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Sample records for innovative ngo health

  1. Small NGO Schools in India: Implications for Access and Innovation

    ERIC Educational Resources Information Center

    Blum, Nicole

    2009-01-01

    In addition to the proliferation of private, fee-paying schools in India, non-governmental organisations (NGOs) play an important role in providing educational services, especially in un-served and under-served communities. This paper uses qualitative research to critically examine the nature and potential of NGO provision of primary schooling in…

  2. Context matters in NGO-government contracting for health service delivery: a case study from Pakistan.

    PubMed

    Zaidi, Shehla; Mayhew, Susannah H; Cleland, John; Green, Andrew T

    2012-10-01

    Contracting non-governmental organizations (NGOs) for health service provision is gaining increasing importance in low- and middle-income countries. However, the role of the wider context in influencing the effectiveness of contracting is not well studied and is of relevance given that contracting has produced mixed results so far. This paper applies a policy analysis approach to examine the influence of policy and political factors on contracting origin, design and implementation. Evidence is drawn from a country case study of Pakistan involving extensive NGO contracting for human immunodeficiency virus (HIV) prevention services supported by international donor agencies. A multilevel study was conducted using 84 in-depth interviews, 22 semi-structured interviews, document review and direct observation to examine the national policy design, provincial management of contracting and local contract implementation. There were three main findings. First, contracting origin and implementation was an inherently political process affected by the wider policy context. Although in Pakistan a combination of situational events successfully managed to introduce extensive and sophisticated contracting, it ran into difficulties during implementation due to ownership and capacity issues within government. Second, wide-scale contracting was mis-matched with the capacity of local NGOs, which resulted in sub-optimal contract implementation challenging the reliance on market simulation through contracting. Third, we found that contracting can have unintended knock-on effects on both providers and purchasers. As a result of public sector contracts, NGOs became more distanced from their grounded attributes. Effects on government purchasers were more unpredictable, with greater identification with contracting in supportive governance contexts and further distancing in unsupportive contexts. A careful approach is needed in government contracting of NGOs, taking into account acceptance of

  3. In an Age of Open Access to Research Policies: Physician and Public Health NGO Staff Research Use and Policy Awareness

    PubMed Central

    Maggio, Lauren A.; Steinberg, Ryan M.; Willinsky, John

    2015-01-01

    Introduction Through funding agency and publisher policies, an increasing proportion of the health sciences literature is being made open access. Such an increase in access raises questions about the awareness and potential utilization of this literature by those working in health fields. Methods A sample of physicians (N=336) and public health non-governmental organization (NGO) staff (N=92) were provided with relatively complete access to the research literature indexed in PubMed, as well as access to the point-of-care service UpToDate, for up to one year, with their usage monitored through the tracking of web-log data. The physicians also participated in a one-month trial of relatively complete or limited access. Results The study found that participants' research interests were not satisfied by article abstracts alone nor, in the case of the physicians, by a clinical summary service such as UpToDate. On average, a third of the physicians viewed research a little more frequently than once a week, while two-thirds of the public health NGO staff viewed more than three articles a week. Those articles were published since the 2008 adoption of the NIH Public Access Policy, as well as prior to 2008 and during the maximum 12-month embargo period. A portion of the articles in each period was already open access, but complete access encouraged a viewing of more research articles. Conclusion Those working in health fields will utilize more research in the course of their work as a result of (a) increasing open access to research, (b) improving awareness of and preparation for this access, and (c) adjusting public and open access policies to maximize the extent of potential access, through reduction in embargo periods and access to pre-policy literature. PMID:26200794

  4. Improving and expanding NGO programmes.

    PubMed

    Mukhopadhyay, A

    1993-06-01

    India has massive problems and is in need of improving and expanding non governmental organization (NGO) programs by broadening the scope of NGO activities, identifying successful NGO activities, and by moving closer to the community to participate in their activities. The problems and experience in the last few decades indicate that with expansion bureaucratization takes place. The institution begins to depend on donors and follows donor-driven agendas. As more money is given by the government, many more so called GONGO or Government-NGO projects materialize. Another problem is that the government almost always approaches the NGOs for the implementation of a project, and there is complete lack of cooperation at the planning stage. The government is considering a loan from the World Bank and UNICEF to launch a mother and child health program, but there has not been any discussion with the dozens of people who have worked on issues concerning mother and child health issues for many years. There is a need to be more demanding of the government about the various programs that are implemented for the government. Very few NGO health and family welfare projects are run by ordinary nurses or ordinary Ayurvedic doctors under ordinary conditions. Since successful NGO work has to be extended to other parts of the country, they will have to be run by ordinary people with very ordinary resources. Over the years, the NGO community has become preoccupied with its own agenda. Today, despite very sophisticated equipment and infrastructure, they are not able to reach the 60,000-70,000 workers and employees. Some of the ideas with respect to the strengthens and weaknesses of community participation have to be shared. NGOs should include all the existing non governmental organizations throughout the country, and have a dialogue with other nongovernmental bodies such as trade unions. The challenge is to adjust the current agenda, prevailing style, and present way of operating and move

  5. Mapping synergy and antagony in North-South partnerships for health: a case study of the Tanzanian women's NGO KIWAKKUKI.

    PubMed

    Corbin, J Hope; Mittelmark, Maurice B; Lie, Gro Th

    2013-03-01

    North-South partnerships for health aim to link resources, expertise and local knowledge to create synergy. The literature on such partnerships presents an optimistic view of the promise of partnership on one hand, contrasted by pessimistic depictions of practice on the other. Case studies are called for to provide a more intricate understanding of partnership functioning, especially viewed from the Southern perspective. This case study examined the experience of the Tanzanian women's NGO, KIWAKKUKI, based on its long history of partnerships with Northern organizations, all addressing HIV/AIDS in the Kilimanjaro region. KIWAKKUKI has provided education and other services since its inception in 1990 and has grown to include a grassroots network of >6000 local members. Using the Bergen Model of Collaborative Functioning, the experience of KIWAKKUKI's partnership successes and failures was mapped. The findings demonstrate that even in effective partnerships, both positive and negative processes are evident. It was also observed that KIWAKKUKI's partnership breakdowns were not strictly negative, as they provided lessons which the organization took into account when entering subsequent partnerships. The study highlights the importance of acknowledging and reporting on both positive and negative processes to maximize learning in North-South partnerships. PMID:22180447

  6. Costs of integrating demand-based reproductive health commodity model into the Government and NGO service delivery systems in Bangladesh: a supply side perspective.

    PubMed

    Islam, Ziaul; Sarker, Abdur Razzaque; Anwar, Shahela; Kabir, Humayun; Gazi, Rukhsana

    2015-01-01

    To estimate additional total cost and average cost of integrating the demand-based reproductive health commodity model into the existing Government and NGO facilities in Bangladesh. Activity based cost analysis was conducted during 2006-2008 in two low performing rural sub-districts (Nabigong and Raipur sub-district) and one urban slum area in Dhaka city, Bangladesh. Activity-based cost data were collected using ingredient approach, which comprised of listing all types of inputs by activity, quantities and prices for each input. Total cost was presented according to capital and recurrent items. The supply side perspective was considered for entire analysis. The total cost of integrating demand-based reproductive health commodity (DBRHC) model into the Government and NGO service delivery system was estimated to BDT 18,667,634 (US$274,524). The proportion of capital cost was 59 % and the recurrent cost was 41 % of the total cost. The average cost per beneficiaries was BDT 230 (US$3.38) only for introducing this model into the existing health system. The built-in interventions of DBRHC model were doable at low-cost at the selected Government and NGO settings at the grass-root level. The model has potential of further cost containment during scaling up-if the intervention costs are adjusted with the existing functionaries of the Government and NGOs. PMID:26722628

  7. Understanding the relationship of maternal health behavior change and intervention strategies in a Nicaraguan NGO network.

    PubMed

    Valadez, Joseph J; Hage, Jerald; Vargas, William

    2005-09-01

    Few studies of community interventions examine independent effects of investments in: (1) capital (i.e., physical, human and social capital), and (2) management systems (e.g., monitoring and evaluation systems (M&E)) on maternal and child health behavior change. This paper does this in the context of an inter-organizational network. In Nicaragua, international non-governmental organizations (NGOs) and local NGOs formed the NicaSalud Federation. Using Lot Quality Assurance Sampling (LQAS), 14 member organizations took baselines measures of maternal safe motherhood and child health behavior indicators during November 1999 and August 2000, respectively, and final evaluation measures in December 2001. In April 2002, retrospective interviews were conducted with supervisors and managers in the 14 organizations to explore changes made to community health strategies, factors associated with the changes, and impacts they attributed to participating in NicaSalud. Physical capital (density of health huts), human capital (density and variety of paramedical personnel) and social capital (density of health committees) were associated with pregnant women attending antenatal care (ANC) 3+ times, and/or retaining ANC cards. The variety of paramedic personnel was also associated with women making post-partum visits to clinics. Physical capital (density of health huts) and social capital (density of health committees and mothers' clubs) were associated with child diarrhea case management indicators. One safe motherhood indicator (delivery of babies by a clinician) was not associated with intervention strategies. At the management level, NicaSalud's training of members to use LQAS for M&E was associated with the number of strategic and tactical changes they subsequently made to interventions (organizational learning). Organizational learning was related to changes in maternal and child health behaviors of the women (including changes in the proportion using post-partum care). As the

  8. Innovations in e-health.

    PubMed

    Wicks, Paul; Stamford, Jon; Grootenhuis, Martha A; Haverman, Lotte; Ahmed, Sara

    2014-02-01

    The theme of ISOQOL's 19th Annual Conference in Budapest, Hungary, was The Journey of Quality of Life Research: A Path Towards Personalized Medicine. Innovations in e-health was one of four plenary panels. E-health is changing the landscape of clinical practice and health care, but the best way to leverage the many promised benefits of emerging e-health technologies is still not clear. The Innovations in e-health panel presented emerging changes in technologies and applications that will facilitate clinical decision making, improve quality and efficiency of care, engage individuals in clinical decision making, and empower them to adopt healthy behaviors. The purpose of this paper was to present emerging trends in e-health and considerations for successful adoption of new technologies, and an overview of each of the presentations in the e-health plenary. The presentations included a personal perspective on the use of technology for self-monitoring in Parkinson's disease, an overview of online social networks and emerging technologies, and the collection of patient-reported outcomes through web-based systems in clinical practice. The common thread across all the talks was the application of e-health tools to empower individuals with chronic disease to be actively engaged in the management of their health. Considerations regarding data ownership and privacy, universal access to e-health, interactivity between different types of e-health technologies, and tailoring applications to individual needs were explored. PMID:23852096

  9. Health care entrepreneurship: financing innovation.

    PubMed

    Grazier, Kyle L; Metzler, Bridget

    2006-01-01

    Entrepreneurship is often described as the ability to create new ventures from new or existing concepts, ideas and visions. There has been significant entrepreneurial response to the changes in the scientific and social underpinnings of health care services delivery. However, a growing portion of the economic development driving health care industry expansion is threatened further by longstanding use of financing models that are suboptimal for health care ventures. The delayed pace of entrepreneurial activity in this industry is in part a response to the general economy and markets, but also due to the lack of capital for new health care ventures. The recent dearth of entrepreneurial activities in the health services sector may also due to failure to consider new approaches to partnerships and strategic ventures, despite their mutually beneficial organizational and financing potential. As capital becomes more scarce for innovators, it is imperative that those with new and creative ideas for health and health care improvement consider techniques for capital acquisition that have been successful in other industries and at similar stages of development. The capital and added expertise can allow entrepreneurs to leverage resources, dampen business fluctuations, and strengthen long term prospects. PMID:16583848

  10. Innovation in behavioral health workforce education.

    PubMed

    O'Connell, Maria J; Morris, John A; Hoge, Michael A

    2004-11-01

    This article describes an effort to promote improvement in the quality and relevance of behavioral health workforce education by identifying and disseminating information on innovative training efforts. A national call for nominations was issued, seeking innovations in the education of behavioral health providers, consumers, and family members. A review committee evaluated each nomination on four dimensions: novelty, significance, transferability, and effectiveness. Nineteen innovations were selected for recognition, all of which are briefly described. PMID:15586848

  11. Emerging Innovation: Allied Health Fields

    ERIC Educational Resources Information Center

    Lang, Janell B.

    2004-01-01

    This article takes a closer look at emerging fields in the allied health arena. The relatively new field of Health Information Technology is one of the exciting prospects, surging with growth opportunities. These individuals are medical language experts who interpret, process, store and retrieve health information for research and data collection.…

  12. Sexual health innovations in undergraduate medical education.

    PubMed

    Ferrara, E; Pugnaire, M P; Jonassen, J A; O'Dell, K; Clay, M; Hatem, D; Carlin, M

    2003-10-01

    Recent national and global initiatives have drawn attention to the importance of sexual health to individuals' well-being. These initiatives advocate enhancement of efforts to address this under-represented topic in health professions curricula. University of Massachusetts Medical School (UMMS) has undertaken a comprehensive effort to develop an integrated curriculum in sexual health. The UMMS project draws upon the expertise of a multidisciplinary faculty of clinicians, basic scientists, a medical ethicist, and educators. This article describes the project's genesis and development at UMMS, and reports on three innovations in sexual health education implemented as part of this endeavor. PMID:14551577

  13. The risks of innovation in health care.

    PubMed

    Enzmann, Dieter R

    2015-04-01

    Innovation in health care creates risks that are unevenly distributed. An evolutionary analogy using species to represent business models helps categorize innovation experiments and their risks. This classification reveals two qualitative categories: early and late diversification experiments. Early diversification has prolific innovations with high risk because they encounter a "decimation" stage, during which most experiments disappear. Participants face high risk. The few decimation survivors can be sustaining or disruptive according to Christensen's criteria. Survivors enter late diversification, during which they again expand, but within a design range limited to variations of the previous surviving designs. Late diversifications carry lower risk. The exception is when disruptive survivors "diversify," which amplifies their disruption. Health care and radiology will experience both early and late diversifications, often simultaneously. Although oversimplifying Christensen's concepts, early diversifications are likely to deliver disruptive innovation, whereas late diversifications tend to produce sustaining innovations. Current health care consolidation is a manifestation of late diversification. Early diversifications will appear outside traditional care models and physical health care sites, as well as with new science such as molecular diagnostics. They warrant attention because decimation survivors will present both disruptive and sustaining opportunities to radiology. Radiology must participate in late diversification by incorporating sustaining innovations to its value chain. Given the likelihood of disruptive survivors, radiology should seriously consider disrupting itself rather than waiting for others to do so. Disruption entails significant modifications of its value chain, hence, its business model, for which lessons may become available from the pharmaceutical industry's current simultaneous experience with early and late diversifications. PMID

  14. Federal Program Encourages Health Service Innovations on Developmental Disabilities

    ERIC Educational Resources Information Center

    Nix, Mary P.

