poor indoor environments are generally difficult to regulate and not of sufficient concern to the general public. We discuss several reasons for this lack of concern about IEQ, focusing specifically on home environments. Discussion Economics plays a large role both in political inaction and individual-level indifference. Because little effort has been made to quantify the value of the societal and individual costs of poor housing quality, as well as the benefits achievable by simple interventions, policymakers lack motivation to act on IEQ. Similarly, individual homeowners lack the incentive to remediate homes, as other problems may be more pressing than home environmental quality. Conclusions Although the problem of IEQ involves multiple stakeholders and multiple levels of governance, it is possible to establish economic incentives that would set the wheels in motion for action at all levels to achieve healthy home environments. Also important are education and information dissemination on the public health risks associated with indoor environments. These recommendations are intended for all decision makers who have an influence in developing policy to improve indoor environmental quality. PMID:17589606

  13. Health maintenance organizations; Midwest Health Plan--Health Resources and Services Administration.

    PubMed

    1983-04-26

    On January 21, 1983, the Office of Health Maintenance Organizations (OHMO) notified Midwest Health Plan (MHP), 3415 Bridgeland Drive, Bridgeton, Missouri 63044, a federally qualified health maintenance organization (HMO), that MHP had successfully reestablished compliance with its assurances to the Secretary that it would (1) maintain a fiscally sound operation, and (2) maintain satisfactory administrative and managerial arrangements. This determination took effect on January 1, 1983. PMID:10324428

  14. Recommendations for Biomonitoring of Emergency Responders: Focus on Occupational Health Investigations and Occupational Health Research

    PubMed Central

    Decker, John A.; DeBord, D. Gayle; Bernard, Bruce; Dotson, G. Scott; Halpin, John; Hines, Cynthia J.; Kiefer, Max; Myers, Kyle; Page, Elena; Schulte, Paul; Snawder, John

    2015-01-01

    The disaster environment frequently presents rapidly evolving and unpredictable hazardous exposures to emergency responders. Improved estimates of exposure and effect from biomonitoring can be used to assess exposure–response relationships, potential health consequences, and effectiveness of control measures. Disaster settings, however, pose significant challenges for biomonitoring. A decision process for determining when to conduct biomonitoring during and following disasters was developed. Separate but overlapping decision processes were developed for biomonitoring performed as part of occupational health investigations that directly benefit emergency responders in the short term and for biomonitoring intended to support research studies. Two categories of factors critical to the decision process for biomonitoring were identified: Is biomonitoring appropriate for the intended purpose and is biomonitoring feasible under the circumstances of the emergency response? Factors within these categories include information needs, relevance, interpretability, ethics, methodology, and logistics. Biomonitoring of emergency responders can be a valuable tool for exposure and risk assessment. Information needs, relevance, and interpretability will largely determine if biomonitoring is appropriate; logistical factors will largely determine if biomonitoring is feasible. The decision process should be formalized and may benefit from advance planning. PMID:23356122

  15. Trial-based economic evaluations in occupational health: principles, methods, and recommendations.

    PubMed

    van Dongen, Johanna M; van Wier, Marieke F; Tompa, Emile; Bongers, Paulien M; van der Beek, Allard J; van Tulder, Maurits W; Bosmans, Judith E

    2014-06-01

    To allocate available resources as efficiently as possible, decision makers need information on the relative economic merits of occupational health and safety (OHS) interventions. Economic evaluations can provide this information by comparing the costs and consequences of alternatives. Nevertheless, only a few of the studies that consider the effectiveness of OHS interventions take the extra step of considering their resource implications. Moreover, the methodological quality of those that do is generally poor. Therefore, this study aims to help occupational health researchers conduct high-quality trial-based economic evaluations by discussing the theory and methodology that underlie them, and by providing recommendations for good practice regarding their design, analysis, and reporting. This study also helps consumers of this literature with understanding and critically appraising trial-based economic evaluations of OHS interventions. PMID:24854249

  16. Effects of leather industry on health and recommendations for improving the situation in Pakistan.

    PubMed

    Syed, Madiha; Saleem, Taimur; Shuja-ur-Rehman; Iqbal, Muhammed Asif; Javed, Faisal; Khan, Muhammed Bilal Salman; Sadiq, Kamran

    2010-01-01

    The leather industry and its associated sectors contribute significantly to the Pakistani economy. There are around 600 tanneries in Pakistan that are concentrated in 3 major cities (Kasur, Karachi, Sialkot). Waste discharge from tanneries pollutes the air, soil, and water, causing serious health problems. Exposure to such contaminated environmental milieu has been seen to culminate in a multiple array of disease processes such as asthma, dermatitis, hepatic and neurological disorders, and various malignancies. An overall dearth of research on the occupational hazards of employment in the leather industry as well as its effects on pediatric population was observed during literature review with particular reference to Pakistan. It is recommended that research should be conducted about the health hazards in the leather industry in Pakistan as well as globally to gather data that can be translated into effective prevention programs for both adults as well as pediatric populations. PMID:20705577

  17. Recommendations for health-enhancing physical activities in type 2 diabetes patients

    PubMed Central

    Mynarski, Władysław; Cholewa, Jarosław; Rozpara, Michał; Borek, Zbigniew; Strojek, Krzysztof; Nawrocka, Agnieszka

    2015-01-01

    [Purpose] Type 2 diabetes mellitus is a disease of civilization with epidemiological coverage. An integral component of a comprehensive process of type 2 diabetes mellitus prevention and treatment is reasonably proportioned exercise. The aim of the study was to evaluate the weekly physical activity of patients with type 2 diabetes mellitus and healthy subjects with respect to recommendations of the American College of Sports Medicine and American Diabetes Association. [Subjects] The study involved 31 patients with type 2 diabetes mellitus (treatment duration 9 ± 0.8) and 31 healthy people. [Methods] Physical activity levels were determined by the International Physical Activity Questionnaire. A χ2 test was applied to determine the percentage of people who met recommendations. [Results] Analysis of the obtained results demonstrated that the intensity of physical activity in patients with diabetes was moderate or low. The men in the control group met the recommendations for standard health-related activities significantly more often than the patients with diabetes. In women, there was no such relationship, since most of the women were insufficiently physically active. [Conclusion] The conclusion to be drawn is that there is an urgent need to develop and implement effective programs to enhance physical activity among people at risk of diseases of civilization, including type 2 diabetes. PMID:26356173

  18. Contact Precautions for Multidrug-Resistant Organisms (MDROs): Current Recommendations and Actual Practice

    PubMed Central

    Clock, Sarah A.; Cohen, Bevin; Behta, Maryam; Ross, Barbara; Larson, Elaine L.

    2009-01-01

    Background Contact precautions are recommended for interactions with patients colonized/infected with multidrug-resistant organisms; however, rates of contact precautions practice are unknown. Methods Observers recorded the availability of supplies and staff/visitor adherence to contact precautions at rooms of patients indicated for contact precautions. Data were collected at three sites in a New York City hospital network. Results Contact precautions signs were present for 85.4% of indicated patients. The largest proportions were indicated for isolation for vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus cultures. Isolation carts were available outside 93.7-96.7% of rooms displaying signs, and personal protective equipment was available at rates of 49.4-72.1% for gloves (all sizes: small, medium, and large) and 91.7-95.2% for gowns. Overall adherence rates upon room entry and exit, respectively, were 19.4% and 48.4% for hand hygiene, 67.5% and 63.5% for gloves, and 67.9% and 77.1% for gowns. Adherence was significantly better in intensive care units (p<0.05) and by patient-care staff (p<0.05), and patient-care staff compliance with one contact precautions behavior was predictive of adherence to additional behaviors (p<0.001). Conclusions Our findings support the recommendation that methods to monitor contact precautions and identify and correct non-adherent practices should be a standard component of infection prevention and control programs. PMID:19913329

  19. Factors affecting uptake of recommended immunizations among health care workers in South Australia.

    PubMed

    Tuckerman, Jane L; Collins, Joanne E; Marshall, Helen S

    2015-01-01

    Despite the benefits of vaccination for health care workers (HCWs), uptake of recommended vaccinations is low, particularly for seasonal influenza and pertussis. In addition, there is variation in uptake within hospitals. While all vaccinations recommended for HCWs are important, vaccination against influenza and pertussis are particularly imperative, given HCWs are at risk of occupationally acquired influenza and pertussis, and may be asymptomatic, acting as a reservoir to vulnerable patients in their care. This study aimed to determine predictors of uptake of these vaccinations and explore the reasons for variation in uptake by HCWs working in different hospital wards. HCWs from wards with high and low influenza vaccine uptake in a tertiary pediatric and obstetric hospital completed a questionnaire to assess knowledge of HCW recommended immunizations. Multiple logistic regression was used to determine predictors of influenza and pertussis vaccination uptake. Of 92 HCWs who responded, 9.8% were able to identify correctly the vaccines recommended for HCWs. Overall 80% of respondents reported they had previously received influenza vaccine and 50.5% had received pertussis vaccine. Independent predictors of pertussis vaccination included length of time employed in health sector (P < 0.001), previously receiving hepatitis B/MMR (measles, mumps, rubella) vaccine (P < 0.001), and a respondent being aware influenza infections could be severe in infants (p = 0.023). Independent predictors of seasonal influenza vaccination included younger age (P < 0.001), English as first language (P < 0.001), considering it important to be vaccinated to protect themselves (P < 0.001), protect patients (p = 0.012) or awareness influenza could be serious in immunocompromised patients (p = 0.030). Independent predictors for receiving both influenza and pertussis vaccinations included younger age (P < 0.001), time in area of work (P = 0.020), previously receiving hepatitis B vaccine (P = 0

  20. Factors affecting uptake of recommended immunizations among health care workers in South Australia

    PubMed Central

    Tuckerman, Jane L; Collins, Joanne E; Marshall, Helen S

    2015-01-01

    Despite the benefits of vaccination for health care workers (HCWs), uptake of recommended vaccinations is low, particularly for seasonal influenza and pertussis. In addition, there is variation in uptake within hospitals. While all vaccinations recommended for HCWs are important, vaccination against influenza and pertussis are particularly imperative, given HCWs are at risk of occupationally acquired influenza and pertussis, and may be asymptomatic, acting as a reservoir to vulnerable patients in their care. This study aimed to determine predictors of uptake of these vaccinations and explore the reasons for variation in uptake by HCWs working in different hospital wards. HCWs from wards with high and low influenza vaccine uptake in a tertiary pediatric and obstetric hospital completed a questionnaire to assess knowledge of HCW recommended immunizations. Multiple logistic regression was used to determine predictors of influenza and pertussis vaccination uptake. Of 92 HCWs who responded, 9.8% were able to identify correctly the vaccines recommended for HCWs. Overall 80% of respondents reported they had previously received influenza vaccine and 50.5% had received pertussis vaccine. Independent predictors of pertussis vaccination included length of time employed in health sector (P < 0.001), previously receiving hepatitis B/MMR (measles, mumps, rubella) vaccine (P < 0.001), and a respondent being aware influenza infections could be severe in infants (p = 0.023). Independent predictors of seasonal influenza vaccination included younger age (P < 0.001), English as first language (P < 0.001), considering it important to be vaccinated to protect themselves (P < 0.001), protect patients (p = 0.012) or awareness influenza could be serious in immunocompromised patients (p = 0.030). Independent predictors for receiving both influenza and pertussis vaccinations included younger age (P < 0.001), time in area of work (P = 0.020), previously receiving hepatitis B vaccine (P = 0

  1. [Declared dead? Recommendations regarding integrated care from the perspective of German statutory health insurance].

    PubMed

    Amelung, Volker; Wolf, S; Ozegowski, S; Eble, S; Hildebrandt, H; Knieps, F; Lägel, R; Schlenker, R-U; Sjuts, R

    2015-04-01

    The traditional separation of health care into sectors in Germany causes communication problems that hinder continuous, patient-oriented care. This is most evident in the transition from inpatient to outpatient care. That said, there are also breaks in the flow of information, a lack of supply, or even incorrect information flowing within same-sector care. The transition from a division of functions into sectors to a patient-oriented process represents a change in the paradigm of health care that can only be successfully completed with considerable effort. Germany's statutory health insurance (SHI) funds play a key role here, as they are the contracting parties as well as the financiers of integrated care, and are strategically located at the center of the development process.The objective of this article is to explore how Germany's SHI funds view integrated care, what they regard as being the drivers of and barriers to transitioning to such a system, and what recommendations they can provide with regard to the further development of integrated care. For this purpose semi-structured interviews with board members and those responsible for implementing integrated care into the operations of ten SHI funds representing more than half of Germany's SHI-insured population were conducted. According to the interviewees, a better framework for integrated care urgently needs to be developed and rendered more receptive to innovation.Only in this way will the widespread stagnation of the past several years be overcome. The deregulation of § 140a-d SGB V and the establishment of a uniform basis for new forms of care in terms of a new innovation clause are among the central recommendations of this article. The German federal government's innovation fund was met with great hope, but also implied risks. Nonetheless, the new law designed to strengthen health care overall generated high expectations. PMID:25776522

  2. The Management of Low Vision in Children: Report of the 1992 World Health Organization Consultation.

    ERIC Educational Resources Information Center

    Best, A. B.; Corn, A. L.

    1993-01-01

    This paper presents a summary of presentations and discussion from a World Health Organization meeting of experienced low vision practitioners. It outlines the magnitude of the problem; current status of low vision care; enhancement of the use of vision; and recommendations in definitions, identification, assessment, low vision centers, education,…

  3. Behavioral Recommendations in Health Research News as Cues to Action: Self-Relevancy and Self-Efficacy Processes.

    PubMed

    Chang, Chingching

    2016-08-01

    This study argues that behavioral recommendations in health news function as cues to action. A proposed self-oriented model seeks to explore the impacts of behavioral recommendations in health research news as cues to action through their influences on self-relevancy and self-efficacy. A content analysis (Study 1) first establishes that health research news commonly features behavioral recommendations. A message experiment (Study 2) then explores the utility of behavioral recommendations as cues to action by demonstrating a self-relevancy effect: Health research news with, as opposed to without, behavioral recommendations increases the self-relevancy of advocated health behaviors, which then improve people's attitudes toward and intentions to adopt those behaviors. A second message experiment (Study 3) tests whether varying presentations of behavioral recommendations alter their effectiveness as cues to action and thus people's behavioral intentions through a dual effect process. In addition to the previously demonstrated self-relevancy effect, this experiment shows that concrete, as opposed to abstract, behavioral recommendations trigger a self-efficacy effect, increasing perceived self-efficacy and further improving behavioral intentions. PMID:27442057

  4. Military Youth and the Deployment Cycle: Emotional Health Consequences and Recommendations for Intervention

    PubMed Central

    Esposito-Smythers, Christianne; Wolff, Jennifer; Lemmon, Keith M.; Bodzy, Mary; Swenson, Rebecca R.; Spirito, Anthony

    2011-01-01

    The United States military force includes over 2.2 million volunteer service members. Three out of five service members who are deployed or are preparing for deployment have spouses and/or children. Stressors associated with the deployment cycle can lead to depression, anxiety, and behavior problems in children, as well as psychological distress in the military spouse. Further, the emotional and behavioral health of family members can affect the psychological functioning of the military service member during the deployment and re-integration periods. Despite widespread acknowledgement of the need for emotional and behavioral health services for youth from military families, many professionals in a position to serve them struggle with how to best respond and select appropriate interventions. The purpose of this paper is to provide an empirically-based and theoretically informed review to guide service provision and the development of evidence based treatments for military youth in particular. This review includes an overview of stressors associated with the deployment cycle, emotional and behavioral health consequences of deployment on youth and their caretaking parent, and existing preventative and treatment services for youth from military families. It concludes with treatment recommendations for older children and adolescents experiencing emotional and behavioral health symptoms associated with the deployment cycle. PMID:21707172

  5. Influencing Organizations to Promote Health: Applying Stakeholder Theory

    ERIC Educational Resources Information Center

    Kok, Gerjo; Gurabardhi, Zamira; Gottlieb, Nell H.; Zijlstra, Fred R. H.

    2015-01-01

    Stakeholder theory may help health promoters to make changes at the organizational and policy level to promote health. A stakeholder is any individual, group, or organization that can influence an organization. The organization that is the focus for influence attempts is called the focal organization. The more salient a stakeholder is and the more…

  6. Emergency preparedness in high school-based athletics: a review of the literature and recommendations for sport health professionals.

    PubMed

    Olympia, Robert P; Brady, Jodi

    2013-05-01

    Approximately 7.6 million high school students in the United States participate in sports. Although most sport-related injuries in adolescents are considered minor emergencies, life-threatening illnesses or injuries may occur, such as sudden cardiac arrest, heat stroke, status asthmaticus and exercise-induced asthma, catastrophic brain injuries, cervical spine injuries, heat- and cold-related illness, blunt chest/abdominal injuries, and extremity fractures resulting in compartment syndrome. Emergency preparedness in athletics involves the identification of and planning for medical services to promote the safety of the athlete, to limit injury, and to provide medical care at the site of practice or competition. Several national organizations have published guidelines for emergency preparedness in school-based athletics. Our article reviews guidelines for emergency preparedness put forth by the Sideline Preparedness collaboration (comprised of 6 major professional associations, including the American Academy of Family Physicians, American Academy of Orthopedic Surgeons, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine), the National Athletic Trainers' Association, the American Academy of Pediatrics' Committee on School Health, and the American Heart Association. Additionally, we review published data examining compliance of US high schools with these recommendations for emergency preparedness in school-based athletics, determine deficiencies, and provide recommendations for improvement based on these deficiencies. PMID:23703513

  7. Impact of a Bereavement and Donation Service incorporating mandatory 'required referral' on organ donation rates: a model for the implementation of the Organ Donation Taskforce's recommendations.

    PubMed

    Murphy, F; Cochran, D; Thornton, S

    2009-08-01

    In 2008 the Organ Donation Taskforce published its recommendations for increasing organ donation in the UK by 50% over 5 years. Bolton NHS Trust has addressed the problem of low rates of organ donation by amalgamating Bereavement and Donation Services and introducing a trigger to refer automatically all potential organ donors to the regional transplant donor co-ordinators. We audited the ability of the new service to deliver the aims and recommendations of the Organ Donation Taskforce. Following the changes in service provision the number of tissue donors rose from six in 2002 to 246 in 2007. In the same period solid organ donation rates remained unchanged. The introduction of an automatic trigger for referral of potential donors in 2007 resulted in 31 referrals and 11 successful multi-organ donors. The current service exceeds the aims of the Taskforce and offers the potential to meet UK organ donation targets without resorting to an 'opt out' system of presumed consent. PMID:19604184

  8. Creating High Reliability in Health Care Organizations

    PubMed Central

    Pronovost, Peter J; Berenholtz, Sean M; Goeschel, Christine A; Needham, Dale M; Sexton, J Bryan; Thompson, David A; Lubomski, Lisa H; Marsteller, Jill A; Makary, Martin A; Hunt, Elizabeth

    2006-01-01

    Objective The objective of this paper was to present a comprehensive approach to help health care organizations reliably deliver effective interventions. Context Reliability in healthcare translates into using valid rate-based measures. Yet high reliability organizations have proven that the context in which care is delivered, called organizational culture, also has important influences on patient safety. Model for Improvement Our model to improve reliability, which also includes interventions to improve culture, focuses on valid rate-based measures. This model includes (1) identifying evidence-based interventions that improve the outcome, (2) selecting interventions with the most impact on outcomes and converting to behaviors, (3) developing measures to evaluate reliability, (4) measuring baseline performance, and (5) ensuring patients receive the evidence-based interventions. The comprehensive unit-based safety program (CUSP) is used to improve culture and guide organizations in learning from mistakes that are important, but cannot be measured as rates. Conclusions We present how this model was used in over 100 intensive care units in Michigan to improve culture and eliminate catheter-related blood stream infections—both were accomplished. Our model differs from existing models in that it incorporates efforts to improve a vital component for system redesign—culture, it targets 3 important groups—senior leaders, team leaders, and front line staff, and facilitates change management—engage, educate, execute, and evaluate for planned interventions. PMID:16898981

  9. A guide for health professionals to interpret and use recommendations in guidelines developed with the GRADE approach.

    PubMed

    Neumann, Ignacio; Santesso, Nancy; Akl, Elie A; Rind, David M; Vandvik, Per Olav; Alonso-Coello, Pablo; Agoritsas, Thomas; Mustafa, Reem A; Alexander, Paul Elias; Schünemann, Holger; Guyatt, Gordon H

    2016-04-01

    An increasing number of organizations worldwide are using new and improved standards for developing trustworthy clinical guidelines. One of such approaches, developed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group, offers systematic and transparent guidance in moving from evidence to recommendations. The GRADE strategy concentrates on four factors: the balance between benefits and harms, the certainty of the evidence, values and preferences, and resource considerations. However, it also considers issues around feasibility, equity, and acceptability of recommendations. GRADE distinguishes two types of recommendations: strong and weak. Strong recommendations reflect a clear preference for one alternative and should apply to all or almost all patients, obviating the need for a careful review of the evidence with each patient. Weak recommendations are appropriate when there is a close balance between desirable and undesirable consequences of alternative management strategies, uncertainty regarding the effects of the alternatives, uncertainty or variability in patients' values and preferences, or questionable cost-effectiveness. Weak recommendations usually require accessing the underlying evidence and a shared decision-making approach. Clinicians using GRADE recommendations should understand the meaning of the strength of the recommendation, be able to critically appraise the recommendation, and apply trustworthy recommendations according to their strength. PMID:26772609

  10. Using Professional Organizations to Prepare the Behavioral Health Workforce to Respond to the Needs of Pediatric Populations Impacted by Health-Related Disasters: Guiding Principles and Challenges.

    PubMed

    Sprang, Ginny; Silman, Miriam

    2015-12-01

    Behavioral health professional organizations are in the unique role of aggregating and disseminating information to their membership before, during, and after health-related disasters to promote the integration of behavioral health services into the public health disaster response plan. This article provides a set of 5 principles to direct this undertaking that are based on the current literature and previous evaluation of the online guidance provided by 6 prominent behavioral health professional organizations. These principles use a strengths-based approach to prioritize resilience; underscore the importance of context, collaboration, and coordination; recognize the unique needs of pediatric populations; and guide ongoing training and content development in the area of biopsychosocial responses to health-related disasters. Recognizing important innovations and strides made by the behavioral health organizations noted in a previous study, this article recommends additional areas in which behavioral health professional organizations can contribute to overall pandemic disaster preparedness and response efforts. PMID:26145465

  11. The First Physical Therapy Summit on Global Health: implications and recommendations for the 21st century.

    PubMed

    Dean, Elizabeth; Al-Obaidi, Saud; De Andrade, Armele Dornelas; Gosselink, Rik; Umerah, Gloria; Al-Abdelwahab, Sami; Anthony, Joseph; Bhise, Anjali R; Bruno, Selma; Butcher, Scotty; Fagevik-Olsén, Monika; Frownfelter, Donna; Gappmaier, Eduard; Gylfadóttir, Sif; Habibi, Mehrdad; Hanekom, Susan; Hasson, Scott; Jones, Alice; LaPier, Tanya; Lomi, Constantina; Mackay, Liz; Mathur, Sunita; O'Donoghue, Grainne; Playford, Kristen; Ravindra, Savita; Sangroula, Kanchan; Scherer, Susan; Skinner, Margot; Wong, Wai Pong

    2011-11-01

    The First Physical Therapy Summit on Global Health was convened at the 2007 World Confederation for Physical Therapy (WCPT) Congress to vision practice in the 21st century and, in turn, entry-level education and research, as informed by epidemiological indicators, and consistent with evidence-based noninvasive interventions, the hallmark of physical therapy. The Summit and its findings were informed by WHO data and validated through national databases of the countries of the five WCPT regions. The health priorities based on mortality were examined in relation to proportions of physical therapists practicing in the areas of regional priorities and of the curricula in entry-level programs. As a validation check and to contextualize the findings, input from members of the 800 Summit participants was integrated and international consultants refined the recommendations. Lifestyle-related conditions (ischemic heart disease, smoking-related conditions, hypertension, stroke, cancer, and diabetes) were leading causes of premature death across regions. Contemporary definitions of physical therapy support that the profession has a leading role in preventing, reversing, as well as managing lifestyle-related conditions. The proportions of practitioners practicing primarily in these priority areas and of the entry-level curricula based on these priorities were low. The proportions of practitioners in priority areas and entry-level curricula devoted to lifestyle-related conditions warrant being better aligned with the prevalence of these conditions across regions in the 21st century. A focus on clinical competencies associated with effective health education and health behavior change formulates the basis for The Second Physical Therapy Summit on Global Health. PMID:21612551

  12. The effects of flooding on mental health: Outcomes and recommendations from a review of the literature

    PubMed Central

    Stanke, Carla; Murray, Virginia; Amlôt, Richard; Nurse, Jo; Williams, Richard

    2012-01-01

    Introduction While most people who are involved in disasters recover with the support of their families, friends and colleagues, the effects on some people’s health, relationships and welfare can be extensive and sustained. Flooding can pose substantial social and mental health problems that may continue over extended periods of time. Flooding can challenge the psychosocial resilience of the hardiest of people who are affected. Methods The Health Protection Agency (HPA) undertook a review of the literature published from 2004 to 2010. It is intended to: assess and appraise the epidemiological evidence on flooding and mental health; assess the existing guidance on emergency planning for the impacts of flooding on psychosocial and mental health needs; provide a detailed report for policymakers and services on practical methods to reduce the impacts of flooding on the mental health of affected people; and identify where research can support future evidence-based guidance. The HPA identified 48 papers which met its criteria. The team also reviewed and discussed relevant government and non-government guidance documents. This paper presents a summary of the outcomes and recommendations from this review of the literature. Results The review indicates that flooding affects people of all ages, can exacerbate or provoke mental health problems, and highlights the importance of secondary stressors in prolonging the psychosocial impacts of flooding. The distressing experiences that the majority of people experience transiently or for longer periods after disasters can be difficult to distinguish from symptoms of common mental disorders. This emphasises the need to reduce the impact of primary and secondary stressors on people affected by flooding and the importance of narrative approaches to differentiate distress from mental disorder. Much of the literature focuses on post-traumatic stress disorder; diagnosable depressive and anxiety disorders and substance misuse are under

  13. The effects of flooding on mental health: Outcomes and recommendations from a review of the literature.

    PubMed

    Stanke, Carla; Murray, Virginia; Amlôt, Richard; Nurse, Jo; Williams, Richard

    2012-01-01

    Introduction While most people who are involved in disasters recover with the support of their families, friends and colleagues, the effects on some people's health, relationships and welfare can be extensive and sustained. Flooding can pose substantial social and mental health problems that may continue over extended periods of time. Flooding can challenge the psychosocial resilience of the hardiest of people who are affected. Methods The Health Protection Agency (HPA) undertook a review of the literature published from 2004 to 2010. It is intended to: assess and appraise the epidemiological evidence on flooding and mental health; assess the existing guidance on emergency planning for the impacts of flooding on psychosocial and mental health needs; provide a detailed report for policymakers and services on practical methods to reduce the impacts of flooding on the mental health of affected people; and identify where research can support future evidence-based guidance. The HPA identified 48 papers which met its criteria. The team also reviewed and discussed relevant government and non-government guidance documents. This paper presents a summary of the outcomes and recommendations from this review of the literature. Results The review indicates that flooding affects people of all ages, can exacerbate or provoke mental health problems, and highlights the importance of secondary stressors in prolonging the psychosocial impacts of flooding. The distressing experiences that the majority of people experience transiently or for longer periods after disasters can be difficult to distinguish from symptoms of common mental disorders. This emphasises the need to reduce the impact of primary and secondary stressors on people affected by flooding and the importance of narrative approaches to differentiate distress from mental disorder. Much of the literature focuses on post-traumatic stress disorder; diagnosable depressive and anxiety disorders and substance misuse are under

  14. Recommendations for Internet-Based Qualitative Health Research With Hard-to-Reach Populations

    PubMed Central

    Wilkerson, J. Michael; Iantaffi, Alex; Grey, Jeremy A.; Bockting, Walter O.; Simon Rosser, B. R.

    2014-01-01

    Researchers new to online qualitative health research frequently have questions about how to transfer knowledge of offline data collection to an online environment. In this article, we present best-practice guidelines derived from the literature and our experience to help researchers determine if an online qualitative study design is appropriate for their research project and, if so, when to begin data collection with a hard-to-reach population. Researchers should reflect on administrative, population, and data collection considerations when deciding between online and offline data collection. Decisions must be made regarding whether to conduct interviews or focus groups, to collect data using asynchronous or synchronous methods, and to use only text or incorporate visual media. Researchers should also reflect on human subjects, recruitment, research instrumentation, additional data collection, and public relations considerations when writing protocols to guide the research team’s response to various situations. Our recommendations direct researchers’ reflection on these considerations. PMID:24623662

  15. Recommendations for internet-based qualitative health research with hard-to-reach populations.

    PubMed

    Wilkerson, J Michael; Iantaffi, Alex; Grey, Jeremy A; Bockting, Walter O; Rosser, B R Simon

    2014-04-01

    Researchers new to online qualitative health research frequently have questions about how to transfer knowledge of offline data collection to an online environment. In this article, we present best-practice guidelines derived from the literature and our experience to help researchers determine if an online qualitative study design is appropriate for their research project and, if so, when to begin data collection with a hard-to-reach population. Researchers should reflect on administrative, population, and data collection considerations when deciding between online and offline data collection. Decisions must be made regarding whether to conduct interviews or focus groups, to collect data using asynchronous or synchronous methods, and to use only text or to incorporate visual media. Researchers should also reflect on human subjects, recruitment, research instrumentation, additional data collection, and public relations considerations when writing protocols to guide the research team's response to various situations. Our recommendations direct researchers' reflection on these considerations. PMID:24623662

  16. Identifying Male College Students' Perceived Health Needs, Barriers to Seeking Help, and Recommendations To Help Men Adopt Healthier Lifestyles.

    ERIC Educational Resources Information Center

    Davies, Jon; McCrae, Byron P.; Frank, Joanne; Dochnahl, Annie; Pickering, Tony; Harrison, Brent; Zakrzewski, Mark; Wilson, Kirsten

    2000-01-01

    Information from focus groups identified college males' health concerns, barriers to seeking help, and recommendations to help them adopt healthier lifestyles. Respondents were aware of their health needs, identifying both physical and emotional concerns, but rarely addressed them. Alcohol and substance abuse were the main concerns. Socialization…

  17. Implementation intention and planning interventions in Health Psychology: Recommendations from the Synergy Expert Group for research and practice.

    PubMed

    Hagger, Martin S; Luszczynska, Aleksandra; de Wit, John; Benyamini, Yael; Burkert, Silke; Chamberland, Pier-Eric; Chater, Angel; Dombrowski, Stephan U; van Dongen, Anne; French, David P; Gauchet, Aurelie; Hankonen, Nelli; Karekla, Maria; Kinney, Anita Y; Kwasnicka, Dominika; Hing Lo, Siu; López-Roig, Sofía; Meslot, Carine; Marques, Marta Moreira; Neter, Efrat; Plass, Anne Marie; Potthoff, Sebastian; Rennie, Laura; Scholz, Urte; Stadler, Gertraud; Stolte, Elske; Ten Hoor, Gill; Verhoeven, Aukje; Wagner, Monika; Oettingen, Gabriele; Sheeran, Paschal; Gollwitzer, Peter M

    2016-07-01

    The current article details a position statement and recommendations for future research and practice on planning and implementation intentions in health contexts endorsed by the Synergy Expert Group. The group comprised world-leading researchers in health and social psychology and behavioural medicine who convened to discuss priority issues in planning interventions in health contexts and develop a set of recommendations for future research and practice. The expert group adopted a nominal groups approach and voting system to elicit and structure priority issues in planning interventions and implementation intentions research. Forty-two priority issues identified in initial discussions were further condensed to 18 key issues, including definitions of planning and implementation intentions and 17 priority research areas. Each issue was subjected to voting for consensus among group members and formed the basis of the position statement and recommendations. Specifically, the expert group endorsed statements and recommendations in the following areas: generic definition of planning and specific definition of implementation intentions, recommendations for better testing of mechanisms, guidance on testing the effects of moderators of planning interventions, recommendations on the social aspects of planning interventions, identification of the preconditions that moderate effectiveness of planning interventions and recommendations for research on how people use plans. PMID:26892502

  18. Collective-Intelligence Recommender Systems: Advancing Computer Tailoring for Health Behavior Change Into the 21st Century

    PubMed Central

    Cutrona, Sarah L; Kinney, Rebecca L; Marlin, Benjamin M; Mazor, Kathleen M; Lemon, Stephenie C; Houston, Thomas K

    2016-01-01

    Background What is the next frontier for computer-tailored health communication (CTHC) research? In current CTHC systems, study designers who have expertise in behavioral theory and mapping theory into CTHC systems select the variables and develop the rules that specify how the content should be tailored, based on their knowledge of the targeted population, the literature, and health behavior theories. In collective-intelligence recommender systems (hereafter recommender systems) used by Web 2.0 companies (eg, Netflix and Amazon), machine learning algorithms combine user profiles and continuous feedback ratings of content (from themselves and other users) to empirically tailor content. Augmenting current theory-based CTHC with empirical recommender systems could be evaluated as the next frontier for CTHC. Objective The objective of our study was to uncover barriers and challenges to using recommender systems in health promotion. Methods We conducted a focused literature review, interviewed subject experts (n=8), and synthesized the results. Results We describe (1) limitations of current CTHC systems, (2) advantages of incorporating recommender systems to move CTHC forward, and (3) challenges to incorporating recommender systems into CTHC. Based on the evidence presented, we propose a future research agenda for CTHC systems. Conclusions We promote discussion of ways to move CTHC into the 21st century by incorporation of recommender systems. PMID:26952574

  19. Medical informatics and health care organizations.

    PubMed

    Holden, F M

    1991-01-01

    A dialogue between upper management and operational elements over an organization's informatics policies and procedures could take place in an environment in which both parties could succeed. Excellent patient care practices can exist in organizational settings where upper management is not concerned with the specifics of the medical care process. But as the medical care process itself becomes costly, complex, and part of the purview of upper management, solutions to ambiguous informatics policies and practices need to be found. As the discussion of cost determination suggests, a comprehensive "top-down" solution may not be feasible. Allowing patient care expertise to drive the design and implementation of clinical computing modules without unduly restrictive specifications from above is probably the best way to proceed. But if the organization needs to know the specifics of a treatment episode, then the informatics definitions specific to treatment episodes need to be unambiguous and consistently applied. As the discussion of Social Security numbers suggests, communication of information across various parts of the organization not only requires unambiguous data structure definitions, but also suggests that the communication process not be dependent on the content of the messages. Both ideas--consistent data structure definitions for essential data and open system communication architectures--are current in the medical informatician's vocabulary. The same ideas are relevant to the management and operation of large and diffuse health care enterprises. The lessons we are learning about informatics policy and practice controls in clinical computing need to be applied to the enterprise as a whole. PMID:1921663

  20. Microsporidiosis Acquired Through Solid Organ Transplantation: A Public Health Investigation

    PubMed Central

    Hocevar, Susan N.; Paddock, Christopher D.; Spak, Cedric W.; Rosenblatt, Randall; Diaz-Luna, Hector; Castillo, Isabel; Luna, Sergio; Friedman, Glen C.; Antony, Suresh; Stoddard, Robyn A.; Tiller, Rebekah V.; Peterson, Tammie; Blau, Dianna M.; Sriram, Rama R.; da Silva, Alexandre; de Almeida, Marcos; Benedict, Theresa; Goldsmith, Cynthia S.; Zaki, Sherif R.; Visvesvara, Govinda S.; Kuehnert, Matthew J.

    2015-01-01

    Background Encephalitozoon cuniculi, a microsporidial species most commonly recognized as a cause of renal, respiratory, and central nervous system infections in immunosuppressed patients, was identified as the cause of a temporally associated cluster of febrile illness among 3 solid organ transplant recipients from a common donor. Objective To confirm the source of the illness, assess donor and recipient risk factors, and provide therapy recommendations for ill recipients. Design Public health investigation. Setting Two transplant hospitals and community interview with the deceased donor’s family. Patients Three transplant recipients and the organ donor. Measurements Specimens were tested for microsporidia by using culture, immunofluorescent antibody, polymerase chain reaction, immunohistochemistry, and electron microscopy. Donor medical records were reviewed and a questionnaire was developed to assess for microsporidial infection. Results Kidneys and lungs were procured from the deceased donor and transplanted to 3 recipients who became ill with fever 7 to 10 weeks after the transplant. Results of urine culture, serologic, and polymerase chain reaction testing were positive for Encephalitozoon cuniculi of genotype III in each recipient; the organism was also identified in biopsy or autopsy specimens in all recipients. The donor had positive serologic test results for Encephalitozoon cuniculi. Surviving recipients received albendazole. Donor assessment did not identify factors for suspected Encephalitozoon cuniculi infection. Limitation Inability to detect organism by culture or polymerase chain reaction in donor due to lack of autopsy specimens. Conclusion Transmission of microsporidiosis through organ transplantation is described. Microsporidiosis is now recognized as an emerging transplant-associated disease and should be considered in febrile transplant recipients when tests for routinely encountered agents are unrevealing. Donor-derived disease is critical

  1. Metal-Organic Frameworks: Literature Survey and Recommendation of Potential Sorbent Materials

    SciTech Connect

    Baumann, T F

    2010-04-29

    Metal-organic frameworks (MOFs) are a special type of porous material with a number of unique properties, including exceptionally high surface areas, large internal pore volumes (void space) and tunable pore sizes. These materials are prepared through the assembly of molecular building blocks into ordered three-dimensional structures. The bulk properties of the MOF are determined by the nature of the building blocks and, as such, these materials can be designed with special characteristics that cannot be realized in other sorbent materials, like activated carbons. For example, MOFs can be constructed with binding sites or pockets that can exhibit selectivity for specific analytes. Alternatively, the framework can be engineered to undergo reversible dimensional changes (or 'breathing') upon interaction with an analyte, effectively trapping the molecule of interest in the lattice structure. In this report, we have surveyed the 4000 different MOF structures reported in the open literature and provided recommendations for specific MOF materials that should be investigated as sorbents for this project.

  2. Staff Report to the Senior Department Official on Recognition Compliance Issues. Recommendation Page: Council on Education for Public Health

    ERIC Educational Resources Information Center

    US Department of Education, 2010

    2010-01-01

    Between 1945-1973, the American Public Health Association (APHA), a membership organization for public professionals, accredited graduate programs in public health. In 1974, the APHA and the Association of Schools of Public Health (ASPH), a national association representing deans, faculty, and students of accredited schools of public health,…

  3. [Toward a new organization of public health services in Spain. 2008 SESPAS Report].

    PubMed

    Artundo Purroy, Carlos; Rivadeneyra Sicilia, Ana

    2008-04-01

    Public health in Spain shows significant weaknesses. Spanish public health services respond reasonably well in crisis situations but tend to be invisible and occupy a marginal position in political agendas and in relation to health services. The organization of the public health subsystem is clearly out of date in terms of its ability to promote and protect community health, to prevent diseases, and to cope effectively with the new public health threats and challenges related to the physical and social environment in today's globalized world. Consequently, there is broad consensus on the need to rethink functions, strategies and the organization of public health in Spain, in line with European and international trends. Thus, public health reform is currently a pending challenge and a strategic priority. Indeed, some Autonomous Communities have initiated a process of modernization and change. Empowerment of public health in the political agendas and in relation to the health services is strongly recommended by promoting intersectorial approaches, the Health in All Policies strategy and Health Impact Assessment. There is also a need for a specific law that would update public health functions, organization and structures, allocate competencies by facilitating alliances and partnership, and regulate coordination and intersectorial intervention. The following key elements related to this reform are described: 1) a participatory leadership in public health; 2) the generation of intelligence and evidence in public health; 3) improvement of professional education and development; 4) the importance of transparent, independent and competent performance and communication, and 5) new and flexible organization coherent with the new strategies and close to the local level and primary health care services. Coordination between the State and the Autonomous Communities should involved a functional and intelligent relationship by building up common spaces, alliances, networks and

  4. Bioassay procedures and health physics recommendations for a promethium-147 luminescent dial painting industry

    SciTech Connect

    Dunlap, J.H.

    1981-01-01

    A study was conducted to determine the hazard to workers who were applying a radioactive luminescent paint to devices such as clock dials and hands, signs, etc. The paint used was a mixture of macrospheres containing /sup 147/Pm, ZnS, and a binder. It was applied by workers either manually or by machine. This study was designed to determine the radiological safety of these operations. The potential routes of intake of /sup 147/Pm by workers were identified as inhalation and ingestion. Air samples were taken at work stations; total and respirable-sized /sup 147/Pm particles were measured. Both were shown to be at a safe level. An animal inhalation study was conducted to determine deposition of respirable-sized /sup 147/Pm particles. Testing by a bioassay procedure developed specifically for this purpose revealed low levels of deposited activity in the respiratory systems of these animals. A health physics evaluation of the dial painting facility firm and operation revealed that extensive improvements in engineering controls and worker protection were needed. The health physics recommendations made, as a result, should be adopted as a minimum for maximization of long term benefits to both the employee and the employer.

  5. A flood of health functional foods: what is to be recommended?

    PubMed

    Lee, Eun Sil

    2015-04-01

    Health functional food is referred to a food prepared or processed from specific components or ingredients for functionality beneficial to the body through extraction, concentration, purification, blending and other methods. The demand for health functional foods is steadily increasing, and red ginseng is the most demanded food among women in the 50s, followed by multivitamin, omega-3, glucosamine and aloe. To date, there is insufficient evidence on the effect of red ginseng on exercise capacity, somatic symptom and cognitive performance in healthy individuals. Moreover, evidence is insufficient that a nutritional dose of vitamin or mineral reduces the incidence of cardiovascular disease and cancer, or mortality rate. A steady intake of oily fish is recommended to prevent the incidence of cardiovascular disease for postmenopausal women. Consumption of omega-3 fatty acids is expected to prevent cardiovascular disease in postmenopausal women with almost no intake of oily fish and those not taking statins. It still remains controversial whether glucosamine is effective in the treatment of osteoarthritis. Hence, physicians should fully inform patients with all controversial information about the effectiveness of glucosamine when prescribing glucosamine for patients with osteoarthritis. PMID:26046032

  6. Authorship in Global Mental Health Research: Recommendations for Collaborative Approaches to Writing and Publishing

    PubMed Central

    Kohrt, Brandon A.; Upadhaya, Nawaraj; Luitel, Nagendra P.; Maharjan, Sujen M.; Kaiser, Bonnie N.; MacFarlane, Elizabeth K.; Khan, Noreen

    2014-01-01

    Background Collaborations among researchers, clinicians, and individuals with mental illness from high-income countries (HICs) and low- and middle-income countries (LMICs) are crucial to produce research, interventions, and policies that are relevant, feasible, and ethical. However, global mental health and cultural psychiatry research publications have been dominated by HIC investigators. Objective The aim of this review was to present recommendations for collaborative writing with a focus on early career researchers in HICs and LMICs. Methods A workshop was conducted with HIC and LMIC investigators in Nepal to discuss lessons learned for collaborative writing. The researchers had experience in cross-cultural psychiatric epidemiology, health services research, randomized controlled trials, and projects with war and disaster-affected populations in complex humanitarian emergencies including child soldiers and refugees. Additional lessons learned were contributed from researchers engaged in similar collaborations in Haiti. Findings A step-by-step process for collaborative writing was developed. Conclusions HIC and LMIC writing collaborations will encourage accurate, ethical, and contextually grounded publications to foster understanding and facilitate reduction of the global burden of mental illness. PMID:24976552

  7. Carbon financing of household water treatment: background, operation and recommendations to improve potential for health gains.

    PubMed

    Hodge, James M; Clasen, Thomas F

    2014-11-01

    Household water treatment (HWT) provides a means for vulnerable populations to take charge of their own drinking water quality as they patiently wait for the pipe to finally reach them. In many low-income countries, however, promoters have not succeeded in scaling up the intervention among the target population or securing its consistent and sustained use. Carbon financing can provide the funding for reaching targeted populations with effective HWT solutions and the incentives to ensure their long-term uptake. Nevertheless, programs have been criticized because they do not actually reduce carbon emissions. We summarize the background and operation of carbon financing of HWT interventions, including the controversial construct of "suppressed demand". We agree that these programs have limited potential to reduce greenhouse gas emissions and that their characterization of trading "carbon for water" is misleading. Nevertheless, we show that the Kyoto Protocol expressly encouraged the use of suppressed demand as a means of allowing low-income countries to benefit from carbon financing provided it is used to advance development priorities such as health. We conclude by recommending changes to existing criteria for eligible HWT programs that will help ensure that they meet the conditions of microbiological effectiveness and actual use that will improve their potential for health gains. PMID:25314642

  8. Flavanols and vascular health: molecular mechanisms to build evidence-based recommendations.

    PubMed

    Fraga, Cesar G; Oteiza, Patricia

    2014-10-01

    Observational studies as well as public awareness and ancient medicine identify tea, wine and cocoa as healthy foods. Further compilations of epidemiological data reinforce the healthy properties of the grape, tea and cocoa derived foods and drinks made from, especially when considering cardiovascular disease, some cancers and other inflammation-related pathologies. Flavanols have emerged as bioactives responsible for such health effects, and flavanol-rich foods have been used in clinical studies. Results of these studies show a major participation of flavanols in mechanisms positively affecting endpoints of cardiovascular disease, i.e. hypertension and vascular function. In line, based on the chemistry (bioavailability and molecular structure of flavanol and target entities) several physiological mechanisms have been described backing the epidemiological and clinical studies. In summary, the discussion for defining evidence-based recommendations for flavanols is based on: a) the extensive research done and the positive results obtained support the incorporation of flavanol-rich foods as part of a healthy diet, this is a cost-effective action to ameliorate silent undesirable conditions as it is chronic inflammation; b) the fact that cardiovascular health seems especially sensitive to the beneficial effects of flavanols: based on clinical and mechanistic studies showing that certain flavanols, favor NO production; and c) the increasing technical possibilities to evaluate flavanols in foods and biological samples. Supported by UBACyT 20020120100177, CONICET PIP-20110100752, and ANPCyT PICT 2012/0765. PMID:26461285

  9. The Effects of Bikram Yoga on Health: Critical Review and Clinical Trial Recommendations

    PubMed Central

    Hewett, Zoe L.; Cheema, Birinder S.; Pumpa, Kate L.; Smith, Caroline A.

    2015-01-01

    Bikram yoga is a style of hatha yoga involving a standarized series of asanas performed to an instructional dialogue in a heated environment (40.6°C, 40% humidity). Several studies evaluating the effect of Bikram yoga on health-related outcomes have been published over the past decade. However, to date, there are no comprehensive reviews of this research and there remains a lack of large-scale, robustly-designed randomised controlled trials (RCT) of Bikram yoga training. The purpose of this review is to contextualise and summarise trials that have evaluated the effects of Bikram yoga on health and to provide recommendations for future research. According to published literature, Bikram yoga has been shown to improve lower body strength, lower and upper body range of motion, and balance in healthy adults. Non-RCTs report that Bikram yoga may, in some populations, improve glucose tolerance, bone mineral density, blood lipid profile, arterial stiffness, mindfulness, and perceived stress. There is vast potential for further, improved research into the effects of Bikram yoga, particularly in unhealthy populations, to better understand intervention-related adaptations and their influence on the progression of chronic disease. Future research should adhere to CONSORT guidelines for better design and reporting to improve research quality in this field. PMID:26504475

  10. Health effects of electric and magnetic fields: Overview of research recommendations

    SciTech Connect

    Savitz, D.A.

    1993-12-01

    We developed a series of articles concerning epidemiologic research on potential health effects of electric and magnetic fields. Our goal was to identify methodological issues that have arisen through past studies of cancer, reproduction, and neurobehavioral outcomes in order to suggest strategies to extend knowledge. Following an overview of relevant physics and engineering principles, cancer epidemiology of electric and magnetic fields is discussed separately with a focus on epidemiologic methods and cancer biology, respectively. Reproductive health studies, many of which focus on exposure from video display terminals are then summarized, followed by an evaluation of the limited literature on neurobehavioral outcomes, including suicide and depression. Methodological issues in exposure assessment are discussed, focusing on the challenges in residential exposure assessment and interpretation of wire configuration codes. An overview offers recommendations for priorities across these topic areas, emphasizing the importance of resolving the question of wire codes and childhood cancer. Collectively, these articles provide an array of observations and suggestions regarding the epidemiologic literature, recognizing the potential benefits to science and public policy. 10 refs.

  11. The Effects of Bikram Yoga on Health: Critical Review and Clinical Trial Recommendations.

    PubMed

    Hewett, Zoe L; Cheema, Birinder S; Pumpa, Kate L; Smith, Caroline A

    2015-01-01

    Bikram yoga is a style of hatha yoga involving a standarized series of asanas performed to an instructional dialogue in a heated environment (40.6°C, 40% humidity). Several studies evaluating the effect of Bikram yoga on health-related outcomes have been published over the past decade. However, to date, there are no comprehensive reviews of this research and there remains a lack of large-scale, robustly-designed randomised controlled trials (RCT) of Bikram yoga training. The purpose of this review is to contextualise and summarise trials that have evaluated the effects of Bikram yoga on health and to provide recommendations for future research. According to published literature, Bikram yoga has been shown to improve lower body strength, lower and upper body range of motion, and balance in healthy adults. Non-RCTs report that Bikram yoga may, in some populations, improve glucose tolerance, bone mineral density, blood lipid profile, arterial stiffness, mindfulness, and perceived stress. There is vast potential for further, improved research into the effects of Bikram yoga, particularly in unhealthy populations, to better understand intervention-related adaptations and their influence on the progression of chronic disease. Future research should adhere to CONSORT guidelines for better design and reporting to improve research quality in this field. PMID:26504475

  12. Review of refugee mental health interventions following resettlement: best practices and recommendations.

    PubMed

    Murray, Kate E; Davidson, Graham R; Schweitzer, Robert D

    2010-10-01

    There are increasing numbers of refugees worldwide, with approximately 16 million refugees in 2007 and over 2.5 million refugees resettled in the United States since the start of its humanitarian program. Psychologists and other health professionals who deliver mental health services for individuals from refugee backgrounds need to have confidence that the therapeutic interventions they employ are appropriate and effective for the clients with whom they work. The current review briefly surveys refugee research, examines empirical evaluations of therapeutic interventions in resettlement contexts, and provides recommendations for best practices and future directions in resettlement countries. The resettlement interventions found to be most effective typically target culturally homogeneous client samples and demonstrate moderate to large outcome effects on aspects of traumatic stress and anxiety reduction. Further evaluations of the array of psychotherapeutic, psychosocial, pharmacological, and other therapeutic approaches, including psychoeducational and community-based interventions that facilitate personal and community growth and change, are encouraged. There is a need for increased awareness, training and funding to implement longitudinal interventions that work collaboratively with clients from refugee backgrounds through the stages of resettlement. PMID:20950298

  13. The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations.

    PubMed

    Fazel, Seena; Geddes, John R; Kushel, Margot

    2014-10-25

    In the European Union, more than 400,000 individuals are homeless on any one night and more than 600,000 are homeless in the USA. The causes of homelessness are an interaction between individual and structural factors. Individual factors include poverty, family problems, and mental health and substance misuse problems. The availability of low-cost housing is thought to be the most important structural determinant for homelessness. Homeless people have higher rates of premature mortality than the rest of the population, especially from suicide and unintentional injuries, and an increased prevalence of a range of infectious diseases, mental disorders, and substance misuse. High rates of non-communicable diseases have also been described with evidence of accelerated ageing. Although engagement with health services and adherence to treatments is often compromised, homeless people typically attend the emergency department more often than non-homeless people. We discuss several recommendations to improve the surveillance of morbidity and mortality in homeless people. Programmes focused on high-risk groups, such as individuals leaving prisons, psychiatric hospitals, and the child welfare system, and the introduction of national and state-wide plans that target homeless people are likely to improve outcomes. PMID:25390578

  14. The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations

    PubMed Central

    Fazel, Seena; Geddes, John R; Kushel, Margot

    2015-01-01

    In the European Union, more than 400 000 individuals are homeless on any one night and more than 600 000 are homeless in the USA. The causes of homelessness are an interaction between individual and structural factors. Individual factors include poverty, family problems, and mental health and substance misuse problems. The availability of low-cost housing is thought to be the most important structural determinant for homelessness. Homeless people have higher rates of premature mortality than the rest of the population, especially from suicide and unintentional injuries, and an increased prevalence of a range of infectious diseases, mental disorders, and substance misuse. High rates of non-communicable diseases have also been described with evidence of accelerated ageing. Although engagement with health services and adherence to treatments is often compromised, homeless people typically attend the emergency department more often than non-homeless people. We discuss several recommendations to improve the surveillance of morbidity and mortality in homeless people. Programmes focused on high-risk groups, such as individuals leaving prisons, psychiatric hospitals, and the child welfare system, and the introduction of national and state-wide plans that target homeless people are likely to improve outcomes. PMID:25390578

  15. Health systems organization for emergency care.

    PubMed

    Pedroto, Isabel; Amaro, Pedro; Romãozinho, José Manuel

    2013-10-01

    The increasing number of acute and severe digestive diseases presenting to hospital emergency departments, mainly related with an ageing population, demands an appropriate answer from health systems organization, taking into account the escalating pressure on cost reduction. However, patients expect and deserve a response that is appropriate, effective, efficient and safe. The huge variety of variables which can influence the evolution of such cases warranting intensive monitoring, and the coordination and optimization of a range of human and technical resources involved in the care of these high-risk patients, requires their admission in hospital units with conveniently equipped facilities, as is done for heart attack and stroke patients. Little information of gastroenterology emergencies as a function of structure, processes and outcome is available at the organizational level. Surveys that have been conducted in different countries just assess local treatment outcome and question the organizational structure and existing resources but its impact on the outcome is not clear. Most studies address the problem of upper gastrointestinal bleeding and the out-of-hours endoscopy services in the hospital setting. The demands placed on emergency (part of the overall continuum of care) are obvious, as are the needs for the efficient use of resources and processes to improve the quality of care, meaning data must cover the full care cycle. Gastrointestinal emergencies, namely gastrointestinal bleeding, must be incorporated into the overall emergency response as is done for heart attack and stroke. This chapter aims to provide a review of current literature/evidence on organizational health system models towards a better management of gastroenterology emergencies and proposes a research agenda. PMID:24160936

  16. Incorporating immunizations into routine obstetric care to facilitate Health Care Practitioners in implementing maternal immunization recommendations

    PubMed Central

    Webb, Heather; Street, Jackie; Marshall, Helen

    2014-01-01

    Immunization against pertussis, influenza, and rubella reduces morbidity and mortality in pregnant women and their offspring. Health care professionals (HCPs) caring for women perinatally are uniquely placed to reduce maternal vaccine preventable diseases (VPDs). Despite guidelines recommending immunization during the perinatal period, maternal vaccine uptake remains low. This qualitative study explored the role of obstetricians, general practitioners, and midwives in maternal vaccine uptake. Semi-structured interviews (n = 15) were conducted with perinatal HCPs at a tertiary maternity hospital in South Australia. HCPs were asked to reflect on their knowledge, beliefs, and practice relating to immunization advice and vaccine provision. Interviews were transcribed and coded using thematic analysis. Data collection and analysis was an iterative process, with collection ceasing with theoretical saturation. Participants unanimously supported maternal vaccination as an effective way of reducing risk of disease in this vulnerable population, however only rubella immunity detection and immunization is embedded in routine care. Among these professionals, delegation of responsibility for maternal immunization was unclear and knowledge about maternal immunization was variable. Influenza and pertussis vaccine prevention measures were not included in standard pregnancy record documentation, information provision to patients was “ad hoc” and vaccinations not offered on-site. The key finding was that the incorporation of maternal vaccinations into standard care through a structured process is an important facilitator for immunization uptake. Incorporating vaccine preventable disease management measures into routine obstetric care including incorporation into the Pregnancy Record would facilitate HCPs in implementing recommendations. Rubella prevention provides a useful “template” for other vaccines. PMID:24509790

  17. Public health departments and accountable care organizations: finding common ground in population health.

    PubMed

    Ingram, Richard; Scutchfield, F Douglas; Costich, Julia F

    2015-05-01

    We examined areas of potential collaboration between accountable care organizations and public health agencies, as well as perceived barriers and facilitators. We interviewed 9 key informants on 4 topics: advantages of public health agency involvement in accountable care organizations; services public health agencies could provide; practical, cultural, and legal barriers to accountable care organization-public health agency involvement; and business models that facilitate accountable care organization-public health agency collaboration. Public health agencies could help accountable care organizations partner with community organizations and reach vulnerable patients, provide population-based services and surveillance data, and promote policies that improve member health. Barriers include accountable care organizations' need for short-term financial yield, limited public health agency technical and financial capacity, and the absence of a financial model. PMID:25790392

  18. Health Care System Measures to Advance Preconception Wellness: Consensus Recommendations of the Clinical Workgroup of the National Preconception Health and Health Care Initiative.

    PubMed

    Frayne, Daniel J; Verbiest, Sarah; Chelmow, David; Clarke, Heather; Dunlop, Anne; Hosmer, Jennifer; Menard, M Kathryn; Moos, Merry-K; Ramos, Diana; Stuebe, Alison; Zephyrin, Laurie

    2016-05-01

    Preconception wellness reflects a woman's overall health before conception as a strategy to affect health outcomes for the woman, the fetus, and the infant. Preconception wellness is challenging to measure because it attempts to capture health status before a pregnancy, which may be affected by many different service points within a health care system. The Clinical Workgroup of the National Preconception Health and Health Care Initiative proposes nine core measures that can be assessed at initiation of prenatal care to index a woman's preconception wellness. A two-stage web-based modified Delphi survey and a face-to-face meeting of key opinion leaders in women's reproductive health resulted in identifying seven criteria used to determine the core measures. The Workgroup reached unanimous agreement on an aggregate of nine preconception wellness measures to serve as a surrogate but feasible assessment of quality preconception care within the larger health community. These include indicators for: 1) pregnancy intention, 2) access to care, 3) preconception multivitamin with folic acid use, 4) tobacco avoidance, 5) absence of uncontrolled depression, 6) healthy weight, 7) absence of sexually transmitted infections, 8) optimal glycemic control in women with pregestational diabetes, and 9) teratogenic medication avoidance. The focus of the proposed measures is to quantify the effect of health care systems on advancing preconception wellness. The Workgroup recommends that health care systems adopt these nine preconception wellness measures as a metric to monitor performance of preconception care practice. Over time, monitoring these baseline measures will establish benchmarks and allow for comparison within and among regions, health care systems, and communities to drive improvements. PMID:27054935

  19. Sampling protocol recommendations for measuring soil organic carbon stocks in the tropics

    NASA Astrophysics Data System (ADS)

    van Straaten, Oliver; Veldkamp, Edzo; Corre, Marife D.

    2013-04-01

    In the tropics, there is an urgent need for cost effective sampling approaches to quantify soil organic carbon (SOC) changes associated with land-use change given the lack of reliable data. The tropics are especially important considering the high deforestation rates, the huge belowground carbon pool and the fast soil carbon turnover rates. In the framework of a pan-tropic (Peru, Cameroon and Indonesia) land-use change study, some highly relevant recommendations on the SOC stocks sampling approaches have emerged. In this study, where we focused on deeply weathered mineral soils, we quantified changes in SOC stock following land-use change (deforestation and subsequent establishment of other land-uses). We used a space-for-time substitution sampling approach, measured SOC stocks in the top three meters of soil and compared recently converted land-uses with adjacent reference forest plots. In each respective region we investigated the most predominant land-use trajectories. In total 157 plots were established across the three countries, where soil samples were taken to a depth of three meters from a central soil pit and from the topsoil (to 0.5m) from 12 pooled composite samples. Finding 1 - soil depth: despite the fact that the majority of SOC stock from the three meter profile is found below one meter depth (50 to 60 percent of total SOC stock), the significant changes in SOC were only measured in the top meter of soil, while the subsoil carbon stock remained relatively unchanged by the land-use conversion. The only exception was for older (>50 yrs) cacao plantations in Cameroon where significant decreases were found below one meter. Finding 2 - pooled composite samples taken across the plot provided more spatially representative estimates of SOC stocks than samples taken from the central soil pit.

  20. Recommendations of the International Medical Informatics Association (IMIA) on Education in Biomedical and Health Informatics. First Revision.

    PubMed

    Mantas, John; Ammenwerth, Elske; Demiris, George; Hasman, Arie; Haux, Reinhold; Hersh, William; Hovenga, Evelyn; Lun, K C; Marin, Heimar; Martin-Sanchez, Fernando; Wright, Graham

    2010-01-01

    Objective: The International Medical Informatics Association (IMIA) agreed on revising the existing international recommendations in health informatics/medical informatics education. These should help to establish courses, course tracks or even complete programs in this field, to further develop existing educational activities in the various nations and to support international initiatives concerning education in biomedical and health informatics (BMHI), particularly international activities in educating BMHI specialists and the sharing of courseware. Method: An IMIA task force, nominated in 2006, worked on updating the recommendations' first version. These updates have been broadly discussed and refined by members of IMIA's National Member Societies, IMIA's Academic Institutional Members and by members of IMIA's Working Group on Health and Medical Informatics Education. Results and Conclusions: The IMIA recommendations center on educational needs for health care professionals to acquire knowledge and skills in information processing and information and communication technology. The educational needs are described as a three-dimensional framework. The dimensions are: 1) professionals in health care (e.g. physicians, nurses, BMHI professionals), 2) type of specialization in BMHI (IT users, BMHI specialists), and 3) stage of career progression (bachelor, master, doctorate). Learning outcomes are defined in terms of knowledge and practical skills for health care professionals in their role a) as IT user and b) as BMHI specialist. Recommendations are given for courses/course tracks in BMHI as part of educational programs in medicine, nursing, health care management, dentistry, pharmacy, public health, health record administration, and informatics/computer science as well as for dedicated programs in BMHI (with bachelor, master or doctor degree). To support education in BMHI, IMIA offers to award a certificate for high-quality BMHI education. It supports information

  1. Advanced Dental Education: Recommendations for the 80's. Issues in Dental Health Policy.

    ERIC Educational Resources Information Center

    American Association of Dental Schools, Washington, DC.

    Six statements of working principles and 11 major recommendations falling within those areas, as established by the Task Force on Advanced Dental Education, are presented. Supporting recommendations are also provided. The six principles include: (1) no change is recommended in the present goal of predoctoral education, to prepare students for…

  2. Updated CDC recommendations for the management of hepatitis B virus-infected health-care providers and students.

    PubMed

    2012-07-01

    This report updates the 1991 CDC recommendations for the management of hepatitis B virus (HBV)-infected health-care providers and students to reduce risk for transmitting HBV to patients during the conduct of exposure-prone invasive procedures (CDC. Recommendations for preventing transmission of human immunodeficiency virus and hepatitis B virus to patients during exposure-prone invasive procedures. MMWR 1991;40[No. RR-8]). This update reflects changes in the epidemiology of HBV infection in the United States and advances in the medical management of chronic HBV infection and policy directives issued by health authorities since 1991. The primary goal of this report is to promote patient safety while providing risk management and practice guidance to HBV-infected health-care providers and students, particularly those performing exposure-prone procedures such as certain types of surgery. Because percutaneous injuries sustained by health-care personnel during certain surgical, obstetrical, and dental procedures provide a potential route of HBV transmission to patients as well as providers, this report emphasizes prevention of operator injuries and blood exposures during exposure-prone surgical, obstetrical, and dental procedures. These updated recommendations reaffirm the 1991 CDC recommendation that HBV infection alone should not disqualify infected persons from the practice or study of surgery, dentistry, medicine, or allied health fields. The previous recommendations have been updated to include the following changes: no prenotification of patients of a health-care provider's or student's HBV status; use of HBV DNA serum levels rather than hepatitis B e-antigen status to monitor infectivity; and, for those health-care professionals requiring oversight, specific suggestions for composition of expert review panels and threshold value of serum HBV DNA considered "safe" for practice (<1,000 IU/ml). These recommendations also explicitly address the issue of medical and

  3. Maternal perceptions of social context and adherence to maternal and child health (MCH) clinic recommendations among marginalized Bedouin mothers.

    PubMed

    Daoud, Nihaya; Shoham-Vardi, Ilana

    2015-03-01

    National maternal and child health (MCH) care systems often deliver universal health care recommendations that do not take into consideration the social context of infant care (IC) for marginalized groups. We examined associations between maternal perceptions of social context (MPSC) and adherence by minority Bedouin mothers in Israel to three commonly recommended IC practices. We conducted personal interviews with 464 mothers visiting 14 MCH clinics using a structured questionnaire based on findings from a previous focus-group study, and guided by constructs of the Health Beliefs Model. Items were tested for validity and reliability. We used multivariate analysis to identify MPSC constructs associated with adherence to MCH clinic recommendations (timely postnatal first visit, sustaining breastfeeding, and use of infant car seat). Social context, when perceived as a barrier to IC, was negatively associated with adherence to timely first postnatal MCH clinic visit (odds ratio, 95 %, confidence intervals (OR 1.45, 95 % CI 1.24, 1.70) and use of infant car seat (OR 1.43, 95 % CI 1.21, 1.69). However, social context was positively associated with sustained breastfeeding (OR 0.54, 95 % CI 0.37, 0.79). Perceptions of the severity of infant health problems, and family financial and relationship problems had less significant associations with adherence to MCH clinic recommendations. Adherence by marginalized mothers to MCH clinic recommendations is related to their perceptions of social context. When there are higher financial and other living conditions barriers mothers tend toward lower adherence to these recommendations. MCH policy makers and service providers must consider MPSC in planning and delivery of MCH recommendations. PMID:24927786

  4. Competition between health maintenance organizations and nonintegrated health insurance companies in health insurance markets.

    PubMed

    Baranes, Edmond; Bardey, David

    2015-12-01

    This article examines a model of competition between two types of health insurer: Health Maintenance Organizations (HMOs) and nonintegrated insurers. HMOs vertically integrate health care providers and pay them at a competitive price, while nonintegrated health insurers work as indemnity plans and pay the health care providers freely chosen by policyholders at a wholesale price. Such difference is referred to as an input price effect which, at first glance, favors HMOs. Moreover, we assume that policyholders place a positive value on the provider diversity supplied by their health insurance plan and that this value increases with the probability of disease. Due to the restricted choice of health care providers in HMOs a risk segmentation occurs: policyholders who choose nonintegrated health insurers are characterized by higher risk, which also tends to favor HMOs. Our equilibrium analysis reveals that the equilibrium allocation only depends on the number of HMOs in the case of exclusivity contracts between HMOs and providers. Surprisingly, our model shows that the interplay between risk segmentation and input price effects may generate ambiguous results. More precisely, we reveal that vertical integration in health insurance markets may decrease health insurers' premiums. PMID:26608954

  5. Organization and evaluation of health fairs.

    PubMed

    Germer, P; Price, J H

    1981-02-01

    In summary, the success of a health fair as a source of health education and promoter of healthful behaviors depends to a great extent upon the organizational expertise of the sponsor and cooperating forces. However, even more essential is the stimulation of health fair visitors' interest and participation, the provision of information and health status feedback and the reinforcement of positive health values. The health fair which best achieves these objectives will have a greater likelihood of also attaining its original preventive health goals and objectives. Although evaluation articles tend to stress the positive findings, this review does not imply that every health fair is a success or that every successful health fair is without criticism. Long waiting lines, unexpected equipment malfunctions, inadequate hours for visiting, understaffed activities, limited floor space and/or visual distractions and noise disturbances may still occur despite the most thorough organizational efforts. This review has attempted to synthesize from the existing sources on health fairs those essential organizational and evaluative factors necessary for a health fair to maximize its potential health education impact. PMID:6907548

  6. Volatile Organic Compunds (Environmental Health Student Portal)

    MedlinePlus

    ... Gases Impact on Weather Health Effects Take Action Water Pollution Water Pollution Home Chemicals and Pollutants Natural Disasters Drinking Water ... Gases Impact on Weather Health Effects Take Action Water Pollution Water Pollution Home Chemicals and Pollutants Natural Disasters ...

  7. Copy, paste, and cloned notes in electronic health records: prevalence, benefits, risks, and best practice recommendations.

    PubMed

    Weis, Justin M; Levy, Paul C

    2014-03-01

    The modern medical record is not only used by providers to record nuances of patient care, but also is a document that must withstand the scrutiny of insurance payers and legal review. Medical documentation has evolved with the rapid growth in the use of electronic health records (EHRs). The medical software industry has created new tools and more efficient ways to document patient care encounters and record results of diagnostic testing. While these techniques have resulted in efficiencies and improvements in patient care and provider documentation, they have also created a host of new problems, including authorship attribution, data integrity, and regulatory concerns over the accuracy and medical necessity of billed services. Policies to guide provider documentation in EHRs have been developed by institutions and payers with the goal of reducing patient care risks as well as preventing fraud and abuse. In this article, we describe the major content-importing technologies that are commonly used in EHR documentation as well as the benefits and risks associated with their use. We have also reviewed a number of institutional policies and offer some best practice recommendations. PMID:24590024

  8. Health technology assessment in middle-income countries: recommendations for a balanced assessment system

    PubMed Central

    Dankó, Dávid

    2014-01-01

    Because of significant differences in institutional contexts, health technology assessment (HTA) systems that are in place in core pharmaceutical markets may not be suitable, fully or in part, for middle-income countries (MICs) and for other noncore markets. Particular challenges may arise when systems based on the economic evaluation paradigm are conceptualized and implemented in MICs, sometimes with an insufficient level of awareness of the local institutional factors that influence pricing and reimbursement decision making. Focusing on pharmaceuticals, this article investigates possible development directions for HTA systems in MICs and noncore markets bearing similar institutional characteristics, and it provides recommendations for a balanced assessment system (BAS). For this, the main paradigms of HTA have also been reviewed briefly and factors influencing HTA and pricing and reimbursement decisions in MICs and in similar noncore countries have been summarized. The proposed BAS framework takes into account available resources and capabilities and is supposed to facilitate access to new pharmaceuticals while ensuring the transparency of decision-making processes and the stability of the pharmaceutical budget. PMID:27226832

  9. Increasing access to care for cultural and linguistic minorities: ethnicity-specific health care organizations and infrastructure.

    PubMed

    Yang, Joshua S; Kagawa-Singer, Marjorie

    2007-08-01

    Racial and ethnic disparities in health care have been attributed in part to cultural and linguistic dissonance between certain patient populations and the health care system. Yet in the long term, structural solutions for ameliorating health care disparities have not been forthcoming. One strategy for increasing access to care for cultural and linguistic minorities is ethnicity-specific subsystems of care. The historical experiences of the Chinese community in San Francisco are used to reconstruct the evolution of its ethnicity-specific health care infrastructure and to create an organizational development model for ethnicity-specific health care organizations and infrastructures. The four stages of the model include developing and recruiting a bicultural and bilingual health care workforce, structuring health care resources for maximum accessibility, expanding health care organizations, and integrating ethnicity-specific health care resources into the mainstream health care system. Policy recommendations to develop ethnicity-specific subsystems of care are presented. PMID:17675712

  10. Do youth in out-of-home care receive recommended mental health and educational services following screening evaluations?

    PubMed

    Petrenko, Christie L M; Culhane, Sara E; Garrido, Edward F; Taussig, Heather N

    2011-10-01

    For children in out-of-home care, a significant gap exists between those who need services and those who receive them. Screening all children in out-of-home care is recommended to reduce this gap. This study was designed to determine if recommendations from mental health and educational screening evaluations were related to service implementation for youth in out-of-home care. Screening evaluations were completed with 171 maltreated youth (ages 9 to 11) in out-of-home care within the prior year. Written reports summarizing the findings were provided to children's caseworkers. Service utilization was assessed at baseline (T1; before screening reports were completed) and follow-up (T2; 9-12 months later) interviews. For children not already receiving services at T1, logistic regression analyses tested the association between T1 recommendations for services and new service implementation by T2. Mental health (youth-report) and educational (teacher-report) outcomes were analyzed separately. Screening evaluations identified 22% of children with unmet mental health needs and 36% with unmet educational needs at T1. Children who received a recommendation for new services (i.e., all of those with unmet needs) were more likely to receive mental health (OR=2.50, p=.06) and/or educational (OR=3.54, p=.04) services by T2 than children who did not receive recommendations for services. While recommendations increased the odds of receiving services, almost half of the children with unmet mental health needs did not receive services, and 84% of children with unmet educational needs did not receive services by T2. Much work remains to ensure youth receive needed services. PMID:21912444

  11. Do youth in out-of-home care receive recommended mental health and educational services following screening evaluations?

    PubMed Central

    Petrenko, Christie L. M.; Culhane, Sara E.; Garrido, Edward F.; Taussig, Heather N.

    2011-01-01

    For children in out-of-home care, a significant gap exists between those who need services and those who receive them. Screening all children in out-of-home care is recommended to reduce this gap. This study was designed to determine if recommendations from mental health and educational screening evaluations were related to service implementation for youth in out-of-home care. Screening evaluations were completed with 171 maltreated youth (ages 9 to 11) in out-of-home care within the prior year. Written reports summarizing the findings were provided to children's caseworkers. Service utilization was assessed at baseline (T1; before screening reports were completed) and follow-up (T2; 9-12 months later) interviews. For children not already receiving services at T1, logistic regression analyses tested the association between T1 recommendations for services and new service implementation by T2. Mental health (youth-report) and educational (teacher-report) outcomes were analyzed separately. Screening evaluations identified 22% of children with unmet mental health needs and 36% with unmet educational needs at T1. Children who received a recommendation for new services (i.e., all of those with unmet needs) were more likely to receive mental health (OR=2.50, p=.06) and/or educational (OR=3.54, p=.04) services by T2 than children who did not receive recommendations for services. While recommendations increased the odds of receiving services, almost half of the children with unmet mental health needs did not receive services, and 84% of children with unmet educational needs did not receive services by T2. Much work remains to ensure youth receive needed services. PMID:21912444

  12. Communicating in Multicultural Health Care Organizations.

    ERIC Educational Resources Information Center

    Kreps, Gary L.; Kunimoto, Elizabeth

    This paper investigates the multicultural demands of health care delivery by examining the role of organizational communication in promoting effective multicultural relations in modern health care systems. The paper describes the multicultural make-up of modern health care systems--noting, for example that providers from different professional…

  13. Electronic medical records and the transgender patient: recommendations from the World Professional Association for Transgender Health EMR Working Group

    PubMed Central

    Deutsch, Madeline B; Green, Jamison; Keatley, JoAnne; Mayer, Gal; Hastings, Jennifer; Hall, Alexandra M

    2013-01-01

    Transgender patients have particular needs with respect to demographic information and health records; specifically, transgender patients may have a chosen name and gender identity that differs from their current legally designated name and sex. Additionally, sex-specific health information, for example, a man with a cervix or a woman with a prostate, requires special attention in electronic health record (EHR) systems. The World Professional Association for Transgender Health (WPATH) is an international multidisciplinary professional association that publishes recognized standards for the care of transgender and gender variant persons. In September 2011, the WPATH Executive Committee convened an Electronic Medical Records Working Group comprised of both expert clinicians and medical information technology specialists, to make recommendations for developers, vendors, and users of EHR systems with respect to transgender patients. These recommendations and supporting rationale are presented here. PMID:23631835

  14. Environmental Health Research Recommendations from the Inter-Environmental Health Sciences Core Center Working Group on Unconventional Natural Gas Drilling Operations

    PubMed Central

    Breysse, Patrick N.; Gray, Kathleen; Howarth, Marilyn; Yan, Beizhan

    2014-01-01

    Background: Unconventional natural gas drilling operations (UNGDO) (which include hydraulic fracturing and horizontal drilling) supply an energy source that is potentially cleaner than liquid or solid fossil fuels and may provide a route to energy independence. However, significant concerns have arisen due to the lack of research on the public health impact of UNGDO. Objectives: Environmental Health Sciences Core Centers (EHSCCs), funded by the National Institute of Environmental Health Sciences (NIEHS), formed a working group to review the literature on the potential public health impact of UNGDO and to make recommendations for needed research. Discussion: The Inter-EHSCC Working Group concluded that a potential for water and air pollution exists that might endanger public health, and that the social fabric of communities could be impacted by the rapid emergence of drilling operations. The working group recommends research to inform how potential risks could be mitigated. Conclusions: Research on exposure and health outcomes related to UNGDO is urgently needed, and community engagement is essential in the design of such studies. Citation: Penning TM, Breysse PN, Gray K, Howarth M, Yan B. 2014. Environmental health research recommendations from the Inter-Environmental Health Sciences Core Center Working Group on Unconventional Natural Gas Drilling Operations. Environ Health Perspect 122:1155–1159; http://dx.doi.org/10.1289/ehp.1408207 PMID:25036093

  15. Weight Status, Gender, and Race/Ethnicity: Are There Differences in Meeting Recommended Health Behavior Guidelines for Adolescents?

    ERIC Educational Resources Information Center

    Minges, Karl E.; Chao, Ariana; Nam, Soohyun; Grey, Margaret; Whittemore, Robin

    2015-01-01

    Healthy behaviors including limited screen time (ST), high physical activity (PA), and adequate fruits and vegetables consumption (FV) are recommended for adolescents, but it is unclear how gender, race/ethnicity, and weight status relate to these public health guidelines in diverse urban adolescents. Participants (N = 384) were recruited from…

  16. Influencing organizations to promote health: applying stakeholder theory.

    PubMed

    Kok, Gerjo; Gurabardhi, Zamira; Gottlieb, Nell H; Zijlstra, Fred R H

    2015-04-01

    Stakeholder theory may help health promoters to make changes at the organizational and policy level to promote health. A stakeholder is any individual, group, or organization that can influence an organization. The organization that is the focus for influence attempts is called the focal organization. The more salient a stakeholder is and the more central in the network, the stronger the influence. As stakeholders, health promoters may use communicative, compromise, deinstitutionalization, or coercive methods through an ally or a coalition. A hypothetical case study, involving adolescent use of harmful legal products, illustrates the process of applying stakeholder theory to strategic decision making. PMID:25829111

  17. The organization of health services for Indian people.

    PubMed Central

    Rhoades, E R; Reyes, L L; Buzzard, G D

    1987-01-01

    The Indian Health Service (IHS) is a bureau of the Health Resources and Services Administration, an agency of the Public Health Service. It was formed in 1955 by a transfer of health services from the Bureau of Indian Affairs, Department of the Interior. Since that time, IHS has grown larger and more complicated and has become a truly complex national organization that is responsible for direct and contract health care services to approximately 1 million Indian people. The historical background of the Service, its present organization, and the services that it provides through a variety of organizational structures are outlined in this report. PMID:3112842

  18. Recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, Computer-based Patient Record Institute, Medical Library Association, Association of Academic Health Science Libraries, American Health Information Management Association, American Nurses Association.

    PubMed

    Miller, R A; Gardner, R M

    1997-01-01

    In mid-1996, the FDA called for discussions on regulation of clinical software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology has developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. Organizations assisting in development of recommendations, or endorsing the consortium position include the American Medical Informatics Association, the Computer-based Patient Record Institute, the Medical Library Association, the Association of Academic Health Sciences Libraries, the American Health Information Management Association, the American Nurses Association, the Center for Healthcare Information Management, and the American College of Physicians. The consortium proposes four categories of clinical system risks and four classes of measured monitoring and regulatory actions that can be applied strategically based on the level of risk in a given setting. The consortium recommends local oversight of clinical software systems, and adoption by healthcare information system developers of a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively. FDA regulation should exempt most clinical software systems and focus on those systems posing highest clinical risk, with limited opportunities for competent human intervention. PMID:9391932

  19. Recommendations for Modeling Disaster Responses in Public Health and Medicine: A Position Paper of The Society for Medical Decision Making

    PubMed Central

    Brandeau, Margaret L.; McCoy, Jessica H.; Hupert, Nathaniel; Holty, Jon-Erik; Bravata, Dena M.

    2013-01-01

    Purpose Mathematical and simulation models are increasingly used to plan for and evaluate health sector responses to disasters, yet no clear consensus exists regarding best practices for the design, conduct, and reporting of such models. We examined a large selection of published health sector disaster response models to generate a set of best practice guidelines for such models. Methods We reviewed a spectrum of published disaster response models addressing public health or healthcare delivery, focusing in particular on the type of disaster and response decisions considered, decision makers targeted, choice of outcomes evaluated, modeling methodology, and reporting format. We developed initial recommendations for best practices for creating and reporting such models and refined these guidelines after soliciting feedback from response modeling experts and from members of the Society for Medical Decision Making. Results We propose six recommendations for model construction and reporting, inspired by the most exemplary models: Health sector disaster response models should address real-world problems; be designed for maximum usability by response planners; strike the appropriate balance between simplicity and complexity; include appropriate outcomes, which extend beyond those considered in traditional cost-effectiveness analyses; and be designed to evaluate the many uncertainties inherent in disaster response. Finally, good model reporting is particularly critical for disaster response models. Conclusions Quantitative models are critical tools for planning effective health sector responses to disasters. The recommendations we propose can increase the applicability and interpretability of future models, thereby improving strategic, tactical, and operational aspects of preparedness planning and response. PMID:19605887

  20. Civil Society Organizations and the Functions of Global Health Governance: What Role within Intergovernmental Organizations?

    PubMed Central

    Lee, Kelley

    2016-01-01

    Amid discussion of how global health governance should and could be strengthened, the potential role of civil society organizations has been frequently raised. This paper considers the role of Civil Society Organizations (CSOs) in four health governance instruments under the auspices of the World Health Organization – the International Code on the Marketing of Breastmilk Substitutes, Framework Convention on Tobacco Control, International Health Regulations and Codex Alimentarius - and maps the functions they have contributed to. The paper draws conclusions about the opportunities and limitations CSOs represent for strengthening global health governance (GHG). PMID:27274776

  1. Quantifying the linkages among soil health, organic farming, and food

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Organic farming systems utilize organic amendments, diverse crop rotations and cover crops to promote soil fertility and enhance soil health. These practices increase biologically available forms of soil organic matter, and increase the activities of beneficial soil microbes and invertebrates. Physi...

  2. [New recommendations for the Dutch neonatal screening programme. A report from the Health Council of the Netherlands].

    PubMed

    Cornel, Martina C

    2015-01-01

    The Health Council of the Netherlands recently issued a report advising adding 14 new disorders to the current neonatal screening programme: 11 metabolic conditions, severe combined immunodeficiency disease, beta-thalassaemia major and HbH disease. This recommendation was made because of the availability of new tests and treatments. The new criteria of availability and accessibility of treatment became relevant following discussions on reimbursement of enzyme replacement therapy for Pompe's disease. The potential for alternative or complementary measures for prevention are discussed, such as preconception and prenatal carrier screening. This report advises against reporting carrier information following newborn screening: advice that is not in line with earlier Health Council advice. A further recommendation is that newborn screening for untreatable conditions is not indicated now. Screening for untreatable conditions may not be the responsibility of national public health agencies, but alternative stakeholders have not been considered in the report. PMID:25970680

  3. Director of anesthesiology for liver transplantation: existing practices and recommendations by the United Network for Organ Sharing.

    PubMed

    Mandell, M Susan; Pomfret, Elizabeth A; Steadman, Randall; Hirose, Ryutaro; Reich, David J; Schumann, Roman; Walia, Ann

    2013-04-01

    A new Organ Procurement and Transplantation Network/United Network for Organ Sharing bylaw recommends that all centers appoint a director of liver transplant anesthesia with a uniform set of criteria. We obtained survey data from the Liver Transplant Anesthesia Consortium so that we could compare existing criteria for a director in the United States with the current recommendations. The data set included responses from adult academic liver transplant programs before the new bylaw. The respondent rates were within statistical limits to exclude sampling bias. All centers had a director of liver transplant anesthesia. The criteria varied between institutions, and the data suggest that the availability of resources influenced the choice of criteria. The information suggests that the criteria used in the new bylaw reflect existing practices. The bylaw plays an important role in supporting emerging leadership roles in liver transplant anesthesia and brings greater uniformity to the directorship position. PMID:23447113

  4. Health literacy as controversy: an online community's discussion of the U.S. Food and Drug Administration acetaminophen recommendations.

    PubMed

    Mackert, Michael; Love, Brad; Donovan-Kicken, Erin; Uhle, Katharine A

    2011-12-01

    Adults in the United States increasingly use the Internet for health information, and online discussions can provide insights into public perceptions of health issues. The purpose of this project was to investigate public perceptions of issues related to health literacy, within the context of a conversation about recommendations to the U.S. Food and Drug Administration, driven by concerns about acetaminophen-related liver injuries due in part to health literacy issues. The discussion took place July 2-8, 2009, on a technology/science blog and included 625 comments. Participants debated the risks and benefits of acetaminophen, and most believed responsibility for taking medication safely falls on consumers. Some were implicitly aware of issues related to health literacy and its relationship to patient outcomes; most felt improved education is all that is needed, whereas others acknowledged that health information is confusing--particularly for the elderly and sick. Recommendations for future research into public perceptions of health literacy are discussed. PMID:21788648

  5. Core competencies of the entrepreneurial leader in health care organizations.

    PubMed

    Guo, Kristina L

    2009-01-01

    The purpose of this article is to discuss core competencies that entrepreneurial health care leaders should acquire to ensure the survival and growth of US health care organizations. Three overlapping areas of core competencies are described: (1) health care system and environment competencies, (2) organization competencies, and (3) interpersonal competencies. This study offers insight into the relationship between leaders and entrepreneurship in health care organizations and establishes the foundation for more in-depth studies on leadership competencies in health care settings. The approach for identifying core competencies and designing a competency model is useful for practitioners in leadership positions in complex health care organizations, so that through the understanding and practice of these 3 areas of core competencies, they can enhance their entrepreneurial leadership skills to become more effective health care entrepreneurial leaders. This study can also be used as a tool by health care organizations to better understand leadership performance, and competencies can be used to further the organization's strategic vision and for individual improvement purposes. PMID:19225332

  6. Organically grown food provides health benefits to Drosophila melanogaster.

    PubMed

    Chhabra, Ria; Kolli, Santharam; Bauer, Johannes H

    2013-01-01

    The "organic food" market is the fastest growing food sector, yet it is unclear whether organically raised food is nutritionally superior to conventionally grown food and whether consuming organic food bestows health benefits. In order to evaluate potential health benefits of organic foods, we used the well-characterized fruit fly Drosophila melanogaster as a model system. Fruit flies were raised on a diets consisting of extracts of either conventionally or organically raised produce (bananas, potatoes, raisins, soy beans). Flies were then subjected to a variety of tests designed to assess overall fly health. Flies raised on diets made from organically grown produce had greater fertility and longevity. On certain food sources, greater activity and greater stress resistance was additionally observed, suggesting that organic food bestows positive effects on fly health. Our data show that Drosophila can be used as a convenient model system to experimentally test potential health effects of dietary components. Using this system, we provide evidence that organically raised food may provide animals with tangible benefits to overall health. PMID:23326371

  7. Animal Health and Welfare Issues Facing Organic Production Systems

    PubMed Central

    Sutherland, Mhairi A.; Webster, Jim; Sutherland, Ian

    2013-01-01

    Simple Summary The demand for organically grown, animal derived produce is increasing due to a growing desire for consumer products that have minimal chemical inputs and high animal welfare standards. Evaluation of the scientific literature suggests that a major challenge facing organic animal production systems is the management and treatment of health-related issues. However, implementation of effective management practices can help organic animal producers achieve and maintain high standards of health and welfare, which is necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. Abstract The demand for organically-grown produce is increasing worldwide, with one of the drivers being an expectation among consumers that animals have been farmed to a high standard of animal welfare. This review evaluates whether this expectation is in fact being met, by describing the current level of science-based knowledge of animal health and welfare in organic systems. The primary welfare risk in organic production systems appears to be related to animal health. Organic farms use a combination of management practices, alternative and complementary remedies and convenional medicines to manage the health of their animals and in many cases these are at least as effective as management practices employed by non-organic producers. However, in contrast to non-organic systems, there is still a lack of scientifically evaluated, organically acceptable therapeutic treatments that organic animal producers can use when current management practices are not sufficient to maintain the health of their animals. The development of such treatments are necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. PMID:26479750

  8. [Individuals and changes in health organizations: a psychosociological approach].

    PubMed

    Azevedo, Creuza da Silva; Braga Neto, Francisco Campos; Sá, Marilene de Castilho

    2002-01-01

    The Brazilian health sector has undergone a severe crisis, affecting the case-resolving capacity, efficiency and governability of the health system as a whole and health organizations in particular. Although innovative management systems and tools have been encouraged, such innovations are limited in their ability to spawn organizational change, especially with regard to the challenge of enabling individual adherence to institutional projects and relations involving individuals and organizations. This paper focuses on the French psychosociological approach for analyzing and intervening in organizations, one of whose main thinkers is Eugène Enriquez. In its view of contemporary organizations, this approach focuses on the conflict between reproduction and creation as the main problem to be solved by management processes. While an organization is essentially seen as a place of order and repetition, organizational change implies the challenge of bringing creative individuals into the organization's project, avoiding the trap of controlling their minds and behavior. PMID:11910442

  9. [The Argentine Health System: organization and financial features].