    2009-01-01

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

  15. Technological innovation and inequality in health.

    PubMed

    Glied, Sherry; Lleras-Muney, Adriana

    2008-08-01

    The effect of education on health has been increasing over the past several decades. We hypothesize that this increasing disparity is related to health-related technical progress: more-educated people are the first to take advantage of technological advances that improve health. We test this hypothesis using data on disease-specific mortality rates for 1980 and 1990, and cancer registry data for 1973-1993. We estimate education gradients in mortality using compulsory schooling as a measure of education. We then relate these gradients to two measures of health-related innovation: the number of active drug ingredients available to treat a disease, and the rate of change in mortality from that disease. We find that more-educated individuals have a greater survival advantage in those diseases for which there has been more health-related technological progress. PMID:18939670

  16. Convergent innovation for sustainable economic growth and affordable universal health care: innovating the way we innovate.

    PubMed

    Dubé, Laurette; Jha, Srivardhini; Faber, Aida; Struben, Jeroen; London, Ted; Mohapatra, Archisman; Drager, Nick; Lannon, Chris; Joshi, P K; McDermott, John

    2014-12-01

    This paper introduces convergent innovation (CI) as a form of meta-innovation-an innovation in the way we innovate. CI integrates human and economic development outcomes, through behavioral and ecosystem transformation at scale, for sustainable prosperity and affordable universal health care within a whole-of-society paradigm. To this end, CI combines technological and social innovation (including organizational, social process, financial, and institutional), with a special focus on the most underserved populations. CI takes a modular approach that convenes around roadmaps for real world change-a portfolio of loosely coupled complementary partners from the business community, civil society, and the public sector. Roadmaps serve as collaborative platforms for focused, achievable, and time-bound projects to provide scalable, sustainable, and resilient solutions to complex challenges, with benefits both to participating partners and to society. In this paper, we first briefly review the literature on technological innovation that sets the foundations of CI and motivates its feasibility. We then describe CI, its building blocks, and enabling conditions for deployment and scaling up, illustrating its operational forms through examples of existing CI-sensitive innovation. PMID:25294668

  17. Will disruptive innovations cure health care?

    PubMed

    Christensen, C M; Bohmer, R; Kenagy, J

    2000-01-01

    It's no secret that health care delivery is convoluted, expensive, and often deeply dissatisfying to consumers. But what is less obvious is that a way out of this crisis exists. Simpler alternatives to expensive care are already here--everything from $5 eyeglasses that people can use to correct their own vision to angioplasty instead of open-heart surgery. Just as the PC replaced the mainframe and the telephone replaced the telegraph operator, disruptive innovations are changing the landscape of health care. Nurse practitioners, general practitioners, and even patients can do things in less-expensive, decentralized settings that could once be performed only by expensive specialists in centralized, inconvenient locations. But established institutions--teaching hospitals, medical schools, insurance companies, and managed care facilities--are fighting these innovations tooth and nail. Instead of embracing change, they're turning the thumbscrews on their old processes--laying off workers, delaying payments, merging, and adding layers of overhead workers. Not only is this at the root of consumer dissatisfaction with the present system, it sows the seeds of its own destruction. The history of disruptive innovations tells us that incumbent institutions will be replaced with ones whose business models are appropriate to the new technologies and markets. Instead of working to preserve the existing systems, regulators, physicians, and pharmaceutical companies need to ask how they can enable more disruptive innovations to emerge. If the natural process of disruption is allowed to proceed, the result will be higher quality, lower cost, more convenient health care for everyone. PMID:11143147

  18. A model for 'reverse innovation' in health care.

    PubMed

    Depasse, Jacqueline W; Lee, Patrick T

    2013-01-01

    'Reverse innovation,' a principle well established in the business world, describes the flow of ideas from emerging to more developed economies. There is strong and growing interest in applying this concept to health care, yet there is currently no framework for describing the stages of reverse innovation or identifying opportunities to accelerate the development process. This paper combines the business concept of reverse innovation with diffusion of innovation theory to propose a model for reverse innovation as a way to innovate in health care. Our model includes the following steps: (1) identifying a problem common to lower- and higher-income countries; (2) innovation and spread in the low-income country (LIC); (3) crossover to the higher-income country (HIC); and (4) innovation and spread in the HIC. The crucial populations in this pathway, drawing from diffusion of innovation theory, are LIC innovators, LIC early adopters, and HIC innovators. We illustrate the model with three examples of current reverse innovations. We then propose four sets of specific actions that forward-looking policymakers, entrepreneurs, health system leaders, and researchers may take to accelerate the movement of promising solutions through the reverse innovation pipeline: (1) identify high-priority problems shared by HICs and LICs; (2) create slack for change, especially for LIC innovators, LIC early adopters, and HIC innovators; (3) create spannable social distances between LIC early adopters and HIC innovators; and (4) measure reverse innovation activity globally. PMID:24001367

  19. Health biotechnology innovation on a global stage.

    PubMed

    Thorsteinsdóttir, Halla; Ray, Monali; Kapoor, Andrew; Daar, Abdallah S

    2011-02-01

    With increasing globalization, infectious diseases are spreading faster than ever before, creating an urgent need for international collaboration. The rise of emerging economies has changed the traditional collaborative landscape and provided opportunities for more diverse models of collaboration involving developing countries, including North-South, South-South and North-South-South partnerships. Here, we discuss how developing countries can partner with other nations to address their shared health problems and to promote innovation. We look specifically at what drives collaborations and at the challenges that exist for them, and we propose actions that can strengthen these partnerships. PMID:21233851

  20. Health Systems Innovation at Academic Health Centers: Leading in a New Era of Health Care Delivery.

    PubMed

    Ellner, Andrew L; Stout, Somava; Sullivan, Erin E; Griffiths, Elizabeth P; Mountjoy, Ashlin; Phillips, Russell S

    2015-07-01

    Challenged by demands to reduce costs and improve service delivery, the U.S. health care system requires transformational change. Health systems innovation is defined broadly as novel ideas, products, services, and processes-including new ways to promote healthy behaviors and better integrate health services with public health and other social services-which achieve better health outcomes and/or patient experience at equal or lower cost. Academic health centers (AHCs) have an opportunity to focus their considerable influence and expertise on health systems innovation to create new approaches to service delivery and to nurture leaders of transformation. AHCs have traditionally used their promotions criteria to signal their values; creating a health systems innovator promotion track could be a critical step towards creating opportunities for innovators in academic medicine. In this Perspective, the authors review publicly available promotions materials at top-ranked medical schools and find that while criteria for advancement increasingly recognize systems innovation, there is a lack of specificity on metrics beyond the traditional yardstick of peer-reviewed publications. In addition to new promotions pathways and alternative evidence for the impact of scholarship, other approaches to fostering health systems innovation at AHCs include more robust funding for career development in health systems innovation, new curricula to enable trainees to develop skills in health systems innovation, and new ways for innovators to disseminate their work. AHCs that foster health systems innovation could meet a critical need to contribute both to the sustainability of our health care system and to AHCs' continued leadership role within it. PMID:25738387

  1. Telehealth Innovations in Health Education and Training

    PubMed Central

    De, Suvranu; Hall, Richard W.; Johansen, Edward; Meglan, Dwight; Peng, Grace C.Y.

    2010-01-01

    Abstract Telehealth applications are increasingly important in many areas of health education and training. In addition, they will play a vital role in biomedical research and research training by facilitating remote collaborations and providing access to expensive/remote instrumentation. In order to fulfill their true potential to leverage education, training, and research activities, innovations in telehealth applications should be fostered across a range of technology fronts, including online, on-demand computational models for simulation; simplified interfaces for software and hardware; software frameworks for simulations; portable telepresence systems; artificial intelligence applications to be applied when simulated human patients are not options; and the development of more simulator applications. This article presents the results of discussion on potential areas of future development, barries to overcome, and suggestions to translate the promise of telehealth applications into a transformed environment of training, education, and research in the health sciences. PMID:20155874

  2. Telehealth innovations in health education and training.

    PubMed

    Conde, José G; De, Suvranu; Hall, Richard W; Johansen, Edward; Meglan, Dwight; Peng, Grace C Y

    2010-01-01

    Telehealth applications are increasingly important in many areas of health education and training. In addition, they will play a vital role in biomedical research and research training by facilitating remote collaborations and providing access to expensive/remote instrumentation. In order to fulfill their true potential to leverage education, training, and research activities, innovations in telehealth applications should be fostered across a range of technology fronts, including online, on-demand computational models for simulation; simplified interfaces for software and hardware; software frameworks for simulations; portable telepresence systems; artificial intelligence applications to be applied when simulated human patients are not options; and the development of more simulator applications. This article presents the results of discussion on potential areas of future development, barries to overcome, and suggestions to translate the promise of telehealth applications into a transformed environment of training, education, and research in the health sciences. PMID:20155874

  3. Health innovation for patient safety improvement.

    PubMed

    Sellappans, Renukha; Chua, Siew Siang; Tajuddin, Nur Amani Ahmad; Mei Lai, Pauline Siew

    2013-01-01

    Medication error has been identified as a major factor affecting patient safety. Many innovative efforts such as Computerised Physician Order Entry (CPOE), a Pharmacy Information System, automated dispensing machines and Point of Administration Systems have been carried out with the aim of improving medication safety. However, areas remain that require urgent attention. One main area will be the lack of continuity of care due to the breakdown of communication between multiple healthcare providers. Solutions may include consideration of "health smart cards" that carry vital patient medical information in the form of a "credit card" or use of the Malaysian identification card. However, costs and technical aspects associated with the implementation of this health smart card will be a significant barrier. Security and confidentiality, on the other hand, are expected to be of primary concern to patients. Challenges associated with the implementation of a health smart card might include physician buy-in for use in his or her everyday practice. Training and technical support should also be available to ensure the smooth implementation of this system. Despite these challenges, implementation of a health smart card moves us closer to seamless care in our country, thereby increasing the productivity and quality of healthcare. PMID:23423150

  4. Social innovation for the promotion of health equity.

    PubMed

    Mason, Chris; Barraket, Jo; Friel, Sharon; O'Rourke, Kerryn; Stenta, Christian-Paul

    2015-09-01

    The role of social innovations in transforming the lives of individuals and communities has been a source of popular attention in recent years. This article systematically reviews the available evidence of the relationship between social innovation and its promotion of health equity. Guided by Fair Foundations: The VicHealth framework for health equity and examining four types of social innovation--social movements, service-related social innovations, social enterprise and digital social innovations--we find a growing literature on social innovation activities, but inconsistent evaluative evidence of their impacts on health equities, particularly at the socio-economic, political and cultural level of the framework. Distinctive characteristics of social innovations related to the promotion of health equity include the mobilization of latent or unrealised value through new combinations of (social, cultural and material) resources; growing bridging social capital and purposeful approaches to linking individual knowledge and experience to institutional change. These have implications for health promotion practice and for research about social innovation and health equity. PMID:26420807

  5. Imagining value, imagining users: academic technology transfer for health innovation.

    PubMed

    Miller, Fiona Alice; Sanders, Carrie B; Lehoux, Pascale

    2009-04-01

    Governments have invested heavily in the clinical and economic promise of health innovation and express increasing concern with the efficacy and efficiency of the health innovation system. In considering strategies for 'better' health innovation, policy makers and researchers have taken a particular interest in the work of universities and related public research organizations: How do these organizations identify and transfer promising innovations to market, and do these efforts make best use of public sector investments? We conducted an ethnographic study of technology transfer offices (TTOs) in Ontario and British Columbia, Canada, to consider the place of health and health system imperatives in judgments of value in early-stage health innovation. Our analysis suggests that the valuation process is poorly specified as a set of task-specific judgments. Instead, we argue that technology transfer professionals are active participants in the construction of the innovation and assign value by 'imagining' the end product in its 'context of use'. Oriented as they are to the commercialization of health technology, TTOs understand users primarily as market players. The immediate users of TTOs' efforts are commercial partners (i.e., licensees, investors) who are capable of translating current discoveries into future commodities. The ultimate end users - patients, clinicians, health systems - are the future consumers of the products to be sold. Attention to these proximate and more distal users in the valuation process is a complex and constitutive feature of the work of health technology transfer. At the same time, judgements about individual technologies are made in relation to a broader imperative through which TTOs seek to imagine and construct sustainable innovation systems. Judgments of value are rendered sensible in relation to the logic of valuation for systems of innovation that, in turn, configure users of health innovation in systemic ways. PMID:19231055

  6. Managing Scale and Innovation in Health IT.

    PubMed

    Enzmann, Dieter R; Pfeffer, Michael

    2016-09-01

    Given the high-intensity interaction between radiology and IT, radiology leadership should understand IT's new, somewhat conflicting, dual roles. Managing large-scale and small-scale projects concurrently has become an important challenge for leaders of health IT (HIT). Historical parallels of this challenge can be drawn from transportation and communication systems, in which a large-scale mind-set is needed to build the initial network, whereas a small-scale mind-set is more useful to develop the content that will traverse this network. Innovation and creativity is a cornerstone of content small-scale thinking, and in HIT, that is what is needed to extract the value from it. However, unlike the early historical transportation and communication examples, the time between the development of the infrastructure and the follow-on, value-rich content is shortened greatly because it has become nearly simultaneous in HIT. Weaving the ability to concomitantly manage both large- and small-scale projects into the fabric of the organizational HIT culture will be critical for its success. PMID:27039000

  7. Open Innovation at NASA: A New Business Model for Advancing Human Health and Performance Innovations

    NASA Technical Reports Server (NTRS)

    Davis, Jeffrey R.; Richard, Elizabeth E.; Keeton, Kathryn E.

    2014-01-01

    This paper describes a new business model for advancing NASA human health and performance innovations and demonstrates how open innovation shaped its development. A 45 percent research and technology development budget reduction drove formulation of a strategic plan grounded in collaboration. We describe the strategy execution, including adoption and results of open innovation initiatives, the challenges of cultural change, and the development of virtual centers and a knowledge management tool to educate and engage the workforce and promote cultural change.