    PubMed

    Arce, Hugo E

    2012-01-01

    The Argentine health system is defined by the following features: a) federal country organization; b) coexistence of public and private services with either outpatients or inpatients; c) fragmented entities of social security, most of these originated outside of the state organization. Components of the system are described and weighed; making decisions strength between national and provincial health authorities is analyzed and the Argentine system is compared with that of other countries. Statistical data on distribution of health expenditures and coverage of health services are presented as well as financial flow among diverse funding sources, insurers, providers and users of each sector. PMID:23089118

  10. Organizing the public health-clinical health interface: theoretical bases.

    PubMed

    St-Pierre, Michèle; Reinharz, Daniel; Gauthier, Jacques-Bernard

    2006-01-01

    This article addresses the issue of the interface between public health and clinical health within the context of the search for networking approaches geared to a more integrated delivery of health services. The articulation of an operative interface is complicated by the fact that the definition of networking modalities involves complex intra- and interdisciplinary and intra- and interorganizational systems across which a new transversal dynamics of intervention practices and exchanges between service structures must be established. A better understanding of the situation is reached by shedding light on the rationale underlying the organizational methods that form the bases of the interface between these two sectors of activity. The Quebec experience demonstrates that neither the structural-functionalist approach, which emphasizes remodelling establishment structures and functions as determinants of integration, nor the structural-constructivist approach, which prioritizes distinct fields of practice in public health and clinical health, adequately serves the purpose of networking and integration. Consequently, a theoretical reframing is imperative. In this regard, structuration theory, which fosters the simultaneous study of methods of inter-structure coordination and inter-actor cooperation, paves the way for a better understanding of the situation and, in turn, to the emergence of new integration possibilities. PMID:16645802

  11. Assessment of hand hygiene techniques using the World Health Organization's six steps.

    PubMed

    Arias, Ariadna V; Garcell, Humberto G; Ochoa, Yagdeline R; Arias, Katiana F; Miranda, Fernando R

    2016-01-01

    The quality of hand hygiene was evaluated via direct observation for compliance with the six recommended World Health Organization steps. A total of 2497 HH opportunities, of which 1573 (63.0%) were hand rubs, were monitored over a five month period. Compliance was higher in nurses compared with physicians and auxiliaries and in steps 1 and 2 for hand rubs as well as the first three steps of hand washing, with lower rates after these steps. Rubbing of the thumbs and fingertips achieved the lowest rates of compliance in both HH types. A combination of the five recommended moments and six steps and staff education is recommended to improve the quality of hand hygiene. PMID:26707705

  12. Applying Community Organizing Principles to Assess Health Needs in New Haven, Connecticut.

    PubMed

    Santilli, Alycia; Carroll-Scott, Amy; Ickovics, Jeannette R

    2016-05-01

    The Affordable Care Act added requirements for nonprofit hospitals to conduct community health needs assessments. Guidelines are minimal; however, they require input and representation from the broader community. This call echoes 2 decades of literature on the importance of including community members in all aspects of research design, a tenet of community organizing. We describe a community-engaged research approach to a community health needs assessment in New Haven, Connecticut. We demonstrate that a robust community organizing approach provided unique research benefits: access to residents for data collection, reliable data, leverage for community-driven interventions, and modest improvements in behavioral risk. We make recommendations for future community-engaged efforts and workforce development, which are important for responding to increasing calls for community health needs assessments. PMID:26985599

  13. Nutritional Guidelines for School Lunch Programs: A Survey of Islamic Schools and Recommendations for Creating a Culture of Healthful Eating

    PubMed Central

    Khan, Sumiya; Saeed, Ziena; Diwan, Hanifa Hameed; Hussain, Iqra; Amer, Sarah; Haq, Mohamed M.

    2011-01-01

    Objective: To determine the status of lunch programs in Islamic schools in the United States and develop recommendations for improving them. Study Design: The Islamic Medical Association of North America (IMANA) conducted a survey of lunch programs by mailing questionnaires to 100 Islamic schools in the United States. Muslims in Dietetics and Nutrition (MIDAN) developed lunch menus using American and ethnic foods conforming to nationally recommended guidelines. Results: Forty-eight Islamic schools responded to the survey, revealing that 20 schools follow guidelines and only six have dietitians advising on menu planning. Based on this survey, IMANA, with the assistance of MIDAN, has developed a summary of guidelines that schools can follow. These guidelines include sample menus of American and ethnic foods, recommendations for creating a n environment for healthful eating, and sources for funding school lunch programs. Conclusions: IMANA and MIDAN, recognizing the scientific significance and religious relevance of a nutritious diet, have developed these recommendations. This information is provided to aid Islamic schools in implementing guidelines for nutritionally balanced school lunch menus and in creating a culture that fosters a healthful lifestyle. PMID:23610485

  14. Partnerships for better mental health worldwide: WPA recommendations on best practices in working with service users and family carers

    PubMed Central

    WALLCRAFT, JAN; AMERING, MICHAELA; FREIDIN, JULIAN; DAVAR, BHARGAVI; FROGGATT, DIANE; JAFRI, HUSSAIN; JAVED, AFZAL; KATONTOKA, SYLVESTER; RAJA, SHOBA; RATAEMANE, SOLOMON; STEFFEN, SIGRID; TYANO, SAM; UNDERHILL, CHRISTPHER; WAHLBERG, HENRIK; WARNER, RICHARD; HERRMAN, HELEN

    2011-01-01

    WPA President M. Maj established the Task Force on Best Practice in Working with Service Users and Carers in 2008, chaired by H. Herrman. The Task Force had the remit to create recommendations for the international mental health community on how to develop successful partnership working. The work began with a review of literature on service user and carer involvement and partnership. This set out a range of considerations for good practice, including choice of appropriate terminology, clarifying the partnership process and identifying and reducing barriers to partnership working. Based on the literature review and on the shared knowledge in the Task Force, a set of ten recommendations for good practice was developed. These recommendations were the basis for a worldwide consultation of stakeholders with expertise as service users, families and carers, and the WPA Board and Council. The results showed a strong consensus across the international mental health community on the ten recommendations, with the strongest agreement coming from service users and carers. This general consensus gives a basis for Task Force plans to seek support for activities to promote shared work worldwide to identify best practice examples and create a resource to assist others to begin successful collaboration. PMID:21991284

  15. A closer look at the World Health Organization's prescribing indicators

    PubMed Central

    Ofori-Asenso, Richard

    2016-01-01

    This communication focuses on the World Health Organization's prescribing indicators. It describes the methods for computing the indicators and highlights their applicability as well as limitations in evaluating the patterns of medicines usage. PMID:27127400

  16. Male circumcision for HIV prevention in Papua New Guinea: a summary of research evidence and recommendations for public health following a national policy forum.

    PubMed

    Vallely, A; MacLaren, D J; Kaleva, W; Millan, J; Tommbe, R; Marape, W; Manineng, C; Buchanan, H; Amos, A; Frank, R; Kelly, A; Kupul, M; Aeno, H; Trowalle, E; John, L N; Redman-Maclaren, M L; Ryan, C; Browne, K; Tynan, A; Hill, P S; Gray, R T; Murray, J; Wilson, D P; Law, G; Siba, P; McBride, W J H; Farley, T; Kaldor, J M

    2011-01-01

    In 2005, a clinical trial in South Africa found that circumcision of young men could reduce their risk of acquiring HIV (human immunodeficiency virus) infection by over 60%. In the following year, two more trials in Africa confirmed this finding, leading the World Health Organization to recommend male circumcision as a public health strategy for HIV prevention in high-incidence countries. In order to inform public health policy in Papua New Guinea (PNG), two major research projects were initiated with the goals of investigating the status of penile cutting practices and assessing understandings, acceptability, feasibility and cost-effectiveness of male circumcision for HIV prevention. In addition, behavioural surveillance surveys systematically asked questions on penile cutting practices and an ethnographic literature review informed historical perspectives of penile cutting in PNG. Key findings from these research activities were presented at a National Policy Forum on Male Circumcision for HIV Prevention held in Port Moresby in November 2011. The Forum made three key recommendations: (1) the formation of a joint National Department of HealthlNational AIDS Council Secretariat Policy Committee on male circumcision; (2) the establishment of an integrated harm reduction program; and (3) that future policy on wide-scale roll-out of male circumcision for HIV prevention in PNG be informed by a combination of data from (a) male circumcision intervention pilot programs and (b) research on the potential protective effect of other forms of penile cutting. PMID:24494506

  17. Barriers to prostate cancer prevention and community recommended health education strategies in an urban African American community in Jackson, Mississippi.

    PubMed

    Ekúndayò, Olúgbémiga T; Tataw, David B

    2013-01-01

    This article describes the use of survey research in collaboration with the African American urban community of Georgetown, Jackson, Mississippi to identify and understand prostate cancer knowledge, resource utilization, and health education strategies considered most effective in reaching the community with prostate cancer prevention messages. The study revealed profound needs in disease identification and resources awareness and utilization. Barriers to utilization were identified by participants to include lack of self-efficacy, low self-esteem, lack of trust in the health care system, limited knowledge of prostate pathology, and limited ability to pay. Participants' recommended strategies for reaching the community with prostate cancer education include traditional and nontraditional strategies. The list of recommendations exclude modern-day outlets such as handheld devices, Twitter, Facebook, blogs, wikis, and other Internet-based outlets. The findings provide a road map for program development and an intervention research agenda custom-tailored to the Georgetown community of Jackson, Mississippi. PMID:23805806

  18. Promoting Correct Car Seat Use in Parents of Young Children: Challenges, Recommendations, and Implications for Health Communication

    PubMed Central

    Weaver, Nancy L.; Brixey, Suzanne N.; Williams, Janice; Nansel, Tonja R.

    2013-01-01

    Injuries involving motor vehicles continue to be the biggest threat to the safety of children. Although child safety seats (CSS) have been established as a central countermeasure in decreasing injury risk, the majority of parents do not use the correct car seat correctly. There are many challenges in promoting correct car seat use, which itself is a complex behavior. To advance this critical protective behavior, the public health community would benefit from clarifying CSS messaging, communicating clearly, and addressing the conflicting recommendations of product use. In this article, we present current challenges in promoting CSS use and draw on health communication and other fields to offer recommendations for future work in this area. PMID:22991278

  19. [Experience in organizing competition of school health education teams].

    PubMed

    Tsurikov, V T; Gavriushenko, V V

    1991-01-01

    One of the main tasks of Soviet medicine--the healthy lifestyle formation among population can be accomplished with the help of school health education teams. The training of school health education teams is one of the forms of out-of-school hours activities in hygienic education and training of pupils and can easily be accomplished through organizational plans of activities at any school or industrial training school. The organization of school health education teams should unite the efforts of teachers, specialists from the service of healthy lifestyle formation, cultural institutions, young communist league and youth organizations and other departments and public agencies concerned. Using various active publicity media school health education teams should become active healthy lifestyle promotion organizations and their performance can be conducted before any audiences. The working experience of school health education teams is in need of investigation, improvement and dissemination. PMID:1876903

  20. Personality organization, five-factor model, and mental health.

    PubMed

    Laverdière, Olivier; Gamache, Dominick; Diguer, Louis; Hébert, Etienne; Larochelle, Sébastien; Descôteaux, Jean

    2007-10-01

    Otto Kernberg has developed a model of personality and psychological functioning centered on the concept of personality organization. The purpose of this study is to empirically examine the relationships between this model, the five-factor model, and mental health. The Personality Organization Diagnostic Form (Diguer et al., The Personality Organization Diagnostic Form-II (PODF-II), 2001), the NEO Five-Factor Inventory (Costa and McCrae, Revised NEO Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI) Professional Manual. 1992a), and the Health-Sickness Rating Scale (Luborsky, Arch Gen Psychiatry. 1962;7:407-417) were used to assess these constructs. Results show that personality organization and personality factors are distinct but interrelated constructs and that both contribute in similar proportion to mental health. Results also suggest that the integration of personality organization and factors can provide clinicians and researchers with an enriched understanding of psychological functioning. PMID:18043522

  1. Contribution of organically grown crops to human health.

    PubMed

    Johansson, Eva; Hussain, Abrar; Kuktaite, Ramune; Andersson, Staffan C; Olsson, Marie E

    2014-04-01

    An increasing interest in organic agriculture for food production is seen throughout the world and one key reason for this interest is the assumption that organic food consumption is beneficial to public health. The present paper focuses on the background of organic agriculture, important public health related compounds from crop food and variations in the amount of health related compounds in crops. In addition, influence of organic farming on health related compounds, on pesticide residues and heavy metals in crops, and relations between organic food and health biomarkers as well as in vitro studies are also the focus of the present paper. Nutritionally beneficial compounds of highest relevance for public health were micronutrients, especially Fe and Zn, and bioactive compounds such as carotenoids (including pro-vitamin A compounds), tocopherols (including vitamin E) and phenolic compounds. Extremely large variations in the contents of these compounds were seen, depending on genotype, climate, environment, farming conditions, harvest time, and part of the crop. Highest amounts seen were related to the choice of genotype and were also increased by genetic modification of the crop. Organic cultivation did not influence the content of most of the nutritional beneficial compounds, except the phenolic compounds that were increased with the amounts of pathogens. However, higher amounts of pesticide residues and in many cases also of heavy metals were seen in the conventionally produced crops compared to the organic ones. Animal studies as well as in vitro studies showed a clear indication of a beneficial effect of organic food/extracts as compared to conventional ones. Thus, consumption of organic food seems to be positive from a public health point of view, although the reasons are unclear, and synergistic effects between various constituents within the food are likely. PMID:24717360

  2. Contribution of Organically Grown Crops to Human Health

    PubMed Central

    Johansson, Eva; Hussain, Abrar; Kuktaite, Ramune; Andersson, Staffan C.; Olsson, Marie E.

    2014-01-01

    An increasing interest in organic agriculture for food production is seen throughout the world and one key reason for this interest is the assumption that organic food consumption is beneficial to public health. The present paper focuses on the background of organic agriculture, important public health related compounds from crop food and variations in the amount of health related compounds in crops. In addition, influence of organic farming on health related compounds, on pesticide residues and heavy metals in crops, and relations between organic food and health biomarkers as well as in vitro studies are also the focus of the present paper. Nutritionally beneficial compounds of highest relevance for public health were micronutrients, especially Fe and Zn, and bioactive compounds such as carotenoids (including pro-vitamin A compounds), tocopherols (including vitamin E) and phenolic compounds. Extremely large variations in the contents of these compounds were seen, depending on genotype, climate, environment, farming conditions, harvest time, and part of the crop. Highest amounts seen were related to the choice of genotype and were also increased by genetic modification of the crop. Organic cultivation did not influence the content of most of the nutritional beneficial compounds, except the phenolic compounds that were increased with the amounts of pathogens. However, higher amounts of pesticide residues and in many cases also of heavy metals were seen in the conventionally produced crops compared to the organic ones. Animal studies as well as in vitro studies showed a clear indication of a beneficial effect of organic food/extracts as compared to conventional ones. Thus, consumption of organic food seems to be positive from a public health point of view, although the reasons are unclear, and synergistic effects between various constituents within the food are likely. PMID:24717360

  3. Allied Health Education/Transfer of Credit: Recommendations of the North Carolina Articulation Project.

    ERIC Educational Resources Information Center

    Boatman, Ralph H., Ed.; Huther, John W., Ed.

    The North Carolina Allied Health Articulation Project was launched to develop procedures which would enable an individual to transfer credit from an allied health education program in one setting to some program in higher education. In 1972-73, study committees were appointed to deal with the allied health professions of physical therapy,…

  4. Reflections and Recommendations Based on a Migrant Health Center's Participation in a CDC Study.

    ERIC Educational Resources Information Center

    Nolon, Anne K.; O'Barr, James

    Hudson Valley Migrant Health (HVMH) (a Public Health Service program) collaborated with the Center for Disease Control (CDC) and the New York State Department of Health (NYSDOH) on a study of the incidence of sexually transmitted diseases and tuberculosis among migrant farmworkers in the mid-Hudson region of New York. CDC research personnel…

  5. Engaging Student Health Organizations in Reducing Health Disparities in Underserved Communities through Volunteerism: Developing a Student Health Corps

    PubMed Central

    Mays, Vickie M.; Ly, Lichin; Allen, Erica; Young, Sophia

    2013-01-01

    One underutilized method for reducing health disparities and training culturally competent health care workers is the engagement of undergraduate student health organizations in conducting health screenings, promotion, and health education outreach activities in in underserved racial/ethnic communities. We conducted a needs assessment of 14 predominantly racial/ethnic minority undergraduate student-run health organizations. The 14 organizations annually served approximately 12,425 people (67% Hispanic, 25% African American, 6.33% Asian Pacific Islander), predominantly at health fairs within Los Angeles County (averaging 138 attendees). Student organizations provided screenings on general health conditions and diseases, with less emphasis on behavioral risk factors (e.g., drinking, smoking). Organizations indicated a need for increased and affordable trainings in preventive health screenings and help in understanding target populations’ needs. Universities are in an excellent position to train, supervise, and organize volunteer health corps in order to engage students in reducing health disparities and to train culturally competent health care providers. PMID:19648716

  6. Recommendation of standardized health learning contents using archetypes and semantic web technologies.

    PubMed

    Legaz-García, María del Carmen; Martínez-Costa, Catalina; Menárguez-Tortosa, Marcos; Fernández-Breis, Jesualdo Tomás

    2012-01-01

    Linking Electronic Healthcare Records (EHR) content to educational materials has been considered a key international recommendation to enable clinical engagement and to promote patient safety. This would suggest citizens to access reliable information available on the web and to guide them properly. In this paper, we describe an approach in that direction, based on the use of dual model EHR standards and standardized educational contents. The recommendation method will be based on the semantic coverage of the learning content repository for a particular archetype, which will be calculated by applying semantic web technologies like ontologies and semantic annotations. PMID:22874336

  7. Advancing Health Marketing Research and Policy Recommendations by Incorporating Source Perspectives.

    PubMed

    Mackert, Michael; Guadagno, Marie; Champlin, Sara

    2015-01-01

    Communication researchers, recognizing the message sent is not necessarily the same as the message received, have incorporated the perspective of advertising professionals into the study of advertising effects. Health marketing research could similarly benefit from incorporating this largely absent perspective into the academic and policy debate surrounding the impact of advertising on health issues ranging from obesity to alcohol use. This commentary serves as a call to action to stakeholders in this academic and policy debate: focus on the perspective of advertising professionals to enrich health marketing and public health research in which advertising is the delivery vehicle for health messages. PMID:26368300

  8. Behavioral Groups as Preventive Care in a Health Maintenance Organization.

    ERIC Educational Resources Information Center

    Shapiro, Joan; And Others

    This paper describes the use of a particular therapeutic modality--behavioral groups--in a relatively new delivery system called a Health Maintenance Organization. The program described, run under the George Washington University Health Plan, offers short-term structured groups designed to aid people at particularly difficult or vulnerable…

  9. [Health care organization and health in a region of Zaire].

    PubMed

    Campanella, N; Tarantini, F

    1989-01-01

    Kampene is a roughly 10,000 inhabitants village in Kivu, eastern region of Republic of Zaire. The equatorial rainforest in river Zaire basin surrounds it, far from the main and most crowded roads. Climate is warm and wet, rainfalls constant throughout ten months a years. Eighty seven per cent of the population of Kampene and of its administrative district (around 100,000 inhabitants) work in agriculture. Most of the remainder gets by on mineral search and mining (tin, cassiterite, gold). Health facilities and their organisation should be set up as according to Zaire Health Planning, worked out of 1977 Alma Ata Conference's guidelines on Primary Health Care, but actually they are hard to be implemented because of the wide territory, of the scattered settlements to be served, because of infrastructure and funds shortages. High children death ratio (roughly from 104 to 200/1000 altogether, short mean lifetimes and generally morbidity are caused by: parasitoses (malaria, filariasis, gut worms, bilharziosis, amebiasis), bacterial infections (breast feeding babies' toxic enteritis, tuberculosis, salmonellosis, shigellosis, gonococcosis, tetanus, epidemic meningitis), viral diseases (measles, poliomyelitis, virus B hepatitis, AIDS), protein-energy malnutrition, obstetric pathology (uterus fractures, ectopic pregnancy, obstructed labour). The management of Kampene Hospital is taken over by a Zaire-Italian team, according to the "Progetto Socio-Sanitario a Kampene", project carried out by Centro Volontari Marchigiani, a not-governmental organisation recognized and financed by Italian Foreign Office. The utilization of Kampene hospital wards has been investigated throughout 20 months (since 1/1/1986 to 31/8/1987) by working some parameters out: numbers of admissions, numbers of hospital days, man length of stay, bed occupancy rate, turnover index for bed. The utilisation of outpatient clinic has been investigated by means of the number of outpatients and outpatients per

  10. Are Public Health Organizations Tweeting to the Choir? Understanding Local Health Department Twitter Followership

    PubMed Central

    Choucair, Bechara; Maier, Ryan C; Jolani, Nina; Bernhardt, Jay M

    2014-01-01

    Background One of the essential services provided by the US local health departments is informing and educating constituents about health. Communication with constituents about public health issues and health risks is among the standards required of local health departments for accreditation. Past research found that only 61% of local health departments met standards for informing and educating constituents, suggesting a considerable gap between current practices and best practice. Objective Social media platforms, such as Twitter, may aid local health departments in informing and educating their constituents by reaching large numbers of people with real-time messages at relatively low cost. Little is known about the followers of local health departments on Twitter. The aim of this study was to examine characteristics of local health department Twitter followers and the relationship between local health department characteristics and follower characteristics. Methods In 2013, we collected (using NodeXL) and analyzed a sample of 4779 Twitter followers from 59 randomly selected local health departments in the United States with Twitter accounts. We coded each Twitter follower for type (individual, organization), location, health focus, and industry (eg, media, government). Local health department characteristics were adopted from the 2010 National Association of City and County Health Officials Profile Study data. Results Local health department Twitter accounts were followed by more organizations than individual users. Organizations tended to be health-focused, located outside the state from the local health department being followed, and from the education, government, and non-profit sectors. Individuals were likely to be local and not health-focused. Having a public information officer on staff, serving a larger population, and “tweeting” more frequently were associated with having a higher percentage of local followers. Conclusions Social media has the

  11. The World Health Organization: Is It Still Relevant?

    PubMed

    Ferguson, Stephanie L

    2015-01-01

    The World Health Organization (WHO) is the United Nation's lead agency for directing and coordinating health. As leaders, nurse executives must advocate for a stronger nursing and midwifery health policy agenda at the global level and a seat at the table on WHO's technical advisory bodies and expert committees. There are no more borders as nurse executives; we are global citizens, leading global change. Nurse leaders hold the master key to shape the world's policies for sustainable global development. PMID:26281282

  12. University Health Center Providers' Beliefs about Discussing and Recommending Sexual Health Prevention to Women College Students

    ERIC Educational Resources Information Center

    Jozkowski, Kristen N.; Geshnizjani, Alireza; Middlestadt, Susan E.

    2013-01-01

    Sexual health concerns such as sexually transmitted infections and unintended pregnancy remain substantial health problems faced by young adults, especially college women. University healthcare providers may be instrumental in increasing female patients' involvement in preventative sexual health behaviors, however little research has examined…

  13. Physical Activity: A Tool for Improving Health (Part 3--Recommended Amounts of Physical Activity for Optimal Health)

    ERIC Educational Resources Information Center

    Gallaway, Patrick J.; Hongu, Nobuko

    2016-01-01

    By promoting physical activities and incorporating them into their community-based programs, Extension professionals are improving the health of individuals, particularly those with limited resources. This article is the third in a three-part series describing the benefits of physical activity for human health: (1) biological health benefits of…

  14. Do health service organizations and community health centres have higher disease prevention and health promotion levels than fee-for-service practices?

    PubMed Central

    Abelson, J; Lomas, J

    1990-01-01

    We interviewed health care providers representing 23 fee-for-service (FFS) practices, 19 health service organizations (HSOs) and 11 community health centres (CHCs) in Ontario to compare self-reported approaches to disease prevention and health promotion. Few significant differences were found across practice types in the presence of recall systems for screening or in knowledge of, compliance with or estimated coverage for selected preventive maneuvers recommended by the Canadian Task Force on the Periodic Health Examination. CHCs reported a significantly greater variety of formal health promotion programs and a greater tendency to use nonphysician health care personnel to carry out both prevention and health promotion activities. The results must be interpreted with caution because of the use of self-reported data, the low response rate for FFS practices and the use of a restrictive definition of disease prevention tied to evidence from the reports of the task force. Thus, the results cast some doubt on the common assumption that increasing the population served by alternative modes of delivery such as HSOs and CHCs necessarily increases the level of disease prevention and health promotion activity. PMID:2311035

  15. The Select Panel for the Promotion of Child Health: Injury. Recommendations in Retrospect.

    ERIC Educational Resources Information Center

    Butler, John A.; Mitrovich, Kimberly A.

    1987-01-01

    In 1980 recommendations were made to prevent child injuries. They addressed the following topics: (1) motor vehicle safety; (2) home and neighborhood safety; and (3) the development of a national data base from which policy can be formulated. There is evidence that progress has been made since the morbidity and mortality rates for accidents have…

  16. Justifying medication decisions in mental health care: Psychiatrists' accounts for treatment recommendations.

    PubMed

    Angell, Beth; Bolden, Galina B

    2015-08-01

    Psychiatric practitioners are currently encouraged to adopt a patient centered approach that emphasizes the sharing of decisions with their clients, yet recent research suggests that fully collaborative decision making is rarely actualized in practice. This paper uses the methodology of Conversation Analysis to examine how psychiatrists justify their psychiatric treatment recommendations to clients. The analysis is based on audio-recordings of interactions between clients with severe mental illnesses (such as, schizophrenia, bipolar disorders, etc.) in a long-term, outpatient intensive community treatment program and their psychiatrist. Our focus is on how practitioners design their accounts (or rationales) for recommending for or against changes in medication type and dosage and the interactional deployment of these accounts. We find that psychiatrists use two different types of accounts: they tailor their recommendations to the clients' concerns and needs (client-attentive accounts) and ground their recommendations in their professional expertise (authority-based accounts). Even though psychiatrists have the institutional mandate to prescribe medications, we show how the use of accounts displays psychiatrists' orientation to building consensus with clients in achieving medical decisions by balancing medical authority with the sensitivity to the treatment relationship. PMID:26046726

  17. Justifying medication decisions in mental health care: Psychiatrists’ accounts for treatment recommendations

    PubMed Central

    Angell, Beth; Bolden, Galina B.

    2015-01-01

    Psychiatric practitioners are currently encouraged to adopt a patient centered approach that emphasizes the sharing of decisions with their clients, yet recent research suggests that fully collaborative decision making is rarely actualized in practice. This paper uses the methodology of Conversation Analysis to examine how psychiatrists justify their psychiatric treatment recommendations to clients. The analysis is based on audio-recordings of interactions between clients with severe mental illnesses (such as, schizophrenia, bipolar disorders, etc.) in a long-term, outpatient intensive community treatment program and their psychiatrist. Our focus is on how practitioners design their accounts (or rationales) for recommending for or against changes in medication type and dosage and the interactional deployment of these accounts. We find that psychiatrists use two different types of accounts: they tailor their recommendations to the clients’ concerns and needs (client-attentive accounts) and ground their recommendations in their professional expertise (authority-based accounts). Even though psychiatrists have the institutional mandate to prescribe medications, we show how the use of accounts displays psychiatrists’ orientation to building consensus with clients in achieving medical decisions by balancing medical authority with the sensitivity to the treatment relationship. PMID:26046726

  18. Towards a Healthy District: Organizing and Managing District Health Systems Based on Primary Health Care.

    ERIC Educational Resources Information Center

    Tarimo, E.

    This book is concerned with orienting health care workers in district health systems in developing countries to ways and means of overcoming problems, and describes briefly how district health systems can be improved. The book is organized around nine issues in nine chapters, each of which is an integral part of a district planning cycle. The…

  19. Health politics meets post-modernism: its meaning and implications for community health organizing.

    PubMed

    Rosenau, P V

    1994-01-01

    In this article, post-modern theory is described and applied to health politics with examples from community health organizing, social movements, and health promotion. Post-modernism questions conventional assumptions about concepts such as representation, participation, empowerment, community, identity, causality, accountability, responsibility, authority, and roles in community health promotion (those of expert, leader, and organizer). I compare post-modern social movements with their modern counterparts: the organizational forms, leadership styles, and substantive intellectual orientations of the two differ. I explain the social planning, community development, and social action models of community health organizing, comparing them with the priorities of post-modern social movements, and show the similarities and differences between them as to structural preferences, process, and strategies. Finally, and most importantly, I present the implicit lessons that post-modernism offers to health politics and outline the strengths and weaknesses of this approach to health politics. PMID:8077633

  20. The health maintenance organization strategy: a corporate takeover of health services delivery.

    PubMed

    Salmon, J W

    1975-01-01

    This paper presents a political economic framework for viewing the social organization of the delivery of health care servies and predicting a qualitatively different institutional configuration involving the health maintenance organization. The principal forces impacting American capitalism today are leading to a fundamental restructuring for increased social efficiency of the entire social welfare sector, including the health services industry. The method to achieve this restructuring involves health policy directed at raising the contribution to the social surplus from the delivery of health care services and eventual corporate domination. The health maintenance organization conceptualization is examined with suggestions as to how the HMO strategy promoted by the state leads to this corporate takeover. The mechanism and extent of the present corporate involvement are examined and implications of health services as a social control mechanism are presented. PMID:1230440

  1. The World Health Organization Global Health Emergency Workforce: What Role Will the United States Play?

    PubMed

    Burkle, Frederick M

    2016-08-01

    During the May 2016 World Health Assembly of 194 member states, the World Health Organization (WHO) announced the process of developing and launching emergency medical teams as a critical component of the global health workforce concept. Over 64 countries have either launched or are in the development stages of vetting accredited teams, both international and national, to provide surge support to national health systems through WHO Regional Organizations and the delivery of emergency clinical care to sudden-onset disasters and outbreak-affected populations. To date, the United States has not yet committed to adopting the emergency medical team concept in funding and registering an international field hospital level team. This article discusses future options available for health-related nongovernmental organizations and the required educational and training requirements for health care provider accreditation. (Disaster Med Public Health Preparedness. 2016;10:531-535). PMID:27364937

  2. Comparing Web search engine performance in searching consumer health information: evaluation and recommendations.

    PubMed Central

    Wu, G; Li, J

    1999-01-01

    Identifying and accessing reliable, relevant consumer health information rapidly on the Internet may challenge the health sciences librarian and layperson alike. In this study, seven search engines are compared using representative consumer health topics for their content relevancy, system features, and attributes. The paper discusses evaluation criteria; systematically compares relevant results; analyzes performance in terms of the strengths and weaknesses of the search engines; and illustrates effective search engine selection, search formulation, and strategies. PMID:10550031

  3. The normative authority of the World Health Organization.

    PubMed

    Gostin, L O; Sridhar, D; Hougendobler, D

    2015-07-01

    The World Health Organization (WHO) was born after the devastation of World War II, as a normative agency endowed with unprecedented constitutional powers. But even as it has achieved stunning successes, such as the eradication of smallpox, it has failed to live up to the exalted expectations of the postwar health and human rights movement - exemplified most recently by its inadequate response to the Ebola epidemic. Our aim is to offer innovative ideas for restoring the Organization to its leadership position by exercising its normative authority, even as it faces a crowded and often chaotic global health architecture. Before doing so, it will be helpful to summarize the main tensions the Organization faces in today's global health landscape. PMID:26100341

  4. “You’ve Gotta Know the Community”: Minority Women Make Recommendations About Community-Focused Health Research

    PubMed Central

    Pinto, Rogério M.; McKay, Mary M.; Escobar, Celeste

    2009-01-01

    Objectives To determine what ethnic and racial minority women recommend as the best approaches to participatory health research in their communities. To achieve this goal, this study focused on HIV prevention research. Methods In 2003, Seven African American and seven Latina women (ages 33 to 52), all members of an HIV Prevention Collaborative Board, participated in individual interviews, lasting about 90 minutes each. Participants discussed their involvement in participatory research, and made recommendations as to how health researchers might better engage their communities. Data were coded independently by two coders following standard procedure for content analysis. Results Women’s voices and expertise can help guide health-related research. This study shows that: (1) participatory HIV prevention research should be founded on trust and commitment, leading to social support; (2) research partners ought to come from diverse backgrounds and be knowledgeable about the community and willing to work on common objectives; and (3) collaborative partnerships ought to portray an image of strength and cohesion, and a clear articulation of the mission around a research project. Implications To develop meaningful health research, researchers need to establish long-term ongoing relationships with community collaborators, including minority women from diverse backgrounds. Researchers ought to take a holistic approach working with communities, and ought to consider their research interests vis-à-vis the community’s needs. PMID:18581694

  5. A suicide in an online mental health support group: reactions of the group members, administrative responses, and recommendations.

    PubMed

    Hsiung, Robert C

    2007-08-01

    Suicides in online mental health support groups are inevitable. This case report of such a suicide describes the responses of the group members and the moderator and makes recommendations. Members of a large, public, mental health message board supported each other, and the moderator, a mental health professional, managed the milieu. A member joined in February 2001 and killed herself in April 2002. The initial response of the members was grief. The moderator attempted to minimize suicide contagion by not making any special announcements and to facilitate mourning by starting a memorial thread. There were no reports of self-injury in response to the suicide, and the online ventilation of grief may in fact have had some preventative effect. One member went to the funeral, and gradually, the group moved on. The moderator later implemented a memorial page. The responses of online groups to suicide may, like those of real-life groups, have resuscitation, rehabilitation, and renewal phases. Diffusion of dependency, a searchable archive, and threaded, asynchronous discussion may facilitate mourning, but anonymity may increase vulnerability to false reports. A thread started in memory of a deceased member may function like a virtual memorial service. A memorial page may function like a virtual cemetery. Preliminary recommendations can be made regarding suicide prevention and responding to suicide in moderated online mental health support groups. PMID:17711356

  6. The contributions of Henry E. Sigerist to health service organization.

    PubMed

    Terris, M

    1975-01-01

    Henry E. Sigerist made profound and strikingly original contributions to health service organization. Not only did he expand greatly our concepts of the functions of medicine, but he redefined health in a manner which was later to be paraphrased by the World Health Organization. Sigerist's account of the evolution of the physician and his discussion of the role of the people in the fight for health provide important new insights into current realities, while his remarkable analysis of the genesis of national health insurance makes it possible to understand its continued absence in the United States. Although he was in the forefront of the campaign for national health insurance, Sigbrist always considered it inferior to a national health service. His thorough studies of the Soviet national health service opened new vistas in the promotion of health and prevention of disease and the development of team practice in health centers. Sigerist's impact was world-wide, and was particularly important in Chile, Cuba, China, and Great Britain. PMID:765888

  7. Health Informatics: Developing a Masters Programme in Rwanda based on the IMIA Educational Recommendations and the IMIA Knowledge Base.

    PubMed

    Wright, Graham; Verbeke, Frank; Nyssen, Marc; Betts, Helen

    2015-01-01

    Since 2011, the Regional e-Health Center of Excellence in Rwanda (REHCE) has run an MSc in Health Informatics programme (MSc HI). A programme review was commissioned in February 2014 after 2 cohorts of students completed the post-graduate certificate and diploma courses and most students had started preparatory activity for their master dissertation. The review developed a method for mapping course content on health informatics competences and knowledge units. Also the review identified and measured knowledge gaps and content redundancy. Using this method, we analyzed regulatory and programme documents combined with stakeholder interviews, and demonstrated that the existing MSc HI curriculum did not completely address the needs of the Rwandan health sector. Teaching strategies did not always match students' expectations. Based on a detailed Rwandan health informatics needs assessment, International Medical Informatics Association (IMIA)'s Recommendations on Education in Biomedical and Health Informatics and the IMIA Health Informatics Knowledge Base, a new curriculum was developed and provided a better competences match for the specifics of healthcare in the Central African region. The new approved curriculum will be implemented in the 2014/2015 academic year and options for regional extension of the programme to Eastern DRC (Bukavu) and Burundi (Bujumbura) are being investigated. PMID:26262106

  8. Can organizations benefit from worksite health promotion?

    PubMed Central

    Leviton, L C

    1989-01-01

    A decision-analytic model was developed to project the future effects of selected worksite health promotion activities on employees' likelihood of chronic disease and injury and on employer costs due to illness. The model employed a conservative set of assumptions and a limited five-year time frame. Under these assumptions, hypertension control and seat belt campaigns prevent a substantial amount of illness, injury, and death. Sensitivity analysis indicates that these two programs pay for themselves and under some conditions show a modest savings to the employer. Under some conditions, smoking cessation programs pay for themselves, preventing a modest amount of illness and death. Cholesterol reduction by behavioral means does not pay for itself under these assumptions. These findings imply priorities in prevention for employer and employee alike. PMID:2499556

  9. [The organization of health services: the comparison as contribution].

    PubMed

    Conill, E M; Mendonça, M H; da Silva, R A; Gawryszewski, V

    1991-01-01

    This article discusses about a recent procedure in health care studies, the comparison as a methodology of analysis. The different analytical currents refer to a particular method of understanding health-disease process. They are: functionalism, the historical-materialism and the new currents. Their phylosophical and sociological basis, concepts, analysis instruments and purposes are showed here by a review of the principal works from representative authors as Navarro, Terris, Roemer, Fry, Illich, Capra and others. The paper suggests that comparative analysis can take two directions: the first is a operational approach for analysing the concrete situations of health's service organization, the second, a more conceptual one, aimed at identifying critical questions and international tendencies in health's systems. The recent discussion search for the overcoming of these dichotomies toward the progress of the production of knowledge and its effects in health's services organization. PMID:15806244

  10. The Highland Park Environmental Health Plan: Evaluation and Recommendations for Improving the Urban Environment.

    ERIC Educational Resources Information Center

    Michigan State Dept. of Commerce, Lansing. Community Planning Div.

    The Highland Park environmental health plan includes the following components: Legal and administrative and programmatic relationships, planning studies, residential environment, disease vector control, water and sewage systems, sanitation, air pollution, food protection, industrial and radiological health, and solid waste facilities. (JR)

  11. Health and Safety in the School Environment. A Manual of Recommended Practice.

    ERIC Educational Resources Information Center

    Center for Disease Control (DHEW/PHS), Atlanta, GA.

    This manual emphasizes the health relationships in the physical school environment and provides environmental criteria by which existing or planned facilities can be evaluated. Individual chapters deal with school health programs; planning for new schools; school site selection, building plan, and plan review; water supply; plumbing; sewage…

  12. Psychiatric workforce needs and recommendations for the community mental health system: a state needs assessment.

    PubMed

    Walker, Elizabeth Reisinger; Berry, Frank W; Citron, Tod; Fitzgerald, Judy; Rapaport, Mark H; Stephens, Bryan; Druss, Benjamin G

    2015-02-01

    Similar to other states, Georgia is facing workforce challenges within its community mental health system. These issues may be exacerbated as implementation of the Affordable Care Act expands demand for behavioral health services. Georgia's Department of Behavioral Health and Developmental Disabilities commissioned a needs assessment to examine the shortage of prescribing providers (psychiatrists, advanced practice registered nurses, and physician assistants) in the state's public mental health system. A unique partnership of key stakeholders developed and conducted the mixed-methods needs assessment at six of Georgia's 27 community mental health centers serving more than 40,000 patients annually. The assessment documented challenges in recruiting and retaining psychiatrists and workforce shortages for all prescriber groups. The authors describe opportunities for optimizing the psychiatric workforce and training the next generation of community psychiatrists. PMID:25642608

  13. [Asylum-seekers' mental and physical health problems: practices and recommendations].

    PubMed

    Kórász, Krisztián

    2016-01-01

    The Hungarian health care system faces new challenges with the unprecedented increased rate of migration. Asylum-seekers arriving are a heterogeneous group. Their health care needs vary depending on their country of origin and the quality of the health care they received prior to arrival, not to mention the impact of the migration process on their health. Described within this paper are the challenges an asylum seeker might face in obtaining care on arrival into the host country and the challenges clinicians face in providing that care. This review is designed to give health professionals the necessary knowledge to care for asylum-seekers in a culturally aware and clinically informed manner. PMID:26708683

  14. Service Networks and Patterns of Utilization: Mental Health Programs, Indian Health Service (IHS). Volume 1: Overview and Recommendations.

    ERIC Educational Resources Information Center

    Attneave, Carolyn L.; Beiser, Morton

    Constituting an overview of a 10-volume report on the historical development and contemporary activities (1966-1973) of each of the 8 administrative Area Offices of the Indian Health Service (IHS) Mental Health Programs, this volume includes: the methods used for data collection (personal interviews with both past and present IHS key officials,…

  15. School Physical Education: The Effectiveness of Health-Related Interventions and Recommendations for Health-Promotion Practice

    ERIC Educational Resources Information Center

    Quitério, Ana Luísa Dias

    2013-01-01

    Objective: To assess the effectiveness of physical education (PE) interventions designed to foster health features among school-aged children, and to present a qualitative perspective of the different approaches that are most effective in promoting health among youth. Design: Systematic review. Method: An extensive electronic literature search was…

  16. Modification of Treatment of Certain Health Organizations. Final regulations.

    PubMed

    2016-06-22

    This document contains final regulations that provide guidance to Blue Cross and Blue Shield organizations, and certain other organizations, on computing and applying the medical loss ratio and the consequences for not meeting the medical loss ratio threshold. The final regulations reflect the enactment of a technical correction to section 833(c)(5) of the Internal Revenue Code by the Consolidated and Further Continuing Appropriations Act of 2015. The final regulations affect Blue Cross and Blue Shield organizations, and certain other organizations involved in providing health insurance. PMID:27373011

  17. Historical review of the List of Occupational Diseases recommended by the International Labour organization (ILO)

    PubMed Central

    2013-01-01

    The list of occupational diseases established in the international and national legal system has played important roles in both prevention of and compensation for workers’ diseases. This report reviewed the historical development in the ILO list of occupational diseases and suggested implications of the trends. Since the first establishment of the ILO list of occupational diseases in 1925, the list has played a key role in harmonizing the development of policies on occupational diseases at the international level. The three occupational diseases (anthrax, lead poisoning, and mercury poisoning) in the first ILO list of occupational diseases, set up in 1925 as workmen’s compensation convention represented an increase of occupational diseases from the Industrial Revolution. Until the 1960s, 10 occupational diseases had been representative compensable occupational diseases listed in Convention No. 121, which implies that occupational diseases in this era were equated to industrial poisoning. Since 1980, with advancements in diagnostic techniques and medical science, noise-induced hearing loss, and several bronchopulmonary diseases have been incorporated into the ILO occupational list. Since 2002, changes in the structure of industries, emerging new chemicals, and advanced national worker’s compensation schemes have provoked the ILO to revise the occupational disease list. A new format of ILO list appended in Recommendation 194 (R194) was composed of two dimensions (causes and diseases) and subcategories. Among 50 member states that had provided their national lists of occupational diseases, until 2012 thirty countries were found to have the list occupational diseases having similar structure to ILO list in R194. PMID:24472440

  18. THE ENVIRONMENTAL PROTECTION AGENCY'S CHILDREN'S HEALTH PROGRAMS: REVIEW OF PROGRESS AND RECOMMENDATIONS FOR FUTURE DIRECTION

    EPA Science Inventory

    While trend data indicate aggregate levels of environmental pollution in the United States is decreasing, the health effects associated with such pollution in children appear to be increasing. The rising recognition that behavioral, developmental, and metabolic differences in chi...

  19. PHYTOTOX DATABASE EVALUATION OF SURROGATE PLANT SPECIES RECOMMENDED BY THE U.S. ENVIRONMENTAL PROTECTION AGENCY AND THE ORGANIZATION FOR ECONOMIC COOPERATION AND DEVELOPMENT

    EPA Science Inventory

    The USEPA and the Organization for Economic Cooperation and Development have recommended or are considering recommendations for phytotoxicity testing. A study was conducted to determine the amount of quantitative data published on the species suggested in those tests. Also, the s...

  20. Security Recommendations for mHealth Apps: Elaboration of a Developer's Guide.

    PubMed

    Morera, Enrique Pérez; de la Torre Díez, Isabel; Garcia-Zapirain, Begoña; López-Coronado, Miguel; Arambarri, Jon

    2016-06-01

    Being the third fastest-growing app category behind games and utilities, mHealth apps are changing the healthcare model, as medicine today involves the data they compile and analyse, information known as Big Data. However, the majority of apps are lacking in security when gathering and dealing with the information, which becomes a serious problem. This article presents a guide regarding security solution, intended to be of great use for developers of mHealth apps. In August 2015 current mobile health apps were sought out in virtual stores such as Android Google Play, Apple iTunes App Store etc., in order to classify them in terms of usefulness. After this search, the most widespread weaknesses in the field of security in the development of these mobile apps were examined, based on sources such as the "OWASP Mobile Security Project, the initiative recently launched by the Office of Civil Rights (OCR), and other articles of scientific interest. An informative, elemental guide has been created for the development of mHealth apps. It includes information about elements of security and its implementation on different levels for all types of mobile health apps based on the data that each app manipulates, the associated calculated risk as a result of the likelihood of occurrence and the threat level resulting from its vulnerabilities - high level (apps for monitoring, diagnosis, treatment and care) from 6 ≤ 9, medium level (calculator, localizer and alarm) from 3 ≤ 6 and low level (informative and educational apps) from 0 ≤ 3. The guide aims to guarantee and facilitate security measures in the development of mobile health applications by programmers unconnected to the ITC and professional health areas. PMID:27147515

  1. The contribution of organization theory to nursing health services research.

    PubMed

    Mick, Stephen S; Mark, Barbara A

    2005-01-01

    We review nursing and health services research on health care organizations over the period 1950 through 2004 to reveal the contribution of nursing to this field. Notwithstanding this rich tradition and the unique perspective of nursing researchers grounded in patient care production processes, the following gaps in nursing research remain: (1) the lack of theoretical frameworks about organizational factors relating to internal work processes; (2) the need for sophisticated methodologies to guide empirical investigations; (3) the difficulty in understanding how organizations adapt models for patient care delivery in response to market forces; (4) the paucity of attention to the impact of new technologies on the organization of patient care work processes. Given nurses' deep understanding of the inner workings of health care facilities, we hope to see an increasing number of research programs that tackle these deficiencies. PMID:16360704

  2. The Pan American Health Organization and international health: a history of training, conceptualization, and collective development.

    PubMed

    Auer, Annella; Guerrero Espinel, Juan Eduardo

    2011-08-01

    A constantly changing and increasingly complex global environment requires leaders with special competencies to respond effectively to this scenario. Within this context, the Pan American Health Organization (PAHO) goes beyond traditional leadership training models both in terms of its design as well as its conceptual approach to international health. As an intergovernmental, centenary organization in health, PAHO allows participants a unique vantage point from which to conceptualize, share experiences and develop projects relevant to international health. Derived from over two decades of experience (1985-2006) training professionals through its predessor Training Program in International Health, the Leaders in International Health Program "Edmundo Granda Ugalde" (LIHP) utilizes an innovative design, virtual and practical learning activities, and a problem-based approach to analyze the main concepts, theories, actors, forces, and processes relevant to international health. In collaboration with PAHO/WHO Representative Offices and national institutions, participants develop country projects based on priority health issues, many of which are integrated into the Organization's technical cooperation and/or implemented by relevant ministries and other entities in their respective countries/subregions. A total of 185 participants representing 31 countries have participated in the LIHP since its inception in 2008, building upon the 187 trained through its predecessor. These initiatives have contributed to the development of health professionals in the Region of the Americas devoted to international health, as well as provided important input towards a conceptual understanding of international health by fostering debate on this issue. PMID:22159721

  3. Recommendations to mitigate against human health risks incurred due to energetic particle irradiation beyond low earth orbit/BLEO

    NASA Astrophysics Data System (ADS)

    McKenna-Lawlor, Susan; Bhardwaj, Anil; Ferrari, Franco; Kuznetsov, Nikolay; Lal, Ajay K.; Li, Yinghui; Nagamatsu, Aiko; Nymmik, Rikho; Panasyuk, Michael; Petrov, Vladislav; Reitz, Günther; Pinsky, Lawrence; Shukor, Muszaphar (Sheikh); Singhvi, Ashok K.; Straube, Ulrich; Tomi, Leena; Lawrence, Townsend

    2015-04-01

    An account is provided of the main sources of energetic particle radiation in interplanetary space (Galactic Cosmic Radiation and Solar Energetic Particles) and career dose limits presently utilized by NASA to mitigate against the cancer and non-cancer effects potentially incurred by astronauts due to irradiation by these components are presented. Certain gaps in knowledge that presently militate against mounting viable human exploration in deep space due to the inherent health risks are identified and recommendations made as to how these gaps might be closed within a framework of global international cooperation.

  4. Scientific panel on electromagnetic field health risks: consensus points, recommendations, and rationales.

    PubMed

    Fragopoulou, Adamantia; Grigoriev, Yuri; Johansson, Olle; Margaritis, Lukas H; Morgan, Lloyd; Richter, Elihu; Sage, Cindy

    2010-01-01

    In November, 2009, a scientific panel met in Seletun, Norway, for three days of intensive discussion on existing scientific evidence and public health implications of the unprecedented global exposures to artificial electromagnetic fields (EMF). EMF exposures (static to 300 GHz) result from the use of electric power and from wireless telecommunications technologies for voice and data transmission, energy, security, military and radar use in weather and transportation. The Scientific Panel recognizes that the body of evidence on EMF requires a new approach to protection of public health; the growth and development of the fetus, and of children; and argues for strong preventative actions. New, biologically-based public exposure standards are urgently needed to protect public health worldwide. PMID:21268443

  5. Money Matters: Recommendations for Financial Stress Research in Occupational Health Psychology.

    PubMed

    Sinclair, Robert R; Cheung, Janelle H

    2016-08-01

    Money is arguably the most important resource derived from work and the most important source of stress for contemporary employees. A substantial body of research supports the relationship between access to financial resources and health and well-being, both at individual and aggregated (e.g. national) levels of analysis. Yet, surprisingly little occupational health psychology research has paid attention to financial issues experienced specifically by those in the labour force. With these issues in mind, the overarching goal of the present paper was to address conceptual and measurement issues in the study of objective and subjective aspects of financial stress and review several assessment options available to occupational health psychology researchers for both aspects of financial stress. Where appropriate, we offer guidance to researchers about choices among various financial stress measures and identify issues that require further research attention. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27400815

  6. Measurement of Religiosity/Spirituality in Adolescent Health Outcomes Research: Trends and Recommendations

    PubMed Central

    McGrady, Meghan E.; Rosenthal, Susan L.

    2010-01-01

    The relationship between religious/spiritual (R/S) factors and adolescent health outcomes has been studied for decades; however, the R/S measurement tools used may not be developmentally relevant for adolescents. A systematic literature review was conducted to review and evaluate trends in measuring R/S in adolescent health outcomes research. In this review a total of 100 articles met criteria for inclusion. Relatively few (n = 15) included adolescent-specific R/S measures or items accounting for developmentally relevant issues such as parental religiosity or age-appropriate language. Future R/S and health research with adolescents would be strengthened by incorporating developmentally relevant R/S measurement tools, psychometrics, and multidimensional measures. PMID:20127172

  7. Case management in the social health maintenance organization demonstrations

    PubMed Central

    Yordi, Cathleen L.

    1988-01-01

    In this article, case management departments and roles during the early years of the social health maintenance organization (S/HMO) demonstrations are compared. These organizations provide acute and chronic care services under a prepaid plan for the elderly. Eligibility criteria for case management and chronic care services at each site are compared, followed by a description of the resultant case mix of members receiving chronic care benefits. Case managers principal activities are described, and a preliminary assessment is made about the strength of the linkages that have been developed between the case management component of these plans and the larger health care system. PMID:10312977

  8. Famine-affected, refugee, and displaced populations: recommendations for public health issues.

    PubMed

    1992-07-24

    During the past three decades, the most common emergencies affecting the health of large populations in developing countries have involved famine and forced migrations. The public health consequences of mass population displacement have been extensively documented. On some occasions, these migrations have resulted in extremely high rates of mortality, morbidity, and malnutrition. The most severe consequences of population displacement have occurred during the acute emergency phase, when relief efforts are in the early stage. During this phase, deaths--in some cases--were 60 times the crude mortality rate (CMR) among non-refugee populations in the country of origin (1). Although the quality of international disaster response efforts has steadily improved, the human cost of forced migration remains high. Since the early 1960s, most emergencies involving refugees and displaced persons have taken place in less developed countries where local resources have been insufficient for providing prompt and adequate assistance. The international community's response to the health needs of these populations has been at times inappropriate, relying on teams of foreign medical personnel with little or no training. Hospitals, clinics, and feeding centers have been set up without assessment of preliminary needs, and essential prevention programs have been neglected. More recent relief programs, however, emphasize a primary health care (PHC) approach, focusing on preventive programs such as immunization and oral rehydration therapy (ORT), promoting involvement by the refugee community in the provision of health services, and stressing more effective coordination and information gathering. The PHC approach offers long-term advantages, not only for the directly affected population, but also for the country hosting the refugees. A PHC strategy is sustainable and strengthens the national health development program. PMID:1326713

  9. Peer reviewing and curating the health care information infrastructure: experiences and recommendations.

    PubMed Central

    D'Alessandro, M. P.; Westenfield, A. M.; D'Alessandro, D. M.; Pomrehn, P. R.; Galvin, J. R.

    1998-01-01

    As part of a digital health sciences library's continuous quality improvement process, a digital textbook of common medical problems was created which contained links to authoritative medical information on the Internet for patients and health care providers. The accomplishments of this project were the: 1) Identification of 50 common medical problems, 2) Development of a methodology for identifying authoritative medical information related to these problems, 3) Creation of a digital textbook containing links to this information with a problem-based interface, 4) Development of a methodology to allow local peer review of this information, and 5) Evaluation of the use of the information and the local peer review methodology. PMID:9929298

  10. Participation in Worksite Health Promotion: A Critique of the Literature and Recommendations for Future Practice.

    ERIC Educational Resources Information Center

    Glasgow, Russell E.; And Others

    1993-01-01

    A literature review found that definitions of participation and participation rates in worksite health promotion programs vary dramatically. Men and blue-collar workers were less likely to participate. To improve participation, programs should involve management and labor representatives, use multiple communication channels, and target subgroups…

  11. Dietary patterns in transition can inform health risk, but detailed assessments are needed to guide recommendations

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Most research on diet and health has historically focused on single nutrients or foods and their effect on disease outcomes. In recent years, this focus has shifted to include the total dietary pattern as a risk factor in epidemiologic studies. This change has occurred for several reasons. First, as...

  12. Creating Peer-Led Media to Teach Sensitive Topics: Recommendations from Practicing Health Educators

    ERIC Educational Resources Information Center

    Hudson, Heather K.; Bliss, Kadi R.; Bice, Matthew R.; Lodyga, Marc G.; Ragon, Bruce M.

    2014-01-01

    Purpose: The purpose of the study was to evaluate consumer (instructor) reception of Channel Surfing Contraceptives in order to determine components necessary for creation of peer-led educational videos to teach sensitive contraceptive topics. Methods: Two focus group interviews with introductory-level undergraduate personal health instructors…

  13. 76 FR 54777 - Center for Devices and Radiological Health 510(k) Clearance Process; Recommendations Proposed in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-02

    ... notice that appeared in the Federal Register of Friday, August 12, 2011 (76 FR 50230). The document...-0002, 301-796-9148. SUPPLEMENTARY INFORMATION: In FR Doc. 2011-20575, appearing on page 50230 in the... HUMAN SERVICES Food and Drug Administration Center for Devices and Radiological Health 510(k)...

  14. Recommendations and Strategies for Addressing Comprehensive Health Issues on Two-Year College Campuses.

    ERIC Educational Resources Information Center

    Winter, Gene M.; And Others

    The Two-Year College Development Center invited representatives from two-year colleges throughout New York to attend a two-day meeting to address comprehensive health issues, particularly pertaining to the transmission and prevention of Acquired Immune Deficiency Syndrome (AIDS), as well as other infectious and chronic diseases. The attending…

  15. Recommendations for constructing school nurses' offices designed to support school health services.

    PubMed

    McKibben, Cynthia S; DiPaolo, Sonja J; Bennett, J Scott

    2005-06-01

    When attempting to locate guidelines for designing school nurses' offices, one finds there are minimal resources that address this need. In an effort to solve this concern, the authors were instrumental in writing an article for The Journal of School Nursing published in April 1997. The current article is an updated perspective that defines recommendations to be utilized in new construction or renovation of school nurses' offices. It encompasses information on square footage, design, utilization of space, location, and necessary equipment. Prototypes are provided that apply to elementary, middle school, and high school settings. The article outlines the importance of continued collaboration between the school nurse and key people involved in the planning and construction process, such as the school principal, administrators, and the district engineer. PMID:15898852

  16. [Cross-cultural aspects of interaction and communication in mental health care. Barriers and recommendations for action].

    PubMed

    Penka, S; Schouler-Ocak, M; Heinz, A; Kluge, U

    2012-09-01

    Mental health care for migrants is often impaired by a lack of policies and provisions in the respective institutions. This article focuses on "communication barriers" in psychosocial and psychotherapeutic settings, where personal communication is of great importance. Barriers that prevent migrants from using health care institutions include translation problems but also more complex misunderstandings based on divergent explanations regarding the causes, course, and adequate treatment of different disorders. The widely recommended intercultural opening of medical and psychosocial institutions involves using interpreters as cultural experts, reflecting on and mediating between divergent explanatory models, and avoiding cultural and ethnic stereotyping as well as encouraging an open, curious, and reflective professional attitude. With respect to institutional settings, rules for the financing of interpreters are as important as tackling barriers that limit migrants' access to medical and psychosocial institutions. PMID:22936485

  17. First Aid Recommendations for Psychosis: Using the Delphi Method to Gain Consensus Between Mental Health Consumers, Carers, and Clinicians

    PubMed Central

    Langlands, Robyn L.; Jorm, Anthony F.; Kelly, Claire M.; Kitchener, Betty A.

    2008-01-01

    Background: Members of the general public often lack the knowledge and skills to intervene effectively to help someone who may be developing a psychotic illness before appropriate professional help is received. Methods: We used the Delphi method to determine recommendations on first aid for psychosis. An international panel of 157 mental health consumers, carers, and clinicians completed a 146-item questionnaire about how a member of the public could help someone who may be experiencing psychosis. The panel members rated each questionnaire item according to whether they believed the statement should be included in the first aid recommendations. The results were analyzed by comparing consensus rates across the 3 groups. Three rounds of ratings were required to consolidate consensus levels. Results: Eighty-nine items were endorsed by ≥80% of panel members from all 3 groups as essential or important for psychosis first aid. These items were grouped under the following 9 headings: how to know if someone is experiencing psychosis; how to approach someone who may be experiencing psychosis; how to be supportive; how to deal with delusions and hallucinations; how to deal with communication difficulties; whether to encourage the person to seek professional help; what to do if the person does not want help; what to do in a crisis situation when the person has become acutely unwell; what to do if the person becomes aggressive. Conclusions: These recommendations will improve the provision of first aid to individuals who are developing a psychotic disorder by informing the content of training courses. PMID:17768307

  18. Selection bias in health maintenance organizations: Analysis of recent evidence

    PubMed Central

    Hellinger, Fred J.

    1987-01-01

    An analysis of recent research regarding selection bias in health maintenance organizations (HMO's) is presented in this article. Review of the available literature leads one to conclude that prepaid group practice HMO's do experience favorable selection. It has been demonstrated in numerous studies that prior use of health services by HMO enrollees is less than prior use of health services by those who remain in the fee-for-service sector, and there is considerable evidence that shows a statistically significant positive relationship between prior use and current use. This is true for both those under 65 years of age and those 65 years of age or over. PMID:10312393

  19. Mental Snapshots: Creating an Organized Plan for Health Assessment.

    PubMed

    Fosbrook, Susan Curro

    2015-01-01

    Beginning nursing students enter a rapidly moving and changing health care climate. Multiple stimulations can frighten and overwhelm the student's ability to find order of essential patient information. Students need to know how to collect, process, and manage important health data accurately and efficiently in the clinical setting. An integrative method for teaching nursing students to walk into the patient's room and construct a patterned sequence of focused assessments assists students in creating an organized plan for health assessment. The Mental Snapshots Method includes three components for health assessment: (a) sequential assessment steps of the patient; (b) color-coded visual images of the patient representing a bodily condition; and (c) focused assessment questions of primary health complaint(s) with a plan for nursing care. This mental snapshots strategy employs an information processing model of sensory, memory, and motor functioning, which enable students to maintain patient quality and safety. PMID:26428347

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

    PubMed

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

    2014-01-01

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

  1. Integrating Agendas for Mental Health in Schools into the Recommendations of the President's New Freedom Commission on Mental Health

    ERIC Educational Resources Information Center

    Center for Mental Health in Schools at UCLA, 2004

    2004-01-01

    It is long been acknowledged that psychosocial and mental health concerns must be addressed if schools are to function satisfactorily and students are to learn and perform effectively. This reality is reflected in the aims of the No Child Left Behind Act and the Individuals with Disabilities Education Act. And, it is consonant with the goals and…

  2. Educating for advocacy: recommendations for professional preparation and development based on a needs and capacity assessment of health education faculty.

    PubMed

    Radius, Susan M; Galer-Unti, Regina A; Tappe, Marlene K

    2009-01-01

    An electronic survey was used to conduct a needs and capacity assessment of health education faculty to determine the extent to which advocacy instruction is present in undergraduate and graduate curricula in health education and to identify faculty members' needs and capacity to provide professional preparation and development experiences related to advocacy. An analysis of the results reveals that most undergraduate and graduate health education programs include advocacy instruction. Although faculty believe advocacy and instruction related to advocacy are important, many lack advocacy-related professional preparation and development experiences and do not participate in advocacy-related training initiatives and advocacy activities. There is wide variability in faculty confidence in their competence to provide advocacy instruction. Partnerships among professional organizations, health education practitioners, university faculty, individuals engaged in policy advocacy initiatives, and policy makers are needed to enhance the capacity of university faculty to provide professional preparation and development experiences related to advocacy. PMID:18381970

  3. Leadership in academic health centers in the US: a review of the role and some recommendations.

    PubMed

    Weil, Thomas P

    2014-01-01

    The leadership of the US's most complex academic health centers (AHCs)/medical centers requires individuals who possess a high level of clinical, organizational, managerial, and interpersonal skills. This paper first outlines the major attributes desired in a dean/vice president of health affairs before then summarizing the educational opportunities now generally available to train for such leadership and management roles. For the most part, the masters in health administration (MHA), the traditional MBA, and the numerous alternatives primarily available at universities are considered far too general and too lacking in emotional intelligence tutoring to be particularly relevant for those who aspire to these most senior leadership positions. More appropriate educational options for these roles are discussed: (a) the in-house leadership and management programs now underway at some AHCs for those selected early on in their career for future executive-type roles as well as for those who are appointed later on to a chair, directorship or similar position; and (b) a more controversial approach of potentially establishing at one or a few universities, a mid-career, professional program (a maximum of 12 months and therefore, being completed in less time than an MBA) leading to a masters degree in academic health center administration (MHCA) for those who aspire to fill a senior AHC leadership position. The proposed curriculum as outlined herein might be along the lines of some carefully designed masters level on-line, self-teaching modules for the more technical subjects, yet vigorously emphasizing integrate-type courses focused on enhancing personal and professional team building and leadership skills. PMID:25595014

  4. International recruitment of health workers: British lessons for Europe? Emerging concerns and future research recommendations.

    PubMed

    Lozano, Mariona; Meardi, Guglielmo; Martín-Artiles, Antonio

    2015-01-01

    Immigration as a solution to staff and skill shortages in the health system is increasingly on the agenda in the European Union. This article highlights the related social and policy dilemmas by comparing a new destination country with an old destination country: Spain and the United Kingdom. After describing the challenges met by the United Kingdom, we ask how well-prepared Spain is to face the same issues. In particular, attention is paid to the occupational mobility of health workers after entry and to how immigration as a staffing solution poses new political and social challenges. Through a review of background information regarding the immigration of health workers in the two countries and the preliminary analysis of 15 exploratory interviews, we aim to identify the primary trends and key concerns for future analysis. Although our interviews only allow us to draw tentative conclusions, they do highlight emerging issues to be explored in the near future. Our conclusions show that many of the problems traditionally encountered in the United Kingdom are now emerging in Spain, suggesting scope for further collaboration among government, employers, and other stakeholders across the European Union. PMID:25813503

  5. Developing and Pretesting a Text Messaging Program for Health Behavior Change: Recommended Steps

    PubMed Central

    Mendel Van Alstyne, Judith; Schindler-Ruwisch, Jennifer M

    2015-01-01

    Background A growing body of evidence demonstrates that text messaging-based programs (short message service [SMS]) on mobile phones can help people modify health behaviors. Most of these programs have consisted of automated and sometimes interactive text messages that guide a person through the process of behavior change. Objective This paper provides guidance on how to develop text messaging programs aimed at changing health behaviors. Methods Based on their collective experience in designing, developing, and evaluating text messaging programs and a review of the literature, the authors drafted the guide. One author initially drafted the guide and the others provided input and review. Results Steps for developing a text messaging program include conducting formative research for insights into the target audience and health behavior, designing the text messaging program, pretesting the text messaging program concept and messages, and revising the text messaging program. Conclusions The steps outlined in this guide may help in the development of SMS-based behavior change programs. PMID:26690917

  6. Preventive health care for older women: life-style recommendations and new directions.

    PubMed

    Ferrucci, L; Benvenuti, E; Bartali, B; Bandinelli, S; Di Iorio, A; Russo, C R; Lauretani, F

    2000-04-01

    One of the key paradoxes in gerontology is that, despite a higher longevity, aging women experience worse health and longer disability than men. However, there is growing evidence that changes in life-style, medical interventions and systematic screening for certain diseases may substantially reduce the excess risk of major chronic conditions and disability in aging women, and therefore improve the quality of their late life. The potentials and public health implications of prevention in older women have been recently emphasized, not only by the scientific literature, but also by the media. More and more women are turning to their primary care physicians or other health professionals to seek counselling and help on how to reduce the burden of chronic disease and disability in old age by quitting smoking, eating a healthy diet, increasing physical activity, and coping with stress. Hormone replacement therapy also has a central role in this action of prevention. To maximize compliance, women should be provided a few guidelines that are easy to understand, and can be followed without interfering too much with their daily life activities. This article reviews the current literature on prevention in older women to select preventive strategies that are based on robust scientific evidence. This list of guidelines should be considered as a starting point for all those who are in charge of caring for middle-aged and older women. PMID:10902053

  7. A Recommendation for the Management of Illness Anxiety Disorder Patients Abusing the Health Care System

    PubMed Central

    Almalki, Mohammad; Al-Tawayjri, Ibrahim; Al-Anazi, Ahmed; Mahmoud, Sami

    2016-01-01

    Introduction. Illness anxiety disorder (IAD) entails a preoccupation with having a serious, undiagnosed illness in which somatic symptoms are, if present, mild in intensity (American Psychiatric Association, 2013). Case Report. This is a case of seventy-three-year-old Saudi man who started visiting the primary health care center around twenty-five years ago. With concerns of having cancer, the patient continuously visited the hospital, costing over $170,000. Throughout this period, the patient has been exposed to extensive unnecessary imaging studies and laboratory tests that have effects on his life in all aspects with such concerns. Five years ago, a family doctor has put an end to that by directing the patient to the right path. The doctor made several actions; most importantly, he directed the patient to a cognitive behavioral therapy which significantly improved a range of hypochondriacal beliefs and attitudes. This patient's case demonstrates the fundamental importance of a proper health system that limits such patients from abusing the health system and depleting the medical resources. Moreover, this case emphasizes the important role of the family physician who can be the first physician to encounter such patients. Thus, proper understanding of the nature of such disorder is a key element for better diagnosis and management. PMID:27313939

  8. Community Organization and Mental Health; The Woodlawn Experience.

    ERIC Educational Resources Information Center

    Lewis, Michael D.; Lewis, Judith A.

    A paraprofessional training program designed to provide community controlled mental health services to the Woodlawn community of Chicago, Illinois, is described in this monograph. The neighborhood and The Woodlawn Organization (T.W.O.A), a self help project formed in early 1960, are described from an historical perspective. Some of the areas…

  9. Professionalism: good for patients and health care organizations.

    PubMed

    Brennan, Michael D; Monson, Verna

    2014-05-01

    Professionalism is an indispensable element in the compact between the medical profession and society that is based on trust and putting the needs of patients above all other considerations. The resurgence of interest in professionalism dates back to the 1980s when health maintenance organizations were formed and proprietary influences in health care increased. Since then, a rich and comprehensive literature has emerged in defining professionalism, including desirable individual attributes and behaviors and how they may be taught, promoted, and assessed. More recently, scholarship has shifted from individual to organizational professionalism. This literature addresses the role that health care organizations can play to establish environments that are conducive to the consistent expression of professionalism by individuals and health care teams. We reviewed interdisciplinary empirical studies from health care effectiveness and outcomes, organizational sciences, positive psychology, and social psychology, finding evidence that organizational and individual professionalism is associated with a wide range of benefits to patients and the organization. We identify actionable organizational strategies and approaches that, if adopted, can foster and promote combined organizational and individual professionalism. In doing so, trust in the medical profession and its institutions can be enhanced, which in turn will reconfirm a commitment to the social compact. PMID:24797645

  10. Valuing the scholarship of integration and the scholarship of application in the academy for health sciences scholars: recommended methods

    PubMed Central

    Hofmeyer, Anne; Newton, Mandi; Scott, Cathie

    2007-01-01

    In the landmark 1990 publication Scholarship Reconsidered, Boyer challenged the 'teaching verses research debates' by advocating for the scholarship of discovery, teaching, integration, and application. The scholarship of discovery considers publications and research as the yardstick in the merit, promotion and tenure system the world over. But this narrow view of scholarship does not fully support the obligations of universities to serve global societies and to improve health and health equity. Mechanisms to report the scholarship of teaching have been developed and adopted by some universities. In this article, we contribute to the less developed areas of scholarship, i.e. integration and application. We firstly situate the scholarship of discovery, teaching, integration and application within the interprofessional and knowledge exchange debates. Second, we propose a means for health science scholars to report the process and outcomes of the scholarship of integration and application with other disciplines, decision-makers and communities. We conclude with recommendations for structural and process change in faculty merit, tenure, and promotion systems so that health science scholars with varied academic portfolios are valued and many forms of academic scholarship are sustained. It is vital academic institutions remain relevant in an era when the production of knowledge is increasingly recognized as a social collaborative activity. PMID:17535436

  11. Health maintenance in school-aged children: Part II. Counseling recommendations.

    PubMed

    Riley, Margaret; Locke, Amy B; Skye, Eric P

    2011-03-15

    School-aged children (kindergarten through early adolescence) are establishing patterns of behavior that may last a lifetime; therefore, it is important to counsel these patients about healthy lifestyle practices during well-child examinations. Children and families should be advised to eat a diet high in fruits, vegetables, whole grains, low-fat or nonfat dairy products, beans, fish, and lean meats, while limiting sugar, fast food, and highly processed foods. Children should engage in at least 60 minutes per day of moderate to vigorous physical activity, and screen time (e.g., television, computer, video games) should be limited to no more than one to two hours of quality programming daily. Most school-aged children require 11 hours of sleep per night. Decreased sleep is associated with behavioral issues, decreased concentration at school, and obesity. Children should brush their teeth twice per day with a toothpaste containing fluoride. Unintentional injury is the leading cause of death in this age group in the United States, and families should be counseled on traffic, water, sports, and firearm safety. Because high-risk behaviors may start in early adolescence, many experts recommend screening for tobacco, alcohol, and drug use beginning at 11 years of age. Sexually active adolescents should be counseled on protecting against sexually transmitted infections, and should be screened for these infections if indicated. PMID:21404979

  12. Electronic health records and transgender patients--practical recommendations for the collection of gender identity data.

    PubMed

    Deutsch, Madeline B; Buchholz, David

    2015-06-01

    Transgender (Trans, Trans*) persons may have a gender identity and a preferred name that differ from those assigned at birth, and/or those listed on their current legal identification (Gender ID, Birth-assigned Sex, Legal Sex). Transgender people who are referred to in a clinical setting using the wrong pronoun or name may suffer distress, ridicule or even assault by others in the waiting area, and may not return for further care. Furthermore, failure to accurately document (and therefore count) transgender identities has negative implications on quality improvement and research efforts, funding priorities and policy activities. The recent announcement that gender identity data may be included in Meaningful Use Stage 3 has accelerated the need for guidance for both vendors and local implementation teams on how to best record and store these data. A recent study demonstrated wide variation in current practices. This manuscript provides a description of identifiers associated with gender identity, and makes practical and evidence based recommendations for implementation and front-end functionality. PMID:25560316

  13. Organizing and managing care in a changing health system.

    PubMed Central

    Kohn, L T

    2000-01-01

    OBJECTIVE: To examine ways in which the management and organization of medical care is changing in response to the shifting incentives created by managed care. DATA SOURCES: Site visits conducted in 12 randomly selected communities in 1996/ 1997. STUDY DESIGN: Approximately 35-60 interviews were conducted per site with key informants in healthcare and community organizations; about half were with providers. DATA COLLECTION: A standardized interview protocol was implemented across all sites, enabling cross-site comparisons. Multiple respondents were interviewed on each issue. PRINCIPAL FINDINGS: A great deal of experimentation and apparent duplication exist in efforts to develop programs to influence physician practice patterns. Responsibility for managing care is being contested by health plans, medical groups and hospitals, as each seeks to accrue the savings that can result from the more efficient delivery of care. To manage the financial and clinical risk, providers are aggressively consolidating and reorganizing. Most significant was the rapid formation of intermediary organizations, such as independent practice arrangements (IPAs), physician-hospital organizations (PHOs), or management services organizations (MSOs), for contracting with managed care organizations. CONCLUSIONS: Managed care appears to have only a modest effect on how healthcare organizations deliver medical care, despite the profound effect that managed care has on how providers are organized. Rather than improving the efficiency of healthcare organizations, provider efforts to build large systems and become indispensable to health plans are exacerbating problems of excess capacity. It is not clear if new organizational arrangements will help providers manage the changing incentives they face, or if their intent is to blunt the effects of the incentives by forming larger organizations to improve their bargaining power and resist change. PMID:10778823

  14. A framework for describing health care delivery organizations and systems.

    PubMed

    Piña, Ileana L; Cohen, Perry D; Larson, David B; Marion, Lucy N; Sills, Marion R; Solberg, Leif I; Zerzan, Judy

    2015-04-01

    Describing, evaluating, and conducting research on the questions raised by comparative effectiveness research and characterizing care delivery organizations of all kinds, from independent individual provider units to large integrated health systems, has become imperative. Recognizing this challenge, the Delivery Systems Committee, a subgroup of the Agency for Healthcare Research and Quality's Effective Health Care Stakeholders Group, which represents a wide diversity of perspectives on health care, created a draft framework with domains and elements that may be useful in characterizing various sizes and types of care delivery organizations and may contribute to key outcomes of interest. The framework may serve as the door to further studies in areas in which clear definitions and descriptions are lacking. PMID:24922130

  15. Capacity of Health Facilities to Manage Hypertension in Mukono and Buikwe Districts in Uganda: Challenges and Recommendations

    PubMed Central

    Musinguzi, Geofrey; Bastiaens, Hilde; Wanyenze, Rhoda K.; Mukose, Aggrey; Van geertruyden, Jean-Pierre; Nuwaha, Fred

    2015-01-01

    Background The burden of chronic diseases is increasing in both low- and middle-income countries. However, healthcare systems in low-income countries are inadequately equipped to deal with the growing disease burden, which requires chronic care for patients. The aim of this study was to assess the capacity of health facilities to manage hypertension in two districts in Uganda. Methods In a cross-sectional study conducted between June and October 2012, we surveyed 126 health facilities (6 hospitals, 4 Health Center IV (HCIV), 23 Health Center III (HCIII), 41 Health Center II (HCII) and 52 private clinics/dispensaries) in Mukono and Buikwe districts in Uganda. We assessed records, conducted structured interviews with heads of facilities, and administered questionnaires to 271 health workers. The study assessed service provision for hypertension, availability of supplies such as medicines, guidelines and equipment, in-service training for hypertension, knowledge of hypertension management, challenges and recommendations. Results Of the 126 health facilities, 92.9% reported managing (diagnosing/treating) patients with hypertension, and most (80.2%) were run by non-medical doctors or non-physician health workers (NPHW). Less than half (46%) of the facilities had guidelines for managing hypertension. A 10th of the facilities lacked functioning blood pressure devices and 28% did not have stethoscopes. No facilities ever calibrated their BP devices except one. About a half of the facilities had anti-hypertensive medicines in stock; mainly thiazide diuretics (46%), beta blockers (56%) and calcium channel blockers (48.4%). Alpha blockers, mixed alpha & beta blockers and angiotensin II receptor antagonists were only stocked by private clinics/dispensaries. Most HCIIs lacked anti-hypertensive medicines, including the first line thiazide diuretics. Significant knowledge gaps in classification of patients as hypertensive were noted among respondents. All health workers (except 5

  16. HIV testing and counselling in Colombia: evidence from a national health survey and recommendations for health-care services.

    PubMed

    Arrivillaga, M; Hoyos, P A; Tovar, L M; Varela, M T; Correa, D; Zapata, H

    2012-11-01

    The purpose of this study was to assess the prevalence of, and the factors associated with HIV testing and pre- and post-test counselling (PPTC) in Colombia. Cross-sectional data from the National Health Survey carried out during 2007 were analysed. Data were gathered from records of 29,760 individuals between the ages of 18 and 69 from the main regions of the country. Only 19.7% of the sample had taken an HIV test. Men, people with no education, those not affiliated with the health-care system, residents of rural areas and those aged older than 65 were less likely to have been tested for HIV; 42% of those tested did not receive pre-test counselling and 56.9% received no report of the results. Considering the low prevalence of HIV testing among the Colombian population, it is necessary to design and apply guidelines for HIV screening in all health-care settings and to conduct targeted testing in high-risk sub-populations. A national norm of PPTC in those who undergo HIV testing should be examined. PMID:23155103

  17. Steps Forward: Review and Recommendations for Research on Walkability, Physical Activity and Cardiovascular Health

    PubMed Central

    Lovasi, Gina S.; Grady, Stephanie; Rundle, Andrew

    2012-01-01

    Built environments that support walking and other physical activities have the potential to reduce cardiovascular disease (CVD). Walkable neighborhoods—characterized by density, land use diversity, and well-connected transportation networks—have been linked to more walking, less obesity, and lower coronary heart disease risk. Yet ongoing research on pedestrian-friendly built environments has the potential to address important gaps. While much of the literature has focused on urban form and planning characteristics, additional aspects of street-scapes, such as natural and architectural amenities, should also be considered. Promising future directions include (1) integration of multiple built environment measures that facilitate an understanding of how individuals perceive and act within their environment; (2) examination of both the daily physical activities that are most feasibly influenced by the local environment and those more deliberate or vigorous patterns of physical activity that are most predictive of CVD; (3) consideration of multiple pathways that could mediate a link between walkability and CVD, including not only physical activity, but also air quality improvements from reduced vehicle mileage and enhanced neighborhood social cohesion from unplanned interactions; (4) testing competing hypotheses that may explain interactions of built environment characteristics with each other and with personal barriers to walking; (5) stronger conceptualization of the multiple neighborhoods or activity spaces that structure opportunities for physical activity throughout the day; (6) collecting and strategically analyzing longitudinal data to support causal inference; and (7) studying neighborhood preferences and selection to move beyond biased assessments of neighborhood health effects. While walkability has been linked to health-related behaviors and CVD risk factors, the implications of the observed correlations are not yet clear. New theoretical insights

  18. Parental Health Beliefs, Socio-demographics, and Healthcare Recommendations Influence Micronutrient Supplementation in Youth with Celiac Disease.

    PubMed

    Hoffmann, Michelle R; Alzaben, Abeer S; Enns, Simone E; Marcon, Margaret A; Turner, Justine; Mager, Diana R

    2016-03-01

    To identify parental influences affecting micronutrient supplementation in children and adolescents (2-18 years of age) with Celiac Disease (CD), a multi-method (survey, focus groups) study was conducted. A 35-item questionnaire consisting of open- and closed-ended questions was launched nationally via Canadian Celiac Association internet sites. Five focus groups were conducted using a semi-structured interview guide. The survey and semi-structured interview guide content was vetted for face and content validity. Thematic analyses were conducted on the focus group content and open-ended survey questions, and χ(2) and Fischer's exact analysis were performed on closed-ended survey data. Survey respondents were predominantly mothers (97%) of female children (80 F, 49 M) between the ages of 9-12 (31%) with CD, residing in western provinces (55%) with a combined family income ≥$100 000/year (63%). Seventy-seven percent of parental respondent's children or adolescents consumed micronutrient supplements, for 1-5 years (52%), 7 days a week (65%), as both multi-vitamin and single vitamin preparations (40%). Parental influences on child micronutrient use included health beliefs and knowledge, parental supplement use, supplement characteristics, age of child (above or below 13 years), household routines, and provincial residential status (P < 0.05). Parents relied on health professional recommendation (69%; MD, RD) and the internet (21%) as sources of information regarding child micronutrient supplementation. Parental health beliefs and knowledge, socio-demographic factors, and practitioner recommendation influence micronutrient supplement use in children and adolescents with CD. PMID:26567875

  19. The Skylab Medical Operations Project: Recommendations to Improve Crew Health and Performance for Future Exploration Missions

    NASA Technical Reports Server (NTRS)

    Polk, James D.; Duncan, James M.; Davis, Jeffrey R.; Williams, Richard S.; Lindgren, Kjell N.; Mathes, Karen L.; Gillis, David B.; Scheuring, Richard A.

    2009-01-01

    From May of 1973 to February of 1974, the National Aeronautics and Space Administration conducted a series of three manned missions to the Skylab space station, a voluminous vehicle largely descendant of Apollo hardware, and America s first space station. The crewmembers of these three manned missions spent record breaking durations of time in microgravity (28 days, 59 days and 84 days, respectively) and gave the U.S. space program its first experiences with long-duration space flight. The program overcame a number of obstacles (including a significant crippling of the Skylab vehicle) to conduct a lauded scientific program that encompassed life sciences, astronomy, solar physics, materials sciences and Earth observation. Skylab has more to offer than the results of its scientific efforts. The operations conducted by the Skylab crews and ground personnel represent a rich legacy of operational experience. As we plan for our return to the moon and the subsequent manned exploration of Mars, it is essential to utilize the experiences and insights of those involved in previous programs. Skylab and SMEAT (Skylab Medical Experiments Altitude Test) personnel have unique insight into operations being planned for the Constellation Program, such as umbilical extra-vehicular activity and water landing/recovery of long-duration crewmembers. Skylab was also well known for its habitability and extensive medical suite; topics which deserve further reflection as we prepare for lunar habitation and missions beyond Earth s immediate sphere of influence. The Skylab Medical Operations Summit was held in January 2008. Crewmembers and medical personnel from the Skylab missions and SMEAT were invited to participate in a two day summit with representatives from the Constellation Program medical operations community. The purpose of the summit was to discuss issues pertinent to future Constellation operations. The purpose of this document is to formally present the recommendations of the

  20. 77 FR 2257 - Adoption of Recommendations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-17

    ...-Setting Organizations in Health and Safety Regulation, 44 FR 1,357 (Jan. 5, 1979) (recommending agencies... Health and Safety Regulation, 44 FR 1,357 (Jan. 5, 1979). 8. Agencies should not address difficulties... Noncontroversial and Expedited Rulemaking, 60 FR 43,108, 43,112 (June 15, 1995). 11. Congress should...

  1. Behavioral Health and Health Care Reform Models: Patient-Centered Medical Home, Health Home, and Accountable Care Organization

    PubMed Central

    Bao, Yuhua; Casalino, Lawrence P.; Pincus, Harold Alan

    2012-01-01

    Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient Centered Medical Home, the Health Home initiative within Medicaid, and the Accountable Care Organization. To incorporate behavioral health into health reform, policymakers and practitioners may consider embedding in the reform efforts explicit tools – accountability measures and payment designs – to improve access to and quality of care for patients with behavioral health needs. PMID:23188486

  2. Health effects of different dietary iron intakes: a systematic literature review for the 5th Nordic Nutrition Recommendations

    PubMed Central

    Domellöf, Magnus; Thorsdottir, Inga; Thorstensen, Ketil

    2013-01-01

    Background The present literature review is part of the NNR5 project with the aim of reviewing and updating the scientific basis of the 4th edition of the Nordic Nutrition Recommendations (NNR) issued in 2004. Objective The objective of this systematic literature review was to assess the health effects of different intakes of iron, at different life stages (infants, children, adolescents, adults, elderly, and during pregnancy and lactation), in order to estimate the requirement for adequate growth, development, and maintenance of health. Methods The initial literature search resulted in 1,076 abstracts. Out of those, 276 papers were identified as potentially relevant. Of those, 49 were considered relevant and were quality assessed (A, B, or C). An additional search on iron and diabetes yielded six articles that were quality assessed. Thus, a total of 55 articles were evaluated. The grade of evidence was classified as convincing (grade 1), probable (grade 2), suggestive (grade 3), and inconclusive (grade 4). Results There is suggestive evidence that prevention or treatment of iron deficiency (ID) and iron deficiency anemia (IDA) improves cognitive, motoric, and behavioral development in young children, and that treatment of IDA improves attention and concentration in school children and adult women. There is insufficient evidence to show negative health effects of iron intakes in doses suggested by the NNR 4. There is insufficient evidence to suggest that normal birth weight, healthy, exclusively breast-fed infants need additional dietary iron before 6 months of life in the Nordic countries. An iron concentration of 4–8 mg/L in infant formulas seems to be safe and effective for normal birth weight infants. There is probable evidence that iron supplements (1–2 mg/kg/day) given up to 6 months of age to infants with low birth weight (<2,500 g) prevents IDA and possibly reduce the risk of behavioral problems later on. There is probable evidence that ID and IDA in

  3. Consensus Recommendations to NCCIH from Research Faculty in a Transdisciplinary Academic Consortium for Complementary and Integrative Health and Medicine

    PubMed Central

    Weeks, John; Anderson, Belinda; Meeker, William; Calabrese, Carlo; O'Bryon, David; Cramer, Greg D.

    2015-01-01

    Abstract Background: This commentary presents the most impactful, shared priorities for research investment across the licensed complementary and integrative health (CIH) disciplines according to the Academic Consortium for Complementary and Alternative Health Care (ACCAHC). These are (1) research on whole disciplines; (2) costs; and (3) building capacity within the disciplines' universities, colleges, and programs. The issue of research capacity is emphasized. Discussion: ACCAHC urges expansion of investment in the development of researchers who are graduates of CIH programs, particularly those with a continued association with accredited CIH schools. To increase capacity of CIH discipline researchers, we recommend National Center for Complementary and Integrative Health (NCCIH) to (1) continue and expand R25 grants for education in evidence-based healthcare and evidence-informed practice at CIH schools; (2) work to limit researcher attrition from CIH institutions by supporting career development grants for clinicians from licensed CIH fields who are affiliated with and dedicated to continuing to work in accredited CIH schools; (3) fund additional stand-alone grants to CIH institutions that already have a strong research foundation, and collaborate with appropriate National Institutes of Health (NIH) institutes and centers to create infrastructure in these institutions; (4) stimulate higher percentages of grants to conventional centers to require or strongly encourage partnership with CIH institutions or CIH researchers based at CIH institutions, or give priority to those that do; (5) fund research conferences, workshops, and symposia developed through accredited CIH schools, including those that explore best methods for studying the impact of whole disciplines; and (6) following the present NIH policy of giving priority to new researchers, we urge NCCIH to give a marginal benefit to grant applications from CIH clinician-researchers at CIH academic

  4. Health maintenance organization environments in the 1980s and beyond

    PubMed Central

    Morrison, Ellen M.; Luft, Harold S.