  8. Why innovation in health care is so hard.

    PubMed

    Herzlinger, Regina E

    2006-05-01

    Health care in the United States--and in most other developed countries--is ailing. Medical treatment has made astonishing advances, but the packaging and delivery of health care are often inefficient, ineffective, and user unfriendly. Problems ranging from costs to medical errors beg for ingenious solutions-and indeed, enormous investments have been made in innovation. But too many efforts fail. To find out why, it's necessary to break down the problem, look at the different types of innovation, and examine the forces that affect them. Three kinds of innovation can make health care better and cheaper: One changes the ways consumers buy and use health care, another taps into technology, and the third generates new business models. The health care system erects an array of barriers to each type of innovation. More often than not, organizations can overcome the barriers by managing the six forces that have an impact on health care innovation: players, the friends and foes who can bolster or destroy;funding, the revenue-generation and capital-acquisition processes, which differ from those in other industries; policy, the regulations that pervade the industry; technology, the foundation for innovations that can make health care delivery more efficient and convenient; customers, the empowered and engaged consumers of health care; and accountability, the demand from consumers, payers, and regulators that innovations be safe, effective, and cost-effective. Companies can often turn these six forces to their advantage. The analytical framework the author describes can also be used to examine other industries. Cataloging the innovation types and identifying the forces that aid or undermine them can reveal insights on how to treat chronic innovation ills- prescriptions that will make any industry healthier. PMID:16649698

  9. Grasping the health horizon: toward a virtual, interoperable platform of health innovations.

    PubMed

    Dawe, Marcus; Dugdale, Paul; Mcgann, Mathew

    2015-01-01

    The emergence of digital health, wearables, apps, telehealth and the proliferation of health services online are all indications that health is undergoing rapid innovation. Health innovation however has been traditionally slow, high cost and the commercialisation journey was not a guaranteed path to adoption outside the setting where it was developed whether in a hospital, university, clinic or lab. Most significant with this new explosion of health innovations is the sheer volume. The startup revolution, mobile health, personalised heath and globalisation of knowledge means that consumers are demanding innovations and are pulling health innovations through commercialisation with new modes of funding such as crowdsourcing and direct vendor purchases. Our Australian team initiated a project to use machine learning, data mining and classification techniques to bring together and analyse this expansion of heath innovations from all over the world. Following two years of data aggregation and quality analysis we present our findings which are applied to over 200,000 innovations from more than 25,000 organisations. Our findings have identified the dynamics and basis for a marketplace for health innovations that could assist innovators, health practitioners, consumers, investors and other health participants to research, evaluate and promote these innovations. PMID:26571640

  10. Observing EMRIs with eLISA/NGO

    NASA Astrophysics Data System (ADS)

    Gair, J. R.; Porter, E. K.

    2013-01-01

    The extreme-mass-ratio inspirals (EMRIs) of stellar mass compact objects into massive black holes in the centres of galaxies are an important source of low-frequency gravitational waves for space-based detectors. We discuss the prospects for detecting these sources with the evolved Laser Interferometer Space Antenna (eLISA), recently proposed as an ESA mission candidate under the name NGO. We show that NGO could observe a few tens of EMRIs over its two year mission lifetime at redshifts z ≤ 0.5 and describe how the event rate changes under possible alternative specifications of the eLISA design.

  11. Innovative Approaches to Health Occupations Education.

    ERIC Educational Resources Information Center

    Gurney, Elizabeth, Comp.; Kintgen, Jean, Comp.

    To improve communications between health occupations educators and health professionals about developments in health occupations education, a compilation of 21 approaches used in health occupations education is presented. Outlines of the 21 different courses are presented, grouped in eight areas: (1) career mobility--modified LPN program for…

  12. Science-based health innovation in sub-Saharan Africa.

    PubMed

    Al-Bader, Sara; Masum, Hassan; Simiyu, Ken; Daar, Abdallah S; Singer, Peter A

    2010-01-01

    In recent years emerging markets such as India, China, and Brazil have developed appropriate business models and lower-cost technological innovations to address health challenges locally and internationally. But it is not well understood what capabilities African countries, with their high disease burden, have in science-based health innovation.This gap in knowledge is addressed by this series in BMC International Health and Human Rights. The series presents the results of extensive on-the-ground research in the form of four country case studies of health and biotechnology innovation, six studies of institutions within Africa involved in health product development, and one study of health venture funds in Africa. To the best of our knowledge it is the first extensive collection of empirical work on African science-based health innovation.The four country cases are Ghana, Rwanda, Tanzania and Uganda. The six case studies of institutions are A to Z Textiles (Tanzania), Acorn Technologies (South Africa), Bioventures venture capital fund (South Africa), the Malagasy Institute of Applied Research (IMRA; Madagascar), the Kenyan Medical Research Institute (KEMRI; Kenya), and Niprisan's development by Nigeria's National Institute for Pharmaceutical Research and Development and Xechem (Nigeria).All of the examples highlight pioneering attempts to build technological capacity, create economic opportunities, and retain talent on a continent significantly affected by brain drain. They point to the practical challenges for innovators on the ground, and suggest potentially helpful policies, funding streams, and other support systems.For African nations, health innovation represents an opportunity to increase domestic capacity to solve health challenges; for international funders, it is an opportunity to move beyond foreign aid and dependency. The shared goal is creating self-sustaining innovation that has both health and development impacts. While this is a long-term strategy

  13. Science-based health innovation in sub-Saharan Africa

    PubMed Central

    2010-01-01

    In recent years emerging markets such as India, China, and Brazil have developed appropriate business models and lower-cost technological innovations to address health challenges locally and internationally. But it is not well understood what capabilities African countries, with their high disease burden, have in science-based health innovation. This gap in knowledge is addressed by this series in BMC International Health and Human Rights. The series presents the results of extensive on-the-ground research in the form of four country case studies of health and biotechnology innovation, six studies of institutions within Africa involved in health product development, and one study of health venture funds in Africa. To the best of our knowledge it is the first extensive collection of empirical work on African science-based health innovation. The four country cases are Ghana, Rwanda, Tanzania and Uganda. The six case studies of institutions are A to Z Textiles (Tanzania), Acorn Technologies (South Africa), Bioventures venture capital fund (South Africa), the Malagasy Institute of Applied Research (IMRA; Madagascar), the Kenyan Medical Research Institute (KEMRI; Kenya), and Niprisan’s development by Nigeria’s National Institute for Pharmaceutical Research and Development and Xechem (Nigeria). All of the examples highlight pioneering attempts to build technological capacity, create economic opportunities, and retain talent on a continent significantly affected by brain drain. They point to the practical challenges for innovators on the ground, and suggest potentially helpful policies, funding streams, and other support systems. For African nations, health innovation represents an opportunity to increase domestic capacity to solve health challenges; for international funders, it is an opportunity to move beyond foreign aid and dependency. The shared goal is creating self-sustaining innovation that has both health and development impacts. While this is a long

  14. INNOVATION IN HEALTH EDUCATION AT THE JUNIOR COLLEGE.

    ERIC Educational Resources Information Center

    CAMPBELL, CHARLES E.

    A REVIEW OF RELEVANT LITERATURE, VISITS TO NINE SOUTHERN CALIFORNIA JUNIOR COLLEGES AND INTERVIEWS WITH ADMINISTRATION AND FACULTY MEMBERS WERE THE MEANS OF COLLECTING INFORMATION ABOUT HEALTH EDUCATION PROGRAMS AND INNOVATIONS IN THIS INSTRUCTIONAL FIELD. THE HEALTH EDUCATION COURSES IN THE COLLEGES VISITED WERE TAUGHT IN A TRADITIONAL MANNER BY…

  15. Allied Health Manpower Development: An Innovative Approach.

    ERIC Educational Resources Information Center

    Lugenbeel, Archie G.

    1980-01-01

    Health care delivery and manpower shortages continually plague rural communities in the United States. This article presents the results of a Rural Allied Health Manpower Project (RAHMP) implemented in Southern Illinois. RAHMP has effectively reduced the health care manpower deficiencies in 31 counties. (CT)

  16. Guatemala -- strength is NGO cooperation.

    PubMed

    1999-04-01

    In early 1999, representations of the UN Population Fund, JOICFP, and APROFAM met in Guatemala to monitor progress of an integrated program promoting reproductive health (RH) and family planning (FP) among Mayans in the Department of Solola. The team observed field activities, such as training, and assessed information, education, and communication (IEC) promotion; service delivery; institutional coordination; and adolescent health programs. The program is training traditional birth attendants (TBAs) to provide RH/FP and general medical services. At one site, a TBA acquires counseling for her clients from a physician via the telephone. This activity will be facilitated with the addition of radio receivers. Resources have been maximized by increasing collaboration among the project, the government, and local nongovernmental organizations. Referrals are being facilitated with improved communication tools and provision of a boat and ambulance for transporting clients. Cooperative efforts are also being made to promote community health and development, health education, and adolescent health. PMID:12295080

  17. HIV-related stigma and NGO-isation in India: an historico-empirical analysis

    PubMed Central

    Nambiar, Devaki

    2011-01-01

    In response to World Bank critiques in 2007, the Indian Ministry of Health and Family Welfare declared that HIV-related stigma was a barrier to the participation of Non-Governmental Organisations (NGOs) in the implementation of HIV prevention Targeted Interventions. Taking a deeper view of HIV-related stigma as an historically inflected process of devaluation, this paper details the history and transformation of NGO involvement in the HIV epidemic from 1986 through economic liberalisation in the 1990s up to the recently concluded National AIDS Control Program (NACP II, 1999-2006). It additionally examines findings from interviews and participant observation of NGO workers (N=24) from four Targeted Intervention NGOs in Delhi funded under NACP II. Analysis reveals that a ‘second wave’ of HIV-related NGO involvement has mushroomed in the past two decades, affording NGO workers multiple pathways to credibility in the Indian response to the epidemic. Contradictions embedded in the overlap of these pathways produce stigma, reflecting ‘adverse incorporation.’ Drawing upon noteworthy exceptions to this trend from the ‘first wave’ of Indian HIV-related NGOs, the paper calls for NGO participation as an explicitly political project of addressing the social inequalities that shape stigma as well as vulnerability to illness writ large. PMID:22150236

  18. The changing environment for technological innovation in health care.

    PubMed

    Goodman, C S; Gelijns, A C

    1996-01-01

    A distinguishing feature of American health care is its emphasis on advanced technology. Yet today's changing health care environment is overhauling the engine of technological innovation. The rate and direction of technological innovation are affected by a complex of supply- and demandside factors, including biomedical research, education, patent law, regulation, health care payment, tort law, and more. Some distinguishing features of technological innovation in health care are now at increased risk. Regulatory requirements and rising payment hurdles are especially challenging to small technology companies. Closer management of health care delivery and payment, particularly the standardization that may derive from practice guidelines and clamping down on payment for investigational technologies, curtails opportunities for innovation. Levels and distribution of biomedical research funding in government and industry are changing. Financial constraints are limiting the traditional roles of academic health centers in fostering innovation. Despite notable steps in recent years to lower regulatory barriers and speed approvals, especially for products for life-threatening conditions, the Food and Drug Administration is under great pressure from Congress, industry, and patients to do more. Technology gatekeeping is shifting from hundreds of thousands of physicians acting on behalf of their patients to fewer, yet more powerful, managed care organizations and health care networks. Beyond its direct effects on adoption, payment, and use of technologies, the extraordinary buying leverage of these large providers is cutting technology profit margins and heightening competition among technology companies. It is contributing to unprecedented restructuring of the pharmaceutical and medical device industries, leading to unprecedented alliances with generic product companies, health care providers, utilization review companies, and other agents. These industry changes are already

  19. Improving NGO collaboration in AIDS prevention in rural Haiti.

    PubMed

    Stetson, V; Narcisse-prudent, M

    1994-05-01

    Zanmi Lasante (Health Friends), a nongovernmental organization (NGO) based in rural Haiti, provides an example of the effective role NGOs can play in acquired immunodeficiency syndrome (AIDS) prevention. The group has produced a video, "Chache Lavi, Detwi Lavi," based on the true story of a rural woman who became infected when she migrated to Port-au-Prince to seek employment. The video illustrates the association between human immunodeficiency virus (HIV) and broader social issues such as peasants' access to land, political upheaval, and unequal gender relationships. To promote collaboration, Save the Children established the NGO Coalition for the Prevention of AIDS and Sexually Transmitted Diseases (STDs) in the Central Plateau. Women, particularly adolescent females, are the coalition's target population. Activities have included literacy and income generation training for women, development of algorithms for STD treatment without laboratory diagnosis, a training course for health professionals on STD services and counseling, training of trainers workshops, and preparation of informational materials. The 10 participating NGOs and private voluntary organizations meet quarterly to share information and evaluate programs. PMID:12345904

  20. A Bright Future: Innovation Transforming Public Health in Chicago

    PubMed Central

    Choucair, Bechara; Bhatt, Jay; Mansour, Raed

    2015-01-01

    Big cities continue to be centers for innovative solutions and services. Governments are quickly identifying opportunities to take advantage of this energy and revolutionize the means by which they deliver services to the public. The governmental public health sector is rapidly evolving in this respect, and Chicago is an emerging example of some of the changes to come. Governments are gradually adopting innovative informatics and big data tools and strategies, led by pioneering jurisdictions that are piecing together the standards, policy frameworks, and leadership structures fundamental to effective analytics use. They give an enticing glimpse of the technology's potential and a sense of the challenges that stand in the way. This is a rapidly evolving environment, and cities can work with partners to capitalize on the innovative energies of civic tech communities, health care systems, and emerging markets to introduce new methods to solve old problems. PMID:25423057

  1. A bright future: innovation transforming public health in Chicago.

    PubMed

    Choucair, Bechara; Bhatt, Jay; Mansour, Raed

    2015-01-01

    Big cities continue to be centers for innovative solutions and services. Governments are quickly identifying opportunities to take advantage of this energy and revolutionize the means by which they deliver services to the public. The governmental public health sector is rapidly evolving in this respect, and Chicago is an emerging example of some of the changes to come. Governments are gradually adopting innovative informatics and big data tools and strategies, led by pioneering jurisdictions that are piecing together the standards, policy frameworks, and leadership structures fundamental to effective analytics use. They give an enticing glimpse of the technology's potential and a sense of the challenges that stand in the way. This is a rapidly evolving environment, and cities can work with partners to capitalize on the innovative energies of civic tech communities, health care systems, and emerging markets to introduce new methods to solve old problems. PMID:25423057

  2. Accelerating innovation in information and communication technology for health.

    PubMed

    Crean, Kevin W

    2010-02-01

    Around the world, inventors are creating novel information and communication technology applications and systems that can improve health for people in disparate settings. However, it is very difficult to find investment funding needed to create business models to expand and develop the prototype technologies. A comprehensive, long-term investment strategy for e-health and m-health is needed. The field of social entrepreneurship offers an integrated approach to develop needed investment models, so that innovations can reach more patients, more effectively. Specialized financing techniques and sustained support from investors can spur the expansion of mature technologies to larger markets, accelerating global health impacts. PMID:20348074

  3. Health Literacy Innovations in California Community College Health Centers

    ERIC Educational Resources Information Center

    Armenia, Joanne Elizabeth

    2013-01-01

    Limited health literacy is a national public health problem contributing to adverse health outcomes and increasing healthcare costs. Both health and educational systems are intervention points for improvement; however, there is paucity in empirical research regarding the role of educational systems. This needs assessment study explored health…

  4. Intensifying Innovation Adoption in Educational eHealth

    ERIC Educational Resources Information Center

    Rissanen, M. K.