    1990-01-01

    Throughout the past decade, health maintenance organizations (HMOs) were buffeted by dramatic regulatory and competitive changes. In this article, literature of the 1980s is reviewed to update our knowledge on the HMO industry and to suggest future research. The influence of intensified competition on these organizations and the determinants of market entry, expansion, and exit are examined. These organizations are now beginning to require copayments and deductibles and to offer point-of-service choice, while indemnity plans are developing sophisticated utilization management techniques. Given these significant structural changes, past distinctions among HMO, preferred provider organization and fee-for-service medicine must be replaced with a distinction between degree of provider choice and level of benefits. PMID:10113465

  5. 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

  6. Building IT capability in health-care organizations.

    PubMed

    Khatri, Naresh

    2006-05-01

    While computer technology has revolutionized industries such as banking and airlines, it has done little for health care so far. Most of the health-care organizations continue the early-computer-era practice of buying the latest technology without knowing how it might effectively be employed in achieving business goals. By investing merely in information technology (IT) rather than in IT capabilities they acquire IT components--primarily hardware, software, and vendor-provided services--which they do not understand and, as a result, are not capable of fully utilizing for achieving organizational objectives. In the absence of internal IT capabilities, health-care organizations have relied heavily on the fragmented IT vendor market in which vendors do not offer an open architecture, and are unwilling to offer electronic interfaces that would make their 'closed' systems compatible with those of other vendors. They are hamstrung as a result because they have implemented so many different technologies and databases that information stays in silos. Health systems can meet this challenge by developing internal IT capabilities that would allow them to seamlessly integrate clinical and business IT systems and develop innovative uses of IT. This paper develops a comprehensive conception of IT capability grounded in the resource-based theory of the firm as a remedy to the woes of IT investments in health care. PMID:16643706

  7. Who Follows eHealth Interventions as Recommended? A Study of Participants' Personal Characteristics From the Experimental Arm of a Randomized Controlled Trial

    PubMed Central

    Schulz, Daniela N; Crutzen, Rik; Kremers, Stef PJ; de Vries, Hein

    2015-01-01

    Background Computer-tailored eHealth interventions to improve health behavior have been demonstrated to be effective and cost-effective if they are used as recommended. However, different subgroups may use the Internet differently, which might also affect intervention use and effectiveness. To date, there is little research available depicting whether adherence to intervention recommendations differs according to personal characteristics. Objective The aim was to assess which personal characteristics are associated with using an eHealth intervention as recommended. Methods A randomized controlled trial was conducted among a sample of the adult Dutch population (N=1638) testing an intervention aimed at improving 5 healthy lifestyle behaviors: increasing fruit and vegetable consumption, increasing physical activity, reducing alcohol intake, and promoting smoking cessation. Participants were asked to participate in those specific online modules for which they did not meet the national guideline(s) for the respective behavior(s). Participants who started with fewer than the recommended number of modules of the intervention were defined as users who did not follow the intervention recommendation. Results The fewer modules recommended to participants, the better participants adhered to the intervention modules. Following the intervention recommendation increased when participants were older (χ2 1=39.8, P<.001), female (χ2 1=15.8, P<.001), unemployed (χ2 1=7.9, P=.003), ill (χ2 1=4.5, P=.02), or in a relationship (χ2 1=7.8, P=.003). No significant relevant differences were found between groups with different levels of education, incomes, or quality of life. Conclusion Our findings indicate that eHealth interventions were used differently by subgroups. The more frequent as-recommended intervention use by unemployed, older, and ill participants may be an indication that these eHealth interventions are attractive to people with a greater need for health care information

  8. Back to the future? Health benefits, organized labor, and universal health care.

    PubMed

    Gottschalk, Marie

    2007-12-01

    The umbrella of employment-based health benefits is growing increasingly threadbare. As a result, health benefits are once again a major arena of labor-management strife, and once again calls for universal health care by many labor leaders mask important differences between them over health care reform. Some labor leaders advocate a bottom-up mobilization in support of a single-payer solution that would dismantle the system of job-based benefits rooted in private insurance. Others stake their health care strategy on wooing key business leaders to be constructive partners in some kind of unspecified comprehensive reform of the health system. Organized labor faces enormous obstacles, both institutional and ideological, to forging an effective united front to fight for comprehensive, high-quality, affordable health care for all. Two entrenched features of the shadow welfare state of job-based benefits, notably the Employee Retirement Income Security Act (ERISA) of 1974 and the union-run health and welfare funds created under the Taft-Hartley Act, remain daunting barriers on the road to reform, exacerbating tensions and differences within organized labor. Moreover, a dramatic ideological schism in the labor movement about its future direction vexes its stance on health care reform. These ideological differences fuel vastly different views within organized labor about how best to confront the unraveling of job-based health benefits and the growing popularity among business leaders, insurers, and public officials of the "individual-mandate" solution, which would penalize people who do not have adequate health insurance. PMID:18000156

  9. Recommended launch-hold criteria for protecting public health from hydrogen chloride (HC1) gas produced by rocket exhaust

    SciTech Connect

    Daniels, J.I.; Baskett, R.L.

    1995-11-01

    Solid-fuel rocket motors used by the United States Air Force (USAF) to launch missiles and spacecraft can produce ambient-air concentrations of hydrogen chloride (HCI) gas. The HCI gas is a reaction product exhausted from the rocket motor during normal launch or emitted as a result of a catastrophic abort destroying the launch vehicle. Depending on the concentration in ambient air, the HCI gas can be irritating or toxic to humans. The diagnostic and complex-terrain wind field and particle dispersion model used by the Lawrence Livermore National Laboratory`s (LLNL`s) Atmospheric Release Advisory Capability (ARAC) Program was applied to the launch of a Peacekeeper missile from Vandenberg Air Force Base (VAFB) in California. Results from this deterministic model revealed that under specific meteorological conditions, cloud passage from normal-launch and catastropic-abort situations can yield measureable ground-level air concentrations of HCI where the general public is located. To protect public health in the event of such cloud passage, scientifically defensible, emergency ambient-air concentration limits for HCI were developed and recommended to the USAF for use as launch-hold criteria. Such launch-hold criteria are used to postpone a launch unless the forecasted meteorological conditions favor the prediction of safe ground-level concentrations of HCl for the general public. The recommended concentration limits are a 2 ppM 1-h time-weighted average (TWA) concentration constrained by a 1-min 10-ppM average concentration. This recommended criteria is supported by human dose-response information, including data for sensitive humans (e.g., asthmatics), and the dose response exhibited experimentally by animal models with respiratory physiology or responses considered similar to humans.

  10. Evaluative Criteria for Qualitative Research in Health Care: Controversies and Recommendations

    PubMed Central

    Cohen, Deborah J.; Crabtree, Benjamin F.

    2008-01-01

    PURPOSE We wanted to review and synthesize published criteria for good qualitative research and develop a cogent set of evaluative criteria. METHODS We identified published journal articles discussing criteria for rigorous research using standard search strategies then examined reference sections of relevant journal articles to identify books and book chapters on this topic. A cross-publication content analysis allowed us to identify criteria and understand the beliefs that shape them. RESULTS Seven criteria for good qualitative research emerged: (1) carrying out ethical research; (2) importance of the research; (3) clarity and coherence of the research report; (4) use of appropriate and rigorous methods; (5) importance of reflexivity or attending to researcher bias; (6) importance of establishing validity or credibility; and (7) importance of verification or reliability. General agreement was observed across publications on the first 4 quality dimensions. On the last 3, important divergent perspectives were observed in how these criteria should be applied to qualitative research, with differences based on the paradigm embraced by the authors. CONCLUSION Qualitative research is not a unified field. Most manuscript and grant reviewers are not qualitative experts and are likely to embrace a generic set of criteria rather than those relevant to the particular qualitative approach proposed or reported. Reviewers and researchers need to be aware of this tendency and educate health care researchers about the criteria appropriate for evaluating qualitative research from within the theoretical and methodological framework from which it emerges. PMID:18626033

  11. Health hazard evaluation report HETA 94-0109-2494, Pan American Health Organization National Smelting Company, Oruro, Bolivia

    SciTech Connect

    Sussell, A.; Singal, M.

    1995-03-01

    In response to a request from the Pan American Health Organization (PAHO), an investigation was begun into possible exposures to heavy metals and sulfur-dioxide at Empresa Metalurigica Vinto, a large tin smelter near Oruro, Bolivia. Fifteen workers were selected for exposure monitoring. Of the 15, 14 had exposures greater than the NIOSH Recommended Exposure Limit or the OSHA Permissible Exposure Level to arsentic; 11 had hazardous exposures to cadmium, and eight had hazardous exposures to sulfur-dioxide. Surfaces throughout the facility were highly contaminated with heavy metals. Fifteen workers participated in biological monitoring studies. The median value for urinary arsenic (UA) was 78 micrograms per gram creatinine. Nine of the 15 workers had UA levels exceeding the American Conference of Governmental Industrial Hygienists Biological Exposure Index. The median blood lead level was 19 micrograms per deciliter.

  12. Weight Status, Gender, and Race/Ethnicity: Are There Differences in Meeting Recommended Health Behavior Guidelines for Adolescents?

    PubMed Central

    Minges, Karl E.; Chao, Ariana; Nam, Soohyun; Grey, Margaret; Whittemore, Robin

    2014-01-01

    Healthy behaviors including limited screen time (ST), high physical activity (PA), and adequate fruits and vegetables consumption (FV) are recommended for adolescents, but it is unclear how gender, race/ethnicity, and weight status relate to these public health guidelines in diverse urban adolescents. Participants (N = 384) were recruited from three public high schools in or near New Haven, Connecticut. Descriptive statistics and logistic regression analyses were conducted. Most adolescents exceeded recommended levels of ST (70.5%) and did not meet guidelines for PA (87.2%) and FV (72.6%). Only 3.5% of the sample met all three guidelines. Boys were more likely to meet guidelines for PA (p < .01), while girls were engaged in less ST (p < .001). Black, non-Latinos were less likely to meet PA guidelines (p < .05). There were no significant differences in meeting ST, PA, or FV guidelines by weight status for the overall sample or when stratified by gender or race/ethnicity. We found alarmingly low levels of healthy behaviors in normal weight and overweight/obese adolescents. PMID:25312400

  13. Bone Health Monitoring in Astronauts: Recommended Use of Quantitative Computed Tomography [QCT] for Clinical and Operational Decisions

    NASA Technical Reports Server (NTRS)

    Sibonga, J. D.; Truskowski, P.

    2010-01-01

    This slide presentation reviews the concerns that astronauts in long duration flights might have a greater risk of bone fracture as they age than the general population. A panel of experts was convened to review the information and recommend mechanisms to monitor the health of bones in astronauts. The use of Quantitative Computed Tomography (QCT) scans for risk surveillance to detect the clinical trigger and to inform countermeasure evaluation is reviewed. An added benefit of QCT is that it facilitates an individualized estimation of bone strength by Finite Element Modeling (FEM), that can inform approaches for bone rehabilitation. The use of FEM is reviewed as a process that arrives at a composite number to estimate bone strength, because it integrates multiple factors.

  14. An Investigation into the Social Context of Low-Income, Urban Black and Latina Women: Implications for Adherence to Recommended Health Behaviors

    ERIC Educational Resources Information Center

    Shelton, Rachel C.; Goldman, Roberta E.; Emmons, Karen M.; Sorensen, Glorian; Allen, Jennifer D.

    2011-01-01

    Understanding factors that promote or prevent adherence to recommended health behaviors is essential for developing effective health programs, particularly among lower income populations who carry a disproportionate burden of disease. We conducted in-depth qualitative interviews (n = 64) with low-income Black and Latina women who shared the…

  15. Recommended Toxicity Equivalence Factors (TEFs) for Human Health Risk Assessments of 2,3,7,8-Tetrachlorodibenzo-p-dioxin and Dioxin-Like Compounds

    EPA Science Inventory

    The Risk Assessment Forum (RAF) Human Health TEFs document describes EPA’s updated approach for evaluating the human health risks from exposures to environmental media containing dioxin-like compounds. It recommends the use of consensus TEF values for 2,3,7,8-tetrachlorodibenzo-...

  16. Physical Activity and Public Health in Older Adults: Recommendation from the American College of Sports Medicine and the American Heart Association

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Objective: To issue a recommendation on the types and amounts of physical activity needed to improve and maintain health in older adults. Participants: A panel of scientists with expertise in public health, behavioral science, epidemiology, exercise science, medicine, and gerontology. Evidence: The ...

  17. The Apollo Medical Operations Project: Recommendations to improve crew health and performance for future exploration missions and lunar surface operations

    NASA Astrophysics Data System (ADS)

    Scheuring, Richard A.; Jones, Jeffrey A.; Novak, Joseph D.; Polk, James D.; Gillis, David B.; Schmid, Josef; Duncan, James M.; Davis, Jeffrey R.

    Introduction: Medical requirements for the future crew exploration vehicle (CEV), lunar surface access module (LSAM), advanced extravehicular activity (EVA) suits, and Lunar habitat are currently being developed within the exploration architecture. While much is known about the vehicle and lunar surface activities during Apollo, relatively little is known about whether the hardware, systems, or environment impacted crew health or performance during these missions. Also, inherent to the proposed aggressive surface activities is the potential risk of injury to crewmembers. The Space Medicine Division at the NASA Johnson Space Center (JSC) requested a study in December 2005 to identify Apollo mission issues relevant to medical operations impacting crew health and/or performance during a lunar mission. The goals of this project were to develop or modify medical requirements for new vehicles and habitats, create a centralized database for future access, and share relevant Apollo information with various working groups participating in the exploration effort. Methods: A review of medical operations during Apollo missions 7-17 was conducted. Ten categories of hardware, systems, or crew factors were identified during preliminary data review generating 655 data records which were captured in an Access® database. The preliminary review resulted in 285 questions. The questions were posed to surviving Apollo crewmembers using mail, face-to-face meetings, phone communications, or online interactions. Results: Fourteen of 22 surviving Apollo astronauts (64%) participated in the project. This effort yielded 107 recommendations for future vehicles, habitats, EVA suits, and lunar surface operations. Conclusions: To date, the Apollo Medical Operations recommendations are being incorporated into the exploration mission architecture at various levels and a centralized database has been developed. The Apollo crewmember's input has proved to be an invaluable resource. We will continue

  18. Summary of papers and research recommendations of Working Group on Tropospheric Ozone, Health Effects Institute environmental epidemiology planning project.

    PubMed Central

    Tager, I B

    1993-01-01

    This paper summarizes the themes and recommendations that emerge from the papers presented by the Working Group on Tropospheric Ozone. In terms of current knowledge, the following are considered of particular importance: a) lack of clear evidence for a human analogue of the terminal bronchiolar and proximal acinar changes observed in the lungs of ozone-exposed animals; b) lack of evidence for a connection between the acute respiratory effects of O3 and possible chronic respiratory effects; c) need to better define the characteristics of O3-susceptible individuals; d) the lack of adequate exposure assessment tools for reconstruction of lifetime O3 exposure; and e) incomplete information on the role of other ambient environmental pollutants in the facilitation of O3 effects or as a cause of effects attributed to O3 in human populations. Based on the above, several recommendations for epidemiologic research on health effects of O3 are offered. a) Studies to investigate the existence of chronic health effects of O3 are essential, particularly those that include autopsied human lung tissue and biologic and physiologic response markers. b) Studies are needed to link acute responses with chronic effects and should include joint epidemiologic and controlled-exposure assessments. c) Studies are needed to identify susceptible subgroups. Such studies should include newly emerging biologic markers of O3 exposure. d) Accurate and precise tools for chronic O3 exposure assessment need to be developed for use in retrospective and prospective studies. e) Collaborative studies between epidemiologists and laboratory investigators are needed to develop and evaluate markers of O3 exposure and to test O3 exposure models. PMID:8206040

  19. Work organization and the health of bank employees.

    PubMed

    Silva, Juliana Lemos; Navarro, Vera Lucia

    2012-01-01

    The Brazilian banking sector has undergone an intense restructuring process and taken a leading position in the incorporation of new technologies and organizational innovations. Computerization in the industry, in association with forms of work organization, has resulted in changes that reflect on the workers' health. Based on the theoretical and methodological frameworks of historical and dialectical materialism, this qualitative study investigates the work conditions of bank employees in order to identify the extent to which changes in work organization interfere with these workers' health. Data were collected through interviews held with 11 bank employees. In addition to physical sickening due to occupational diseases directly related to work intensification, the results also show an increased incidence of mental suffering and a feeling of loss of professional identity. Work-related frustration, instability and concerns related to psychological pressure resulting from the need to achieve goals predominated in the reports. PMID:22699722

  20. What happens to coroners’ recommendations for improving public health and safety? Organisational responses under a mandatory response regime in Victoria, Australia

    PubMed Central

    2014-01-01

    Background Several countries of the British Commonwealth, including Australia and the United Kingdom, vest in coroners the power to issue recommendations for protecting public health and safety. Little is known about whether and how organisations that receive recommendations act on them. Concerns that recommendations are frequently ignored prompted the government of Victoria, Australia, to introduce a requirement in 2008 compelling organisations that receive recommendations to provide a written statement of action. Methods We conducted a prospective study of organisations that received recommendations from Victorian coroners over a 33-month period. Using an online survey, we asked representatives of "recipient organisations" what action (if any) their organisations took, and what factors influenced their decision. We also probed views of the quality of the recommendations and the mandatory response regime in general. Responses were analysed at the recommendation- and recipient organisation-level by calculating counts and proportions and using chi-square analyses to test for sub-group differences. Results Ninety of 153 recipient organisations surveyed responded (59% response rate); they received 164 recommendations (mean = 1.9; range, 1–7) from 74 cases. A total of 37% (60/164) of the recommendations were accepted and implemented, 27% (45/164) were rejected, and for 36% (59/164) the recommended action was "supplanted" (i.e., action had already been taken). In nearly half of rejected recommendations (18/45), recipient organisations indicated implementation was not logistically viable. In half of supplanted recommendations, an internal investigation had prompted the action. Three quarters (67/90) of recipient organisations believed the introduction of a mandatory response regime was a good idea, but fewer regarded the recommendations they received as appropriate (52/90) or likely to be effective in preventing death and injury (45/90). Conclusions Only a third of

  1. Recommended Methods for Monitoring Skeletal Health in Astronauts to Distinguish Specific Effects of Prolonged Spaceflight

    NASA Technical Reports Server (NTRS)

    Vasadi, Lukas J.; Spector, Elizabeth R.; Smith, Scott A.; Yardley, Gregory L.; Evans, Harlan J.; Sibonga, Jean D.

    2016-01-01

    NASA uses areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry (DXA) to monitor skeletal health in astronauts after typical 180-day spaceflights. The osteoporosis field and NASA, however, recognize the insufficiency of DXA aBMD as a sole surrogate for fracture risk. This is an even greater concern for NASA as it attempts to expand fracture risk assessment in astronauts, given the complicated nature of spaceflight-induced bone changes and the fact that multiple 1-year missions are planned. In the past decade, emerging analyses for additional surrogates have been tested in clinical trials; the potential use of these technologies to monitor the biomechanical integrity of the astronaut skeleton will be presented. OVERVIEW: An advisory panel of osteoporosis policy-makers provided NASA with an evidence-based assessment of astronaut biomedical and research data. The panel concluded that spaceflight and terrestrial bone loss have significant differences and certain factors may predispose astronauts to premature fractures. Based on these concerns, a proposed surveillance program is presented which a) uses Quantitative Computed Tomography (QCT) scans of the hip to monitor the recovery of spaceflight-induced deficits in trabecular BMD by 2 years after return, b) develops Finite Element Models [FEM] of QCT data to evaluate spaceflight effect on calculated hip bone strength and c) generates Trabecular Bone Score [TBS] from serial DXA scans of the lumbar spine to evaluate the effect of age, spaceflight and countermeasures on this novel index of bone microarchitecture. SIGNIFICANCE: DXA aBMD is a widely-applied, evidence-based predictor for fractures but not applicable as a fracture surrogate for premenopausal females and males <50 years. Its inability to detect structural parameters is a limitation for assessing changes in bone integrity with and without countermeasures. Collective use of aBMD, TBS, QCT, and FEM analysis for astronaut surveillance could

  2. [Malaria and activities of the World Health Organization].

    PubMed

    Nájera, J A

    1991-08-01

    Malaria has been one of the main health problems demanding the attention of WHO from the time the Organization was created. This review of the historical record analyzes the different approaches to the malaria problem in the past 40 years and shows how WHO tried to fulfill its constitutional mandate. The article exposes the historical roots of the present situation and helps towards an understanding of current problems and approaches to malaria control. PMID:1834084

  3. Adoption of Clinical Information Systems in Health Services Organizations

    PubMed Central

    Austin, Charles J.; Holland, Gloria J.

    1988-01-01

    This paper presents a conceptual model of factors which influence organizational decisions to invest in the installation of clinical information systems. Using results of previous research as a framework, the relative influence of clinical, fiscal, and strategic-institutional decision structures are examined. These adoption decisions are important in health services organizations because clinical information is essential for managing demand and allocating resources, managing quality of care, and controlling costs.

  4. Hispanic Medical Organizations' Support for LGBT Health Issues.

    PubMed

    Sánchez, John Paul; Sola, Orlando; Ramallo, Jorge; Sánchez, Nelson Felix; Dominguez, Kenneth; Romero-Leggott, Valerie

    2014-09-01

    Hispanics represent the fastest growing ethnic segment of the lesbian, gay, bisexual, and transgender (LGBT) community in the United States and are disproportionately burdened by LGBT-related health issues and limited political support from Hispanic medical organizations. Recently, the Latino Medical Student Association, the National Hispanic Medical Association, and the Hispanic Serving Health Professions Schools, representing over 60,000 Hispanic students and providers and 35 institutions, collaborated to support a resolution opposing discrimination based on sexual orientation or gender identity and recognizing the obstacles encountered by LGBTQ Hispanics. The resolution provides an important framework for organizational members and leaders to address LGBT health issues and serve to support a more positive sociopolitical climate for the Hispanic LGBT community nationally and internationally. PMID:26789708

  5. Rural maternal, child, and adolescent health.

    PubMed Central

    McManus, M A; Newacheck, P W

    1989-01-01

    Authors cite recommendations for research in light of a general lack of current literature on health status, health services utilization, organization and delivery of health services, and health care financing in this field. PMID:2645249

  6. Managing corporate governance risks in a nonprofit health care organization.

    PubMed

    Troyer, Glenn T; Brashear, Andrea D; Green, Kelly J

    2005-01-01

    Triggered by corporate scandals, there is increased oversight by governmental bodies and in part by the Sarbanes-Oxley Act of 2002. Corporations are developing corporate governance compliance initiatives to respond to the scrutiny of regulators, legislators, the general public and constituency groups such as investors. Due to state attorney general initiatives, new legislation and heightened oversight from the Internal Revenue Service, nonprofit entities are starting to share the media spotlight with their for-profit counterparts. These developments are changing nonprofit health care organizations as well as the traditional role of the risk manager. No longer is the risk manager focused solely on patients' welfare and safe passage through a complex delivery system. The risk manager must be aware of corporate practices within the organization that could allow the personal objectives of a few individuals to override the greater good of the community in which the nonprofit organization serves. PMID:20200865

  7. Improving Coordination of Addiction Health Services Organizations with Mental Health and Public Health Services.

    PubMed

    Guerrero, Erick G; Andrews, Christina; Harris, Lesley; Padwa, Howard; Kong, Yinfei; M S W, Karissa Fenwick

    2016-01-01

    In this mixed-method study, we examined coordination of mental health and public health services in addiction health services (AHS) in low-income racial and ethnic minority communities in 2011 and 2013. Data from surveys and semistructured interviews were used to evaluate the extent to which environmental and organizational characteristics influenced the likelihood of high coordination with mental health and public health providers among outpatient AHS programs. Coordination was defined and measured as the frequency of interorganizational contact among AHS programs and mental health and public health providers. The analytic sample consisted of 112 programs at time 1 (T1) and 122 programs at time 2 (T2), with 61 programs included in both periods of data collection. Forty-three percent of AHS programs reported high frequency of coordination with mental health providers at T1 compared to 66% at T2. Thirty-one percent of programs reported high frequency of coordination with public health services at T1 compared with 54% at T2. Programs with culturally responsive resources and community linkages were more likely to report high coordination with both services. Qualitative analysis highlighted the role of leadership in leveraging funding and developing creative solutions to deliver coordinated care. Overall, our findings suggest that AHS program funding, leadership, and cultural competence may be important drivers of program capacity to improve coordination with health service providers to serve minorities in an era of health care reform. PMID:26350114

  8. Summary recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, The Computer-based Patient Record Institute, The Medical Library Association, The Association of Academic Health Science Libraries, The American Health Information Management Association, and The American Nurses Association.

    PubMed

    Miller, R A; Gardner, R M

    1997-11-01

    Clinical software systems are becoming ubiquitous. A growing literature documents how these systems can improve health care delivery, but concerns about patient safety must now be formally addressed. In 1996, the U.S. Food and Drug Administration (FDA) called for discussions on regulation of software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. These recommendations were revised and approved by the American Medical informatics Association Public Policy Committee and Board. Other organizations reviewed, modified, and approved the recommendations, and the Boards of Directors of most of the organizations in the consortium endorsed the guidelines. The consortium proposes four categories of clinical system risk and four classes of monitoring and regulatory action that can be applied on the basis of the risk level. The consortium recommends that most clinical software systems be supervised locally and that developers of health care information systems adopt a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively; therefore, the FDA should exempt most clinical software systems and focus on systems that pose high clinical risk and provide limited opportunity for competent human intervention. PMID:9382409

  9. The new organization of the health care delivery system.

    PubMed

    Shortell, S M; Hull, K E

    1996-01-01

    The U.S. health care system is restructuring at a dizzying pace. In many parts of the country, managed care has moved into third-generation models emphasizing capitated payment for enrolled lives and, in the process, turning most providers and institutions into cost centers to be managed rather than generators of revenue. While the full impact of the new managed care models remains to be seen, most evidence to date suggests that it tends to reduce inpatient use, may be associated with greater use of physician services and preventive care, and appears to result in no net differences either positive or negative with regard to quality or outcomes of care in comparison with fee-for-service plans. Some patients, however, tend to be somewhat less satisfied with scheduling of appointments and the amount of time spent with providers. There is no persuasive evidence that managed care lowers the rate of growth in overall health care costs within a given market. Further, managed care performance varies considerably across the country, and the factors influencing managed care performance are not well understood. Organized delivery systems are a somewhat more recent phenomenon representing various forms of ownership and strategic alliances among hospitals, physicians, and insurers designed to provide more cost-effective care to defined populations by achieving desired levels of functional, physician-system, and clinical integration. Early evidence suggests that organized delivery systems that are more integrated have the potential to provide more accessible coordinated care across the continuum, and appear to be associated with higher levels of inpatient productivity, greater total system revenue, greater total system cash flow, and greater total system operating margin than less integrated delivery forms. Some key success factors for developing organized delivery systems have been identified. Important roles are played by organizational culture, information systems, internal

  10. The future of global health cooperation: designing a new World Health Organization.

    PubMed

    Forss, K; Stenson, B; Sterky, G

    1996-06-01

    This article discusses some needed changes to the functioning and management of the World Health Organization (WHO). WHO is unable to meet new challenges and needs reform. The Executive Board of WHO initiated an internal review in 1992 that led to a management-related focus, while informal groups within the agency tackled funding constraints. Some governments and nongovernmental groups have proposed reorganization of international health assistance. The authors urge that the public health sector and researchers join the reform effort. WHO was established in 1948 and was the sole global health agency. The demand for greater international health cooperation has increased over time. WHO is an association of sovereign states. WHO demonstrated success in eliminating smallpox, promotion of health policy, collection and dissemination of epidemiologic information, and establishment of standards in health care and medical ethics. WHO staff comprises about 5000 persons. The annual budget is too small at about US$900 million. In 1995 only 56% of receipts were collected. WHO's constitution mandates complete health for all, but there has been a widening gap between rich and poor and those with access to health services and those without. Absolute and relative poverty are the main determinants of premature mortality and ill health. The major challenge for health policy is this disparity; the focus of international collaboration should be on this issue. The machine metaphor of organizational structure no longer works in today's world. The authors propose that WHO limit functions in health development and create a full mandate for dealing with determinants of health. WHO should be participatory, open to constituents, autonomous, and flexible. Member states must be more powerful in policy formulation. Program implementation should occur in independent programs in a decentralized system. PMID:12291612

  11. Health of returnees in Osijek Region and required special measures of health care and community organization.

    PubMed

    Prlić, Lidija; Ebling, Zdravko; Glavina, Kresimir; Gmajnić, Rudika; Vuletić, Gorka; Kovacić, Luka; Tokalić, Martin

    2004-01-01

    Many citizens from the Osijek-Baranja County, in order to survive, left their homes during the 1991/92 war in Croatia and spent between 5 and 7 years in exile. The aim of this pilot research was to assess the health status (physical, mental and social) of refugee /returnee population and their use of health services, to identify the factors influencing their adaptation, and to propose the health programs, psychological and social support, which could help foster integration into the social and community life, education and employment. The study was done on a randomized sample of 589 respondents using the 2003 Croatian Health Survey with an additional questionnaire related to the problems of returnees. The results of the study show good organization of health service in returnees' communities, with exception of gynecological and dental services. There was also a presence of health transportation problem and the problem in the supply of medicines. Finally, the results show that the returnees' communities were dominated by social problems such as lack of employment, lack of support for elderly, poverty, and concerns for children's prospects. This implies the necessity for intervention in both mental and social aspects. Measures to be undertaken in the next stage of the Project will be aimed at the work in the refugee communities and based on public health working methods such as organization of the community by stimulating intergenerational solidarity, education and raising awareness of self-help. PMID:15571108

  12. Information technology and knowledge exchange in health-care organizations.

    PubMed Central

    Vimarlund, V.; Timpka, T.; Patel, V. L.

    1999-01-01

    Despite the increasing global interest in information technology among health care institutions, little has been discussed about its importance for the effectiveness of knowledge management. In this study, economic theories are used to analyze and describe a theoretical framework for the use of information technology in the exchange of knowledge. The analyses show that health care institutions would benefit from developing global problem-solving collaboration, which allows practitioners to exchange knowledge unrestricted by time and geographical barriers. The use of information technology for vertical integration of health-care institutions would reduce knowledge transaction costs, i.e. decrease costs for negotiating and creating communication channels, and facilitating the determination of what, when, and how to produce knowledge. A global network would allow organizations to increase existing knowledge, and thus total productivity, while also supporting an environment where the generation of new ideas is unrestricted. Using all the intellectual potential of market actors and thereby releasing economic resources can reduce today's global budget conflicts in the public sector, i.e. the necessity to choose between health care services and, for instance, schools and support for the elderly. In conclusion, global collaboration and coordination would reduce the transaction costs inherent in knowledge administration and allow a more effective total use of scarce health-care resources. PMID:10566436

  13. Mental health disorders and solid-organ transplant recipients.

    PubMed

    Corbett, Chris; Armstrong, Matthew J; Parker, Richard; Webb, Kerry; Neuberger, James M

    2013-10-15

    Depression affects up to 60% of solid-organ recipients and is independently associated with both mortality (hazard ratio for death of ~2) and de novo malignancy after transplantation, although the mechanism is not clear. Both pretransplantation psychosis and depression occurring more than 2 years after transplantation are associated with increased noncompliance and graft loss. It remains to be shown that effective treatment of depression is associated with improved outcomes and quality of life. Immunosuppressive drugs (especially corticosteroids and calcineurin inhibitors) and physiologic challenges can precipitate deterioration in mental health. All potential transplant candidates should be assessed for mental health problems and preexisting medical conditions that can mimic mental health problems, such as uremic, hepatic, or hypoxic encephalopathy, should be identified and treated appropriately. Expert mental health review of those with identified risk factors (such as previous suicide attempts, history of mental illness or noncompliance with medications) is advisable early in the transplant assessment process to mitigate risk and support the patient. Patients with mental health disorders, when adequately controlled and socially supported, have outcomes similar to the general transplant population. Therefore, exclusion from transplantation based on the diagnosis alone is neither ethically nor medically justified. However, it is ethically and clinically justifiable to deny access to transplantation to those who, despite full support, would have a quality of life that is unacceptable to the candidate or are likely to be noncompliant with treatment or follow-up, which would lead to graft loss. PMID:23743726

  14. The Effects of Organic Pollutants in Soil on Human Health

    NASA Astrophysics Data System (ADS)

    Burgess, Lynn

    2013-04-01

    The soil has always been depository of the organic chemicals produced naturally or anthropogenically. Soil contamination is a serious human and environmental problem. A large body of evidence has shown the risks of adverse health effects with the exposure to contaminated soil due to the large quantities of organic chemicals used in agriculture and urban areas that have a legacy of environmental pollution linked to industrial activities, coal burning, motor vehicle emissions, waste incineration and waste dumping. In agricultural areas, because of the effort to provide adequate quantities of agricultural products, farmers have been using an increasing amount of organic chemicals, but the resulting pollution has enormous potential for environmental damage. The types of organic pollutants commonly found in soils are polychlorinated biphenyls, polybrominated biphenyls, polychlorinated dibenzofurans, polycyclic aromatic hydrocarbons, organophosphorus and carbamate insecticides, herbicides and organic fuels, especially gasoline and diesel. Another source of soil pollution is the complex mixture of organic chemicals, metals and microorganisms in the effluent from septic systems, animal wastes and other sources of biowaste. The soils of the world are a vast mixture of chemicals and although conditions are such that an individual is rarely exposed to a single compound, the great majority of people are exposed to a vast chemical mixture of organics, their metabolites, and other compounds at low concentrations Human exposure to organic pollutants in the soil is an area of toxicology that is very difficult to study due to the low concentration of the pollutants. The toxicological studies of single organic pollutants found in soils are limited and research on the metabolites and of chemical mixtures is very limited. The majority of toxicological studies are conducted at relatively high doses and for short periods of exposure. This makes the application of this data to exposure

  15. Exploring the state of health and safety management system performance measurement in mining organizations

    PubMed Central

    Haas, Emily Joy; Yorio, Patrick

    2016-01-01

    Complex arguments continue to be articulated regarding the theoretical foundation of health and safety management system (HSMS) performance measurement. The culmination of these efforts has begun to enhance a collective understanding. Despite this enhanced theoretical understanding, however, there are still continuing debates and little consensus. The goal of the current research effort was to empirically explore common methods to HSMS performance measurement in mining organizations. The purpose was to determine if value and insight could be added into the ongoing approaches of the best ways to engage in health and safety performance measurement. Nine site-level health and safety management professionals were provided with 133 practices corresponding to 20 HSMS elements, each fitting into the plan, do, check, act phases common to most HSMS. Participants were asked to supply detailed information as to how they (1) assess the performance of each practice in their organization, or (2) would assess each practice if it were an identified strategic imperative. Qualitative content analysis indicated that the approximately 1200 responses provided could be described and categorized into interventions, organizational performance, and worker performance. A discussion of how these categories relate to existing indicator frameworks is provided. The analysis also revealed divergence in two important measurement issues; (1) quantitative vs qualitative measurement and reporting; and (2) the primary use of objective or subjective metrics. In lieu of these findings we ultimately recommend a balanced measurement and reporting approach within the three metric categories and conclude with suggestions for future research. PMID:26823642

  16. Diversity and cultural competence training in health care organizations: hallmarks of success.

    PubMed

    Curtis, Ellen Foster; Dreachslin, Janice L; Sinioris, Marie

    2007-01-01

    The authors reviewed recent literature on diversity training interventions and identified effective practices for health care organizations. Self-reported satisfaction was especially likely to be found as a result of training, whereas attitude change measured by standardized instruments was mixed. Although those responsible for diversity training in the workplace agree that behavioral change is key, awareness building and associated attitude change remain the focus of most diversity training in the workplace. Consequently, the authors recommend a systems approach to diversity training interventions wherein training is a key component of a health care organization's strategic approach to organizational performance, and diversity training is linked to the organizations' strategic goals for improved quality of care. The systems approach requires these steps: determine diversity and cultural competence goals in the context of strategy, measure current performance against needs, design training to address the gap, implement the training, assess training effectiveness, and strive for continuous improvement. Higher level evaluations measuring whether employees have transferred learning from training to their jobs are paramount to the systems approach to diversity training interventions. Measuring other positive changes in a "return on investment" format can be used to convince stakeholders of training's value. PMID:17938595

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

    PubMed

    Meier, Benjamin Mason; Ayala, Ana S

    2014-01-01

    In the absence of centralized human rights leadership in an increasingly fragmented global health policy landscape, regional health offices have stepped forward to advance the rights-based approach to health. Reviewing the efforts of the Pan American Health Organization (PAHO), this article explores the evolution of human rights in PAHO policy, assesses efforts to mainstream human rights in the Pan American Sanitary Bureau (PASB), and analyzes the future of the rights-based approach through regional health governance, providing lessons for other regional health offices and global health institutions. This article explores PAHO's 15-year effort to mainstream human rights through PASB technical units, national capacity-building, the Inter-American human rights system, and the PAHO Directing Council. Through documentary analysis of PAHO policies and semi-structured interviews with key PASB stakeholders, the authors analyze the understandings and actions of policymakers and technical officers in implementing human rights through PAHO governance. Analyzing the themes arising from this narrative, the authors examine the structural role of secretariat leadership, state support, legal expertise, and technical unit commitment in facilitating a rights-based approach to the health in the Americas. Human rights are increasingly framing PAHO efforts, and this analysis of the structures underlying PAHO's approach provides an understanding of the institutional determinants of the rights-based approach to health, highlighting generalizable themes for the mainstreaming of human rights through regional health governance. With this regional-level understanding of health governance, future national-level research can begin to understand the causal forces linking regional human rights work with national policy reforms and public health outcomes. PMID:25264093

  18. Human Health and the Biological Effects of Tritium in Drinking Water: Prudent Policy Through Science - Addressing the ODWAC New Recommendation.

    PubMed

    Dingwall, S; Mills, C E; Phan, N; Taylor, K; Boreham, D R

    2011-01-01

    Tritium is a radioactive form of hydrogen and is a by-product of energy production in Canadian Deuterium Uranium (CANDU) reactors. The release of this radioisotope into the environment is carefully managed at CANDU facilities in order to minimize radiation exposure to the public. However, under some circumstances, small accidental releases to the environment can occur. The radiation doses to humans and non-human biota from these releases are low and orders of magnitude less than doses received from naturally occurring radioisotopes or from manmade activities, such as medical imaging and air travel. There is however a renewed interest in the biological consequences of low dose tritium exposures and a new limit for tritium levels in Ontario drinking water has been proposed. The Ontario Drinking Water Advisory Council (ODWAC) issued a formal report in May 2009 in response to a request by the Minister of the Environment, concluding that the Ontario Drinking Water Quality Standard for tritium should be revised from the current 7,000 Bq/L level to a new, lower 20 Bq/L level. In response to this recommendation, an international scientific symposium was held at McMaster University to address the issues surrounding this change in direction and the validity of a new policy. Scientists, regulators, government officials, and industrial stakeholders were present to discuss the potential health risks associated with low level radiation exposure from tritium. The regulatory, economic, and social implications of the new proposed limit were also considered.The new recommendation assumed a linear-no-threshold model to calculate carcinogenic risk associated with tritium exposure, and considered tritium as a non-threshold chemical carcinogen. Both of these assumptions are highly controversial given that recent research suggests that low dose exposures have thresholds below which there are no observable detrimental effects. Furthermore, mutagenic and carcinogenic risk calculated from

  19. The association between fruit and vegetable intake, knowledge of the recommendations, and health information seeking within adults in the U.S. mainland and in Puerto Rico.

    PubMed

    Colón-Ramos, Uriyoán; Finney Rutten, Lila J; Moser, Richard P; Colón-Lopez, Vivian; Ortiz, Ana P; Yaroch, Amy Lazarus

    2015-01-01

    Health information correlates of fruit and vegetable intake and of knowledge of the fruit and vegetable recommendations were examined using bivariate and multivariate regressions with data from the 2007-2008 U.S. National Cancer Institute's Health Information National Trends Survey in the United States and in Puerto Rico. Residents from Puerto Rico had the lowest reported fruit and vegetable intake and the lowest knowledge of the recommended servings of fruits and vegetables to maintain good health, compared with U.S. Hispanics, non-Hispanic Whites, and Blacks. Sixty-seven percent of Puerto Rican residents and 62% of U.S. Hispanics reported never seeking information on health or medical topics. In multivariate analysis, those who never sought information on health or medical topics reported significantly lower fruit and vegetable intake (coefficient = -0.24; 95% CI [-0.38, -0.09]), and were less likely to know the fruit and vegetable recommendations (OR = 0.32; 95% CI [0.20, 0.52]), compared with those who obtained information from their health care providers. Health promotion initiatives in the United States and Puerto Rico have invested in mass media campaigns to increase consumption of and knowledge about fruit and vegetables, but populations with the lowest intake are less likely to seek information. Strategies must be multipronged to address institutional, economic, and behavioral constraints of populations who do not seek out health information from any sources. PMID:25204843

  20. Tobacco and oral health--the role of the world health organization.

    PubMed

    Petersen, Poul Erik

    2003-01-01

    In addition to several other chronic diseases, tobacco use is a primary cause of many oral diseases and adverse oral conditions. For example, tobacco is a risk factor for oral cancer, periodontal disease, and congenital defects in children whose mothers smoke during pregnancy. The epidemic of tobacco use is one of the greatest threats to global health; sadly the future appears worse because of the globalization of marketing. The World Health Organization (WHO) has strengthened the work for effective control of tobacco use. At the World Health Assembly in May 2003 the Member States agreed on a groundbreaking public health treaty to control tobacco supply and consumption. The treaty covers tobacco taxation, smoking prevention and treatment, illicit trade, advertising, sponsorship and promotion, and product regulation. Oral health professionals and dental associations worldwide should consider this platform for their future work for tobacco prevention since in several countries they play an important role in communication with patients and communities. The WHO Oral Health Programme gives priority to tobacco control in many ways through the development of national and community programmes which incorporates oral health and tobacco issues, tobacco prevention through schools, tobacco risk assessment in countries, and design of modern surveillance systems on risk factors and oral health. Systematic evaluation of coordinated efforts should be carried out at country and inter-country levels. PMID:15643759

  1. 76 FR 58466 - Request for Comments on World Health Organization Pandemic Influenza Preparedness Framework

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-21

    ... influenza preparedness via the Federal Register on September 14, 2010; 75 FR 55776-55777. The Department of... International Trade Administration Request for Comments on World Health Organization Pandemic Influenza... the World Health Organization Pandemic Influenza Preparedness Framework (...

  2. Comparing ELISA test-positive prevalence, risk factors and management recommendations for Johne's disease prevention between organic and conventional dairy farms in Ontario, Canada.

    PubMed

    Pieper, Laura; Sorge, Ulrike S; DeVries, Trevor; Godkin, Ann; Lissemore, Kerry; Kelton, David

    2015-11-01

    Johne's disease (JD) is a chronic, infectious disease in cattle. Between 2010 and 2013, a voluntary JD control program was successfully launched in Ontario, Canada, including a Risk Assessment and Management Plan (RAMP) and JD ELISA testing of the entire milking herd. Over the last decade, the organic dairy sector has been growing. However, organic farming regulations and philosophies may influence the risk for JD transmission on Ontario organic dairy farms. The aim of this cross-sectional study was to investigate differences in JD ELISA test positive prevalence, risk factors for JD and recommendations for JD prevention between organic and conventional dairy herds in Ontario. RAMP results (i.e. RAMP scores and recommendations) and ELISA results were available for 2103 dairy herds, including 42 organic herds. If available, additional data on milk production, milk quality, and herd characteristics were gathered. Organic and conventional herds had a similar herd-level JD ELISA test-positive prevalence (26.2% and 27.2%, respectively). Organic herds (4.2%) had a higher within-herd JD ELISA test-positive prevalence compared to conventional herds (2.3%) if they had at least one JD test-positive animal on the farm. Organic farms had lower risk scores for biosecurity (9 points lower), and higher scores in the calving (7 points higher) and the calf-rearing management areas (4 points higher). After accounting for RAMP score, organic farms received fewer recommendations for the calving management area (Odds Ratio=0.41) and more recommendations in the adult cow management area (Odds Ratio=2.70). A zero-inflated negative binomial model was built with purchase of animals and the herd size included in the logistic portion of the model. Herd type (organic or conventional), colostrum and milk feeding practices, average bulk tank somatic cell count, and presence of non-Holstein breeds were included in the negative binomial portion of the model. Organic farms had a higher number of

  3. The World Health Organization hand hygiene observation method.

    PubMed

    Sax, Hugo; Allegranzi, Benedetta; Chraïti, Marie-Noëlle; Boyce, John; Larson, Elaine; Pittet, Didier

    2009-12-01

    Monitoring hand hygiene adherence and providing performance feedback to health care workers is a critical component of multimodal hand hygiene promotion programs, but important variations exist in the way adherence is measured. Within the framework of the World Health Organization's (WHO) First Global Patient Safety Challenge known as "Clean Care is Safer Care," an evidence-based, user-centered concept, "My five moments for hand hygiene," has been developed for measuring, teaching, and reporting hand hygiene adherence. This concept is an integral part of the WHO's hand hygiene improvement strategy conceived to translate the WHO Guidelines on Hand Hygiene in Health Care into practice. It has been tested in numerous health care facilities worldwide to ensure its applicability and adaptability to all settings irrespective of the resources available. Here we describe the WHO hand hygiene observation method in detail-the concept, the profile and the task of the observers, their training and validation, the data collection form, the scope, the selection of the observed staff, and the observation sessions-with the objective of making it accessible for universal use. Sample size estimates, survey analysis and report, and major bias and confounding factors associated with observation are discussed. PMID:20004812

  4. Leishmaniasis in the World Health Organization Eastern Mediterranean Region.

    PubMed

    Postigo, Jose A Ruiz

    2010-11-01

    Leishmaniasis represents a major public health problem in the Eastern Mediterranean Region (EMR) of the World Health Organization (WHO). Cutaneous and visceral leishmaniasis are mainly seen in 14 of the 22 countries of the region. In several of these countries outbreaks have an apparent tendency to occur at around 10-year intervals. In 2008, some 100000 new cases of cutaneous leishmaniasis were reported. Foci of zoonotic cutaneous leishmaniasis, caused by Leishmania major, occur in Afghanistan, Egypt, Iran, Iraq, Jordan, Libya, Morocco, Palestine, Pakistan, Saudi Arabia, Sudan, Syria, Tunisia and Yemen. Anthroponotic cutaneous leishmaniasis, caused by L. tropica, occurs in Afghanistan, Iran, Iraq, Morocco, Pakistan, Saudi Arabia, Syria and Yemen. Anthroponotic visceral leishmaniasis, caused by L. donovani, occurs mainly in Sudan and Somalia. Zoonotic visceral leishmaniasis, caused by L. infantum, occurs in most countries of the region. In order to address the problem of leishmaniasis in the EMR, WHO is supporting ministries of health through a strategic plan focusing on (a) training programme managers and health workers on diagnosis and case management; (b) establishing a harmonized regional surveillance system; (c) creating a regional network of experts; (d) promoting political commitment of national governments. PMID:20728317

  5. Demoralization in mental health organizations: leadership and social support help.

    PubMed

    Gabel, Stewart

    2012-12-01

    Demoralization is a commonly observed feeling state that is characterized by a sense of loss of or threat to one's personal values or goals and a perceived inability to overcome obstacles toward achieving these goals. Demoralization has features in common with burnout and may precede or accompany it. Psychiatrists working in many mental health care organizational settings, be they in the public or private sectors, may be at particular risk for demoralization. This is due partly to stressors that threaten their own professional values because of factors such as programmatic cut backs, budgetary reductions and changing social emphases on the value of mental health treatments. They also may be at risk for demoralization because of the effects on them of the governance styles of the agencies in which they are employed. The leadership or governance style in large organizational settings often is authoritarian, hierarchical and bureaucratic, approaches that are antithetical to the more participative leadership styles favored by many mental health professionals in their clinical activities. Clinical leaders in mental health organizations must exhibit various competencies to successfully address demoralization in clinical staff and to provide a counterbalance to the effects of the governance style of many agencies in which they are employed. Appropriate leadership skills, sometimes too simplistically termed "social support", have been found to reduce burnout in various populations and are likely to lessen demoralization as well. This paper reviews these important leadership issues and the relationship of social support to recognized leadership competencies. PMID:22415227

  6. Recommendations for promoting the health and well-being of lesbian, gay, bisexual, and transgender adolescents: a position paper of the Society for Adolescent Health and Medicine.

    PubMed

    2013-04-01

    Adolescent health care providers frequently care for patients who identify as lesbian, gay, bisexual, or transgendered (LGBT), or who may be struggling with or questioning their sexual orientation or gender identity. Whereas these youth have the same health concerns as their non-LGBT peers, LGBT teens may face additional challenges because of the complexity of the coming-out process, as well as societal discrimination and bias against sexual and gender minorities. The Society for Adolescent Health and Medicine encourages adolescent providers and researchers to incorporate the impact of these developmental processes (and understand the impacts of concurrent potential discrimination) when caring for LGBT adolescents. The Society for Adolescent Health and Medicine also encourages providers to help positively influence policy related to LGBT adolescents in schools, the foster care system, and the juvenile justice system, and within the family structure. Consistent with other medical organizations, the Society for Adolescent Health and Medicine rejects the mistaken notion that LGBT orientations are mental disorders, and opposes the use of any type of reparative therapy for LGBT adolescents. PMID:23521897

  7. Serious crisis in the practice of international health by the World Health Organization: the Commission on Social Determinants of Health.

    PubMed

    Banerji, Debabar

    2006-01-01

    The Commission on Social Determinants of Health (CSDH) is the latest effort by the World Health Organization to improve health and narrow health inequalities through action on social determinants. The CSDH does not note that much work has already been done in this direction, does not make a sufficient attempt to analyze why earlier efforts failed to yield the desired results, and does not seem to have devised approaches to ensure that it will be more successful this time. The CSDH intends to complement the work of the earlier WHO Commission on Macroeconomics and Health, which has not had the desired impact, and it is unclear how the CSDH can complement work that suffers from such serious infirmities. Inadequacies of both commissions reflect a crisis in the practice of international health at the WHO, stemming from a combination of unsatisfactory administrative practices and lack of technical competence to provide insights into the problems afflicting the most needy countries. Often the WHO has ended up distorting the rudimentary health systems of the poor countries, by pressuring them into accepting health policies, plans, and programs that lack sound scientific bases. The WHO no longer seems to take into account historical and political factors when it sets out to improve the health situation in low-income countries--which is supposed to be the focus of the CSDH. An alternative approach is suggested. PMID:17175839

  8. Documentation of Sexual Partner Gender Is Low in Electronic Health Records: Observations, Predictors, and Recommendations to Improve Population Health Management in Primary Care

    PubMed Central

    Yehia, Baligh R.

    2015-01-01

    Abstract The 2011 Institute of Medicine report on LGBT health recommended that sexual orientation and gender identity (SO/GI) be documented in electronic health records (EHRs). Most EHRs cannot document all aspects of SO/GI, but some can record gender of sexual partners. This study sought to determine the proportion of patients who have the gender of sexual partners recorded in the EHR and to identify factors associated with documentation. A retrospective analysis was done of EHR data for 40 family medicine (FM) and general internal medicine (IM) practices, comprising 170,570 adult patients seen in 2012. The primary outcome was EHR documentation of sexual partner gender. Multivariate logistic regression assessed the impact of patient, provider, and practice factors on documentation. In all, 76,767 patients (45%) had the gender of sexual partners recorded, 4.3% of whom had same-gender partners (3.5% of females, 5.6% of males). Likelihood of documentation was independently higher for women; blacks; those with a preventive visit; those with a physician assistant, nurse practitioner, or resident primary care provider (vs. attending); those at urban practices; those at smaller practices; and those at a residency FM practice. Older age and Medicare insurance were associated with lower documentation. Sexual partner gender documentation is important to identify patients for targeted prevention and support, and holds great potential for population health management, yet documentation in the EHR currently is low. Primary care practices should routinely record the gender of sexual partners, and additional work is needed to identify best practices for collecting and using SO/GI data in this setting. (Population Health Management 2015;18:217–222). PMID:25290634

  9. Alternative geographic configurations for Medicare payments to health maintenance organizations.

    PubMed

    Porell, F W; Tompkins, C P; Turner, W M

    1990-01-01

    Under prevailing legislation, Medicare payments to health maintenance organizations (HMOs) are based upon projected fee-for-service reimbursement levels for enrollees' county of residence. These rates have been criticized in light of substantial variations in rates among neighboring counties and large fluctuations in rates over time. In this study, the use of nine alternative configurations and the county itself were evaluated on the basis of payment-area homogeneity, payment rate stability, and policy criteria, including the fiscal impacts of reconfiguration on HMOs. The results revealed rather modest differences among most alternative configurations and do not lend strong support for payment area reconfiguration at this time. PMID:10113270

  10. Effect of Mergers on Health Maintenance Organization Premiums

    PubMed Central

    Feldman, Roger; Wholey, Douglas; Christianson, Jon

    1996-01-01

    This study estimated the effect of mergers on health maintenance organization (HMO) premiums, using data on all operational non-Medicaid HMOs in the United States from 1985 to 1993. Two critical issues were examined: whether HMO mergers increase or decrease premiums; and whether the effects of mergers differ according to the degree of competition among HMOs in local markets. The only significant merger effect was found in the most competitive markets, where premiums increased, but only for 1 year after the merger. Our research does not support the argument that consolidation of HMOs in local markets will benefit consumers through lower premiums. PMID:10158729

  11. Stability of frailty in the social/health maintenance organization.

    PubMed

    Hallfors, D; Leutz, W; Capitman, J; Ritter, G

    1994-01-01

    Although many long-term care (LTC) programs assume that the disabilities of their frail elderly participants are stable in nature, there has been suggestive evidence to the contrary. This study tests stability of disability among social/health maintenance organization (S/HMO) members who were judged eligible for admission into a nursing home. Identified persons were reassessed quarterly. By the end of 1 year, less than 50 percent were still considered to be nursing home eligible. Logit analysis revealed an increased likelihood of instability for persons who were newly identified as functionally disabled after hospitalization. Policy implications for capitated managed-care programs for the elderly are discussed. PMID:10138480

  12. Managing the transition to integrated health care organizations.

    PubMed

    Griffith, J R

    1996-01-01

    Today's successful community hospitals should and will evolve into integrated health care organizations (IHCOs) that will share several common characteristics. IHCOs will have a community--not a membership--orientation, and this will be a distinguishing characteristic and a source of market appeal. The transition to IHCO will be a slow one, and to prosper, the IHCO will have to accommodate both price-oriented markets and traditional ones. Successful IHCOs will expand technical skills and capabilities to control costs and quality. New strategic competencies will have to be developed, and to do this, emerging IHCOs will improve the ability of managers to support decisions and sell them both to the buyers and the public at large. Excellent patient care will rest upon better trained, advised, and informed management teams. Making the change to an IHCO will take time and money, but organizations that make steady progress are likely to succeed. PMID:10156172

  13. [Peculiarities of oral health of organized collectives and professional communities].

    PubMed

    Makeeva, I M; Avdeenko, O E

    2016-01-01

    The analysis of scientific literature on the peculiarities of the dental status of organized groups and professional associations. After reviewing the literature, it becomes clear that the studies carried out in organized groups and professional societies are very relevant today, because the prevalence of dental diseases among them remains high, fueled by a number of factors: habitat, diet, lifestyle, occupational hazards, particularly hygienic oral care. Nowadays there is no information about the features of the dental status among the clergy, whose professional activity is connected with direct close contact with people. This profession covers a large number of our population. The research of certain groups is of special interest, since a number of different factors affect dental health. PMID:27182563

  14. Preparing health care organizations for successful case management programs.

    PubMed

    Bonvissuto, C A; Kastens, J M; Atwell, S R

    1997-01-01

    This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program. PMID:9335724

  15. Improvements for international medicine donations: a review of the World Health Organization Guidelines for Medicine Donations, 3rd edition.

    PubMed

    Cañigueral-Vila, Nuria; Chen, Jennifer C; Frenkel-Rorden, Lindsey; Laing, Richard

    2015-01-01

    Some humanitarian and development organizations respond to major natural disasters and emergencies by donating medicines. Many provide medicines on a routine basis to support health systems, particularly those run by Faith-Based Organizations. Although such donations can provide essential medicines to populations in great need, inappropriate donations also take place, with burdensome consequences. The World Health Organization (WHO) has developed the interagency Guidelines for Medicine Donations for use by donors and recipients in the context of emergency aid and international development assistance. Although comprehensive in nature and transferable to various emergency situations, adjustments to both content and formatting would improve this resource. Recommendations for the next version of these guidelines include: specific wording and consistent formatting; definition of who is a recipient, clear distinction between acute and long-term emergencies, and proper donation procedures pertaining to each; inclusion of visual aides such as flowcharts, checklists, and photos; and improving the citations system. PMID:26525948

  16. An exploratory study of organization design configurations in health care delivery organizations.

    PubMed

    Sheppeck, Mick; Militello, Jack

    2014-01-01

    Organizations are configurations of variables that support each other to achieve customer satisfaction. Based on Treacy and Wiersema (1995), we predicted the emergence of two configurations, one supporting a product leadership stance and one predicting the customer intimate approach from a set of 73 for profit health care clinics. In addition, we predicted the emergence of a configuration where the scores on most variables were near the mean for each variable. Using cluster analysis and discriminant function analysis, we identified three configurations: one a "master of two" strategy, one "stuck-in-the-middle," and one showing scores well below the mean on most variables. The implications for organization design and manager actions in the health care industry are discussed. PMID:25004706

  17. Exploring Business Strategy in Health Information Exchange Organizations.

    PubMed

    Langabeer, James R; Champagne, Tiffany

    2016-01-01

    Unlike consumer goods industries, healthcare has been slow to implement technolo gies that support exchange of data in patients' health records. This results in avoid able medication errors, avoidable hospital readmissions, unnecessary duplicate testing, and other inefficient or wasteful practices. Community-based regional health information exchange (HIE) organizations have evolved in response to federal aims to encourage interoperability, yet little is known about their strategic approach. We use the lens of institutional and strategic management theories to empirically explore the differences in business strategies deployed in HIEs that are, to date, financially sustainable versus those that are not. We developed a 20-question survey targeted to CEOs to assess HIE business strategies. Our sample consisted of 60 community-based exchanges distributed throughout the United States, and we achieved a 58% response rate. Questions centered on competitive strategy and financial sustainability. We relied on logistic regression methods to explore relationships between variables. Our regression identified characteristics common to sustainable organizations. We defined sustainability as revenues exceeding operational costs. Seventeen of the 35 organizations (49%) defined themselves as currently sustainable. Focus and cost leadership strategies were significantly associated with sustainability. Growth strate gies, which were much more common than other strategies, were not associated with sustainability. We saw little evidence of a differentiation strategy (i.e., the basis of competition whereby the attributes of a product or service are unmatched by rivals). Most CEOs had a relatively optimistic outlook, with 60% stating they were confident of surviving over the next 5 years; however, nearly 9% of the organizations were in some phase of divestiture or exit from the market. HIEs are evolving differently based on local leadership decisions, yet their strategic approach is

  18. Social media use by community-based organizations conducting health promotion: a content analysis

    PubMed Central

    2013-01-01

    Background Community-based organizations (CBOs) are critical channels for the delivery of health promotion programs. Much of their influence comes from the relationships they have with community members and other key stakeholders and they may be able to harness the power of social media tools to develop and maintain these relationships. There are limited data describing if and how CBOs are using social media. This study assesses the extent to which CBOs engaged in health promotion use popular social media channels, the types of content typically shared, and the extent to which the interactive aspects of social media tools are utilized. Methods We assessed the social media presence and patterns of usage of CBOs engaged in health promotion in Boston, Lawrence, and Worcester, Massachusetts. We coded content on three popular channels: Facebook, Twitter, and YouTube. We used content analysis techniques to quantitatively summarize posts, tweets, and videos on these channels, respectively. For each organization, we coded all content put forth by the CBO on the three channels in a 30-day window. Two coders were trained and conducted the coding. Data were collected between November 2011 and January 2012. Results A total of 166 organizations were included in our census. We found that 42% of organizations used at least one of the channels of interest. Across the three channels, organization promotion was the most common theme for content (66% of posts, 63% of tweets, and 93% of videos included this content). Most organizations updated Facebook and Twitter content at rates close to recommended frequencies. We found limited interaction/engagement with audience members. Conclusions Much of the use of social media tools appeared to be uni-directional, a flow of information from the organization to the audience. By better leveraging opportunities for interaction and user engagement, these organizations can reap greater benefits from the non-trivial investment required to use

  19. Health and Welfare in Dutch Organic Laying Hens

    PubMed Central

    Bestman, Monique; Wagenaar, Jan-Paul

    2014-01-01

    Simple Summary Data on animal health and welfare and farm management during rearing and laying periods were collected from 49 flocks of organic laying hens in the Netherlands to establish how farms performed in terms of animal health and welfare and which factors affected health and welfare. Abstract From 2007–2008, data on animal health and welfare and farm management during rearing and laying periods were collected from 49 flocks of organic laying hens in the Netherlands. Our aim was to investigate how organic egg farms performed in terms of animal health and welfare and which farm factors affected this performance. The flocks in our study were kept on farms with 34 to 25,000 hens (average 9,300 hens). Seventy-one percent of the flocks consisted of ‘silver hybrids’: white hens that lay brown eggs. Fifty-five percent of the flocks were kept in floor-based housing and 45% of the flocks in aviaries. No relation was found between the amount of time spent outdoors during the laying period and mortality at 60 weeks. Flocks that used their outdoor run more intensively had better feather scores. In 40% of the flocks there was mortality caused by predators. The average feed intake was 129 g/day at 30 weeks and 133 g/day at 60 weeks of age. The average percentage of mislaid eggs decreased from three at 30 weeks to two at 60 weeks. The average mortality was 7.8% at 60 weeks. Twenty-five percent of the flocks were not treated for worms in their first 50 weeks. Flubenol© was applied to the flocks that were treated. Ten percent of the flocks followed Flubenol© instructions for use and were wormed five or more times. The other 65% percent were treated irregularly between one and four times. Sixty-eight percent of the flocks showed little or no feather damage, 24% showed moderate damage and 8% showed severe damage. The feather score was better if the hens used the free-range area more intensely, the laying percentage at 60 weeks was higher, and if they were allowed to go

  20. Workgroup Report: Developing Environmental Health Indicators for European Children: World Health Organization Working Group

    PubMed Central

    Pond, Kathy; Kim, Rokho; Carroquino, Maria-Jose; Pirard, Philippe; Gore, Fiona; Cucu, Alexandra; Nemer, Leda; MacKay, Morag; Smedje, Greta; Georgellis, Antonis; Dalbokova, Dafina; Krzyzanowski, Michal

    2007-01-01

    A working group coordinated by the World Health Organization developed a set of indicators to protect children’s health from environmental risks and to support current and future European policy needs. On the basis of identified policy needs, the group developed a core set of 29 indicators for implementation plus an extended set of eight additional indicators for future development, focusing on exposure, health effects, and action. As far as possible, the indicators were designed to use existing information and are flexible enough to be developed further to meet the needs of policy makers and changing health priorities. These indicators cover most of the priority topic areas specified in the Children’s Environment and Health Action Plan for Europe (CEHAPE) as adopted in the Fourth Ministerial Conference on Health and Environment in 2004, and will be used to monitor the implementation of CEHAPE. This effort can be viewed as an integral part of the Global Initiative on Children’s Environmental Health Indicators, launched at the World Summit on Sustainable Development in 2002. PMID:17805431

  1. 42 CFR 475.105 - Prohibition against contracting with health care facilities, affiliates, and payor organizations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Prohibition against contracting with health care facilities, affiliates, and payor organizations. 475.105 Section 475.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT...

  2. Global policy for improvement of oral health in the 21st century--implications to oral health research of World Health Assembly 2007, World Health Organization.

    PubMed

    Petersen, Poul Erik

    2009-02-01

    The World Health Organization (WHO) Global Oral Health Programme has worked hard over the past 5 years to increase the awareness of oral health worldwide as oral health is important component of general health and quality of life. Meanwhile, oral disease is still a major public health problem in high income countries and the burden of oral disease is growing in many low- and middle income countries. In the World Oral Health Report 2003, the WHO Global Oral Health Programme formulated the policies and necessary actions to the continuous improvement of oral health. The strategy is that oral disease prevention and the promotion of oral health needs to be integrated with chronic disease prevention and general health promotion as the risks to health are linked. The World Health Assembly (WHA) and the Executive Board (EB) are supreme governance bodies of WHO and for the first time in 25 years oral health was subject to discussion by those bodies in 2007. At the EB120 and WHA60, the Member States agreed on an action plan for oral health and integrated disease prevention, thereby confirming the approach of the Oral Health Programme. The policy forms the basis for future development or adjustment of oral health programmes at national level. Clinical and public health research has shown that a number of individual, professional and community preventive measures are effective in preventing most oral diseases. However, advances in oral health science have not yet benefited the poor and disadvantaged populations worldwide. The major challenges of the future will be to translate knowledge and experiences in oral disease prevention and health promotion into action programmes. The WHO Global Oral Health Programme invites the international oral health research community to engage further in research capacity building in developing countries, and in strengthening the work so that research is recognized as the foundation of oral heath policy at global level. PMID:19046331

  3. Gender stratification in management. The World Health Organization 2000.

    PubMed

    Brännström, Inger A

    2004-01-01

    The World Health Organization (WHO) is a global organization that nowadays has integrated gender issues into its policy, programmes and budget. How then is the state of affairs in the area of gender equity at the ultimate governing bodies of the modern WHO? This study aims to assess the representation of women and men and their promotion within the supreme decision-making bodies of the WHO during the year 2000. Information sources used are the official and confirmed protocols of the 53rd World Health Assembly (WHA) in 2000 and of the two Executive Board (EB) meetings of the corresponding year. A descriptive quantitative content analysis approach is used exclusively. The present study demonstrates strikingly skewed gender distribution, with men substantially at an advantage numerically in the prominent positions at the WHA 2000. Additionally, men also hold an advantage in terms of being promoted to leading positions within the bodies examined, notably all upgraded chairs of the EB during 2000. However, the formerly male-dominated supervisory positions of the WHO are, these days, challenged by women having been elected at the very top of the WHO. The present study stresses the need to elaborate a qualitative research design to advance the understanding of the social construction of gender in supreme governing positions of the modern WHO. PMID:15133880

  4. The world health organization multicountry survey on maternal and newborn health: study protocol

    PubMed Central

    2011-01-01

    Background Effective interventions to reduce mortality and morbidity in maternal and newborn health already exist. Information about quality and performance of care and the use of critical interventions are useful for shaping improvements in health care and strengthening the contribution of health systems towards the Millennium Development Goals 4 and 5. The near-miss concept and the criterion-based clinical audit are proposed as useful approaches for obtaining such information in maternal and newborn health care. This paper presents the methods of the World Health Organization Multicountry Study in Maternal and Newborn Health. The main objectives of this study are to determine the prevalence of maternal near-miss cases in a worldwide network of health facilities, evaluate the quality of care using the maternal near-miss concept and the criterion-based clinical audit, and develop the near-miss concept in neonatal health. Methods/Design This is a large cross-sectional study being implemented in a worldwide network of health facilities. A total of 370 health facilities from 29 countries will take part in this study and produce nearly 275,000 observations. All women giving birth, all maternal near-miss cases regardless of the gestational age and delivery status and all maternal deaths during the study period comprise the study population. In each health facility, medical records of all eligible women will be reviewed during a data collection period that ranges from two to three months according to the annual number of deliveries. Discussion Implementing the systematic identification of near-miss cases, mapping the use of critical evidence-based interventions and analysing the corresponding indicators are just the initial steps for using the maternal near-miss concept as a tool to improve maternal and newborn health. The findings of projects using approaches similar to those described in this manuscript will be a good starter for a more comprehensive dialogue with

  5. Is organic farming safer to farmers’ health? A comparison between organic and traditional farming

    PubMed Central

    Costa, Carla; García-Lestón, Julia; Costa, Solange; Coelho, Patrícia; Silva, Susana; Valdiglesias, Vanessa; Mattei, Francesca; Dall’Armi, Valentina; Bonassi, Stefano; Laffon, Blanca; Snawder, John; Teixeira, João Paulo

    2015-01-01

    Background Exposure to pesticides is a major public health concern, because of the widespread distribution of these compounds and their possible long term effects. Recently, organic farming has been introduced as a consumer and environmental friendly agricultural system, although little is known about the effects on workers’ health. Objectives To evaluate genetic damage and immunological alterations in workers of both traditional and organic farming. Methods Eighty-five farmers exposed to several pesticides, thirty–six organic farmers and sixty-one controls took part in the study. Biomarkers of exposure (pyrethroids, organophosphates, carbamates, and thioethers in urine and butyrylcholinesterase activity in plasma), early effect (micronuclei in lymphocytes and reticulocytes, T-cell receptor mutation assay, chromosomal aberrations, comet assay and lymphocytes subpopulations) and susceptibility (genetic polymorphisms related to metabolism - EPHX1, GSTM1, GSTT1 and GSTP1 - and DNA repair – XRCC1 and XRCC2) were evaluated. Results When compared to controls and organic farmers, pesticide farmers presented a significant increase of micronuclei in lymphocytes (frequency ratio, FR=2.80) and reticulocytes (FR=1.89), chromosomal aberrations (FR=2.19), DNA damage assessed by comet assay (mean ratio, MR=1.71), and a significant decrease in the proportion of B lymphocytes (MR=0.88). Overall, organic farmers presented similar levels of genetic damage as controls, in some cases modulated by GSTT1 and GSTM1, GSTP1 105Ile/Ile and XRCC1 399Gln/Gln genotypes. Conclusions Results confirmed the increased presence of DNA damage in farmers exposed to pesticides, and showed as exposure conditions and genetic background influence observed effects. Findings from this study indicate that no evident genetic or immunologic damage can be observed in organic farmers. PMID:24576785

  6. Non-Exchangeability of Running vs. Other Exercise in Their Association with Adiposity, and Its Implications for Public Health Recommendations

    PubMed Central

    Williams, Paul T.

    2012-01-01

    Purpose Current physical activity recommendations assume that different activities can be exchanged to produce the same weight-control benefits so long as total energy expended remains the same (exchangeability premise). To this end, they recommend calculating energy expenditure as the product of the time spent performing each activity and the activity's metabolic equivalents (MET), which may be summed to achieve target levels. The validity of the exchangeability premise was assessed using data from the National Runners' Health Study. Methods Physical activity dose was compared to body mass index (BMI) and body circumferences in 33,374 runners who reported usual distance run and pace, and usual times spent running and other exercises per week. MET hours per day (METhr/d) from running was computed from: a) time and intensity, and b) reported distance run (1.02 MET•hours per km). Results When computed from time and intensity, the declines (slope±SE) per METhr/d were significantly greater (P<10−15) for running than non-running exercise for BMI (slopes±SE, male: −0.12±0.00 vs. 0.00±0.00; female: −0.12±0.00 vs. −0.01±0.01 kg/m2 per METhr/d) and waist circumference (male: −0.28±0.01 vs. −0.07±0.01; female: −0. 31±0.01 vs. −0.05±0.01 cm per METhr/d). Reported METhr/d of running was 38% to 43% greater when calculated from time and intensity than distance. Moreover, the declines per METhr/d run were significantly greater when estimated from reported distance for BMI (males: −0.29±0.01; females: −0.27±0.01 kg/m2 per METhr/d) and waist circumference (males: −0.67±0.02; females: −0.69±0.02 cm per METhr/d) than when computed from time and intensity (cited above). Conclusion The exchangeability premise was not supported for running vs. non-running exercise. Moreover, distance-based running prescriptions may provide better weight control than time-based prescriptions for running or other activities. Additional longitudinal studies and

  7. Physician recommendation for colorectal cancer screening by race, ethnicity, and health insurance status among men and women in the United States, 2000.

    PubMed

    Coughlin, Steven S; Thompson, Trevor

    2005-10-01

    In this study, the authors examined whether men and women in the United States had received a physician recommendation to get a colorectal cancer screening test, by race, ethnicity, and health insurance status using data from the 2000 National Health Interview Survey. Among men and women who had had a doctor visit in the past year but who had not had a recent fecal occult blood test, about 94.6% (95% CI 94.0-95.2) reported that their doctor had not recommended the test in the past year. African Americans, Hispanics, and American Indians/Alaska Natives were less likely to report receiving a recommendation for endoscopy compared to Whites. PMID:16210678

  8. Analysis and Recommendations for the Health Education, Physical Education, and Recreation Education Activities of the ERIC Clearinghouse on Teacher Education: A Planning Document.

    ERIC Educational Resources Information Center

    Davies, Hopkin M.; And Others

    This report, prepared by the staff of the ERIC Clearinghouse on Teacher Education, analyzes the health education, physical education, and recreation education (HPR) work of the Clearinghouse, and recommends ways of improving the usefulness and comprehensiveness of that aspect of the ERIC system. The document (1) describes the ERIC system over-all;…

  9. Preparing for effective communications during disasters: lessons from a World Health Organization quality improvement project

    PubMed Central

    2014-01-01

    Background One hundred ninety-four member nations turn to the World Health Organization (WHO) for guidance and assistance during disasters. Purposes of disaster communication include preventing panic, promoting appropriate health behaviors, coordinating response among stakeholders, advocating for affected populations, and mobilizing resources. Methods A quality improvement project was undertaken to gather expert consensus on best practices that could be used to improve WHO protocols for disaster communication. Open-ended surveys of 26 WHO Communications Officers with disaster response experience were conducted. Responses were categorized to determine the common themes of disaster response communication and areas for practice improvement. Results Disasters where the participants had experience included 29 outbreaks of 13 different diseases in 16 countries, 18 natural disasters of 6 different types in 15 countries, 2 technical disasters in 2 countries, and ten conflicts in 10 countries. Conclusion Recommendations to build communications capacity prior to a disaster include pre-writing public service announcements in multiple languages on questions that frequently arise during disasters; maintaining a database of statistics for different regions and types of disaster; maintaining lists of the locally trusted sources of information for frequently affected countries and regions; maintaining email listservs of employees, international media outlet contacts, and government and non-governmental organization contacts that can be used to rapidly disseminate information; developing a global network with 24-h cross-coverage by participants from each time zone; and creating a central electronic sharepoint where all of these materials can be accessed by communications officers around the globe. PMID:24646607

  10. Implementing information systems in health care organizations: myths and challenges.

    PubMed

    Berg, M

    2001-12-01

    Successfully implementing patient care information systems (PCIS) in health care organizations appears to be a difficult task. After critically examining the very notions of 'success' and 'failure', and after discussing the problematic nature of lists of 'critical success- or failure factors', this paper discusses three myths that often hamper implementation processes. Alternative insights are presented, and illustrated with concrete examples. First of all, the implementation of a PCIS is a process of mutual transformation; the organization and the technology transform each other during the implementation process. When this is foreseen, PCIS implementations can be intended strategically to help transform the organization. Second, such a process can only get off the ground when properly supported by both central management and future users. A top down framework for the implementation is crucial to turn user-input into a coherent steering force, creating a solid basis for organizational transformation. Finally, the management of IS implementation processes is a careful balancing act between initiating organizational change, and drawing upon IS as a change agent, without attempting to pre-specify and control this process. Accepting, and even drawing upon, this inevitable uncertainty might be the hardest lesson to learn. PMID:11734382

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

    PubMed Central

    Newcomer, R; Harrington, C; Friedlob, A

    1990-01-01

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

  12. Five focus strategies to organize health care delivery.

    PubMed

    Peltokorpi, Antti; Linna, Miika; Malmström, Tomi; Torkki, Paulus; Lillrank, Paul Martin

    2016-03-14

    Purpose - The focused factory is one of the concepts that decision-makers have adopted for improving health care delivery. However, disorganized definitions of focus have led to findings that cannot be utilized systematically. The purpose of this paper is to discuss strategic options to focus health care operations. Design/methodology/approach - First the literature on focus in health care is reviewed revealing conceptual challenges. Second, a definition of focus in terms of demand and requisite variety is defined, and the mechanisms of focus are explicated. A classification of five focus strategies that follow the original idea to reduce variety in products and markets is presented. Finally, the paper examines managerial possibilities linked to the focus strategies. Findings - The paper proposes a framework of five customer-oriented focus strategies which aim at reducing variety in different characteristics of care pathways: population; urgency and severity; illnesses and symptoms; care practices and processes; and care outcomes. Research limitations/implications - Empirical research is needed to evaluate the costs and benefits of the five strategies and about system-level effects of focused units on competition and coordination. Practical implications - Focus is an enabling condition that needs to be exploited using specific demand and supply management practices. It is essential to understand how focus mechanisms differ between strategies, and to select focus that fits with organization's strategy and key performance indicators. Originality/value - Compared to previous more resource-oriented approaches, this study provides theoretically solid and practically relevant customer-oriented framework for focusing in health care. PMID:26959897

  13. The World Health Organization Library (Geneva) and Health Literature Services Programme.

    PubMed Central

    Ruff, B

    1988-01-01

    The origins and functions of the World Health Organization (WHO) Library and the global, regional, and national objectives of the WHO Health Literature Services Program (HLSP) are reviewed. WHO is an aggregate of nations and not a supra-national body. With limited resources and unlimited needs, HLSP is involved in surveys, training, regional medical libraries, national and regional networks, bibliographic services and document delivery, promotion, coordination, and communication. The basic concept of HLSP eschews internationally-conceived, self-contained technical projects in favor of broad programs based on national planning. Small rural centers receive more attention than large urban hospitals, and preventive medicine together with health education and community involvement are of more immediate concern than curative medicine. National self-reliance implies national initiative but not necessarily national self-sufficiency. Recent planning and implementation of HLSP activities are described. PMID:3370376

  14. Information, market government, and health policy: a study of health data organizations in the states.

    PubMed

    Overman, E S; Cahill, A G

    1994-01-01

    Information is essential to the success of market-oriented policies. Information on health care costs and quality is collected and distributed by state governments through health data organizations (HDOs) to enhance competition and lower costs in the medical industry and to improve consumer choice among medical alternatives. This article examines the information collected, produced, and distributed by state health data organizations in Colorado and Pennsylvania. Findings reveal that information was not the objective determinant of choice and competition as market-oriented policy designers had hoped. Nor did market-oriented bureaucracies produce and distribute data readily accessible for public choice. Instead, information produced and distributed by these HDOs was the result of political and bureaucratic exercises that conform much more to classic interest group policymaking and captured bureaucracies than to contemporary market-oriented government ideals. The findings underscore the extraordinary difficulties facing federal-level policy designers as they contemplate introducing market-oriented health care policies on the national level. PMID:10135356

  15. Development of Health Equity Indicators in Primary Health Care Organizations Using a Modified Delphi

    PubMed Central

    Wong, Sabrina T.; Browne, Annette J.; Varcoe, Colleen; Lavoie, Josée; Fridkin, Alycia; Smye, Victoria; Godwin, Olive; Tu, David

    2014-01-01

    Objective The purpose of this study was to develop a core set of indicators that could be used for measuring and monitoring the performance of primary health care organizations' capacity and strategies for enhancing equity-oriented care. Methods Indicators were constructed based on a review of the literature and a thematic analysis of interview data with patients and staff (n = 114) using procedures for qualitatively derived data. We used a modified Delphi process where the indicators were circulated to staff at the Health Centers who served as participants (n = 63) over two rounds. Indicators were considered part of a priority set of health equity indicators if they received an overall importance rating of>8.0, on a scale of 1–9, where a higher score meant more importance. Results Seventeen indicators make up the priority set. Items were eliminated because they were rated as low importance (<8.0) in both rounds and were either redundant or more than one participant commented that taking action on the indicator was highly unlikely. In order to achieve health care equity, performance at the organizational level is as important as assessing the performance of staff. Two of the highest rated “treatment” or processes of care indicators reflects the need for culturally safe and trauma and violence-informed care. There are four indicators that can be used to measure outcomes which can be directly attributable to equity responsive primary health care. Discussion These indicators and subsequent development of items can be used to measure equity in the domains of treatment and outcomes. These areas represent targets for higher performance in relation to equity for organizations (e.g., funding allocations to ongoing training in equity-oriented care provision) and providers (e.g., reflexive practice, skill in working with the health effects of trauma). PMID:25478914

  16. Food protection activities of the Pan American Health Organization.

    PubMed

    1994-03-01

    One of the most widespread health problems in the Caribbean and Latin America is contaminated food and foodborne illness. The Pan American Health Organization (PAHO) has been a major force in activities to strengthen food protection. The program within the regional Program of Technical Cooperation is administered by the Veterinary Public Health program and under the guidance of the Pan American Institute for Food protection and Zoonoses in Buenos Aires, Argentina. A food action plan for 1986-90 was established at the 1986 Pan American Sanitary Conference, and extended to cover 1991-95. Program activities during the 1990s covered cholera, epidemiologic surveillance, street food vendors, shellfish poisoning, meat, national programs, information systems, air catering, food irradiation, and tourism. The action plan for 1991-95 promoted greater political support and cooperation within and between related sectors and institutions, management, and education. The aims were to organize national integrated programs, to strengthen laboratory services, to strengthen inspection services, to establish epidemiologic surveillance systems, and to promote food protection through community participation. Program activities included the initiatives of the Veterinary Public Health Program in 1991 to distribute literature on the transmission of cholera by foods. Studies were conducted in Bolivia, Colombia, and Peru on food contamination. Microbiologists received training on standard methods for detecting Vibrio cholerae in foods. A working group of experts from 10 countries examined the issues and produced a guide for investigating the incidence of foodborne disease. PAHO has contributed to the formation of an Inter-American Network for Epidemiologic Surveillance of Foodborne Diseases. PAHO has worked to improve hygienic practices among street food vendors. Seminars on paralytic shellfish poisoning were conducted in 1990; the outcome was a network working to strengthen national

  17. Patterns of Health Maintenance Organization Service Areas in Rural Counties

    PubMed Central

    Ricketts, Thomas C.; Slifkin, Rebecca T.; Johnson-Webb, Karen D.

    1995-01-01

    This study analyzes the 1993 National Directory of HMOs to determine the extent to which rural counties are included in health maintenance organization (HMO) service areas. Two specific questions are addressed: (1) How do the patterns of service areas differ across HMO model types? (2) What are the characteristics that distinguish rural counties served by HMOs from those that are not? Although a majority of rural counties are in HMO service areas, substantially fewer are served by non-individual practice association (non-IPA) models. Access to HMO services is found to decrease with county population density, and adjacency to metropolitan areas is an important predictor of inclusion in service areas. PMID:10153478

  18. Physician adaptation to health maintenance organizations and implications for management.

    PubMed Central

    Schulz, R; Scheckler, W E; Girard, C; Barker, K

    1990-01-01

    The growth of health maintenance organizations (HMOs) and other forms of managed care presents a challenge to traditional patterns of private practice. In Dane County, Wisconsin (Madison Metropolitan Area), the proportion of the population enrolled in closed-panel HMOs increased dramatically, from 10 percent in 1983 to over 40 percent by 1986. This study surveyed 850 practicing physicians regarding their expectations before, and experiences after this rapid change to competitive HMOs. Although most physicians expected a loss of earnings and lower-quality care, the majority reported that neither declined. However, most physicians expected and reported a decline in their autonomy. Primary care physicians were most supportive of the change to HMOs. The implications of these findings for management practices are discussed. PMID:2329049

  19. Reducing Health Disparities: Strategy Planning and Implementation in Israel's Largest Health Care Organization

    PubMed Central

    Balicer, Ran D; Shadmi, Efrat; Lieberman, Nicky; Greenberg-Dotan, Sari; Goldfracht, Margalit; Jana, Liora; Cohen, Arnon D; Regev-Rosenberg, Sigal; Jacobson, Orit

    2011-01-01

    Objective To describe an organization-wide disparity reduction strategy and to assess its success in quality improvement and reduction of gaps in health and health care. Study Setting Clalit Health Services, Israel's largest non-for-profit insurer and provider serving 3.8 million persons. Study Design Before and after design: quality assessment before and 12-month postinitiation of the strategic plan. A composite weighted score of seven quality indicators, measuring attainment of diabetes, blood pressure, and lipid control, lack of anemia in infants, and performance of mammography, occult blood tests, and influenza vaccinations. Data Extraction Methods Quality indicator scores, derived from Clalit's central data warehouse, based on data from electronic medical records. Principal Findings Low-performing clinics, of low-socioeconomic and minority populations, were targeted for intervention. Twelve months after the initiation of the project continuous improvement was observed coupled with a reduction of 40 percent of the gap between disadvantaged clinics, serving ∼10 percent of enrollees, and all other medium-large clinics. Conclusion The comprehensive strategy, following a quality improvement framework, with a top-down top-management incentives and monitoring, and a bottom-up locally tailored interventions, approach, is showing promising results of overall quality improvement coupled with disparity reduction in key health and health care indicators. PMID:21352224

  20. Partnerships in Health Systems: Social Organization as limits and possibilities in the Family Health Strategy Management.

    PubMed

    Silva, Vanessa Costa E; Barbosa, Pedro Ribeiro; Hortale, Virgínia Alonso

    2016-05-01

    This is a case study in the municipality of Rio de Janeiro about management in the Family Health Strategy based on the Social Organizations model. The aims were to characterize and analyze aspects of the governance system adopted by the Rio de Janeiro Municipal Health Department and identify limits and possibilities of this model as a management option in Brazil's Unified Health System. A qualitative study was performed based on a literature review, document analysisand interviews with key informants. This management model facilitated the expansion of access to primary healthcare through the Family Health Strategy in Rio - where the population covered increased from 7.2% of the population in 2008 to 45.5% in 2015. The results showthat some practices in the contractual logic need to be improved, including negotiation and accountability with autonomywith the service suppliers. Evaluation and control has focus on processes, not results, and there has not been an increase in transparency and social control. The system of performance incentives has been reported as inducing improvements in the work process of the health teams. It is concluded that the regulatory capacity of the municipal management would need to be improved. On the other hand, there is an important and significant process of learning in progress. PMID:27166887

  1. Antidepressant pharmacotherapy: economic outcomes in a health maintenance organization.

    PubMed

    Sclar, D A; Robison, L M; Skaer, T L; Legg, R F; Nemec, N L; Galin, R S; Hughes, T E; Buesching, D P

    1994-01-01

    Recent pharmacotherapeutic advances in the treatment of depression have included the development of selective serotonin re-uptake inhibitors (SSRIs). The present study was designed to contrast direct health service expenditures for the treatment of depression among patients enrolled in a health maintenance organization (HMO) and prescribed either the SSRI fluoxetine or one of three tricyclic antidepressants (TCAs) (amitriptyline, nortriptyline, or desipramine). Information regarding health service utilization was derived from the computer archive of a network-model HMO system serving 400,000 beneficiaries. A total of 701 HMO beneficiaries were found to satisfy the study selection criteria. Multivariate regression analysis was used to discern the incremental influence of selected demographic, clinical, financial, and provider characteristics on 1 year post-period expenditures (PPE) for health care. Analysis-of-variance procedures with Duncan's multiple-range test, or chi-square analyses, revealed no significant difference across antidepressant pharmacotherapy for age, sex, 6-month prior-period expenditures for physician visits, psychiatric visits, laboratory tests, hospitalizations, or psychiatric hospital services related to the treatment of depression, or number of prescribed therapeutic agents for disease state processes other than depression. Receipt of fluoxetine was associated with a significantly (P < or = 0.05) higher rate of initial prescribing by psychiatrists, an increase in the number of prescriptions for antidepressant pharmacotherapy obtained (30-day supplies), and a reduction in the number of monthly intervals during which time antidepressant pharmacotherapy was not procured. Receipt of fluoxetine as antidepressant pharmacotherapy was associated with a significantly (P < or = 0.05) higher mean medication possession ratio (MPR) relative to amitriptyline, nortriptyline, or desipramine. Multivariate findings for patient-level data reflecting a definitive

  2. Managing facility risk: external threats and health care organizations.

    PubMed

    Reid, Daniel J; Reid, William H

    2014-01-01

    Clinicians and clinical administrators should have a basic understanding of physical and financial risk to mental health facilities related to external physical threat, including actions usually viewed as "terrorism" and much more common sources of violence. This article refers to threats from mentally ill persons and those acting out of bizarre or misguided "revenge," extortionists and other outright criminals, and perpetrators usually identified as domestic or international terrorists. The principles apply both to relatively small and contained acts (such as a patient or ex-patient attacking a staff member) and to much larger events (such as bombings and armed attack), and are relevant to facilities both within and outside the U.S. Patient care and accessibility to mental health services rest not only on clinical skills, but also on a place to practice them and an organized system supported by staff, physical facilities, and funding. Clinicians who have some familiarity with the non-clinical requirements for care are in a position to support non-clinical staff in preventing care from being interrupted by external threats or events such as terrorist activity, and/or to serve at the interface of facility operations and direct clinical care. Readers should note that this article is an introduction to the topic and cannot address all local, state and national standards for hospital safety, or insurance providers' individual facility requirements. PMID:24733720

  3. Organ Donation Among Tiers of Health Workers: Expanding Resources to Optimize Organ Availability in a Developing Country

    PubMed Central

    Oluyombo, Rotimi; Fawale, Bimbo Michael; Busari, Olusegun Adesola; Ogunmola, Jeffery Olarinde; Olanrewaju, Timothy Olusegun; Akinleye, Callistus Adewale; Ojewola, Rufus Wale; Yusuf, Musah; Obajolowo, Omotola; Soje, Michael; Gbadegesin, Babajide

    2016-01-01

    The global increase in end organ failure but disproportional shortage of organ donation calls for attention. Expanding the organ pool by assessing and improving health workers' attitude at all levels of care may be a worthwhile initiative. Methods A questionnaire-based cross sectional study involving tertiary, secondary, and primary health institutions in Southwestern Nigeria was conducted. Results Age range was 18 to 62 (36.7 ± 9.2) years. Only 13.5%, 11.7%, and 11.2% from primary, secondary, and tertiary health centers, respectively, would definitely donate despite high level of awareness (>90%) at each level of care. Participants from primary health care are of low income (P < 0.05), and this cohort is less likely to be aware of organ donation (P < 0.05). At each level of care, permission by religion to donate organs influenced positive attitudes (willingness to donate, readiness to counsel families of potential donors, and signing of organ donation cards) toward organ donation. Good knowledge of organ donation only significantly influenced readiness to counsel donors (P < 0.05) and not willingness to donate (P > 0.05). At each level of health care, young health care workers (P < 0.05) and women (P > 0.05) would be willing to donate, whereas men show positive attitude in signing of organ donor cards (P < 0.05) and counseling of families of potential donors (P > 0.05). Conclusions Knowledge and willingness to donate organs among health care levels were not different. Considering the potential advantage of community placement of other tiers of health care (primary and secondary) in Nigeria, integrating them would be strategically beneficial to organ donation. PMID:27500245

  4. Establishing Trafficking in Human Beings for the Purpose of Organ Removal and Improving Cross-Border Collaboration in Criminal Cases: Recommendations.