    2014-01-01

    In demanding innovation areas such as eHealth, the primary emphasis is easily placed on the product and process quality aspects in the design phase. Customer quality may receive adequate attention when the target audience is well-defined. But if the multidimensional evaluative focus does not get enough space until the implementation phase, this…

  5. Innovation in patient-centered care: lessons from a qualitative study of innovative health care organizations in Washington State

    PubMed Central

    2012-01-01

    Background Growing interest in the promise of patient-centered care has led to numerous health care innovations, including the patient-centered medical home, shared decision-making, and payment reforms. How best to vet and adopt innovations is an open question. Washington State has been a leader in health care reform and is a rich laboratory for patient-centered innovations. We sought to understand the process of patient-centered care innovation undertaken by innovative health care organizations – from strategic planning to goal selection to implementation to maintenance. Methods We conducted key-informant interviews with executives at five health plans, five provider organizations, and ten primary care clinics in Washington State. At least two readers of each interview transcript identified themes inductively; final themes were determined by consensus. Results Innovation in patient-centered care was a strategic objective chosen by nearly every organization in this study. However, other goals were paramount: cost containment, quality improvement, and organization survival. Organizations commonly perceived effective chronic disease management and integrated health information technology as key elements for successful patient-centered care innovation. Inertia, resource deficits, fee-for-service payment, and regulatory limits on scope of practice were cited as barriers to innovation, while organization leadership, human capital, and adaptive culture facilitated innovation. Conclusions Patient-centered care innovations reflected organizational perspectives: health plans emphasized cost-effectiveness while providers emphasized health care delivery processes. Health plans and providers shared many objectives, yet the two rarely collaborated to achieve them. The process of innovation is heavily dependent on organizational culture and leadership. Policymakers can improve the pace and quality of patient-centered innovation by setting targets and addressing conditions for

  6. Open innovation in health care: analysis of an open health platform.

    PubMed

    Bullinger, Angelika C; Rass, Matthias; Adamczyk, Sabrina; Moeslein, Kathrin M; Sohn, Stefan

    2012-05-01

    Today, integration of the public in research and development in health care is seen as essential for the advancement of innovation. This is a paradigmatic shift away from the traditional assumption that solely health care professionals are able to devise, develop, and disseminate novel concepts and solutions in health care. The present study builds on research in the field of open innovation to investigate the adoption of an open health platform by patients, care givers, physicians, family members, and the interested public. Results suggest that open innovation practices in health care lead to interesting innovation outcomes and are well accepted by participants. During the first three months, 803 participants of the open health platform submitted challenges and solutions and intensively communicated by exchanging 1454 personal messages and 366 comments. Analysis of communication content shows that empathic support and exchange of information are important elements of communication on the platform. The study presents first evidence for the suitability of open innovation practices to integrate the general public in health care research in order to foster both innovation outcomes and empathic support. PMID:22440194

  7. Recent developments in health care law: partners in innovation.

    PubMed

    Berry, Roberta M; Bliss, Lisa; Caley, Sylvia; Lombardo, Paul A; Rooker, Jerri Nims; Todres, Jonathan; Wolf, Leslie E

    2010-06-01

    This article reviews recent developments in health care law, focusing on the engagement of law as a partner in health care innovation. The article addresses: the history and contents of recent United States federal law restricting the use of genetic information by insurers and employers; the recent federal policy recommending routine HIV testing; the recent revision of federal policy regarding the funding of human embryonic stem cell research; the history, current status, and need for future attention to advance directives; the recent emergence of medical-legal partnerships and their benefits for patients; the obesity epidemic and its implications for the child's right to health under international conventions. PMID:20490620

  8. Health innovation networks to help developing countries address neglected diseases.

    PubMed

    Morel, Carlos M; Acharya, Tara; Broun, Denis; Dangi, Ajit; Elias, Christopher; Ganguly, N K; Gardner, Charles A; Gupta, R K; Haycock, Jane; Heher, Anthony D; Hotez, Peter J; Kettler, Hannah E; Keusch, Gerald T; Krattiger, Anatole F; Kreutz, Fernando T; Lall, Sanjaya; Lee, Keun; Mahoney, Richard; Martinez-Palomo, Adolfo; Mashelkar, R A; Matlin, Stephen A; Mzimba, Mandi; Oehler, Joachim; Ridley, Robert G; Senanayake, Pramilla; Singer, Peter; Yun, Mikyung

    2005-07-15

    Gross inequities in disease burden between developed and developing countries are now the subject of intense global attention. Public and private donors have marshaled resources and created organizational structures to accelerate the development of new health products and to procure and distribute drugs and vaccines for the poor. Despite these encouraging efforts directed primarily from and funded by industrialized countries, sufficiency and sustainability remain enormous challenges because of the sheer magnitude of the problem. Here we highlight a complementary and increasingly important means to improve health equity: the growing ability of some developing countries to undertake health innovation. PMID:16020723

  9. Helping public sector health systems innovate: the strategic approach to strengthening reproductive health policies and programs.

    PubMed

    Fajans, Peter; Simmons, Ruth; Ghiron, Laura

    2006-03-01

    Public sector health systems that provide services to poor and marginalized populations in developing countries face great challenges. Change associated with health sector reform and structural adjustment often leaves these already-strained institutions with fewer resources and insufficient capacity to relieve health burdens. The Strategic Approach to Strengthening Reproductive Health Policies and Programs is a methodological innovation developed by the World Health Organization and its partners to help countries identify and prioritize their reproductive health service needs, test appropriate interventions, and scale up successful innovations to a subnational or national level. The participatory, interdisciplinary, and country-owned process can set in motion much-needed change. We describe key features of this approach, provide illustrations from country experiences, and use insights from the diffusion of innovation literature to explain the approach's dissemination and sustainability. PMID:16449594

  10. Transforming global health with mobile technologies and social enterprises: global health and innovation conference.

    PubMed

    Kayingo, Gerald

    2012-09-01

    More than 2,000 people convened for the ninth annual Global Health and Innovation Conference at Yale University on April 21-22, 2012. Participants discussed the latest innovations, ideas in development, lessons learned, opportunities and challenges in global health activities. Several themes emerged, including the important role of frontline workers, strengthening health systems, leveraging social media, and sustainable and impact-driven philanthropy. Overall, the major outcome of the conference was the increased awareness of the potential of mobile technologies and social enterprises in transforming global health. Experts warned that donations and technological advances alone will not transform global health unless there are strong functioning health infrastructures and improved workforce. It was noted that there is a critical need for an integrated systems approach to global health problems and a need for scaling up promising pilot projects. Lack of funding, accountability, and sustainability were identified as major challenges in global health. PMID:23012591

  11. How community trust was gained by an NGO in Malawi, Central Africa, to mitigate the impact of HIV/AIDS.

    PubMed

    MacIntyre, Linda M; Waters, Catherine M; Rankin, Sally H; Schell, Ellen; Laviwa, Jones; Luhanga, Melton Richard

    2013-07-01

    Trust is valuable social capital that is essential for effective partnerships to improve a community's health. Yet, how to establish trust in culturally diverse communities is elusive for many researchers, practitioners, and agencies. The purpose of this qualitative study was to obtain perspectives of individuals working for a nongovernmental organization (NGO) about gaining community trust in Malawi in order to mitigate the impact of HIV/AIDS. Twenty-six interviews were conducted over 12 months. Content analysis revealed the relationship between NGO staff and the community is crucial to gaining community trust. Gender, social context, and religious factors influence the establishment of trust within the relationship, but NGO assumptions about the community can erode community trust. Nurses and other health professionals working with the NGOs can help create conditions to build trust in an ethically and culturally sensitive manner whereby communities can develop processes to address their own health concerns. PMID:23610161

  12. Mentoring, training and support to global health innovators: a scoping review.

    PubMed

    Cho, Dan-Bi; Cole, Donald; Simiyu, Ken; Luong, Winnie; Neufeld, Vic

    2013-09-01

    Global health innovators must navigate substantial complexities to successfully develop, implement and sustain global health innovations with impact through application of an Integrated InnovationTM approach. We sought to examine the nature of the literature and evidence around mentoring, training and support of global health innovators. We conducted a scoping review searching eight databases with terms capturing different kinds of innovation and support. Assessment of relevance and mapping was completed by two reviewers, with interpretation by the review team. Twenty-eight relevant papers provided perspectives on fostering global health innovators and innovation. Fifteen included empirical data on supports to global health innovators involving a wide range of innovators. Eight included documentation of outcomes but without designs to determine effectiveness. The diverse mentoring, training and support activities included: business incubators, support organizations and centres for entrepreneurship, technology transfer and intellectual property management, internship programs for business skill development, initiatives to bridge industry and researchers, and platforms for South-led innovation for global health. We propose the cultivation of a pipeline of global health innovators to increase the number of appropriate, sustainable innovations with impact in global health. Further empirical work on how to effectively support global health innovators is needed. PMID:23985118

  13. Health technology assessment. Evaluation of biomedical innovative technologies.

    PubMed

    Turchetti, Giuseppe; Spadoni, Enza; Geisler, Eliezer Elie

    2010-01-01

    This article describes health technology assessment (HTA) as an evaluation tool that applies systematic methods of inquiry to the generation and use of health technologies and new products. The focus of this article is on the contributions of HTA to the management of the new product development effort in the biomedical organization. Critical success factors (CSFs) are listed, and their role in assessing success is defined and explained. One of the conclusions of this article is that HTA is a powerful tool for managers in the biomedical sector, allowing them to better manage their innovation effort in their continuing struggle for competitiveness and survival. PMID:20659860

  14. Relationship-Relevant and Family-Friendly eHealth: Innovations in Interactive Health Communication Systems

    PubMed Central

    ROBERTS, LINDA J.; JAPUNTICH, SANDRA

    2012-01-01

    As the reach of the Internet grows, eHealth is fast becoming a major adjunct to traditional delivery of health information and support worldwide. Existing Interactive health communication systems, however, typically target individual users, focus on individual rather than on relational health, and neglect the relational and familial context of individual health issues. Reviewing developments primarily in the United States, this article applies a “marriage and family lens” to examine web-based technologies for health and well-being and suggests innovations to make eHealth both relationship relevant and family friendly. Although recent innovations offer great promise for supporting the relational “fabric” of family life, specific cautions and the need for research on effectiveness are underscored. PMID:23144519

  15. Mentoring, Training and Support to Global Health Innovators: A Scoping Review

    PubMed Central

    Cho, Dan-Bi; Cole, Donald; Simiyu, Ken; Luong, Winnie; Neufeld, Vic

    2013-01-01

    Global health innovators must navigate substantial complexities to successfully develop, implement and sustain global health innovations with impact through application of an Integrated Innovation™ approach. We sought to examine the nature of the literature and evidence around mentoring, training and support of global health innovators. We conducted a scoping review searching eight databases with terms capturing different kinds of innovation and support. Assessment of relevance and mapping was completed by two reviewers, with interpretation by the review team. Twenty-eight relevant papers provided perspectives on fostering global health innovators and innovation. Fifteen included empirical data on supports to global health innovators involving a wide range of innovators. Eight included documentation of outcomes but without designs to determine effectiveness. The diverse mentoring, training and support activities included: business incubators, support organizations and centres for entrepreneurship, technology transfer and intellectual property management, internship programs for business skill development, initiatives to bridge industry and researchers, and platforms for South-led innovation for global health. We propose the cultivation of a pipeline of global health innovators to increase the number of appropriate, sustainable innovations with impact in global health. Further empirical work on how to effectively support global health innovators is needed. PMID:23985118

  16. Venture funding for science-based African health innovation

    PubMed Central

    2010-01-01

    Background While venture funding has been applied to biotechnology and health in high-income countries, it is still nascent in these fields in developing countries, and particularly in Africa. Yet the need for implementing innovative solutions to health challenges is greatest in Africa, with its enormous burden of communicable disease. Issues such as risk, investment opportunities, return on investment requirements, and quantifying health impact are critical in assessing venture capital’s potential for supporting health innovation. This paper uses lessons learned from five venture capital firms from Kenya, South Africa, China, India, and the US to suggest design principles for African health venture funds. Discussion The case study method was used to explore relevant funds, and lessons for the African context. The health venture funds in this study included publicly-owned organizations, corporations, social enterprises, and subsidiaries of foreign venture firms. The size and type of investments varied widely. The primary investor in four funds was the International Finance Corporation. Three of the funds aimed primarily for financial returns, one aimed primarily for social and health returns, and one had mixed aims. Lessons learned include the importance of measuring and supporting both social and financial returns; the need to engage both upstream capital such as government risk-funding and downstream capital from the private sector; and the existence of many challenges including difficulty of raising capital, low human resource capacity, regulatory barriers, and risky business environments. Based on these lessons, design principles for appropriate venture funding are suggested. Summary Based on the cases studied and relevant experiences elsewhere, there is a case for venture funding as one support mechanism for science-based African health innovation, with opportunities for risk-tolerant investors to make financial as well as social returns. Such funds should

  17. Sustainable Rural Telehealth Innovation: A Public Health Case Study

    PubMed Central

    Singh, Rajendra; Mathiassen, Lars; Stachura, Max E; Astapova, Elena V

    2010-01-01

    Objective To examine adoption of telehealth in a rural public health district and to explain how the innovation became sustainable. Study Setting Longitudinal, qualitative study (1988–2008) of the largest public health district in Georgia. Study Design Case study design provided deep insights into the innovation's social dynamics. Punctuated equilibrium theory helped present and make sense of the process. We identified antecedent conditions and outcomes, and we distinguished between episodes and encounters based on the disruptive effects of events. Data Collection Twenty-five semistructured interviews with 19 decision makers and professionals, direct observations, published papers, grant proposals, technical specifications, and other written materials. Principal Findings Strong collaboration within the district, with local community, and with external partners energized the process. Well-functioning outreach clinics made telehealth desirable. Local champions cultivated participation and generative capability, and overcame barriers through opportunistic exploitation of technological and financial options. Telehealth usage fluctuated between medical and administrative operations in response to internal needs and contextual dynamics. External agencies provided initial funding and supported later expansion. Conclusions Extensive internal and external collaboration, and a combination of technology push and opportunistic exploitation, can enable sustainable rural telehealth innovation. PMID:20459449

  18. Measuring the diffusion of innovative health promotion programs.

    PubMed

    Steckler, A; Goodman, R M; McLeroy, K R; Davis, S; Koch, G

    1992-01-01

    Once a health promotion program has proven to be effective in one or two initial settings, attempts may be made to transfer the program to new settings. One way to conceptualize the transference of health promotion programs from one locale to another is by considering the programs to be innovations that are being diffused. In this way, diffusion of innovation theory can be applied to guide the process of program transference. This article reports on the development of six questionnaires to measure the extent to which health promotion programs are successfully disseminated: Organizational Climate, Awareness-Concern, Rogers's Adoption Variables, Level of Use, Level of Success, and Level of Institutionalization. The instruments are being successfully used in a study of the diffusion of health promotion/tobacco prevention curricula to junior high schools in North Carolina. The instruments, which measure the four steps of the diffusion process, have construct validity since they were developed within existing theories and are derived from the work of previous researchers. No previous research has attempted to use instruments like these to measure sequentially the stages of the diffusion process. PMID:10148679

  19. Retail health clinics drive innovation into primary care practices.

    PubMed

    Kissinger, Mark

    2008-01-01

    A myriad of patient dissatisfaction issues stemming from antiquated approaches to primary care access are resulting in the establishment of retail health clinics (RHCs) throughout the country. RHCs are usually located within retail stores or stand-alone pharmacies and are staffed by nurse practitioners (NPs). They offer treatment for colds, coughs, skin rashes, and ear infections along with offering preventive care and physicals. As disruptive innovations, or innovations that offer services to ignored markets, these clinics are siphoning patient care visits away from primary care physicians because of their attention to quick access, affordable prices, and consumer-friendly approaches. In response, family and internal medicine physicians must follow three strategies to secure their patient population as well as attract new patients: build relationships with RHCs through referral networks and NP supervisory agreements, transform the provision of patient access through the development of physician-owned RHCs, and support the concept of the advanced medical home. PMID:18472612

  20. Innovations in Rwanda's health system: looking to the future.

    PubMed

    Logie, Dorothy E; Rowson, Michael; Ndagije, Felix

    2008-07-19

    Rwanda is making substantial progress towards improvement of health and is working towards achievement of the Millennium Development Goals, which is a challenging task because the country has had genocide in 1994, has few natural resources, is landlocked, and has high population growth. Like many impoverished sub-Saharan countries, Rwanda's health system has had an uncoordinated plethora of donors, shortage of health staff, inequity of access, and poor quality of care in health facilities. This report describes three health system developments introduced by the Rwandan government that are improving these barriers to care-ie, the coordination of donors and external aid with government policy, and monitoring the effectiveness of aid; a country-wide independent community health insurance scheme; and the introduction of a performance-based pay initiative. If these innovations are successful, they might be of interest to other sub-Saharan countries. However, Rwanda still does not have sufficient financial resources for health and will need additional external aid for some time to attain the Millennium Development Goals. PMID:18619670

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2013-09-01

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

  3. Symposium on Plant Polyphenols: Nutrition, Health and Innovations, June 2009.

    PubMed

    Chang, Ann S; Yeong, Boon-Yee; Koh, Woon-Puay

    2010-04-01

    Reported here is a summary of the proceedings of the Symposium on Plant Polyphenols: Nutrition, Health and Innovations, which was cosponsored by the Southeast Asia Region branch of the International Life Sciences Institute and the Nutrition Society of Malaysia in Kuala Lumpur, Malaysia, June 22-23, 2009. The symposium provided a timely update of research regarding the protective effects of polyphenols in chronic diseases, such as cardiovascular disease and cancer, as well as the development of innovative polyphenol-containing food products with enhanced nutritive and health properties. Presentations covered polyphenols from a wide range of food sources such as tea, coffee, nuts and seeds, cocoa and chocolate, soy, and Asian fruits, vegetables, and spices. The symposium was attended by a large and diverse group of nutritionists, dietitians, researchers and allied health professionals, as well as management, research and development, and marketing personnel from the food and beverage industry. Their enthusiastic participation was a testament to the increasing awareness and interest in polyphenols in the prevention and control of chronic diseases. Presented here are some of the highlights and important information from the symposium. PMID:20416020

  4. Innovations in Public Health Education: Promoting Professional Development and a Culture of Health

    PubMed Central

    Gentry, Daniel; Klesges, Lisa M.

    2015-01-01

    As the field of public health advances toward addressing complex, systemic problems, future public health professionals must be equipped with leadership and interprofessional skills that support collaboration and a culture of health. The University of Memphis School of Public Health has infused innovative strategies into graduate education via experiential learning opportunities to enhance leadership, collaboration, and professional development. Novel training programs such as Day One, Public Health Interdisciplinary Case Competition, and Memphis Healthy U support Association of Schools and Programs of Public Health cross-cutting competencies and prepare Master of Public Health and Master of Health Administration graduates to function effectively at the outset of their careers and become catalysts for creating a culture of health. PMID:25706016

  5. Innovations in public health education: promoting professional development and a culture of health.

    PubMed

    Levy, Marian; Gentry, Daniel; Klesges, Lisa M

    2015-03-01

    As the field of public health advances toward addressing complex, systemic problems, future public health professionals must be equipped with leadership and interprofessional skills that support collaboration and a culture of health. The University of Memphis School of Public Health has infused innovative strategies into graduate education via experiential learning opportunities to enhance leadership, collaboration, and professional development. Novel training programs such as Day One, Public Health Interdisciplinary Case Competition, and Memphis Healthy U support Association of Schools and Programs of Public Health cross-cutting competencies and prepare Master of Public Health and Master of Health Administration graduates to function effectively at the outset of their careers and become catalysts for creating a culture of health. PMID:25706016

  6. Innovative requirements and technologies for future RLVs health management system

    NASA Astrophysics Data System (ADS)

    Maltecca, L.; Miccichè, L.; Russo, G.; Sellitto, M.

    2002-07-01

    The Italian aerospace research program PRORA (PROgramma nazionale di Ricerche Aerospaziali), which has been conceived and managed by CIRA (Italian Aerospace Research Center), is focused on the development of innovative technologies, also based on experience from flying test beds. One family of these test beds, designated USV (Unmanned Space Vehicle) will be dedicated to acquire the knowledge about future RLV (Reusable Launch Vehicle) technologies. Major strategic technologies identified are reusability, hypersonic flight and atmospheric re-entry. The Phase-A study has been concluded and recently approved. Laben (a Finmeccanica Company) has contributed to identify requirements for the next generations of on board Vehicle Health Management System (VHMS) and to investigate possible innovative architectures. This new generation VHMS will be able to manage in a real-time mode the health of the vehicle (structure, propulsion, avionics, etc.). The proposed approach is based on a set of decentralised computers linked via an advanced high-speed interconnect system. This paper will describe preliminary requirements analysis and trade-off's mainly in terms of HW (e.g. use of general purpose CPUs versus DSPs, interconnects and topologies).

  7. Building a Culture of Health Informatics Innovation and Entrepreneurship: A New Frontier.

    PubMed

    Househ, Mowafa; Alshammari, Riyad; Almutairi, Mariam; Jamal, Amr; Alshoaib, Saleh

    2015-01-01

    Entrepreneurship and innovation within the health informatics (HI) scientific community are relatively sluggish when compared to other disciplines such as computer science and engineering. Healthcare in general, and specifically, the health informatics scientific community needs to embrace more innovative and entrepreneurial practices. In this paper, we explore the concepts of innovation and entrepreneurship as they apply to the health informatics scientific community. We also outline several strategies to improve the culture of innovation and entrepreneurship within the health informatics scientific community such as: (I) incorporating innovation and entrepreneurship in health informatics education; (II) creating strong linkages with industry and healthcare organizations; (III) supporting national health innovation and entrepreneurship competitions; (IV) creating a culture of innovation and entrepreneurship within healthcare organizations; (V) developing health informatics policies that support innovation and entrepreneurship based on internationally recognized standards; and (VI) develop an health informatics entrepreneurship ecosystem. With these changes, we conclude that embracing health innovation and entrepreneurship may be more readily accepted over the long-term within the health informatics scientific community. PMID:26153003

  8. Developing a Questionnaire to Measure Perceived Attributes of eHealth Innovations

    ERIC Educational Resources Information Center

    Atkinson, Nancy L.

    2007-01-01

    Objectives: To design a valid and reliable questionnaire to assess perceived attributes of technology-based health education innovations. Methods: College students in 12 personal health courses reviewed a prototype eHealth intervention using a 30-item instrument based upon diffusion theory's perceived attributes of an innovation. Results:…

  9. In search of the quickest way to disseminate health care innovations

    PubMed Central

    Schrijvers, Guus; Oudendijk, Nico; de Vries, Pety

    2003-01-01

    Abstract Research Question Innovations in health care are slowly disseminated in The Netherlands and elsewhere. That's why the researchers defined their research question: What is the quickest way of disseminating health care innovations? Research method The design was a comparative, qualitative case study. The researchers invited a group of 52 authors to describe their 21 health care innovations. All case descriptions were published in a book of 261 pages [2]. Results Six types of innovations were distinguished. Most innovations simultaneously improved quality from the patient's point of view (18 out of 21 cases), professional pride (18/21) and speed of introduction (16/21). Clinical outcomes were better or comparable in 13 of the 21 cases. Brainstorm sessions took place with the innovators and the 22 experts on the quickest way to disseminate the innovations more widely in The Netherlands. These sessions looked for the critical success factors for the dissemination of the 21 projects and identified nine. The following factors were identified: 1. A clear distribution of responsibilities between professionals within the innovation (20/21) 2. Enough educational programs about the innovations for the professionals (18/21) 3. Adequate ICT support for the running of the innovations (15/21) 4. Suitable publicity for the innovations (12/21) 5. An adequate payment system for innovative care providers (7/21) 6. The right size of catchment's area for the innovations (6/21) 7. Enough professional freedom to adopt the innovation (5/21) 8. Fast managerial and public decision-making about the adoption of the innovation (3/21) 9. The embedding of the innovations in quality management assurance policy (1/21). Discussion The results of the study had some influence on the political health agenda in The Netherlands, leading to greater emphasis on innovations and quality of care. PMID:16896422

  10. Diffusion of complex health innovations--implementation of primary health care reforms in Bosnia and Herzegovina.

    PubMed

    Atun, Rifat A; Kyratsis, Ioannis; Jelic, Gordan; Rados-Malicbegovic, Drazenka; Gurol-Urganci, Ipek

    2007-01-01

    Most transition countries in Central and Eastern Europe and Central Asia are engaged in health reform initiatives aimed at introducing primary health care (PHC) centred on family medicine to enhance performance of their health systems. But, in these countries the introduction of PHC reforms has been particularly challenging; while some have managed to introduce pilots, many have failed to these scale up. Using an innovation lens, we examine the introduction and diffusion of family-medicine-centred PHC reforms in Bosnia and Herzegovina (BiH), which experienced bitter ethnic conflicts that destroyed much of the health systems infrastructure. The study was conducted in 2004-05 over a 18-month period and involved both qualitative and quantitative methods of inquiry. In this study we report the findings of the qualitative research, which involved in-depth interviews in three stages with key informants that were purposively sampled. In our research, we applied a proprietary analytical framework which enables simultaneous and holistic analysis of the context, the innovation, the adopters and the interactions between them over time. While many transition countries have struggled with the introduction of family-medicine-centred PHC reforms, in spite of considerable resource constraints and a challenging post-war context, within a few years, BiH has managed to scale up multifaceted reforms to cover over 25% of the country. Our analysis reveals a complex setting and bidirectional interaction between the innovation, adopters and the context, which have collectively influenced the diffusion process. Family-medicine-centred PHC reform is a complex innovation-involving organizational, financial, clinical and relational changes-within a complex adaptive system. An important factor influencing the adoption of this complex innovation in BiH was the perceived benefits of the innovation: benefits which accrue to the users, family physicians, nurses and policy makers. In the case of Bi

  11. Optimizing Population Health and Economic Outcomes: Innovative Treatment for BPH

    PubMed Central

    2013-01-01

    Optimizing Population Health and Economic Outcomes: Innovative Treatment for Benign Prostatic Hyperplasia (BPH) Transcribed and adapted for publication by Janice L. Clarke, RN, BBA Editorial: David B. Nash, MD, MBA   S-2 Introduction   S-2 Benign Prostatic Hyperplasia (BPH)   S-3 • Overview   S-3• Current BPH Treatment Paradigm   S-4• BPH Continuum of Care: Bladder Health   S-5 New Treatment Option for BPH   S-5 • The UroLift® System   S-6• Positioning of UroLift® in BPH Treatment Paradigm   S-7 New Value Proposition   S-8 • Addressing Bladder Health: Breaking the Cycle   S-8• Cost Benefit Analysis: The Big Picture   S-8 Patient and Family Engagement   S-10 Summary   S-11 PMID:22823180

  12. Telenovela: an innovative colorectal cancer screening health messaging tool

    PubMed Central

    Cueva, Melany; Kuhnley, Regina; Slatton, Jozieta; Dignan, Mark; Underwood, Emily; Landis, Kate

    2013-01-01

    Background Alaska Native people have nearly twice the rate of colorectal cancer (CRC) incidence and mortality as the US White population. Objective Building upon storytelling as a culturally respectful way to share information among Alaska Native people, a 25-minute telenovela-style movie, What's the Big Deal?, was developed to increase CRC screening awareness and knowledge, role-model CRC conversations, and support wellness choices. Design Alaska Native cultural values of family, community, storytelling, and humor were woven into seven, 3–4 minute movie vignettes. Written post-movie viewing evaluations completed by 71.3% of viewers (305/428) were collected at several venues, including the premiere of the movie in the urban city of Anchorage at a local movie theater, seven rural Alaska community movie nights, and five cancer education trainings with Community Health Workers. Paper and pencil evaluations included check box and open-ended questions to learn participants' response to a telenovela-style movie. Results On written-post movie viewing evaluations, viewers reported an increase in CRC knowledge and comfort with talking about recommended CRC screening exams. Notably, 81.6% of respondents (249/305) wrote positive intent to change behavior. Multiple responses included: 65% talking with family and friends about colon screening (162), 24% talking with their provider about colon screening (59), 31% having a colon screening (76), and 44% increasing physical activity (110). Conclusions Written evaluations revealed the telenovela genre to be an innovative way to communicate colorectal cancer health messages with Alaska Native, American Indian, and Caucasian people both in an urban and rural setting to empower conversations and action related to colorectal cancer screening. Telenovela is a promising health communication tool to shift community norms by generating enthusiasm and conversations about the importance of having recommended colorectal cancer screening

  13. Innovation in mental health services: what are the key components of success?

    PubMed Central

    2011-01-01

    Background Service development innovation in health technology and practice is viewed as a pressing need within the field of mental health yet is relatively poorly understood. Macro-level theories have been criticised for their limited explanatory power and they may not be appropriate for understanding local and fine-grained uncertainties of services and barriers to the sustainability of change. This study aimed to identify contextual influences inhibiting or promoting the acceptance and integration of innovations in mental health services in both National Health Service (NHS) and community settings. Methods A comparative study using qualitative and case study data collection methods, including semi-structured interviews with key stakeholders and follow-up telephone interviews over a one-year period. The analysis was informed by learning organisation theory. Drawn from 11 mental health innovation projects within community, voluntary and NHS settings, 65 participants were recruited including service users, commissioners, health and non-health professionals, managers, and caregivers. The methods deployed in this evaluation focused on process-outcome links within and between the 11 projects. Results Key barriers to innovation included resistance from corporate departments and middle management, complexity of the innovation, and the availability and access to resources on a prospective basis within the host organisation. The results informed the construction of a proposed model of innovation implementation within mental health services. The main components of which are context, process, and outcomes. Conclusions The study produced a model of conducive and impeding factors drawn from the composite picture of 11 innovative mental health projects, and this is discussed in light of relevant literature. The model provides a rich agenda to consider for services wanting to innovate or adopt innovations from elsewhere. The evaluation suggested the importance of studying

  14. Improving the Effectiveness of Health Care Innovation Implementation: Middle Managers as Change Agents

    PubMed Central

    Birken, Sarah A.; Lee, Shoou-Yih Daniel; Weiner, Bryan J.; Chin, Marshall H.; Schaefer, Cynthia T.