    PubMed

    Holmes, Paul; Rijken, Conny; D'Orsi, Sergio; Esser, Luuk; Hol, Floor; Gallagher, Anne; Greenberg, Galit; Helberg, Louis; Horvatits, Lisa; McCarthy, Sean; Ratel, Jonathan; Scheper-Hughes, Nancy; Forsythe, John

    2016-02-01

    In this short summary report on the legal definition of trafficking in human beings for the purpose of organ removal and improving cross-border collaboration in criminal cases, challenges, and recommendations in the areas of defining the crime, criminal investigation and prosecution, and cross-border cooperation are made. These are the outcomes of a working group discussion during the writers' conference of the HOTT project, a European Union-funded project against trafficking in human beings for the purpose of organ removal. PMID:27500251

  5. Establishing Trafficking in Human Beings for the Purpose of Organ Removal and Improving Cross-Border Collaboration in Criminal Cases: Recommendations

    PubMed Central

    Holmes, Paul; Rijken, Conny; D'Orsi, Sergio; Esser, Luuk; Hol, Floor; Gallagher, Anne; Greenberg, Galit; Helberg, Louis; Horvatits, Lisa; McCarthy, Sean; Ratel, Jonathan; Scheper-Hughes, Nancy; Forsythe, John

    2016-01-01

    Abstract In this short summary report on the legal definition of trafficking in human beings for the purpose of organ removal and improving cross-border collaboration in criminal cases, challenges, and recommendations in the areas of defining the crime, criminal investigation and prosecution, and cross-border cooperation are made. These are the outcomes of a working group discussion during the writers' conference of the HOTT project, a European Union-funded project against trafficking in human beings for the purpose of organ removal. PMID:27500251

  6. Treatment of Childhood and Adolescent Obesity: An Integrative Review of Recent Recommendations from Five Expert Groups

    ERIC Educational Resources Information Center

    Kirschenbaum, Daniel S.; Gierut, Kristen

    2013-01-01

    Objective: To compare and contrast 5 sets of expert recommendations about the treatment of childhood and adolescent obesity. Method: We reviewed 5 sets of recent expert recommendations: 2007 health care organizations' four stage model, 2007 Canadian clinical practice guidelines, 2008 Endocrine Society recommendations, 2009 seven step model, and…

  7. [Health maintenance organizations: starting point of a market economical reform of health care].

    PubMed

    Hauser, H

    1981-05-01

    The present work was based on the observations that, as regards health care costs, the major problem in most present systems is that those who are responsible for the treatment decision (physician and patient) do not bear a direct financial responsibility for it, and that the overall system is very fragmented, which leads to numerous externalities. In accordance with this diagnosis, a reform strategy should particularly aim at creating units which are responsible for the provision and the financial coverage of comprehensive health services to a given population. Health Maintenance Organizations (HMOs) are a private economy oriented solution in this direction. They have proved to be a real possibility in the USA over years, at least for part of the population, and show interesting performances as regards costs. They were able to develop and evolve in the largely open US institutional framework. In Switzerland, we have more strongly structured systems, which appear to stand in relative contradiction to the HMO solution. A potential adaptation of the concept to our country would therefore require a preliminary in depth discussion about the meaning of the present collective (insurance) contract structure, the position of hospitals in a private economy health care system as well as about the conditions of the sought for competition in the HMO model. PMID:7303928

  8. Patients Provide Recommendations for Improving Patient Satisfaction.

    PubMed

    Moore, Angelo D; Hamilton, Jill B; Krusel, Jessica L; Moore, LeeAntoinette G; Pierre-Louis, Bosny J

    2016-04-01

    National Committee for Quality Assurance recommends patient-centered medical homes incorporate input from patient populations; however, many health care organizations do not. This qualitative study used two open-ended questions from 148 active duty Army Soldiers and their family members to illicit recommendations for primary care providers and clinic leadership that would improve their health care experiences. Content analysis and descriptive statistics were used to analyze responses. Participant responses were related to four major themes: Access to Care, Interpersonal Interaction, Satisfaction of Care, and Quality of Care. Participants were overall satisfied with their care; however, spending less time waiting for appointments and to see the provider or specialist were the most frequently requested improvements related to Access to Care. For Interpersonal Interaction, 82% of the responses recommended that providers be more attentive listeners, courteous, patient, caring, and respectful. Decreasing wait times and improving interpersonal skills would improve health care experiences and patient satisfaction. PMID:27046182

  9. Trend of application of World Health Organization control strategy of tuberculosis in Egypt.

    PubMed

    Saad-Hussein, Amal; Mohammed, Asmaa M

    2014-09-01

    World Health Organization (WHO) control policy for tuberculosis (TB) includes Bacillus Calmette-Guérin (BCG) vaccine at birth, case detection, and treatment of cases with directly observed therapy short-course (DOTS). This policy has been applied through the Ministry of Health and Population in Egypt for more than 30years. The controversies about the efficacy of the BCG vaccination against TB in adults initiate some suggestions for its discontinuation from compulsory vaccinations in countries with low incidence of TB. The present work aimed to study the trend of applying the WHO control policy for TB in Egypt among the Egyptian population throughout the last 20years (1992-2011). The documented database of the country, bibliographic review on MEDLINE, published studies and reports, WHO and EMRO databases that covered the period from 1992 to 2011 were used in this study. The incidence rate of all forms of TB (pulmonary and extrapulmonary) dropped by 50% from 34 cases to 17 cases per 100,000 population, as well as the prevalence rate declined by 60.6% from 71 cases per 100,000 population throughout the last 20years. Case detection and treatment success rates have increased throughout the studied period while it flat-lined over the past 6years which may need attention. The results of this study introduce an evidence-based recommendation for continuation of the WHO TB control policy in Egypt towards elimination of the disease. PMID:25107655

  10. Global Health Security Demands a Strong International Health Regulations Treaty and Leadership From a Highly Resourced World Health Organization.

    PubMed

    Burkle, Frederick M

    2015-10-01

    If the Ebola tragedy of West Africa has taught us anything, it should be that the 2005 International Health Regulations (IHR) Treaty, which gave unprecedented authority to the World Health Organization (WHO) to provide global public health security during public health emergencies of international concern, has fallen severely short of its original goal. After encouraging successes with the 2003 severe acute respiratory syndrome (SARS) pandemic, the intent of the legally binding Treaty to improve the capacity of all countries to detect, assess, notify, and respond to public health threats has shamefully lapsed. Despite the granting of 2-year extensions in 2012 to countries to meet core surveillance and response requirements, less than 20% of countries have complied. Today it is not realistic to expect that these gaps will be solved or narrowed in the foreseeable future by the IHR or the WHO alone under current provisions. The unfortunate failures that culminated in an inadequate response to the Ebola epidemic in West Africa are multifactorial, including funding, staffing, and poor leadership decisions, but all are reversible. A rush by the Global Health Security Agenda partners to fill critical gaps in administrative and operational areas has been crucial in the short term, but questions remain as to the real priorities of the G20 as time elapses and critical gaps in public health protections and infrastructure take precedence over the economic and security needs of the developed world. The response from the Global Outbreak Alert and Response Network and foreign medical teams to Ebola proved indispensable to global health security, but both deserve stronger strategic capacity support and institutional status under the WHO leadership granted by the IHR Treaty. Treaties are the most successful means the world has in preventing, preparing for, and controlling epidemics in an increasingly globalized world. Other options are not sustainable. Given the gravity of ongoing

  11. 75 FR 53304 - Office of the Assistant Secretary for Health; Statement of Organization, Functions, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

    ... health disparities related to sexual orientation. Dated: July 29, 2010. Kathleen Sebelius, Secretary... ``Office of Adolescent Health,'' established in section 1708 of the Public Health Service (PHS) Act (42 U.S.... Under Part A, Chapter AC, Section AC.10 Organization, insert ``M. Office of Adolescent Health...

  12. [Pollution characteristics and health risk assessment of atmospheric volatile organic compounds (VOCs) in pesticide factory].

    PubMed

    Tan, Bing; Wang, Tie-Yu; Pang, Bo; Zhu, Zhao-Yun; Wang, Dao-Han; Lü, Yong-Long

    2013-12-01

    A method for determining volatile organic compounds (VOCs) in air by summa canister collecting and gas chromatography/ mass spectroscopy detecting was adopted. Pollution condition and characteristics of VOCs were discussed in three representative pesticide factories in Zhangjiakou City, Hebei Province. Meanwhile, an internationally recognized four-step evaluation model of health risk assessment was applied to preliminarily assess the health risk caused by atmospheric VOCs in different exposure ways, inhalation and dermal exposure. Results showed that serious total VOCs pollution existed in all factories. Concentrations of n-hexane (6161.90-6910.00 microg x m(-3)), benzene (126.00-179.30 microg x m(-3)) and 1,3-butadiene (115.00-177.30 microg x m(-3)) exceeded the Chronic Inhalation Reference Concentrations recommended by USEPA, corresponding to 700, 30 and 2 microg x m(-3), respectively. Concentration of dichloromethane (724.00 microg x m(-3)) in factory B was also higher than the reference concentration (600 microg x m(-3)). Results of health risk assessment indicated that non-carcinogenic risk indexes of VOCs ranged from 1.00E-04 to 1.00E + 00 by inhalation exposure, and 1.00E-09 to 1.00E-05 by dermal exposure. Risk indexes of n-hexane and dichloromethane by inhalation exposure in all factories exceeded 1, and risk index of benzene by inhalation in factory B was also higher than 1. Carcinogenic risk indexes exposed to VOCs ranged from 1.00E-08 to 1.00E-03 by inhalation exposure and 1. oo00E -13 to 1.00E-08 by dermal exposure. Cancer risk of 1,3-butadiene by inhalation exceeded 1.0E-04, which lead to definite risk, and those of benzene by inhalation also exceeded the maximum allowable level recommended by International Commission on Radiological Protection (5.0E-05). The risks of dermal exposure presented the same trend as inhalation exposure, but the level was much lower than that of inhalation exposure. Thus, inhalation exposure of atmospheric VOCs was the

  13. 78 FR 19491 - Walking as a Way for Americans To Get the Recommended Amount of Physical Activity for Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-01

    ...To address the public health problem of physical inactivity, the Centers for Disease Control and Prevention (CDC), within the Department of Health and Human Services (HHS) announces the opening of a docket to obtain information from the public on walking as an effective way to be sufficiently active for health. The information obtained will be used to frame an anticpated Surgeon General's call......

  14. Advancing the right to health through global organizations: The potential role of a Framework Convention on Global Health.

    PubMed

    Friedman, Eric A; Gostin, Lawrence O; Buse, Kent

    2013-01-01

    Organizations, partnerships, and alliances form the building blocks of global governance. Global health organizations thus have the potential to play a formative role in determining the extent to which people are able to realize their right to health. This article examines how major global health organizations, such as WHO, the Global Fund to Fight AIDS, TB and Malaria, UNAIDS, and GAVI approach human rights concerns, including equality, accountability, and inclusive participation. We argue that organizational support for the right to health must transition from ad hoc and partial to permanent and comprehensive. Drawing on the literature and our knowledge of global health organizations, we offer good practices that point to ways in which such agencies can advance the right to health, covering nine areas: 1) participation and representation in governance processes; 2) leadership and organizational ethos; 3) internal policies; 4) norm-setting and promotion; 5) organizational leadership through advocacy and communication; 6) monitoring and accountability; 7) capacity building; 8) funding policies; and 9) partnerships and engagement. In each of these areas, we offer elements of a proposed Framework Convention on Global Health (FCGH), which would commit state parties to support these standards through their board membership and other interactions with these agencies. We also explain how the FCGH could incorporate these organizations into its overall financing framework, initiate a new forum where they collaborate with each other, as well as organizations in other regimes, to advance the right to health, and ensure sufficient funding for right to health capacity building. We urge major global health organizations to follow the leadership of the UN Secretary-General and UNAIDS to champion the FCGH. It is only through a rights-based approach, enshrined in a new Convention, that we can expect to achieve health for all in our lifetimes. PMID:25006092

  15. The need to advance nutrition education in the training of health care professionals and recommended research to evaluate implementation and effectiveness1234

    PubMed Central

    Kris-Etherton, Penny M; Akabas, Sharon R; Bales, Connie W; Bistrian, Bruce; Braun, Lynne; Edwards, Marilyn S; Laur, Celia; Lenders, Carine M; Levy, Matthew D; Palmer, Carole A; Pratt, Charlotte A; Ray, Sumantra; Rock, Cheryl L; Saltzman, Edward; Seidner, Douglas L; Van Horn, Linda

    2014-01-01

    Nutrition is a recognized determinant in 3 (ie, diseases of the heart, malignant neoplasms, cerebrovascular diseases) of the top 4 leading causes of death in the United States. However, many health care providers are not adequately trained to address lifestyle recommendations that include nutrition and physical activity behaviors in a manner that could mitigate disease development or progression. This contributes to a compelling need to markedly improve nutrition education for health care professionals and to establish curricular standards and requisite nutrition and physical activity competencies in the education, training, and continuing education for health care professionals. This article reports the present status of nutrition and physical activity education for health care professionals, evaluates the current pedagogic models, and underscores the urgent need to realign and synergize these models to reflect evidence-based and outcomes-focused education. PMID:24717343

  16. Grafting Perspective into Health Law: Organ Transplantation as a Tool for Teaching.

    ERIC Educational Resources Information Center

    Bovbjerg, Randall R.

    1988-01-01

    The topic of organ transplantation adds interest and perspective to the basic health law curriculum. It can be used well to integrate a variety of topics by focusing on the policy and law of organ rationing. (MSE)

  17. [Recommendations of the Seminar on "Women, Population and Development", jointly organized by the Projet Institut de Recherches et d'Etudes de Population and the United Nations Population Fund, Tunis, June 29 - July 3, 1992].

    PubMed

    1992-08-01

    This work outlines actions recommended by the 1992 Tunis Seminar on Women, Population, and Development to be taken by national governments, international organizations and nongovernmental organizations. In the area of fertility, seminar participants urged adherence to the 1979 International Convention on the Elimination of All Forms of Discrimination Against Women, which was ratified in 1992 by more than 100 UN member nations; respect for the basic right of women and especially for their access to family planning information and services; close monitoring of the quality and availability of family planning and maternal-child health services and the use of contraceptive methods; and initiation of studies on the impact of socioeconomic factors on fertility to aid in design of policies concerning promotion of women, population, and development. In the area of health, seminar participants urged governments and international organizations to increase efforts to control maternal mortality; to provide information and education for prevention of sexually transmitted diseases and elimination of social practices harmful to women such as excision, forced marriage, and early pregnancy; and to encourage research and programs relating to the socioeconomic causes of mortality among infants and women. Governments and international organizations were urged to take necessary measures to improve conditions among migrant and refugee women and to conduct in-depth studies of the socioeconomic determinants of female migration and the condition of wives of migrants. In the area population policy, the seminar recommended that population policy address not just fertility and population growth but also mortality and migration; that governments reinforce their institutional facilities related to population policy, especially through creation of a high level population institute; the nongovernmental organizations educate women about their individual and collective rights, fertility behavior

  18. Organization of ambulatory care provision: a critical determinant of health system performance in developing countries.

    PubMed Central

    Berman, P.

    2000-01-01

    Success in the provision of ambulatory personal health services, i.e. providing individuals with treatment for acute illness and preventive health care on an ambulatory basis, is the most significant contributor to the health care system's performance in most developing countries. Ambulatory personal health care has the potential to contribute the largest immediate gains in health status in populations, especially for the poor. At present, such health care accounts for the largest share of the total health expenditure in most lower income countries. It frequently comprises the largest share of the financial burden on households associated with health care consumption, which is typically regressively distributed. The "organization" of ambulatory personal health services is a critical determinant of the health system's performance which, at present, is poorly understood and insufficiently considered in policies and programmes for reforming health care systems. This article begins with a brief analysis of the importance of ambulatory care in the overall health system performance and this is followed by a summary of the inadequate global data on ambulatory care organization. It then defines the concept of "macro organization of health care" at a system level. Outlined also is a framework for analysing the organization of health care services and the major pathways through which the organization of ambulatory personal health care services can affect system performance. Examples of recent policy interventions to influence primary care organization--both government and nongovernmental providers and market structure--are reviewed. It is argued that the characteristics of health care markets in developing countries and of most primary care goods result in relatively diverse and competitive environments for ambulatory care services, compared with other types of health care. Therefore, governments will be required to use a variety of approaches beyond direct public provision

  19. Closing the health equity gap: evidence-based strategies for primary health care organizations

    PubMed Central

    2012-01-01

    Introduction International evidence shows that enhancement of primary health care (PHC) services for disadvantaged populations is essential to reducing health and health care inequities. However, little is known about how to enhance equity at the organizational level within the PHC sector. Drawing on research conducted at two PHC Centres in Canada whose explicit mandates are to provide services to marginalized populations, the purpose of this paper is to discuss (a) the key dimensions of equity-oriented services to guide PHC organizations, and (b) strategies for operationalizing equity-oriented PHC services, particularly for marginalized populations. Methods The PHC Centres are located in two cities within urban neighborhoods recognized as among the poorest in Canada. Using a mixed methods ethnographic design, data were collected through intensive immersion in the Centres, and included: (a) in-depth interviews with a total of 114 participants (73 patients; 41 staff), (b) over 900 hours of participant observation, and (c) an analysis of key organizational documents, which shed light on the policy and funding environments. Results Through our analysis, we identified four key dimensions of equity-oriented PHC services: inequity-responsive care; trauma- and violence-informed care; contextually-tailored care; and culturally-competent care. The operationalization of these key dimensions are identified as 10 strategies that intersect to optimize the effectiveness of PHC services, particularly through improvements in the quality of care, an improved 'fit' between people's needs and services, enhanced trust and engagement by patients, and a shift from crisis-oriented care to continuity of care. Using illustrative examples from the data, these strategies are discussed to illuminate their relevance at three inter-related levels: organizational, clinical programming, and patient-provider interactions. Conclusions These evidence- and theoretically-informed key dimensions and

  20. US Public Universities' Compliance with Recommended Tobacco-Control Policies

    ERIC Educational Resources Information Center

    Halperin, Abigail C.; Rigotti, Nancy A.

    2003-01-01

    To address the rise in tobacco use among college students, several national health organizations, including the American College Health Association,recommend that colleges enact smoking bans in and around all campus buildings, including student housing, and prohibit the sale, advertisement, and promotion of tobacco products on campus. Key…

  1. Underserved minority children are not meeting the US public health recommendation for moderate-vigorous physical activity

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In the US childhood obesity is more prevalent among underserved minority children. It is recommended that children should spend a minimum of 60 min/d in moderate-vigorous physical activity (MVPA) in order to maintain a healthy body weight. We measured the amount of MVPA based on a minimum of 5 conse...

  2. Good Practice Recommendations in the Field of Heating, Ventilation, and Air Conditioning for Health Related Research Laboratories.

    ERIC Educational Resources Information Center

    Laboratory Design Notes, 1966

    1966-01-01

    A collection of laboratory design notes to set forth minimum criteria required in the design of basic medical research laboratory buildings. Recommendations contained are primarily concerned with features of design which affect quality of performance and future flexibility of facility systems. Subjects of economy and safety are discussed where…

  3. Organization of health care in small plants in the USA

    PubMed Central

    Miller, Seward E.

    1955-01-01

    In the USA, the concept of an occupational health programme has grown steadily, and now embraces the total health of the worker. Elements of basic in-plant health programmes have been identified and patterns developed for successful operation. Today, health services in small plants still fall far short of optimal requirements. No more than 5% of workers in small plants enjoy the benefit of occupational health services. The main reason for the arrested development of these programmes is the lack of organizational and administrative techniques for providing health services in small plants. Recently, however, several projects have demonstrated that these difficulties can be overcome, and the future development of such programmes in small plants thus looks hopeful. Other recent developments hold promise of strengthening the health services available to workers. Union health centres, now being established in increasing numbers, offer the workers varying services, ranging from diagnostic and preventive procedures to complete medical care. Further benefits to both the worker and his family are being provided under collective bargaining agreements by voluntary health-insurance schemes. In addition to making services available to large numbers of workers previously not covered, the development of both union health centres and the prepaid health-insurance schemes offer future possibilities for integration of these programmes into the preventive and diagnostic services offered in the plant. Finally, governmental occupational health agencies, in addition to their industrial hygiene activities, are taking an increasing interest in the establishment and development of in-plant health programmes. PMID:13276820

  4. Latina Workers in North Carolina: Work Organization, Domestic Responsibilities, Health, and Family Life.

    PubMed

    Rodriguez, Guadalupe; Trejo, Grisel; Schiemann, Elizabeth; Quandt, Sara A; Daniel, Stephanie S; Sandberg, Joanne C; Arcury, Thomas A

    2016-06-01

    This analysis describes the work organization and domestic work experienced by migrant Latinas, and explores the linkage between work and health. Twenty Latina workers in North Carolina with at least one child under age 12 completed in-depth interviews focused on their work organization, domestic responsibilities, work-family conflict, health, and family health. Using a systematic qualitative analysis, these women described a demanding work organization that is contingent and exploitative, with little control or support. They also described demanding domestic roles, with gendered and unequal division of household work. The resulting work-family conflict affects their mental and physical health, and has negative effects on the care and health of their families. The findings from this study highlight that work stressors from an unfavorable work organization create work-family conflict, and that work-family conflict in this population has a negative influence on workers' health and health behaviors. PMID:26590923

  5. An Evaluation of the Impact of HEW Assistance on Recent Immigrants in the State of Hawaii. A Study of Health, Education and Welfare Service Delivery to Hawaii Immigrants: Recommendations to the U.S. Department of Health, Education, and Welfare.

    ERIC Educational Resources Information Center

    Agbayani, Amefil

    This study identifies the problems and needs of recent immigrants to Hawaii, identifies those factors that hinder the effective delivery of Federally funded health, educational, and social services to immigrants, and recommends ways in which government agencies can meet immigrant needs in Hawaii. The study is based on a 1978 survey in which…

  6. Firearm-related injury and death in the United States: a call to action from 8 health professional organizations and the American Bar Association.

    PubMed

    Weinberger, Steven E; Hoyt, David B; Lawrence, Hal C; Levin, Saul; Henley, Douglas E; Alden, Errol R; Wilkerson, Dean; Benjamin, Georges C; Hubbard, William C

    2015-04-01

    Deaths and injuries related to firearms constitute a major public health problem in the United States. In response to firearm violence and other firearm-related injuries and deaths, an interdisciplinary, interprofessional group of leaders of 8 national health professional organizations and the American Bar Association, representing the official policy positions of their organizations, advocate a series of measures aimed at reducing the health and public health consequences of firearms. The specific recommendations include universal background checks of gun purchasers, elimination of physician "gag laws," restricting the manufacture and sale of military-style assault weapons and large-capacity magazines for civilian use, and research to support strategies for reducing firearm-related injuries and deaths. The health professional organizations also advocate for improved access to mental health services and avoidance of stigmatization of persons with mental and substance use disorders through blanket reporting laws. The American Bar Association, acting through its Standing Committee on Gun Violence, confirms that none of these recommendations conflict with the Second Amendment or previous rulings of the U.S. Supreme Court. PMID:25706470

  7. Mobile Health Applications for the Most Prevalent Conditions by the World Health Organization: Review and Analysis

    PubMed Central

    2013-01-01

    Background New possibilities for mHealth have arisen by means of the latest advances in mobile communications and technologies. With more than 1 billion smartphones and 100 million tablets around the world, these devices can be a valuable tool in health care management. Every aid for health care is welcome and necessary as shown by the more than 50 million estimated deaths caused by illnesses or health conditions in 2008. Some of these conditions have additional importance depending on their prevalence. Objective To study the existing applications for mobile devices exclusively dedicated to the eight most prevalent health conditions by the latest update (2004) of the Global Burden of Disease (GBD) of the World Health Organization (WHO): iron-deficiency anemia, hearing loss, migraine, low vision, asthma, diabetes mellitus, osteoarthritis (OA), and unipolar depressive disorders. Methods Two reviews have been carried out. The first one is a review of mobile applications in published articles retrieved from the following systems: IEEE Xplore, Scopus, ScienceDirect, Web of Knowledge, and PubMed. The second review is carried out by searching the most important commercial app stores: Google play, iTunes, BlackBerry World, Windows Phone Apps+Games, and Nokia's Ovi store. Finally, two applications for each condition, one for each review, were selected for an in-depth analysis. Results Search queries up to April 2013 located 247 papers and more than 3673 apps related to the most prevalent conditions. The conditions in descending order by the number of applications found in literature are diabetes, asthma, depression, hearing loss, low vision, OA, anemia, and migraine. However when ordered by the number of commercial apps found, the list is diabetes, depression, migraine, asthma, low vision, hearing loss, OA, and anemia. Excluding OA from the former list, the four most prevalent conditions have fewer apps and research than the final four. Several results are extracted from

  8. Tackling antibiotic resistance in febrile neutropenia: current challenges with and recommendations for managing infections with resistant Gram-negative organisms.

    PubMed

    Nouér, Simone A; Nucci, Marcio; Anaissie, Elias

    2015-10-01

    Multidrug resistant (MDR) Gram-negative bacteria (GNB) have emerged as important pathogens and a serious challenge in the management of neutropenic patients worldwide. The great majority of infections are caused by the Enterobacteriaceae (especially Escherichia coli and Klebsiella spp.) and Pseudomonas aeruginosa, and less frequently Acinetobacter spp. and Stenotrophomonas maltophilia. A broader-spectrum empiric antibiotic regimen is usually recommended in patients with a history of prior bloodstream infection caused by a MDR GNB, in those colonized by a MDR GNB, and if MDR GNBs are frequently isolated in the initial blood cultures. In any situation, de-escalation to standard empiric regimen is advised if infection with MDR GNB is not documented. PMID:26115679

  9. Advanced Imaging Among Health Maintenance Organization Enrollees With Cancer

    PubMed Central

    Loggers, Elizabeth T.; Fishman, Paul A.; Peterson, Do; O'Keeffe-Rosetti, Maureen; Greenberg, Caprice; Hornbrook, Mark C.; Kushi, Lawrence H.; Lowry, Sarah; Ramaprasan, Arvind; Wagner, Edward H.; Weeks, Jane C.; Ritzwoller, Debra P.

    2014-01-01

    Purpose: Fee-for-service (FFS) Medicare expenditures for advanced imaging studies (defined as computed tomography [CT], magnetic resonance imaging [MRI], positron emission tomography [PET] scans, and nuclear medicine studies [NM]) rapidly increased in the past two decades for patients with cancer. Imaging rates are unknown for patients with cancer, whether under or over age 65 years, in health maintenance organizations (HMOs), where incentives may differ. Materials and Methods: Incident cases of breast, colorectal, lung, prostate, leukemia, and non-Hodgkin lymphoma (NHL) cancers diagnosed in 2003 and 2006 from four HMOs in the Cancer Research Network were used to determine 2-year overall mean imaging counts and average total imaging costs per HMO enrollee by cancer type for those under and over age 65. Results: There were 44,446 incident cancer patient cases, with a median age of 75 (interquartile range, 71-81), and 454,029 imaging procedures were performed. The mean number of images per patient increased from 7.4 in 2003 to 12.9 in 2006. Rates of imaging were similar across age groups, with the exception of greater use of echocardiograms and NM studies in younger patients with breast cancer and greater use of PET among younger patients with lung cancer. Advanced imaging accounted for approximately 41% of all imaging, or approximately 85% of the $8.7 million in imaging expenditures. Costs were nearly $2,000 per HMO enrollee; costs for younger patients with NHL, leukemia, and lung cancer were nearly $1,000 more in 2003. Conclusion: Rates of advanced imaging appear comparable among FFS and HMO participants of any age with these six cancers. PMID:24844241

  10. Recommendations for individual participant data meta-analyses on work stressors and health outcomes: comments on IPD-Work Consortium papers.

    PubMed

    Choi, Bong Kyoo; Schnall, Peter; Landsbergis, Paul; Dobson, Marnie; Ko, Sangbaek; Gómez-Ortiz, Viviola; Juárez-Garcia, Arturo; Baker, Dean

    2015-05-01

    The IPD-Work (individual-participant data meta-analysis of working populations) Consortium has published several papers on job strain (the combination of low job control and high job demands) based on Karasek's demand-control model (1) and health-related outcomes including cardiovascular disease (CVD), cancer, obesity, diabetes as well as health-related behaviors, utilizing meta-analyses of a pooled database of study participants from 17 European cohorts. An IPD approach has some advantages over typical meta-analyses, eg, having access to all the data for each individual allows for additional analyses, compared to typical meta-analyses. However, such an approach, like other meta-analyses, is not free from errors and biases (2-6) when it is not conducted appropriately. In our review of the IPD-Work Consortium's (hereafter called the Consortium) publications of the last two years, we have identified and pointed out several conceptual and methodological errors, as well as unsubstantiated conclusions and inappropriate recommendations for worksite public health policies (6-15). However, the Consortium has not yet appropriately addressed many of the issues we have raised. Also several major errors and biases underlying the Consortium IPD meta-analysis publications have not been presented in a comprehensive way, nor have they been discussed widely among work stress researchers. We are concerned that the same errors and biases could be repeated in future IPD Consortium meta-analysis publications as well as by other researchers who are interested in meta-analyses on work stressors and health outcomes. It is possible that the inappropriate interpretations in the Consortium publications, which remained uncorrected to date, may have a negative impact on the international efforts of the work stress research community to improve the health of working populations. Recently, Dr. Töres Theorell, a principal investigator of the Consortium, responded in this journal (16) to some of

  11. Low vaccination coverage for seasonal influenza and pneumococcal disease among adults at-risk and health care workers in Ireland, 2013: The key role of GPs in recommending vaccination.

    PubMed

    Giese, Coralie; Mereckiene, Jolita; Danis, Kostas; O'Donnell, Joan; O'Flanagan, Darina; Cotter, Suzanne

    2016-07-12

    The World Health Organization (WHO), and European Agencies recommend influenza vaccination for individuals at-risk due to age (≥65 years), underlying diseases, pregnancy and for health care workers (HCWs) in Europe. Pneumococcal vaccine is recommended for those at-risk of pneumococcal disease. In Ireland, vaccination uptake among at-risk adults is not routinely available. In 2013, we conducted a national survey among Irish residents ≥18 years of age, to estimate size and vaccination coverage of at-risk groups, and identify predictive factors for influenza vaccination. We used computer assisted telephone interviews to collect self-reported information on health, vaccination status, attitudes towards vaccination. We calculated prevalence and prevalence ratios (PR) using binomial regression. Overall, 1770 individuals participated. For influenza, among those aged 18-64 years, 22% (325/1485) [95%CI: 17%-20%] were at-risk; 28% [95%CI: 23%-33%] were vaccinated. Among those aged ≥65 years, 60% [95%CI: 54%-66%] were vaccinated. Influenza vaccine uptake among HCWs was 28% [95%CI: 21%-35%]. For pneumococcal disease, among those aged 18-64 years, 18% [95%CI: 16%-20%] were at-risk; 16% [95%CI: 12%-21%] reported ever-vaccination; among those aged ≥65 years, 36% [95%CI: 30%-42%] reported ever-vaccination. Main reasons for not receiving influenza vaccine were perceptions of not being at-risk, or not thinking of it; and among HCWs thinking that vaccination was not necessary or they were not at-risk. At-risk individuals were more likely to be vaccinated if their doctor had recommended it (PR 3.2; [95%CI: 2.4%-4.4%]) or they had access to free medical care or free vaccination services (PR 2.0; [95%CI: 1.5%-2.8%]). Vaccination coverage for both influenza and pneumococcal vaccines in at-risk individuals aged 18-64 years was very low. Influenza vaccination coverage among individuals ≥65 years was moderate. Influenza vaccination status was associated with GP vaccination

  12. An Exploratory Study of Women in the Health Professions Schools. Volume I: Data Analysis, Findings, Conclusions, Recommendations.

    ERIC Educational Resources Information Center

    Urban and Rural Systems Associates, San Francisco, CA.

    The study focused on women's education in eight health professions: medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, pharmacy, and public health. Its central tasks were to identify and explore the barriers to success that women face as school applicants and students. Almost 600 interviews were conducted with…

  13. Report a Complaint (about a Health Care Organization)

    MedlinePlus

    ... What Is Accreditation? Become Accredited Download the Gold Seal Find Accredited Organizations Newsletters Publicity Kits State Recognition ... What Is Certification? Become Certified Download the Gold Seal Find Certified Organizations Newsletters Publicity Kit State Recognition ...

  14. 78 FR 52924 - Office of the Assistant Secretary for Health, Statement of Organization, Functions, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Office of the Assistant Secretary for Health, Statement of Organization, Functions, and Delegations of Authority Part A, Office of the Secretary, Statement of Organization, Function, and Delegation of Authority...

  15. 75 FR 48691 - Single Source Cooperative Agreement Award for the World Health Organization (WHO) To Continue...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-11

    ... HUMAN SERVICES Single Source Cooperative Agreement Award for the World Health Organization (WHO) To... Authority ACTION: Notice. SUMMARY: Notification of Single Source Cooperative Agreement Award for the World... 2010, BARDA plans to provide a Single Source Continuation Award to the World Health Organization...

  16. Appraisal of the research grant schemes of the World Health Organization Regional Office for the Eastern Mediterranean: the way forward.

    PubMed

    Shideed, O; Al-Gasseer, N

    2012-05-01

    One way that the World Health Organization Regional Office for the Eastern Mediterranean (EMRO) promotes the important area of health research is by providing research grants within the Region. A desk review of 2 of the EMRO-supported research grant schemes was done to assess: the selection process ofthe research proposals, the priority areas, country data and information on the principal investigator. The 2 schemes were: EMRO grant for Research in Priority Areas of Public Health, started in 2002, and the EMRO and Organization of Islamic Conference Standing Committee for Science and Technological Cooperation Grant for Research in Applied Biotechnology & Genomics in Health, started in 2004. The paper proposes the following recommendations to enhance benefit from the grant process: create a critical mass of researchers through joint collaboration in proposals and mentoring; instigate a more rigorous process to disseminate the call for proposals more widely and effectively; and include relevant stakeholders in the identification of priority areas for research and overall monitoring of the process. PMID:22764440

  17. On Recommending.

    ERIC Educational Resources Information Center

    Furner, Jonathan

    2002-01-01

    Discusses recommendation, or preference ordering, in document retrieval systems that ranks documents in order of the likelihood with which they match the preferences of any person searching the system. Describes the ERIn (Evaluation-Recommendation-Information) model, a decision-theoretic framework for understanding information-related activity…

  18. Meat quality and health implications of organic and conventional beef production.

    PubMed

    Kamihiro, S; Stergiadis, S; Leifert, C; Eyre, M D; Butler, G

    2015-02-01

    Recommendation to reduce fat consumption from ruminant meat does not consider the contribution of nutritionally beneficial fatty acids in lean beef. Here we report effects of production system (organic vs conventional) and finishing season on meat and fat quality of sirloin steaks from retail outlets and simulated fatty acid intakes by consumers. There was little difference in meat quality (pH, shear force and colour), but the fat profiles varied considerably between production systems and season. Meat fat from organic and summer finished cattle contained higher concentrations of conjugated linoleic acid, its precursor vaccenic acid and individual omega-3 fatty acids and had a lower ratio of omega-6 to omega-3 fatty acids compared with non-organic and winter finished cattle respectively. The fat profile from summer finished organic beef aligns better to recommended dietary guideline including those for long chain omega-3 fatty acids compared with that from winter finished, non-organic steak. PMID:25460141

  19. Organ harvesting from anencephalic infants: health management over a sinkhole.

    PubMed

    Alatis, A J

    As technology increases in the field of organ transplantation for newborns, a problematic limitation persists: too few organ donors are available to match the number of needy organ donees. Anencephalic newborns have been suggested (and recently used) as organ sources. Anencephalic infants are born without the upper part of their brain and usually die within a week after birth. This article will address the ethical considerations of using these infants as organ sources, particularly from the view of a physician and an attorney. This piece will further analyze the medico-legal ramifications of the various legislative proposals addressing this subject. PMID:10292200

  20. The World Health Organization's mechanisms for increasing the health sector budget: The South African context.

    PubMed

    Venter, Fouche Hendrik Johannes; Wolfaardt, Jaqueline Elizabeth

    2016-08-01

    South Africa (SA) has limited scope for raising income taxes, and the proposed National Health Insurance (NHI) scheme will necessitate growth in the health sector budget. The NHI White Paper suggests five funding scenarios to meet the expected shortfall. These scenarios are a mixture of a surcharge on taxable income, an increase in value-added tax and a payroll tax. Five alternative options, suggested by the World Health Organization, are interrogated as ways to decrease the general taxation proposed in the White Paper. The five mechanisms (corporate tax, financial transaction levy, and taxes on tobacco, alcohol and unhealthy foods) were chosen based on their fund-raising potential and their mandatory element. A literature review provides the information for a discussion of the potential costs of each mechanism. Within specific assumptions, potential budgetary contribution is compared with the requirement. First, raising corporate tax rates could raise enough funds, but the losses due to capital flight might be too much for the local economy to bear. Second, a levy on currency transactions is unlikely to raise the required resources, even without a probable decrease in the number of transactions. Third, the increase in the tax on tobacco and alcohol would need to be very large, even assuming that consumption patterns would remain unchanged. Lastly, a tax on unhealthy food products is a new idea and could be explored as an option - especially as the SA Treasury has announced its future implementation. Implementing only one of the mechanisms is unlikely to increase available funding sufficiently, but if they are implemented together the welfare-maximising tax rate for each mechanism may be high enough to fulfil the NHI scheme's budgetary requirement, moderating the increases in the tax burden of the SA population. PMID:27499398

  1. Recommender systems

    NASA Astrophysics Data System (ADS)

    Lü, Linyuan; Medo, Matúš; Yeung, Chi Ho; Zhang, Yi-Cheng; Zhang, Zi-Ke; Zhou, Tao

    2012-10-01

    The ongoing rapid expansion of the Internet greatly increases the necessity of effective recommender systems for filtering the abundant information. Extensive research for recommender systems is conducted by a broad range of communities including social and computer scientists, physicists, and interdisciplinary researchers. Despite substantial theoretical and practical achievements, unification and comparison of different approaches are lacking, which impedes further advances. In this article, we review recent developments in recommender systems and discuss the major challenges. We compare and evaluate available algorithms and examine their roles in the future developments. In addition to algorithms, physical aspects are described to illustrate macroscopic behavior of recommender systems. Potential impacts and future directions are discussed. We emphasize that recommendation has great scientific depth and combines diverse research fields which makes it interesting for physicists as well as interdisciplinary researchers.

  2. Health and research organization to meet complex needs of developing energy technologies

    SciTech Connect

    Griffith, R.V.

    1980-01-01

    At the Lawrence Livermore Laboratory, a unique safety technology organization has been established that is especially geared to respond to interdisciplinary health and safety questions in response to rapidly growing energy technology problems. This concept can be adopted by smaller organizations at a more modest cost, and still maintains the efficiency, flexibility, and technical rigor that are needed more and more in support of any industry health and safety problem. The separation of the technology development role from the operation safety organization allows the operational safety specialists to spend more time upgrading the occupational health and safety program but yet provides the opportunity for interchange with health and safety technology development specialists. In fact, a personnel assignment flow between an operational health and safety organization and a special technology development organization provides a mechanism for upgrading the overall safety capability and program provided by a given industrial or major laboratory.

  3. Work organization research at the National Institute for Occupational Safety and Health.

    PubMed

    Rosenstock, L

    1997-01-01

    For 25 years, the National Institute for Occupational Safety and Health (NIOSH) has conducted and sponsored laboratory, field, and epidemiological studies that have helped define the role of work organization factors in occupational safety and health. Research has focused on the health effects of specific job conditions, occupational stressors in specific occupations, occupational difference in the incidence of stressors and stress-related disorders, and intervention strategies. NIOSH and the American Psychological Association have formalized the concept of occupational health psychology and developed a postdoctoral training program. The National Occupational Research Agenda recognizes organization of work as one of 21 national occupational safety and health research priority areas. Future research should focus on industries, occupations, and populations at special risk; the impact of work organization on overall health; the identification of healthy organization characteristics; and the development of intervention strategies. PMID:9552275

  4. Post-upgrade testing on a radiotherapy oncology information system with an embedded record and verify system following the IAEA Human Health Report No. 7 recommendations.

    PubMed

    Nyathi, Thulani; Colyer, Christopher; Bhardwaj, Anup Kumar; Rijken, James; Morton, Jason

    2016-06-01

    Record and verify (R&V) systems have proven that their application in radiotherapy clinics leads to a significant reduction in mis-treatments of patients. The purpose of this technical note is to share our experience of acceptance testing, commissioning and setting up a quality assurance programme for the MOSAIQ® oncology information system and R&V system after upgrading from software version 2.41 to 2.6 in a multi-vendor, multi-site environment. Testing was guided primarily by the IAEA Human Report No. 7 recommendations, but complemented by other departmental workflow specific tests. To the best of our knowledge, this is the first time successful implementation of the IAEA Human Health Report Series No. 7 recommendations have been reported in the literature. PMID:27245299

  5. The strains recommended for use in the bacterial reverse mutation test (OECD guideline 471) can be certified as non-genetically modified organisms.

    PubMed

    Sugiyama, Kei-Ichi; Yamada, Masami; Awogi, Takumi; Hakura, Atsushi

    2016-01-01

    The bacterial reverse mutation test, commonly called Ames test, is used worldwide. In Japan, the genetically modified organisms (GMOs) are regulated under the Cartagena Domestic Law, and organisms obtained by self-cloning and/or natural occurrence would be exempted from the law case by case. The strains of Salmonella typhimurium and Escherichia coli recommended for use in the bacterial reverse mutation test (OECD guideline 471), have been considered as non-GMOs because they can be constructed by self-cloning or naturally occurring bacterial strains, or do not disturb the biological diversity. The present article explains the reasons why these tester strains should be classified as non-GMOs. PMID:27350822

  6. An Investigation into the Social Context of Low-income, Urban Black and Latina Women: Implications for Adherence to Recommended Health Behaviors

    PubMed Central

    2012-01-01

    Understanding factors that promote or prevent adherence to recommended health behaviors is essential for developing effective health programs, particularly among lower-income populations who carry a disproportionate burden of disease. We conducted in-depth qualitative interviews (n=64) with low-income Black and Latina women who shared the experience of requiring diagnostic follow-up after having an abnormal screening mammogram. In addition to holding negative and fatalistic cancer-related beliefs, we found that the social context of these women was largely defined by multiple challenges and major life stressors that interfered with their ability to attain health. Factors commonly mentioned included competing health issues, economic hardship, demanding caretaking responsibilities and relationships, insurance-related challenges, distrust of healthcare providers, and inflexible work policies. Black women also reported discrimination and medical mistrust, while Latinas experienced difficulties associated with immigration and social isolation. These results suggest that effective health interventions not only address change among individuals, but must also change healthcare systems and social policies in order to reduce health disparities. PMID:21856885

  7. The New Left and Public Health The Health Policy Advisory Center, Community Organizing, and the Big Business of Health, 1967–1975

    PubMed Central

    2011-01-01

    Soon after its founding in the politically tumultuous late 1960s, the Health Policy Advisory Center (Health/PAC) and its Health/PAC Bulletin became the strategic hub of an intense urban social movement around health care equality in New York City. I discuss its early formation, its intellectual influences, and the analytical framework that it devised to interpret power relations in municipal health care. I also describe Health/PAC's interpretation of health activism, focusing in particular on a protracted struggle regarding Lincoln Hospital in the South Bronx. Over the years, the organization's stance toward community-oriented health politics evolved considerably, from enthusiastically promoting its potential to later confronting its limits. I conclude with a discussion of Health/PAC's major theoretical contributions, often taken for granted today, and its book American Health Empire. PMID:21228287

  8. [New growth references of the World Health Organization based on breast fed infants].