    2013-01-01

    The rate of successful health care innovation implementation is dismal. Middle managers have a potentially important yet poorly understood role in health care innovation implementation. This study used self-administered surveys and interviews of middle managers in health centers that implemented an innovation to reduce health disparities to address the questions: Does middle managers’ commitment to health care innovation implementation influence implementation effectiveness? If so, in what ways does their commitment influence implementation effectiveness? Although quantitative survey data analysis results suggest a weak relationship, qualitative interview data analysis results indicate that middle managers’ commitment influences implementation effectiveness when middle managers are proactive. Scholars should account for middle managers’ influence in implementation research, and health care executives may promote implementation effectiveness by hiring proactive middle managers and creating climates in which proactivity is rewarded, supported, and expected. PMID:22930312

  15. Social marketing meets health literacy: Innovative improvement of health care providers’ comfort with patient interaction

    PubMed Central

    Primack, Brian A.; Bui, Thuy; Fertman, Carl I.

    2010-01-01

    Objective It is essential to train health care providers to deliver care sensitive to the needs of diverse individuals with varying degrees of health literacy. We aimed to evaluate an innovative, theory-based, educational intervention involving social marketing and health literacy. Methods In 2006 at a large medical school, all first-year students were exposed to the intervention. They completed pre- and post-test anonymous surveys including demographic data, covariates, and key outcome variables. Paired t-tests and multiple linear regression were used to evaluate the intervention and to determine independent associations among the key outcome variables. Results Post-intervention scores were significantly higher than pre-intervention scores for social marketing (3.31 versus 1.90, p < 0.001), health literacy (3.41 versus 2.98, p < 0.001), and comfort in brochure development (3.11 versus 2.52, p < 0.001) (N = 83). After controlling for demographic and covariate data, health literacy and comfort in brochure development were independent predictors of comfort interacting with diverse populations. Conclusion A brief intervention involving social marketing and health literacy can improve skills that improve medical students’ comfort with patients of diverse backgrounds. Practice implications Health care providers can be taught educational principles and skills involved in developing effective patient education materials. These skills may improve providers’ comfort with direct patient interaction. PMID:17418522

  16. 'Innovation' in health care coverage decisions: all talk and no substance?

    PubMed

    Bryan, Stirling; Lee, Helen; Mitton, Craig

    2013-01-01

    There has been much discussion recently about 'innovation', or more precisely the lack of it, in pharmaceuticals and devices in health care. The concern has been expressed by national guideline bodies, such as the Common Drugs Review in Canada and the National Institute for Health & Clinical Excellence in the UK, applying strict cost-effectiveness criteria in their decision-making and, therefore, failing adequately to recognize the full benefits that come from innovation. In order to explore the legitimacy of such claims, we first define innovation, and second, explore the basis for assuming an independent and separable social value associated with innovation. We conclude that demands relating to innovation, such as relaxation of thresholds and premium prices for innovatory products, remain hollow until we have a compelling case on the demand side for a separable social value on 'innovation'. We see no such case currently. PMID:22977184

  17. Innovating in rural health in Wales: applied findings from the practitioner's perspective.

    PubMed

    Best, Stephanie

    2015-11-01

    The demand for novel and innovative activity is commonplace in health and social care owing to multiple factors, such as ageing, lack of new resources, or the rising prevalence of long-term conditions. These factors are felt more acutely in rural communities because of a variety of influences, for example, access and a more rapidly ageing population. This study, conducted in rural Wales from 2011 to 2012, aims to explore practitioners' perceptions of the process of innovating in health and social care. A mixed-methods approach, including a questionnaire and interviews, was employed. Findings centre on the phases of innovating from generation to future activity. The lack of clarity around the term 'innovation' is found to hinder the innovation process, with risk (averseness) further stifling activity. An organisational culture of expectation and support is reported to be fundamental to initiating innovative activity. PMID:26551386

  18. Introducing a complex health innovation--primary health care reforms in Estonia (multimethods evaluation).

    PubMed

    Atun, Rifat Ali; Menabde, Nata; Saluvere, Katrin; Jesse, Maris; Habicht, Jarno

    2006-11-01

    All post-Soviet countries are trying to reform their primary health care (PHC) systems. The success to date has been uneven. We evaluated PHC reforms in Estonia, using multimethods evaluation: comprising retrospective analysis of routine health service data from Estonian Health Insurance Fund and health-related surveys; documentary analysis of policy reports, laws and regulations; key informant interviews. We analysed changes in organisational structure, regulations, financing and service provision in Estonian PHC system as well as key informant perceptions on factors influencing introduction of reforms. Estonia has successfully implemented and scaled-up multifaceted PHC reforms, including new organisational structures, user choice of family physicians (FPs), new payment methods, specialist training for family medicine, service contracts for FPs, broadened scope of services and evidence-based guidelines. These changes have been institutionalised. PHC effectiveness has been enhanced, as evidenced by improved management of key chronic conditions by FPs in PHC setting and reduced hospital admissions for these conditions. Introduction of PHC reforms - a complex innovation - was enhanced by strong leadership, good co-ordination between policy and operational level, practical approach to implementation emphasizing simplicity of interventions to be easily understood by potential adopters, an encircling strategy to roll-out which avoided direct confrontations with narrow specialists and opposing stakeholders in capital Tallinn, careful change-management strategy to avoid health reforms being politicized too early in the process, and early investment in training to establish a critical mass of health professionals to enable rapid operationalisation of policies. Most importantly, a multifaceted and coordinated approach to reform - with changes in laws; organisational restructuring; modifications to financing and provider payment systems; creation of incentives to enhance

  19. Science-based health innovation in Ghana: health entrepreneurs point the way to a new development path

    PubMed Central

    2010-01-01

    Background Science, technology and innovation have long played a role in Ghana’s vision for development, including in improving its health outcomes. However, so far little research has been conducted on Ghana’s capacity for health innovation to address local diseases. This research aims to fill that gap, mapping out the key actors involved, highlighting examples of indigenous innovation, setting out the challenges ahead and outlining recommendations for strengthening Ghana’s health innovation system. Methods Case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 48 people from across the science-based health innovation system. Data was collected over three visits to Ghana from February 2007 to August 2008, and stakeholders engaged subsequently. Results Ghana has strengths which could underpin science-based health innovation in the future, including health and biosciences research institutions with strong foreign linkages and donor support; a relatively strong regulatory system which is building capacity in other West African countries; the beginnings of new funding forms such as venture capital; and the return of professionals from the diaspora, bringing expertise and contacts. Some health products and services are already being developed in Ghana by individual entrepreneurs, which are innovative in the sense of being new to the country and, in some cases, the continent. They include essential medicines, raw pharmaceutical materials, new formulations for pediatric use and plant medicines at various stages of development. Conclusions While Ghana has many institutions concerned with health research and its commercialization, their ability to work together to address clear health goals is low. If Ghana is to capitalize on its assets, including political and macroeconomic stability which underpin investment in health enterprises, it needs to

  20. An NGO Training Guide for Peace Corps Volunteers.

    ERIC Educational Resources Information Center

    Peace Corps, Washington, DC. Information Collection and Exchange Div.

    This training guide provides Peace Corps volunteers (PCVs) with knowledge, tools, and techniques to work with a nongovernmental organization's (NGO's) staff, board of directors, clients, and donors to build its capacity. An introduction provides information on the trainer role, trainer's notes at the end of each module, and guidelines for placing…

  1. Promoting development and uptake of health innovations: The Nose to Tail Tool

    PubMed Central

    Gupta, Archna; Thorpe, Cathy; Bhattacharyya, Onil; Zwarenstein, Merrick

    2016-01-01

    Introduction Health sector management is increasingly complex as new health technologies, treatments, and innovative service delivery strategies are developed. Many of these innovations are implemented prematurely, or fail to be implemented at scale, resulting in substantial wasted resources.   Methods A scoping review was conducted to identify articles that described the scale up process conceptually or that described an instance in which a healthcare innovation was scaled up. We define scale up as the expansion and extension of delivery or access to an innovation for all end users in a jurisdiction who will benefit from it. Results Sixty nine articles were eligible for review. Frequently described stages in the innovation process and contextual issues that influence progress through each stage were mapped. 16 stages were identified: 12 deliberation and 4 action stages. Included papers suggest that innovations progress through stages of maturity and the uptake of innovation depends on the innovation aligning with the interests of 3 critical stakeholder groups (innovators, end users and the decision makers) and is also influenced by 3 broader contexts (social and physical environment, the health system, and the regulatory, political and economic environment). The 16 stages form the rows of the Nose to Tail Tool (NTT) grid and the 6 contingency factors form columns. The resulting stage-by-issue grid consists of 72 cells, each populated with cell-specific questions, prompts and considerations from the reviewed literature. Conclusion We offer a tool that helps stakeholders identify the stage of maturity of their innovation, helps facilitate deliberative discussions on the key considerations for each major stakeholder group and the major contextual barriers that the innovation faces. We believe the NTT will help to identify potential problems that the innovation will face and facilitates early modification, before large investments are made in a potentially flawed

  2. 77 FR 4326 - Announcement of Requirements and Registration for “Health Innovations in Commuting Challenge”

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-27

    .... Registration Process for Participants: To register for this challenge participants should: Access the www... Investing in Innovation (i2) Challenge Web site at: http://www.health2challenge.org/category/onc/ ....

  3. Transformative Innovations in Reproductive, Maternal, Newborn, and Child Health over the Next 20 Years.

    PubMed

    Engmann, Cyril M; Khan, Sadaf; Moyer, Cheryl A; Coffey, Patricia S; Bhutta, Zulfiqar A

    2016-03-01

    As part of the "Grand Convergence: Aligning Technologies and Realities in Global Health" Collection, Cyril Engmann and colleagues discuss promising innovations that have the potential to move the RMNCH agenda forward. PMID:26933951

  4. The Science And Art Of Delivery: Accelerating The Diffusion Of Health Care Innovation.

    PubMed

    Parston, Greg; McQueen, Julie; Patel, Hannah; Keown, Oliver P; Fontana, Gianluca; Al Kuwari, Hanan; Al Kuwari, Hannan; Darzi, Ara

    2015-12-01

    There is a widely acknowledged time lag in health care between an invention or innovation and its widespread use across a health system. Much is known about the factors that can aid the uptake of innovations within discrete organizations. Less is known about what needs to be done to enable innovations to transform large systems of health care. This article describes the results of in-depth case studies aimed at assessing the role of key agents and agencies that facilitate the rapid adoption of innovations. The case studies-from Argentina, England, Nepal, Singapore, Sweden, the United States, and Zambia-represent widely varying health systems and economies. The implications of the findings for policy makers are discussed in terms of key factors within a phased approach for creating a climate for change, engaging and enabling the whole organization, and implementing and sustaining change. Purposeful and directed change management is needed to drive system transformation. PMID:26643638

  5. Innovators.

    ERIC Educational Resources Information Center

    NEA Today, 2001

    2001-01-01

    Describes various innovations that have been developed to enhance education. These innovations include: helping educators help at-risk students succeed; promoting high school journalism; ensuring quality online learning experiences; developing a student performing group that uses theater to address social issues; and having students design their…

  6. Where are the NGOs and why? The distribution of health and development NGOs in Bolivia

    PubMed Central

    2012-01-01

    Background The presence and influence of nongovernmental organizations (NGOs) in the landscape of global health and development have dramatically increased over the past several decades. The distribution of NGO activity and the ways in which contextual factors influence the distribution of NGO activity across geographies merit study. This paper explores the distribution of NGO activity, using Bolivia as a case study, and identifies local factors that are related to the distribution of NGO activity across municipalities in Bolivia. Methods The research question is addressed using a geographic information system (GIS) and multiple regression analyses of count data. We used count data of the total number of NGO projects across Bolivian municipalities to measure NGO activity both in general and in the health sector specifically and national census data for explanatory variables of interest. Results This study provides one of the first empirical analyses exploring factors related to the distribution of NGO activity at the national scale. Our analyses show that NGO activity in Bolivia, both in general and health-sector specific, is distributed unevenly across the country. Results indicate that NGO activity is related to population size, extent of urbanization, size of the indigenous population, and health system coverage. Results for NGO activity in general and health-sector specific NGO activity were similar. Conclusions The uneven distribution of NGO activity may suggest a lack of co-ordination among NGOs working in Bolivia as well as a lack of co-ordination among NGO funders. Co-ordination of NGO activity is most needed in regions characterized by high NGO activity in order to avoid duplication of services and programmes and inefficient use of limited resources. Our findings also indicate that neither general nor health specific NGO activity is related to population need, when defined as population health status or education level or poverty levels. Considering these

  7. Diabetes Technology, Innovation, and the U.S. Health Insurance System

    PubMed Central

    Quinn, Bruce

    2013-01-01

    The flow of funds in the U.S. health care system is crucial both for the provision of services to patients and to encourage innovation that enables long-term improvement of health services. Rising concern about health care costs often includes concerns about inappropriate adoption of costly or unnecessary technology. Many innovations in diabetes technology may involve personal technology, which does not qualify under existing health insurance categories such as “durable medical equipment” or under a currently defined telehealth technology. In such cases, the diabetes technology industry may be developing types of technology that are so innovative they do not have clearly established payment mechanisms in the existing U.S. fee for service health care reimbursement system. This article describes key features of the U.S. health care payment system relevant to developers of new diabetes technologies. PMID:24124970

  8. Science-based health innovation in Rwanda: unlocking the potential of a late bloomer

    PubMed Central

    2010-01-01

    Background This paper describes and analyses Rwanda’s science-based health product ‘innovation system’, highlighting examples of indigenous innovation and good practice. We use an innovation systems framework, which takes into account the wide variety of stakeholders and knowledge flows contributing to the innovation process. The study takes into account the destruction of the country’s scientific infrastructure and human capital that occurred during the 1994 genocide, and describes government policy, research institutes and universities, the private sector, and NGOs that are involved in health product innovation in Rwanda. Methods Case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 38 people from across the science-based health innovation system. Data was collected over two visits to Rwanda between November – December 2007 and in May 2008. A workshop was held in Kigali on May 23rd and May 24th 2009 to validate the findings. A business plan was then developed to operationalize the findings. Results and discussion The results of the study show that Rwanda has strong government will to support health innovation both through its political leadership and through government policy documents. However, it has a very weak scientific base as most of its scientific infrastructure as well as human capital were destroyed during the 1994 genocide. The regulatory agency is weak and its nascent private sector is ill-equipped to drive health innovation. In addition, there are no linkages between the various actors in the country’s health innovation system i.e between research institutions, universities, the private sector, and government bureaucrats. Conclusions Despite the fact that the 1994 genocide destroyed most of the scientific infrastructure and human capital, the country has made remarkable progress towards developing its health innovation

  9. An Innovative Mixed Methods Approach to Studying the Online Health Information Seeking Experiences of Adults with Chronic Health Conditions

    ERIC Educational Resources Information Center

    Mayoh, Joanne; Bond, Carol S.; Todres, Les

    2012-01-01

    This article presents an innovative sequential mixed methods approach to researching the experiences of U.K. adults with chronic health conditions seeking health information online. The use of multiple methods integrated within a single study ensured that the focus of the research was emergent and relevant and ultimately provided a more complete…

  10. Biomedical innovation in the era of health care spending constraints.

    PubMed

    Robinson, James C

    2015-02-01

    Insurers, hospitals, physicians, and consumers are increasingly weighing price against performance in their decisions to purchase and use new drugs, devices, and other medical technologies. This approach will tend to affect biomedical innovation adversely by reducing the revenues available for research and development. However, a more constrained funding environment may also have positive impacts. The passing era of largely cost-unconscious demand fostered the development of incremental innovations priced at premium levels. The new constrained-funding era will require medical technology firms to design their products with the features most valued by payers and patients, price them at levels justified by clinical performance, and manage distribution through organizations rather than to individual physicians. The emerging era has the potential to increase the social value of innovation by focusing industry on design, pricing, and distribution principles that are more closely aligned with the preferences-and pocketbooks-of its customers. PMID:25646099

  11. Novel food processing innovations to improve food safety and health

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Innovative food processing can be used to improve safety of specialty crops and their co-products, while improving sustainability of agricultural and food processing operations and enhancing overall nutritional quality of foods for both domestic and international consumers. The potential of various...