    PubMed

    Lozano de la Torre, Maria J

    2007-02-01

    The World Health Organization Multicenter Growth Reference Study is a multinational project to develop new growth references for infants and young children. The design combines a longitudinal study from birth to 24 months with a cross-sectional study of children aged 18 to 71 months. The pooled sample from the six participating countries (Brazil, Ghana, India, Norway, Oman, and the United States) consists of 8440 children. The new WHO Child Growth Standards confirm that all children worldwide, given an optimum start in life, have the same potential for growth and prove that differences in children's growth to the age of 5 years are more influenced by nutrition, feeding practices, environment, and healthcare than by genetics or ethnicity. The new standards are based on the breast fed child as the norm for growth and development. For the first time, this ensures coherence among the tools used to assess growth and national and international infant feeding guidelines, which recommend breast feeding as the optimal source of nutrition during infancy. PMID:17306105

  9. Biochemistry in Undergraduate Health Courses: Structure and Organization

    ERIC Educational Resources Information Center

    Silva, Irani F.; Batista, Nildo A.

    2003-01-01

    This article describes the following aspects of teaching biochemistry in undergraduate health courses: objectives, number of hours, time in which the subject is studied, selection of content, teaching strategies, and evaluation methodologies used. Fifty-three courses distributed in 13 areas within the health field and offered by 12 institutions…

  10. Services Shared by Health Care Organizations: An Annotated Bibliography.

    ERIC Educational Resources Information Center

    Hospital Research and Educational Trust, Chicago, IL.

    This bibliography is designed to assist planners in the field of institutional health and health support services in gaining access to knowledge that will enhance their efforts to achieve new or expanded arrangements of service sharing. Entries are cross-referenced to as many categories as the material warrants. Case studies that are not annotated…

  11. Managing professional work: three models of control for health organizations.

    PubMed Central

    Scott, W R

    1982-01-01

    Three arrangements for structuring the work of professional participants in professional organizations are described, contrasted and evaluated. Arguments are illustrated by application to the organization of physicians within hospitals. The primary rationale, the support structures that have fostered its development, the key structural features and the advantages and disadvantages of each arrangement are described. The effect on these arrangements of structures and forces external to any particular professional organization is emphasized. PMID:6749761

  12. Design of high reliability organizations in health care

    PubMed Central

    Carroll, J S; Rudolph, J W

    2006-01-01

    To improve safety performance, many healthcare organizations have sought to emulate high reliability organizations from industries such as nuclear power, chemical processing, and military operations. We outline high reliability design principles for healthcare organizations including both the formal structures and the informal practices that complement those structures. A stage model of organizational structures and practices, moving from local autonomy to formal controls to open inquiry to deep self‐understanding, is used to illustrate typical challenges and design possibilities at each stage. We suggest how organizations can use the concepts and examples presented to increase their capacity to self‐design for safety and reliability. PMID:17142607

  13. Healthcare organization-education partnerships and career ladder programs for health care workers.

    PubMed

    Dill, Janette S; Chuang, Emmeline; Morgan, Jennifer C

    2014-12-01

    Increasing concerns about quality of care and workforce shortages have motivated health care organizations and educational institutions to partner to create career ladders for frontline health care workers. Career ladders reward workers for gains in skills and knowledge and may reduce the costs associated with turnover, improve patient care, and/or address projected shortages of certain nursing and allied health professions. This study examines partnerships between health care and educational organizations in the United States during the design and implementation of career ladder training programs for low-skill workers in health care settings, referred to as frontline health care workers. Mixed methods data from 291 frontline health care workers and 347 key informants (e.g., administrators, instructors, managers) collected between 2007 and 2010 were analyzed using both regression and fuzzy-set qualitative comparative analysis (QCA). Results suggest that different combinations of partner characteristics, including having an education leader, employer leader, frontline management support, partnership history, community need, and educational policies, were necessary for high worker career self-efficacy and program satisfaction. Whether a worker received a wage increase, however, was primarily dependent on leadership within the health care organization, including having an employer leader and employer implementation policies. Findings suggest that strong partnerships between health care and educational organizations can contribute to the successful implementation of career ladder programs, but workers' ability to earn monetary rewards for program participation depends on the strength of leadership support within the health care organization. PMID:25441318

  14. The evolution of human rights in World Health Organization policy and the future of human rights through global health governance.

    PubMed

    Meier, B M; Onzivu, W

    2014-02-01

    The World Health Organization (WHO) was intended to serve at the forefront of efforts to realize human rights to advance global health, and yet this promise of a rights-based approach to health has long been threatened by political constraints in international relations, organizational resistance to legal discourses, and medical ambivalence toward human rights. Through legal research on international treaty obligations, historical research in the WHO organizational archives, and interview research with global health stakeholders, this research examines WHO's contributions to (and, in many cases, negligence of) the rights-based approach to health. Based upon such research, this article analyzes the evolving role of WHO in the development and implementation of human rights for global health, reviews the current state of human rights leadership in the WHO Secretariat, and looks to future institutions to reclaim the mantle of human rights as a normative framework for global health governance. PMID:24439475

  15. The Effect of Graphic Organizers on Subjective and Objective Comprehension of a Health Education Text

    ERIC Educational Resources Information Center

    Kools, Marieke; van de Wiel, Margaretha W. J.; Ruiter, Robert A. C.; Cruts, Anica; Kok, Gerjo

    2006-01-01

    This study examined the effect of graphic organizers on the comprehension of a health education brochure text and compared subjective with objective comprehension measures. Graphic organizers are graphical depictions of relations among concepts in a text. Participants read a brochure text about asthma with and without these organizers, and…

  16. Health behavior change models for HIV prevention and AIDS care: practical recommendations for a multi-level approach.

    PubMed

    Kaufman, Michelle R; Cornish, Flora; Zimmerman, Rick S; Johnson, Blair T

    2014-08-15

    Despite increasing recent emphasis on the social and structural determinants of HIV-related behavior, empirical research and interventions lag behind, partly because of the complexity of social-structural approaches. This article provides a comprehensive and practical review of the diverse literature on multi-level approaches to HIV-related behavior change in the interest of contributing to the ongoing shift to more holistic theory, research, and practice. It has the following specific aims: (1) to provide a comprehensive list of relevant variables/factors related to behavior change at all points on the individual-structural spectrum, (2) to map out and compare the characteristics of important recent multi-level models, (3) to reflect on the challenges of operating with such complex theoretical tools, and (4) to identify next steps and make actionable recommendations. Using a multi-level approach implies incorporating increasing numbers of variables and increasingly context-specific mechanisms, overall producing greater intricacies. We conclude with recommendations on how best to respond to this complexity, which include: using formative research and interdisciplinary collaboration to select the most appropriate levels and variables in a given context; measuring social and institutional variables at the appropriate level to ensure meaningful assessments of multiple levels are made; and conceptualizing intervention and research with reference to theoretical models and mechanisms to facilitate transferability, sustainability, and scalability. PMID:25007194

  17. Health Behavior Change Models for HIV Prevention and AIDS Care: Practical Recommendations for a Multi-Level Approach

    PubMed Central

    Cornish, Flora; Zimmerman, Rick S.; Johnson, Blair T.

    2014-01-01

    Abstract: Despite increasing recent emphasis on the social and structural determinants of HIV-related behavior, empirical research and interventions lag behind, partly because of the complexity of social–structural approaches. This article provides a comprehensive and practical review of the diverse literature on multi-level approaches to HIV-related behavior change in the interest of contributing to the ongoing shift to more holistic theory, research, and practice. It has the following specific aims: (1) to provide a comprehensive list of relevant variables/factors related to behavior change at all points on the individual–structural spectrum, (2) to map out and compare the characteristics of important recent multi-level models, (3) to reflect on the challenges of operating with such complex theoretical tools, and (4) to identify next steps and make actionable recommendations. Using a multi-level approach implies incorporating increasing numbers of variables and increasingly context-specific mechanisms, overall producing greater intricacies. We conclude with recommendations on how best to respond to this complexity, which include: using formative research and interdisciplinary collaboration to select the most appropriate levels and variables in a given context; measuring social and institutional variables at the appropriate level to ensure meaningful assessments of multiple levels are made; and conceptualizing intervention and research with reference to theoretical models and mechanisms to facilitate transferability, sustainability, and scalability. PMID:25007194

  18. The World Health Organization and the Transition From “International” to “Global” Public Health

    PubMed Central

    Brown, Theodore M.; Cueto, Marcos; Fee, Elizabeth

    2006-01-01

    The term “global health” is rapidly replacing the older terminology of “international health.” We describe the role of the World Health Organization (WHO) in both international and global health and in the transition from one to the other. We suggest that the term “global health” emerged as part of larger political and historical processes, in which WHO found its dominant role challenged and began to reposition itself within a shifting set of power alliances. Between 1948 and 1998, WHO moved from being the unquestioned leader of international health to being an organization in crisis, facing budget shortfalls and diminished status, especially given the growing influence of new and powerful players. We argue that WHO began to refashion itself as the coordinator, strategic planner, and leader of global health initiatives as a strategy of survival in response to this transformed international political context. PMID:16322464

  19. Trucking organization and mental health disorders of truck drivers.

    PubMed

    Shattell, Mona; Apostolopoulos, Yorghos; Collins, Chad; Sönmez, Sevil; Fehrenbacher, Caitlin

    2012-07-01

    There are over 3 million truck drivers employed in the commercial transportation and material moving occupations, one of the largest occupational groups in the United States. Workers in this large and growing occupational segment are at risk for a range of occupational health-induced conditions, including mental health and psychiatric disorders due to high occupational stress, low access and use of health care, and limited social support. The purpose of this study was to explore male truck drivers' mental health risks and associated comorbidities, using a cross-sectional and quantitative design. Data were collected from a random sample of 316 male truckers between the ages of 23 and 76 at a large truck stop located within a 100-mile radius of Greensboro, North Carolina, USA, using a self-administered 82-item questionnaire. Surveyed truckers were found to have significant issues affecting their mental health, such as loneliness (27.9%), depression (26.9%), chronic sleep disturbances (20.6%), anxiety (14.5%), and other emotional problems (13%). Findings have potential to help researchers develop interventions to improve the emotional and occupational health of truck drivers, a highly underserved population. Mental health promotion, assessment, and treatment must become a priority to improve the overall trucking environment for truckers, the transportation industry, and safety on US highways. PMID:22757596

  20. Organic farming: Impacts on soil, food, and human health

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The importance of responsible stewardship in managing soil is a central tenet of organic farming. Organic farmers believe that practices which stimulate biology and overall quality of soil enhance production of healthy and nutritious crops. Few involved in agriculture would argue this point. Neverth...

  1. Recommended Paperbacks.

    ERIC Educational Resources Information Center

    Horn Book Magazine, 1980

    1980-01-01

    Lists recommended paperback books for children in the following categories: picture books; stories for younger, for intermediate, and for older readers; folklore, legend, and mythology; and nonfiction. Tells if and when the original editions were reviewed in this journal. (GT)

  2. Mental Health and Resilience in HIV/AIDS-Affected Children: A Review of the Literature and Recommendations for Future Research

    PubMed Central

    Betancourt, T.S.; Meyers-Ohki, S.E.; Charrow, A.; Hansen, N.

    2012-01-01

    Background To date, research on mental health in HIV-affected children (children who have an HIV-positive caregiver or live with the virus themselves) has focused on risk factors associated with the disease. However, simultaneous identification of factors that contribute to resilience in the face of risks is also needed. A greater understanding of modifiable protective processes that contribute to resilience in the mental health of children affected by HIV can inform the design of interventions that bolster naturally-occurring supports and contribute to early prevention or better management of risks. Methods We reviewed the recent literature on mental health and resilience in children and adolescents affected by HIV/AIDS. Literature searches of PsycInfo and PubMed were conducted during July-December 2011 consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Qualitative and quantitative studies were included for review if primary research questions pertained to mental health and coping or protective processes in children and families affected by HIV/AIDS. All studies subject to full review were evaluated for quality using a modified Systematic Assessment of Quality in Observational Research (SAQOR) rating system. Results 171 unique studies were returned from online searches of the literature and bibliography mining. Of these, 29 were evaluated as pertaining directly to mental health and resilience in families and children living with HIV/AIDS. Eight studies presented qualitative analyses. Ten quantitative studies examined individual resources contributing to child resilience and four quantitative studies looked at family-level resources. Ten studies also investigated community-level interactions. Four presented findings from resilience-focused interventions. Conclusions There is a clear need for rigorous research on mental health and resilience in HIV-affected children and adolescents. The evidence base would greatly

  3. The paradox of physicians and administrators in health care organizations.

    PubMed

    Peirce, J C

    2000-01-01

    Rapidly changing times in health care challenge both physicians and health care administrators to manage the paradox of providing orderly, high quality, and efficient care while bringing forth innovations to address present unmet problems and surprises that emerge. Health care has grown throughout the past several centuries through differentiation and integration, becoming a highly complex biological system with the hospital as the central attractive force--or "strange attractor"--during this century. The theoretical model of complex adaptive systems promises more effective strategic direction in addressing these chaotic times where the new strange attractor moves beyond the hospital. PMID:10710724

  4. Opportunities for Excellence. Findings, Conclusions, and Recommendations of a Survey of Illinois School District Organization. Final Report of the Committee on School Organization.

    ERIC Educational Resources Information Center

    Governor's Commission on Schools, Springfield, IL.

    This report contains a history of school district organization in Illinois, a statistical profile of Illinois education today, a survey of selected districts offering quality education, and an agenda for change. Findings indicate that, of the measurable factors affecting the quality of local educational opportunity, district size is most critical.…

  5. Tribal Recommendations for Designing Culturally Appropriate Technology-Based Sexual Health Interventions Targeting Native Youth in the Pacific Northwest

    ERIC Educational Resources Information Center

    Rushing, Stephanie Craig; Stephens, David

    2012-01-01

    Media technologies, including the Internet, cell phones, and video games, offer new avenues to reach Native youth on sensitive health topics. Project Red Talon, a sexually transmitted disease (STD)/HIV prevention project that serves the 43 federally recognized tribes in Oregon, Washington, and Idaho, used community-based participatory research…

  6. Announcement: Release of CDC's 2016 Model Aquatic Health Code, Second Edition and Revised Hyperchlorination and Fecal Incident Response Recommendations.

    PubMed

    2016-01-01

    The 2016 Model Aquatic Health Code (MAHC), Second Edition was released on July 15, 2016 (http://www.cdc.gov/mahc/editions/current.html). MAHC is national guidance that can be voluntarily adopted by state and local jurisdictions to minimize the risk for illness and injury at public aquatic facilities through facility design, construction, operation, maintenance, and management. PMID:27442593

  7. User Preferences and Design Recommendations for an mHealth App to Promote Cystic Fibrosis Self-Management

    PubMed Central

    Hilliard, Marisa E; Hahn, Amy; Ridge, Alana K; Eakin, Michelle N

    2014-01-01

    Background mHealth apps hold potential to provide automated, tailored support for treatment adherence among individuals with chronic medical conditions. Yet relatively little empirical research has guided app development and end users are infrequently involved in designing the app features or functions that would best suit their needs. Self-management apps may be particularly useful for people with chronic conditions like cystic fibrosis (CF) that have complex, demanding regimens. Objective The aim of this mixed-methods study was to involve individuals with CF in guiding the development of engaging, effective, user-friendly adherence promotion apps that meet their preferences and self-management needs. Methods Adults with CF (n=16, aged 21-48 years, 50% male) provided quantitative data via a secure Web survey and qualitative data via semi-structured telephone interviews regarding previous experiences using apps in general and for health, and preferred and unwanted features of potential future apps to support CF self-management. Results Participants were smartphone users who reported sending or receiving text messages (93%, 14/15) or emails (80%, 12/15) on their smartphone or device every day, and 87% (13/15) said it would be somewhat or very hard to give up their smartphone. Approximately one-half (53%, 8/15) reported having health apps, all diet/weight-related, yet many reported that existing nutrition apps were not well-suited for CF management. Participants wanted apps to support CF self-management with characteristics such as having multiple rather than single functions (eg, simple alarms), being specific to CF, and minimizing user burden. Common themes for desired CF app features were having information at one’s fingertips, automation of disease management activities such as pharmacy refills, integration with smartphones’ technological capabilities, enhancing communication with health care team, and facilitating socialization within the CF community

  8. Integrating patient voices into health information for self-care and patient-clinician partnerships: Veterans Affairs design recommendations for patient-generated data applications.

    PubMed

    Woods, Susan S; Evans, Neil C; Frisbee, Kathleen L

    2016-05-01

    Electronic health record content is created by clinicians and is driven largely by intermittent and brief encounters with patients. Collecting data directly from patients in the form of patient-generated data (PGD) provides an unprecedented opportunity to capture personal, contextual patient information that can supplement clinical data and enhance patients' self-care. The US Department of Veterans Affairs (VA) is striving to implement the enterprise-wide capability to collect and use PGD in order to partner with patients in their care, improve the patient healthcare experience, and promote shared decision making. Through knowledge gained from Veterans' and healthcare teams' perspectives, VA created a taxonomy and an evolving framework on which to design and develop applications that capture and help physicians utilize PGD. Ten recommendations for effectively collecting and integrating PGD into patient care are discussed, addressing health system culture, data value, architecture, policy, data standards, clinical workflow, data visualization, and analytics and population reach. PMID:26911810

  9. Consumer-directed health care: implications for health care organizations and managers.

    PubMed

    Guo, Kristina L

    2010-01-01

    This article uses a pyramid model to illustrate the key components of consumer-directed health care. Consumer-directed health care is considered the essential strategy needed to lower health care costs and is valuable for making significant strides in health care reform. Consumer-directed health care presents new challenges and opportunities for all health care stakeholders and their managers. The viability of the health system depends on the success of managers to respond rapidly and with precision to changes in the system; thus, new and modified roles of managers are necessary to successfully sustain consumerism efforts to control costs while maintaining access and quality. PMID:20436329

  10. Mammography Screening in a Large Health System Following the U.S. Preventive Services Task Force Recommendations and the Affordable Care Act

    PubMed Central

    Nelson, Heidi D.; Weerasinghe, Roshanthi; Wang, Lian; Grunkemeier, Gary

    2015-01-01

    Background Practice recommendations for mammography screening were issued by the U.S. Preventive Services Task Force in 2009 and expansion of insurance coverage was provided under the Patient Protection and Affordable Care Act soon thereafter, yet the influence of these changes on screening practices in the United States is not known. Methods To determine changes in mammography screening and their associations with new practice recommendations and the Affordable Care Act, we examined patient-level data from 249,803 screening mammograms from January 1, 2008 through December 31, 2012 in a large community-based health system in the northwestern United States. Associations were determined by an intervention analysis of time-series data method. Results Among women screened, 64% were age 50-74 years; 84% self-identified as white race; 62% had commercial insurance; and 70% were seen in facilities located in metropolitan areas. Practice recommendations were associated with decreased screening volumes among women age <40 (-37.4 mammograms/month; -39.4% change; P<0.001), 40-49 (-106.0 mammograms/month; -11.2% change; P<0.001), and ≥75 (-54.7 mammograms/month; -10.0% change; P<0.001), but not women age 50-74. Implementation of the Affordable Care Act was associated with increased screening among women age 50-74 (+184.3 mammograms/month; +7.2% change; P=0.001), but not women <40 or ≥75; increases for age 40-49 were of borderline statistical significance (+56.9 mammograms/month; +6% change; P=0.06). Practice recommendations were also associated with decreased screening for women with commercial insurance, while the Affordable Care Act was associated with increased screening for women with Medicare, Medicaid, or other noncommercial sources of payment. Conclusions Mammography screening volumes in a large community health system decreased among women age <50 and ≥75 in association with new U.S. Preventive Services Task Force practice recommendations, while insurance coverage

  11. e-business means survival for health care organizations in 2010.

    PubMed

    Lutz, S

    2000-01-01

    Within the next five years, most health care organizations will communicate with suppliers, other providers, payers, regulators, and patients through the Internet. The Internet will recalibrate expectations of speed and service for patients and providers, but it also will increase accountability in which digitalized information is tracked and analyzed. The rate at which health care organizations are developing Web-based solutions is neck-snapping in the United States. As individual product lines, departments, and subsidiaries grow their own e-health businesses, organizations must decide which initiatives they must fund, which are essential to survival, and which could be financial black holes. PMID:11184343

  12. Health in the news: an analysis of magazines coverage of health issues in veterans and military service organizations.

    PubMed

    Jitnarin, Nattinee; Poston, Walker S C; Haddock, Christopher K; Jahnke, Sara

    2015-05-01

    The purpose of this study was to conduct a content analysis of Veterans and Military Service Organizations (VMSOs) magazines to determine what health-related topics VMSOs target and how they inform their constituencies about health issues. Health-related topics in 288 VMSOs' magazines from 21 VMSOs published in 2011 and 2012 were coded by trained raters using a standardized manual. The top three most addressed health topics were Health Services (Health care, Insurance), Disability and Disability benefits, and post-traumatic stress disorder. Topics least frequently covered were Tobacco and Smoking cessation, Illegal drugs, Alcohol, Gulf War Syndrome, and Weight and Body composition. VMSOs are concerned about the health and well-being of their members given the considerable amount of content devoted to certain health topics such as health insurance concerns, disability, and post-traumatic stress disorder. However, other health concerns that affect a considerable number of both current military personnel and veterans and cost both the Department of Veterans Affairs and the Department of Defense millions annually, such as drug and alcohol problems, and tobacco use and smoking cessation, are infrequently covered. The results of this study improve our understanding of the health-related information that reaches the military and veteran populations through this important media outlet. PMID:25939108

  13. Advocating self-advocacy: board membership in a statewide mental health consumer organization.

    PubMed

    Tanenbaum, Sandra J

    2014-08-01

    Until 2008 Ohio Advocates for Mental Health was a statewide mental health advocacy organization run by mental health consumers and supportive of consumer-run organizations around the state. The author's tenure on the board entailed repeated engagement with questions of identity - self-identity, peer support through personal identification, and negotiation of public identities with provider groups and the state agency. These are fundamental to defining and legitimating the claims of mentally ill people not just for health care resources but for full participation as citizens in the public sphere. PMID:24842977

  14. Using mobile technology to promote safe sex and sexual health in adolescents: current practices and future recommendations

    PubMed Central

    Cornelius, Judith B; Appiah, Josephine A

    2016-01-01

    Youth and young adults (19–24 years of age) shoulder the burden of sexually transmitted infections accounting for nearly half of all new infections annually. Mobile technology is one way that we have reached this population with safer sex information but challenges exist with the delivery process. The literature between 2010 and 2015 was reviewed for data on safe sex and sexual health information delivered using mobile cell phone devices. A search for relevant databases revealed that 17 articles met our inclusion criteria. Findings suggest that mobile cell phone interventions are an effective mode for delivering safe sex and sexual health information to youth; those at the highest risk may not be able to access cell phones based on availability and cost of the text messages or data plans. PMID:27103845

  15. Optimal shift duration and sequence: recommended approach for short-term emergency response activations for public health and emergency management.

    PubMed

    Burgess, Paula A

    2007-04-01

    Since September 11, 2001, and the consequent restructuring of the US preparedness and response activities, public health workers are increasingly called on to activate a temporary round-the-clock staffing schedule. These workers may have to make key decisions that could significantly impact the health and safety of the public. The unique physiological demands of rotational shift work and night shift work have the potential to negatively impact decisionmaking ability. A responsible, evidence-based approach to scheduling applies the principles of circadian physiology, as well as unique individual physiologies and preferences. Optimal scheduling would use a clockwise (morning-afternoon-night) rotational schedule: limiting night shifts to blocks of 3, limiting shift duration to 8 hours, and allowing 3 days of recuperation after night shifts. PMID:17413074

  16. Optimal Shift Duration and Sequence: Recommended Approach for Short-Term Emergency Response Activations for Public Health and Emergency Management

    PubMed Central

    Burgess, Paula A.

    2007-01-01

    Since September 11, 2001, and the consequent restructuring of the US preparedness and response activities, public health workers are increasingly called on to activate a temporary round-the-clock staffing schedule. These workers may have to make key decisions that could significantly impact the health and safety of the public. The unique physiological demands of rotational shift work and night shift work have the potential to negatively impact decisionmaking ability. A responsible, evidence-based approach to scheduling applies the principles of circadian physiology, as well as unique individual physiologies and preferences. Optimal scheduling would use a clockwise (morning-afternoon-night) rotational schedule: limiting night shifts to blocks of 3, limiting shift duration to 8 hours, and allowing 3 days of recuperation after night shifts. PMID:17413074

  17. Using mobile technology to promote safe sex and sexual health in adolescents: current practices and future recommendations.

    PubMed

    Cornelius, Judith B; Appiah, Josephine A

    2016-01-01

    Youth and young adults (19-24 years of age) shoulder the burden of sexually transmitted infections accounting for nearly half of all new infections annually. Mobile technology is one way that we have reached this population with safer sex information but challenges exist with the delivery process. The literature between 2010 and 2015 was reviewed for data on safe sex and sexual health information delivered using mobile cell phone devices. A search for relevant databases revealed that 17 articles met our inclusion criteria. Findings suggest that mobile cell phone interventions are an effective mode for delivering safe sex and sexual health information to youth; those at the highest risk may not be able to access cell phones based on availability and cost of the text messages or data plans. PMID:27103845

  18. Vitamin D supplementation review and recommendations for women diagnosed with breast or ovary cancer in the context of bone health and cancer prognosis/risk.

    PubMed

    Martin-Herranz, Ana; Salinas-Hernández, Pedro

    2015-10-01

    Vitamin D review and supplementation recommendations for women diagnosed with breast or ovary cancer have been defined in the context of bone health and cancer prognosis/risk taking as reference wider cancer patients and postmenopausal women. This specific group has been selected due to its higher osteoporosis risk versus postmenopausal women. Early vitamin D supplementation could help maintain bone health, as well as potentially enhance cancer survival rate. Factors considered for supplementation include daily dose, periodicity, chemical form, administration, and serum levels. Sufficient vitamin D serum levels are recommended to be above 30 ng/ml (75 nmol/l). Maintenance oral supplementation equivalent to a minimum daily dosage of 800-1000 IU (20-25 μg) cholecalciferol provided in a daily to monthly bases is preferred, also advised to start with higher dosages when vitamin D serum levels are <10 ng/ml (25 nmol/l). Calcidiol supplementation is more effective, making it advantageous for cases with very low or difficult to raise vitamin D serum levels. PMID:26068240

  19. Exercise and Physical Activity Recommendations for People with Cerebral Palsy

    PubMed Central

    Peterson, Mark D.; Balemans, Astrid C.J.; Hurvitz, Edward A.

    2016-01-01

    Physical activity (PA) and its promotion, as well as the avoidance of sedentary behaviour play important roles in health promotion and prevention of lifestyle-related diseases. Guidelines for typically developing youth and adults published by the World Health Organization and American College of Sports Medicine are available. However, detailed recommendations for PA and sedentary behaviour have not been established for children, adolescents and adults with cerebral palsy (CP). This paper presents the first CP-specific PA and exercise recommendations. The recommendations are based on (1) a comprehensive review and analysis of the literature, (2) expert opinion and (3) extensive clinical experience. The evidence supporting these recommendations are based on randomized controlled trials and observational studies involving children, adolescents and adults with CP, and buttressed by the previous guidelines for the general population. These recommendations may be used to guide healthcare providers on exercise and daily PA prescription for individuals with CP. PMID:26853808

  20. [Implementation of preventive measures recommended by the federal public health office and acceptance of advice by managers of commercial solaria--studies by the public health office of the Ammerland district].

    PubMed

    Dahmen, H G

    1990-06-01

    Commercial solaria are not always up to the standards that would be desirable from a Public Health point of view in respect of protection of users against health hazards of exposure to UV radiation, and also with regard to supervision, qualified personal advice given to users by the staff, and qualification of the staff members to give such advice. Hygiene is definitely also a problem, as is evident from bacteriological swabs made from tanning beds. However, the talks conducted by a local Public Health board in Lower Saxony (North Germany) revealed considerable open-mindedness on the part of the entrepreneurs who were quite willing to follow expert health advice and to display a poster with recommendations regarding protective measures. This was combined with a questioning procedure that has proved successful with the proprietors. PMID:2143008

  1. Organic solvents impair life-traits and biomarkers in the New Zealand mudsnail Potamopyrgus antipodarum (Gray) at concentrations below OECD recommendations.

    PubMed

    Lecomte, V; Noury, P; Tutundjian, R; Buronfosse, T; Garric, J; Gust, M

    2013-09-15

    Potamopyrgus antipodarum is a gastropod mollusk proposed for use in the development of reproduction tests within the Organization for Economic Cooperation and Development (OECD). Numerous chemicals, including endocrine disrupters, are relatively water-insoluble, and water-miscible solvents are currently used for testing them. OECD recommends a maximum concentration of 100 μll(-1). As several studies highlighted effects of lower concentrations of solvents, this study assessed the effects of 20 μll(-1) acetone, ethanol, methanol and dimethylsulfoxide (DMSO) on juvenile and adult snails during 42 days. Ethanol decreased juvenile growth, while acetone increased the rate of embryonic development. All solvents increased estradiol-like levels in adult snails. DMSO only increased mRNA expression of vitellogenin-like gene, while acetone, ethanol and methanol decreased mRNA expression of three nuclear receptor (estrogen receptor-like, ecdysone-induced protein and chicken ovalbumin upstream promoter transcription factor) genes as well as of genes encoding proteins involved in genomic (prohibitin-2) and non-genomic (striatin) pathways of estrogens activity in vertebrates. This study highlights the confounding effects of low concentrations of solvents and recommends avoiding their use. Where solvent use is inevitable, their concentrations and type should be investigated for suitability for the measured endpoints prior to use in chemical testing strategies. PMID:23811024

  2. Studies in Ambulatory Care Quality Assessment in the Indian Health Service. Volume III: Comparison of Rural Private Practice, Health Maintenance Organizations, and the Indian Health Service.

    ERIC Educational Resources Information Center

    Nutting, Paul A.; And Others

    Utilizing a quality assessment methodology for ambulatory patient care currently under development by the Indian Health Service's (IHS) Office of Research and Development, comparisons were made between results derived from a pilot test in IHS service units, 2 metropolitan Health Maintenance Organizations (HMO), and 3 rural private practices.…

  3. The Australian experiment: how primary health care organizations supported the evolution of a primary health care system.

    PubMed

    Nicholson, Caroline; Jackson, Claire L; Marley, John E; Wells, Robert

    2012-03-01

    Primary health care in Australia has undergone 2 decades of change. Starting with a vision for a national health strategy with general practice at its core, Australia established local meso-level primary health care organizations--Divisions of General Practice--moving from focus on individual practitioners to a professional collective local voice. The article identifies how these meso-level organizations have helped the Australian primary health care system evolve by supporting the roll-out of initiatives including national practice accreditation, a focus on quality improvement, expansion of multidisciplinary teams into general practice, regional integration, information technology adoption, and improved access to care. Nevertheless, there are still challenges to ensuring equitable access and the supply and distribution of a primary care workforce, addressing the increasing rates of chronic disease and obesity, and overcoming the fragmentation of funding and accountability in the Australian system. PMID:22403246

  4. Assessment of volatile organic compounds and particulate matter in a dental clinic and health risks to clinic personnel.

    PubMed

    Hong, Yu-Jue; Huang, Yen-Ching; Lee, I-Long; Chiang, Che-Ming; Lin, Chitsan; Jeng, Hueiwang Anna

    2015-01-01

    This study was conducted to assess (1) levels of volatile organic compounds (VOCs) and particulate matter (PM) in a dental clinic in southern Taiwan and (2) dental care personnel's health risks associated with due to chronic exposure to VOCs. An automatic, continuous sampling system and a multi-gas monitor were employed to quantify the air pollutants, along with environmental comfort factors, including temperature, CO2, and relative humidity at six sampling sites in the clinic over eight days. Specific VOC compounds were identified and their concentrations were quantified. Both non-carcinogenic and carcinogenic VOC compounds were assessed based on the US Environmental Protection Agency's Principles of Health Risk Assessment in terms of whether those indoor air pollutants increased health risks for the full-time dental care professionals at the clinic. Increased levels of VOCs were recorded during business hours and exceeded limits recommended by the Taiwan Environmental Protection Agency. A total of 68 VOC compounds were identified in the study area. Methylene methacrylate (2.8 ppm) and acetone (0.176 ppm) were the only two non-carcinogenic compounds that posed increased risks for human health, yielding hazard indexes of 16.4 and 4.1, respectively. None of the carcinogenic compounds increased cancer risk. All detected PM10 levels ranged from 20 to 150 μg/m(3), which met the Taiwan EPA and international limits. The average PM10 level during business hours was significantly higher than that during non-business hours (P = 0.04). Improved ventilation capacity in the air conditioning system was recommended to reduce VOCs and PM levels. PMID:26301846

  5. 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

  6. Global policy change and women's access to safe abortion: the impact of the World Health Organization's guidance in Africa.

    PubMed

    Hessini, Leila; Brookman-Amissah, Eunice; Crane, Barbara B

    2006-12-01

    Along with governments from around the world, African leaders agreed at the International Conference on Population and Development (ICPD) in 1994 to address unsafe abortion as a major public health problem. At the five-year review of the ICPD, they decided further that health systems should make safe abortion services accessible for legal indications. Based on this mandate, the World Health Organization (WHO) developed norms and standards for quality abortion services, Safe Abortion: Technical and Policy Guidance for Health Systems, released in 2003. While abortion-related maternal mortality and morbidity remains very high in many African countries, stakeholders are increasingly using WHO recommendations in conjunction with other global and regional policy frameworks, including the African Union Protocol on the Rights of Women in Africa, to spur new action to address this persistent problem. Efforts include: reforming national laws and policies; preparing service-delivery guidelines and regulations; strengthening training programs; and expanding community outreach programs. This paper reviews progress and lessons learned while drawing attention to the fragility of the progress made thus far and the key challenges that remain in ensuring access to safe abortion care for all African women. PMID:17518128

  7. Offering-level strategy formulation in health service organizations.

    PubMed

    Pointer, D D

    1990-01-01

    One of six different strategies must be selected for a health service offering to provide consumers with distinctive value and achieve sustainable competitive advantage in a market or market segment. Decisions must be made regarding objectives sought, market segmentation, market scope, and the customer-value proposition that will be pursued. PMID:2118882

  8. Armenia: Influences and Organization of Mental Health Services

    ERIC Educational Resources Information Center

    McCarthy, John; Harutyunyan, Hasmik; Smbatyan, Meri; Cressley, Heidi

    2013-01-01

    Relatively little has been published on mental health care and counseling as they pertain to Armenia, a country of approximately three million residents that gained independence in 1991 from the former Soviet Union. Various influences, such as its history, economy, religious and family systems, and a major natural disaster in 1988, have affected…

  9. Understanding and Responding to the Needs of Commercially Sexually Exploited Youth: Recommendations for the Mental Health Provider.

    PubMed

    Ijadi-Maghsoodi, Roya; Cook, Mekeila; Barnert, Elizabeth S; Gaboian, Shushanik; Bath, Eraka

    2016-01-01

    Mental health providers are frequently at the forefront of addressing the multifaceted needs of commercially sexually exploited youth. This article provides an overview of the definition of commercial sexual exploitation of children and relevant legislation including the shift toward decriminalization of commercially sexually exploited youth. To provide clinicians with tools needed to deliver competent care to this population, a review of risk factors for commercial sexual exploitation of children and the role of the clinician in identification, assessment, and treatment of commercially sexually exploited youth are discussed. PMID:26593123

  10. Algae as promising organisms for environment and health

    PubMed Central

    2011-01-01

    Algae, like other plants, produce a variety of remarkable compounds collectively referred to as secondary metabolites. They are synthesized by these organisms at the end of the growth phase and/or due to metabolic alterations induced by environmental stress conditions. Carotenoids, phenolic compounds, phycobiliprotein pigments, polysaccharides and unsaturated fatty acids are same of the algal natural products, which were reported to have variable biological activities, including antioxidant activity, anticancer activity, antimicroabial activity against bacteria-virus-algae-fungi, organic fertilizer and bioremediation potentials. PMID:21862867

  11. Algae as promising organisms for environment and health.

    PubMed

    Shalaby, Emad A

    2011-09-01

    Algae, like other plants, produce a variety of remarkable compounds collectively referred to as secondary metabolites. They are synthesized by these organisms at the end of the growth phase and/or due to metabolic alterations induced by environmental stress conditions. Carotenoids, phenolic compounds, phycobiliprotein pigments, polysaccharides and unsaturated fatty acids are same of the algal natural products, which were reported to have variable biological activities, including antioxidant activity, anticancer activity, antimicroabial activity against bacteria-virus-algae-fungi, organic fertilizer and bioremediation potentials. PMID:21862867

  12. 78 FR 44574 - Third Annual Food and Drug Administration Health Professional Organizations Conference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-24

    ... HUMAN SERVICES Food and Drug Administration Third Annual Food and Drug Administration Health Professional Organizations Conference AGENCY: Food and Drug Administration, HHS. ACTION: Notice of conference. The Food and Drug Administration (FDA) is announcing a conference for representatives of...

  13. 76 FR 55928 - Food and Drug Administration Health Professional Organizations Conference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-09

    ... HUMAN SERVICES Food and Drug Administration Food and Drug Administration Health Professional Organizations Conference AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public conference. The Food and Drug Administration (FDA) is announcing a conference for representatives of...

  14. 77 FR 47652 - Second Annual Food and Drug Administration Health Professional Organizations Conference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-09

    ... HUMAN SERVICES Food and Drug Administration Second Annual Food and Drug Administration Health Professional Organizations Conference AGENCY: Food and Drug Administration, HHS. ACTION: Notice of conference. The Food and Drug Administration (FDA) is announcing a conference for representatives of...

  15. Improvement in the Diagnostic Evaluation of a Positive Fecal Occult Blood Test in an Integrated Health Care Organization

    PubMed Central

    Miglioretti, Diana L.; Rutter, Carolyn M.; Bradford, Susan Carol; Zauber, Ann G.; Kessler, Larry G.; Feuer, Eric J.; Grossman, David C.

    2014-01-01

    Background Screening for fecal occult blood can be effective in reducing colorectal cancer mortality only if positive tests are appropriately followed up with complete diagnostic evaluation (i.e., colonoscopy or flexible sigmoidoscopy with double contrast barium enema) and treatment. Objectives To examine whether rates of complete diagnostic evaluation following a positive fecal occult blood test (FOBT) have improved over time after the implementation of tracking systems and physician guidelines within a large integrated health care organization. Research Design From 1993 to 2005, 8513 positive FOBTs were identified on 8291 enrollees aged 50–79 of a large health care system. Automated records were used to identify repeat FOBTs, colonoscopy, flexible sigmoidoscopy, and double-contrast barium enema within one year after the positive FOBT. National rates of complete diagnostic evaluation were estimated from the 2005 National Health Interview Survey. Results In this integrated health care organization, the percentage of positive FOBTs followed by complete diagnostic evaluation within one year increased from 57%–64% in 1993–1996 to 82%–86% from 2000–2005. Use of repeat FOBT following a positive FOBT decreased from 28–31% in 1993–1996 to 6–11% in 2000–2005. Based on the National Health Interview Survey, only 52% of positive FOBTs from 2000–2005 were followed by complete diagnostic evaluation nationally. Conclusions Adherence to recommendations for complete diagnostic evaluation following a positive FOBT has greatly improved over time in an integrated group medical practice. Through the use of tracking systems and screening guidelines, it may be possible to reach levels of follow-up that are comparable to those observed in randomized trials. PMID:18725839

  16. Developing Effective Health Interventions for Women Who Inject Drugs: Key Areas and Recommendations for Program Development and Policy

    PubMed Central

    Pinkham, Sophie; Stoicescu, Claudia; Myers, Bronwyn

    2012-01-01

    Women who inject drugs face multiple gender-specific health risks and barriers to healthcare access. These gendered factors may contribute to elevated rates of HIV for this population. Though few countries systematically collect gender-disaggregated data related to injecting drug use, evidence indicates that there are large populations of women who inject drugs and who are in need of improved health services, including HIV prevention. Research on the effectiveness of interventions specifically tailored for women who inject drugs, along with the experience of programs working with this subpopulation, suggests that HIV risk practices need to be addressed within the larger context of women's lives. Multifaceted interventions that address relationship dynamics, housing, employment, and the needs of children may have more success in reducing risky practices than interventions that focus exclusively on injecting practices and condom use. Improved sexual and reproductive healthcare for women who use drugs is an area in need of development and should be better integrated into basic harm reduction programs. PMID:23198158

  17. Environment Health & Safety Research Program. Organization and 1979-1980 Publications

    SciTech Connect

    1981-01-01

    This document was prepared to assist readers in understanding the organization of Pacific Northwest Laboratory, and the organization and functions of the Environment, Health and Safety Research Program Office. Telephone numbers of the principal management staff are provided. Also included is a list of 1979 and 1980 publications reporting on work performed in the Environment, Health and Safety Research Program, as well as a list of papers submitted for publication.

  18. [International cooperation and affirmative action policies: the role of the Pan American Health Organization (PAHO)].

    PubMed

    Maio, Marcos Chor; Pires-Alves, Fernando A; Paiva, Carlos Henrique Assunção; Silva Magalhães, Rodrigo Cesar da

    2010-07-01

    The article analyzes the formulation, legitimation, and implementation of a policy with an ethnic/race approach by the Pan American Health Organization (PAHO). The study includes the emergence of the theme within this international organization, the institutional dynamics related to it, and the proposals focused on the Black population in Latin America. These issues are discussed on the basis of interaction between PAHO and a range of intergovernmental agencies and private organizations working in the international health domain. Participation by PAHO in the ethnic/racial theme provides elements for understanding the dual role played by intergovernmental organizations in the new global scenario, as both social actors and arenas. As an important social actor in the international health field, PAHO has produced and disseminated values and guidelines related to the ethnic/racial theme. As an arena, the organization has proven open to various interests, seeking to work harmoniously with them through its internal administration. PMID:20694349

  19. Oregon's experiment in health care delivery and payment reform: coordinated care organizations replacing managed care.

    PubMed

    Howard, Steven W; Bernell, Stephanie L; Yoon, Jangho; Luck, Jeff; Ranit, Claire M

    2015-02-01

    To control Medicaid costs, improve quality, and drive community engagement, the Oregon Health Authority introduced a new system of coordinated care organizations (CCOs). While CCOs resemble traditional Medicaid managed care, they have differences that have been deliberately designed to improve care coordination, increase accountability, and incorporate greater community governance. Reforms include global budgets integrating medical, behavioral, and oral health care and public health functions; risk-adjusted payments rewarding outcomes and evidence-based practice; increased transparency; and greater community engagement. The CCO model faces several implementation challenges. If successful, it will provide improved health care delivery, better health outcomes, and overall savings. PMID:25480844

  20. Oceans and Human Health: Linking Ocean, Organism, and Human Health for Sustainable Management of Coastal Ecosystems

    NASA Astrophysics Data System (ADS)

    Sandifer, P. A.; Trtanj, J.; Collier, T. K.

    2012-12-01

    Scientists and policy-makers are increasingly recognizing that sustainable coastal communities depend on healthy and resilient economies, ecosystems, and people, and that the condition or "health" of the coastal ocean and humans are intimately and inextricably connected. A wealth of ecosystem services provided by ocean and coastal environments are crucial for human survival and well being. Nonetheless, the health of coastal communities, their economies, connected ecosystems and ecosystem services, and people are under increasing threats from health risks associated with environmental degradation, climate change, and unwise land use practices, all of which contribute to growing burdens of naturally-occurring and introduced pathogens, noxious algae, and chemical contaminants. The occurrence, frequency, intensity, geographic range, and number and kinds of ocean health threats are increasing, with concomitant health and economic effects and eroding public confidence in the safety and wholesomeness of coastal environments and resources. Concerns in the research and public health communities, many summarized in the seminal 1999 NRC Report, From Monsoons to Microbes and the 2004 final report of the US Commission on Ocean Policy, resulted in establishment of a new "meta-discipline" known as Oceans and Human Health (OHH). OHH brings together practitioners in oceanography, marine biology, ecology, biomedical science, medicine, economics and other social sciences, epidemiology, environmental management, and public health to focus on water- and food-borne causes of human and animal illnesses associated with ocean and coastal systems and on health benefits of seafood and other marine products. It integrates information across multiple disciplines to increase knowledge of ocean health risks and benefits and communicate such information to enhance public safety. Recognizing the need for a comprehensive approach to ocean health threats and benefits, Congress passed the Oceans and