  12. An NGO at work: CARE-Ethiopia.

    PubMed

    1999-01-01

    Cooperation for American Relief to Everywhere (CARE) was established in response to the needs of the people after World War II through the distribution of food and clothes. CARE/Ethiopia, which signed its first Basic Agreement with the Relief and Rehabilitation Commission, was provided with assistance during the 1994 drought that affected Ethiopia. The primary objective of CARE was to alleviate the suffering brought about by severe food shortages and to expand the program to mitigation and development. This approach was based on the premise of a community-based development philosophy and as an implementation strategy for reaching the rural poor. The five programmatic areas highlighted by the CARE projects were the rural and urban infrastructure; water and sanitation; small-scale irrigation; reproductive health and HIV/AIDS; and microcredit. On the other hand, the family planning and HIV/AIDS project aimed to improve the knowledge, attitude and practice of rural communities towards family planning and reproductive health through community-based family planning services. Results of the project evaluation emphasize the significance of community-based programs in the improvement of health status. Two critical program constraints identified in this paper are lack of access to referral-level services and lack of systemic provision of contraceptive commodities. Several suggestions for future programs include the assurance that the volunteers would be provided with aid in work, childcare and free health services for their families. PMID:12349450

  13. Fueling innovation in medical devices (and beyond): venture capital in health care.

    PubMed

    Ackerly, D Clay; Valverde, Ana M; Diener, Lawrence W; Dossary, Kristin L; Schulman, Kevin A

    2009-01-01

    Innovation in health care requires new ideas and the capital to develop and commercialize those ideas into products or services. The necessary capital is often "venture capital," but the link between public policy and the venture capital industry has not been well examined. In this paper we explore the link between venture capital and innovation in health care, and we present new descriptive data from a survey of health care venture capital fund managers. Respondents generally viewed policy levers (for example, reimbursement and regulations) as important risks to venture capital investments, potentially affecting their ability to raise capital for early-stage investment funds. PMID:19049999

  14. Technological and social innovation: a unifying new paradigm for global health.

    PubMed

    Gardner, Charles A; Acharya, Tara; Yach, Derek

    2007-01-01

    This paper highlights the growing capacity for innovation in some developing countries. To maximize the potential of this phenomenon for global health, countries and donors need to link two disparate schools of thought: (1) a search for technological solutions exemplified by global public-private product development partnerships, and (2) a focus on systemic solutions exemplified by health policy and systems research. A strong capacity for both technological and social innovation in developing countries represents the only truly sustainable means of improving the effectiveness of health systems. Local public-private research and development partnerships, implementation research, and individual leadership are needed to achieve this goal. PMID:17630448

  15. Product Development Partnerships: Case studies of a new mechanism for health technology innovation

    PubMed Central

    2011-01-01

    There is a continuing need for new health technologies to address the disease burdens of developing countries. In the last decade Product Development Partnerships (PDP) have emerged that are making important contributions to the development of these technologies. PDPs are a form of public private partnerships that focus on health technology development. PDPs reflect the current phase in the history of health technology development: the Era of Partnerships, in which the public and private sectors have found productive ways to collaborate. Successful innovation depends on addressing six determinants of innovation. We examine four case studies of PDPs and show how they have addressed the six determinants to achieve success. PMID:21871103

  16. Closing the Gap: Principal Perspectives on an Innovative School-Based Mental Health Intervention

    ERIC Educational Resources Information Center

    Blackman, Kate F.; Powers, Joelle D.; Edwards, Jeffrey D.; Wegmann, Kate M.; Lechner, Ethan; Swick, Danielle C.

    2016-01-01

    Mental health needs among children in the United States have significant consequences for children and their families, as well as the schools that serve them. This qualitative study evaluated the second year of an innovative school-based mental health project that created a multi-system partnership between an urban school district, a public mental…

  17. The future of health IT innovation and informatics: a report from AMIA's 2010 policy meeting.

    PubMed

    McGowan, Julie J; Cusack, Caitlin M; Bloomrosen, Meryl

    2012-01-01

    While much attention has been paid to the short-term impact that widespread adoption of health information technology (health IT) will have on the healthcare system, there is a corresponding need to look at the long-term effects that extant policies may have on health IT system resilience, innovation, and related ethical, social/legal issues. The American Medical Informatics Association's 2010 Health Policy Conference was convened to further the national discourse on the issues surrounding these longer-term considerations. Conference participants self-selected into three broad categories: resilience in healthcare and health IT; ethical, legal, and social challenges; and innovation, adoption, and sustainability. The discussions about problem areas lead to findings focusing on the lack of encouragement for long-term IT innovation that may result from current health IT policies; the potential impact of uneven adoption of health IT based on the exclusions of the current financial incentives; the weaknesses of contingency and risk mitigation planning that threaten system resilience; and evolving standards developed in response to challenges relating to the security, integrity, and availability of electronic health information. This paper discusses these findings and also offers recommendations that address the interwoven topics of innovation, resilience, and adoption. The goal of this paper is to encourage public and private sector organizations that have a role in shaping health information policy to increase attention to developing a national strategy that assures that health IT innovation and resilience are not impeded by shorter-term efforts to implement current approaches emphasizing adoption and meaningful use of electronic health records. PMID:22037887

  18. The future of health IT innovation and informatics: a report from AMIA's 2010 policy meeting

    PubMed Central

    McGowan, Julie J; Cusack, Caitlin M

    2012-01-01

    While much attention has been paid to the short-term impact that widespread adoption of health information technology (health IT) will have on the healthcare system, there is a corresponding need to look at the long-term effects that extant policies may have on health IT system resilience, innovation, and related ethical, social/legal issues. The American Medical Informatics Association's 2010 Health Policy Conference was convened to further the national discourse on the issues surrounding these longer-term considerations. Conference participants self-selected into three broad categories: resilience in healthcare and health IT; ethical, legal, and social challenges; and innovation, adoption, and sustainability. The discussions about problem areas lead to findings focusing on the lack of encouragement for long-term IT innovation that may result from current health IT policies; the potential impact of uneven adoption of health IT based on the exclusions of the current financial incentives; the weaknesses of contingency and risk mitigation planning that threaten system resilience; and evolving standards developed in response to challenges relating to the security, integrity, and availability of electronic health information. This paper discusses these findings and also offers recommendations that address the interwoven topics of innovation, resilience, and adoption. The goal of this paper is to encourage public and private sector organizations that have a role in shaping health information policy to increase attention to developing a national strategy that assures that health IT innovation and resilience are not impeded by shorter-term efforts to implement current approaches emphasizing adoption and meaningful use of electronic health records. PMID:22037887

  19. Perestroika and health care in the USSR: innovations in state financing.

    PubMed

    Weiss, L D; Theno, S A

    1991-01-01

    The budget of the USSR Ministry of Health has steadily been shrinking during the period 1960-1985 as a proportion of the standard measure of national productivity. In the age of perestroika, however, the Ministry of Health and various units within it have instituted a number of innovative attempts to increase available funds and resources on one hand, and make facilities operate more efficiently on the other. Some of these strategies include the expansion of pay polyclinics and hospitals, the institution of self-financing and cost accounting procedures, the initiation of health insurance forms of reimbursement, more control over the budget at lower levels, and the geographical reorganization of health care facilities. There are concerns about the effectiveness of these innovations, and the issue of quality of care. It is not clear which if any of these innovations will achieve the desired goals. PMID:1909349

  20. Developing Partnerships to Promote Local Innovation

    ERIC Educational Resources Information Center

    Waters-Bayer, Ann; van Veldhuizen, Laurens; Wettasinha, Chesha; Wongtschowski, Mariana

    2004-01-01

    Local innovation in agriculture and natural resource management is the process through which individuals or groups discover or develop new and better ways of managing resources, building on and expanding the boundaries of their existing knowledge. Prolinnova (Promoting Local Innovation) is a NGO-led global partnership programme that is being built…

  1. Health Physics Innovations Developed During Cassini for Future Space Applications

    NASA Technical Reports Server (NTRS)

    Nickell, Rodney E.; Rutherford, Theresa M.; Marmaro, George M.

    1999-01-01

    The long history of space flight includes missions that used Space Nuclear Auxiliary Power devices, starting with the Transit 4A Spacecraft (1961), continuing through the Apollo, Pioneer, Viking, Voyager, Galileo, Ulysses, Mars Pathfinder, and most recently, Cassini (1997). All Major Radiological Source (MRS) missions were processed at Kennedy Space Center/Cape Canaveral Air Station (KSC/CCAS) Launch Site in full compliance with program and regulatory requirements. The cumulative experience gained supporting these past missions has led to significant innovations which will be useful for benchmarking future MRS mission ground processing. Innovations developed during ground support for the Cassini mission include official declaration of sealed-source classifications, utilization of a mobile analytical laboratory, employment of a computerized dosimetry record management system, and cross-utilization of personnel from related disciplines.

  2. Public health education at the University of Florida: synergism and educational innovation.

    PubMed

    Perri, Michael G; Peoples-Sheps, Mary; Blue, Amy; Lednicky, John A; Prins, Cindy

    2015-03-01

    The College of Public Health and Health Professions at the University of Florida is composed of five public health departments and four clinical health professions departments, and the college is one of six that make up the university's Health Science Center. These organizational resources, along with the university's explicit emphasis on collaboration across professions, colleges, institutes, and centers and the strong leadership and full support of deans and other academic leaders, provide a strong foundation for educational innovations. Three key areas in which the college has built upon these opportunities are interprofessional education, development of One Health instructional programs, and application of cutting-edge technology to students' educational experiences. These innovations represent the types of creative approaches to preparing the 21st-century workforce that can be developed through collaboration among multiple disciplines in a major university. PMID:25706027

  3. Innovation and technology transfer in the health sciences: a cross-sectional perspective.

    PubMed

    Blanch, L; Guerra, L; Lanuza, A; Palomar, G

    2014-11-01

    This article is based on the strategic reflection and discussion that took place on occasion of the first conference on innovation and technology transfer in the health sciences organized by the REGIC-ENS-FENIN-SEMICYUC and held in Madrid in the Instituto de Salud Carlos III on May 7th, 2013, with the aim of promoting the transfer of technological innovation in medicine and health care beyond the European program "Horizon 2020". The presentations dealt with key issues such as evaluation of the use of new technologies, the need to impregnate the decisions related to adoption and innovation with the concepts of value and sustainability, and the implication of knowledge networks in the need to strengthen their influence upon the creation of a "culture of innovation" among health professionals. But above all, emphasis was placed on the latent innovation potential of hospitals, and the fact that these, being the large companies that they are, should seriously consider that much of their future sustainability may depend on proper management of their ability to generate innovation, which is not only the generation of ideas but also their transformation into products or processes that create value and economic returns. PMID:24958440

  4. Commentary: Teaching creativity and innovative thinking in medicine and the health sciences.

    PubMed

    Ness, Roberta B

    2011-10-01

    The National Academies of Science recently criticized the state of scientific innovation and competitiveness in the United States. Evaluations of already-established creativity training programs--examining a broad array of students, from school age to adult and with a wide range of abilities--have shown that such courses improve thinking skills, attitudes, and performance. Although academic medicine provides informal training in creativity and innovation, it has yet to incorporate formal instruction on these topics into medical education. A number of existing, thoughtfully constructed and evaluated creativity programs in other fields provide a pedagogical basis for developing creativity training programs for the health sciences. The content of creativity training programs typically includes instruction and application in (1) divergent thinking, (2) problem solving, and (3) creative production. Instructional formats that have been shown to elicit the best outcomes are an admixture of lectures, discussion, and guided practice. A pilot program to teach innovative thinking to health science students at the University of Texas includes instruction in recognizing and finding alternatives to frames or habitual cognitive patterns, in addition to the constructs already mentioned. As innovation is the engine of scientific progress, the author, founder of Innovative Thinking, the creativity training pilot program at the University of Texas, argues in this commentary that academic health centers should implement and evaluate new methods for enhancing science students' innovative thinking to keep the United States as a worldwide leader in scientific discovery. PMID:21955715

  5. Analysis of pan-African Centres of excellence in health innovation highlights opportunities and challenges for local innovation and financing in the continent.

    PubMed

    Nwaka, Solomon; Ochem, Alexander; Besson, Dominique; Ramirez, Bernadette; Fakorede, Foluke; Botros, Sanaa; Inyang, Uford; Mgone, Charles; Adae-Mensah, Ivan; Konde, Victor; Nyasse, Barthelemy; Okole, Blessed; Guantai, Anastasia; Loots, Glaudina; Atadja, Peter; Ndumbe, Peter; Sanou, Issa; Olesen, Ole; Ridley, Robert; Ilunga, Tshinko

    2012-01-01

    A pool of 38 pan-African Centres of Excellence (CoEs) in health innovation has been selected and recognized by the African Network for Drugs and Diagnostics Innovation (ANDI), through a competitive criteria based process. The process identified a number of opportunities and challenges for health R&D and innovation in the continent: i) it provides a direct evidence for the existence of innovation capability that can be leveraged to fill specific gaps in the continent; ii) it revealed a research and financing pattern that is largely fragmented and uncoordinated, and iii) it highlights the most frequent funders of health research in the continent. The CoEs are envisioned as an innovative network of public and private institutions with a critical mass of expertise and resources to support projects and a variety of activities for capacity building and scientific exchange, including hosting fellows, trainees, scientists on sabbaticals and exchange with other African and non-African institutions. PMID:22838941

  6. Analysis of pan-African Centres of excellence in health innovation highlights opportunities and challenges for local innovation and financing in the continent

    PubMed Central

    2012-01-01

    A pool of 38 pan-African Centres of Excellence (CoEs) in health innovation has been selected and recognized by the African Network for Drugs and Diagnostics Innovation (ANDI), through a competitive criteria based process. The process identified a number of opportunities and challenges for health R&D and innovation in the continent: i) it provides a direct evidence for the existence of innovation capability that can be leveraged to fill specific gaps in the continent; ii) it revealed a research and financing pattern that is largely fragmented and uncoordinated, and iii) it highlights the most frequent funders of health research in the continent. The CoEs are envisioned as an innovative network of public and private institutions with a critical mass of expertise and resources to support projects and a variety of activities for capacity building and scientific exchange, including hosting fellows, trainees, scientists on sabbaticals and exchange with other African and non-African institutions. PMID:22838941

  7. Health innovations in patient decision support: Bridging the gaps and challenges.

    PubMed

    Ng, Chirk Jenn; Lee, Yew Kong; Lee, Ping Yein; Abdullah, Khatijah Lim

    2013-01-01

    Patient decision aids (PDAs) help to support patients in making an informed and value-based decision. Despite advancement in decision support technologies over the past 30 years, most PDAs are still inaccessible and few address individual needs. Health innovation may provide a solution to bridge these gaps. Information and computer technology provide a platform to incorporate individual profiles and needs into PDAs, making the decision support more personalised. Health innovation may enhance accessibility by using mobile, tablet and Internet technologies; make risk communication more interactive; and identify patient values more effectively. In addition, using databases to capture patient data and the usage of PDAs can help: developers to improve PDAs' design; clinicians to facilitate the decisionmaking process more effectively; and policy makers to make shared decision making more feasible and cost-effective. Health innovation may hold the key to advancing PDAs by creating a more personalised and effective decision support tool for patients making healthcare decisions. PMID:23483776

  8. NASA Human Health and Performance Center: Open Innovation Successes and Collaborative Projects

    NASA Technical Reports Server (NTRS)

    Davis, Jeffrey R.; Richard, Elizabeth E.

    2014-01-01

    In May 2007, what was then the Space Life Sciences Directorate published the 2007 Space Life Sciences Strategy for Human Space Exploration, which resulted in the development and implementation of new business models and significant advances in external collaboration over the next five years. The strategy was updated on the basis of these accomplishments and reissued as the NASA Human Health and Performance Strategy in 2012, and continues to drive new approaches to innovation for the directorate. This short paper describes the open innovation successes and collaborative projects developed over this timeframe, including the efforts of the NASA Human Health and Performance Center (NHHPC), which was established to advance human health and performance innovations for spaceflight and societal benefit via collaboration in new markets.

  9. Drugs and diagnostic innovations to improve global health.

    PubMed

    Peeling, Rosanna W; Nwaka, Solomon

    2011-09-01

    Infectious diseases remain the major cause of morbidity and mortality in the developing world. Affordable effective drugs and diagnostics are critical for patient management and disease control but the development of new drugs and diagnostics is too slow to keep up with the emergence and spread of infectious diseases around the world. Innovative collaborative research and development involving disease endemic countries and developed countries are urgently needed to accelerate progress along the path from discovery to product adoption. These emerging approaches and the need for increased investment in human and financial resources to support them are discussed. PMID:21896368

  10. Health physics innovations developed during Cassini for future space applications

    SciTech Connect

    Nickell, Rod; Rutherford, Theresa; Marmaro, George

    1999-01-22

    There has been a long history of space missions involving Space Nuclear Auxiliary Power (SNAP) devices starting with the Transit 4A Spacecraft (1961), on through the Apollo, Pioneer, Viking, Voyager, Galileo, Ulysses, Mars Pathfinder, and most recently, Cassini (1997). All of these Major Radiological Source (MRS) missions were processed at the Kennedy Space Center/Cape Canaveral Air Station (KSC/CCAS) Launch Site in full compliance with program and regulatory requirements. The cumulative experience gained supporting these past missions has led to significant innovations which will be useful for bench-marking future MRS ground processing.

  11. School-Based Adolescent Health Programs: The Oregon Approach. Innovations.

    ERIC Educational Resources Information Center

    Albert, Kate M.

    Oregon has implemented a successful school-based clinic demonstration program. It was the first state to fund directly school-based clinics that provide comprehensive health services, including birth control counseling, to high school students. The program is administered through the Health Division of the Oregon Department of Human Resources,…

  12. Innovations in Mental Health Services to Disaster Victims.

    ERIC Educational Resources Information Center

    Lystad, Mary, Ed.

    This monograph was developed to provide mental health and other service delivery workers with an overview of conceptual, programmatic, and educational developments in mental health services to disaster victims over the past 10 years. It was written primarily for national policymakers, administrators, and service providers of disaster relief…

  13. Mainstreaming Modeling and Simulation to Accelerate Public Health Innovation

    PubMed Central

    Sepulveda, Martin-J.; Mabry, Patricia L.

    2014-01-01

    Dynamic modeling and simulation are systems science tools that examine behaviors and outcomes resulting from interactions among multiple system components over time. Although there are excellent examples of their application, they have not been adopted as mainstream tools in population health planning and policymaking. Impediments to their use include the legacy and ease of use of statistical approaches that produce estimates with confidence intervals, the difficulty of multidisciplinary collaboration for modeling and simulation, systems scientists’ inability to communicate effectively the added value of the tools, and low funding for population health systems science. Proposed remedies include aggregation of diverse data sets, systems science training for public health and other health professionals, changing research incentives toward collaboration, and increased funding for population health systems science projects. PMID:24832426

  14. PiNGO: a Cytoscape plugin to find candidate genes in biological networks

    PubMed Central

    Smoot, Michael; Ono, Keiichiro; Ideker, Trey; Maere, Steven

    2011-01-01

    Summary: PiNGO is a tool to screen biological networks for candidate genes, i.e. genes predicted to be involved in a biological process of interest. The user can narrow the search to genes with particular known functions or exclude genes belonging to particular functional classes. PiNGO provides support for a wide range of organisms and Gene Ontology classification schemes, and it can easily be customized for other organisms and functional classifications. PiNGO is implemented as a plugin for Cytoscape, a popular network visualization platform. Availability: PiNGO is distributed as an open-source Java package under the GNU General Public License (http://www.gnu.org/), and can be downloaded via the Cytoscape plugin manager. A detailed user guide and tutorial are available on the PiNGO website (http://www.psb.ugent.be/esb/PiNGO. Contact: steven.maere@psb.vib-ugent.be PMID:21278188

  15. Therapeutic innovation: a model for mental health planning.

    PubMed

    Segal, B

    1975-01-01

    Enlightened and progressive care of the mentally ill is closer to reality with the creation of the psychiatric halfway house. The halfway house is not an institutional edifice but a residential facility located in the community and indistinguishable from the other neighboring dwellings. The feature which sets apart the halfway house programmatically is its provision of a housing unit with some services for ex-hospital patients. Human incarceration continues to be a major enforcement instrument for the control of deviant behavior. Mental illness, as one type of poorly understood behavior, is for the most part controlled by institutionalizing the mentally ill person in a large dehumanized total institution such as the state mental hospital. Although major reforms are underway in many total institutions to humanize treatment procedures, innovative alternatives to custodial care are gaining impetus in the community. One such fascinating and rapidly expanding treatment innovation is the psychiatric halfway house. This presentation represents the results and implications of a comparative study of twenty such programs in the United States. PMID:202837

  16. NASA Human Health and Performance Center: Open innovation successes and collaborative projects

    NASA Astrophysics Data System (ADS)

    Richard, Elizabeth E.; Davis, Jeffrey R.

    2014-11-01

    In May 2007, what was then the Space Life Sciences Directorate published the 2007 Space Life Sciences Strategy for Human Space Exploration, setting the course for development and implementation of new business models and significant advances in external collaboration over the next five years. The strategy was updated on the basis of these accomplishments and reissued as the NASA Human Health and Performance Strategy in 2012, and continues to drive new approaches to innovation for the directorate. This short paper describes the successful execution of the strategy, driving organizational change through open innovation efforts and collaborative projects, including efforts of the NASA Human Health and Performance Center (NHHPC).

  17. A Policy Framework for Health Systems to Promote Triple Aim Innovation.

    PubMed

    Verma, Amol; Bhatia, Sacha

    2016-01-01

    With the expiry of the Health Accords, provincial governments must face the challenge of improving performance in the context of ageing demographics, increasing multi-morbidity, and real concerns about financial stability. The Institute for Healthcare Improvement Triple Aim articulates fundamental goals that can guide health system transformation: improved population health, enhanced patient experience and reduced or stable per capita costs. Advancing fragmented and costly health systems in pursuit of these goals requires transformative, as opposed to iterative, change. Provincial governments are ideally suited to lead this change by acting as "integrators" who link healthcare organizations and align incentives across the spectrum of delivery. Although there is very limited evidence regarding the effectiveness of system-level reforms, we draw on initiatives from around the world to suggest policies that can promote system-level Triple Aim innovation. We categorize these policies within the classic functions ascribed to health systems: financing, stewardship and resource generation. As healthcare financers, governments should orient procurement policy towards the Triple Aim innovation and reform payment to reward value not volume. As health system stewards, governments should define a Triple Aim vision; measure and report outcomes, patient experience, and costs; integrate across sectors; and facilitate learning from failure and spread of successful innovation. As resource generators, governments should invest in health information technology to exploit "big data" and ensure that professional education equips front-line clinicians with skills necessary to improve systems. There are a number of barriers to system-level Triple Aim innovation. There is a lack of evidence for macro-level policy changes, innovation is costly and complicated, and system reform may not be politically appealing. Triple Aim innovation may also be conflated with organization-level quality

  18. Methodological innovations in public health education: transdisciplinary problem solving.

    PubMed

    Lawlor, Edward F; Kreuter, Matthew W; Sebert-Kuhlmann, Anne K; McBride, Timothy D

    2015-03-01

    In 2008, the faculty of the Brown School at Washington University in St. Louis designed a Master of Public Health program centered on transdisciplinary problem solving in public health. We have described the rationale for our approach, guiding principles and pedagogy for the program, and specific transdisciplinary competencies students acquire. We have explained how transdisciplinary content has been organized and delivered, how the program is being evaluated, and how we have demonstrated the feasibility of this approach for a Master of Public Health degree. PMID:25706031

  19. Beyond magic bullets: true innovation in health care.

    PubMed

    Narayan, Vaibhav A; Mohwinckel, Marco; Pisano, Gary; Yang, Michael; Manji, Husseini K

    2013-02-01

    The time has come to move beyond product-focused 'magic bullet' therapeutic development strategies towards models that can also incorporate devices, tools and services to provide integrated health-care solutions. PMID:23370233

  20. Innovation in regulation of rapidly changing health markets.

    PubMed

    Bloom, Gerald; Henson, Spencer; Peters, David H

    2014-01-01

    The rapid evolution and spread of health markets across low and middle-income countries (LMICs) has contributed to a significant increase in the availability of health-related goods and services around the world. The support institutions needed to regulate these markets have lagged behind, with regulatory systems that are weak and under-resourced. This paper explores the key issues associated with regulation of health markets in LMICs, and the different goals of regulation, namely quality and safety of care, value for money, social agreement over fair access and financing, and accountability. Licensing, price controls, and other traditional approaches to the regulation of markets for health products and services have played an important role, but they have been of questionable effectiveness in ensuring safety and efficacy at the point of the user in LMICs. The paper proposes a health market systems conceptual framework, using the value chain for the production, distribution and retail of health goods and services, to examine regulation of health markets in the LMIC context. We conclude by exploring the changing context going forwards, laying out implications for future heath market regulation. We argue that the case for new approaches to the regulation of markets for health products and services in LMICs is compelling. Although traditional "command and control" approaches will have a place in the toolkit of regulators, a broader bundle of approaches is needed that is adapted to the national and market-level context of particular LMICs. The implication is that it is not possible to apply standard or single interventions across countries, as approaches proven to work well in one context will not necessarily work well elsewhere. PMID:24961602

  1. Innovation in regulation of rapidly changing health markets

    PubMed Central

    2014-01-01

    The rapid evolution and spread of health markets across low and middle-income countries (LMICs) has contributed to a significant increase in the availability of health-related goods and services around the world. The support institutions needed to regulate these markets have lagged behind, with regulatory systems that are weak and under-resourced. This paper explores the key issues associated with regulation of health markets in LMICs, and the different goals of regulation, namely quality and safety of care, value for money, social agreement over fair access and financing, and accountability. Licensing, price controls, and other traditional approaches to the regulation of markets for health products and services have played an important role, but they have been of questionable effectiveness in ensuring safety and efficacy at the point of the user in LMICs. The paper proposes a health market systems conceptual framework, using the value chain for the production, distribution and retail of health goods and services, to examine regulation of health markets in the LMIC context. We conclude by exploring the changing context going forwards, laying out implications for future heath market regulation. We argue that the case for new approaches to the regulation of markets for health products and services in LMICs is compelling. Although traditional "command and control" approaches will have a place in the toolkit of regulators, a broader bundle of approaches is needed that is adapted to the national and market-level context of particular LMICs. The implication is that it is not possible to apply standard or single interventions across countries, as approaches proven to work well in one context will not necessarily work well elsewhere. PMID:24961602

  2. Open innovation as a new paradigm for global collaborations in health

    PubMed Central

    2013-01-01

    Open innovation, which refers to combining internal and external ideas and internal and external paths to market in order to achieve advances in processes or technologies, is an attractive paradigm for structuring collaborations between developed and developing country entities and people. Such open innovation collaborations can be designed to foster true co-creation among partners in rich and poor settings, thereby breaking down hierarchies and creating greater impact and value for each partner. Using an example from Concern Worldwide’s Innovations for Maternal, Newborn &Child Health initiative, this commentary describes an early-stage pilot project built around open innovation in a low resource setting, which puts communities at the center of a process involving a wide range of partners and expertise, and considers how it could be adapted and make more impactful and sustainable by extending the collaboration to include developed country partners. PMID:24000780

  3. Open innovation as a new paradigm for global collaborations in health.

    PubMed

    Dandonoli, Patricia

    2013-01-01

    Open innovation, which refers to combining internal and external ideas and internal and external paths to market in order to achieve advances in processes or technologies, is an attractive paradigm for structuring collaborations between developed and developing country entities and people. Such open innovation collaborations can be designed to foster true co-creation among partners in rich and poor settings, thereby breaking down hierarchies and creating greater impact and value for each partner. Using an example from Concern Worldwide's Innovations for Maternal, Newborn &Child Health initiative, this commentary describes an early-stage pilot project built around open innovation in a low resource setting, which puts communities at the center of a process involving a wide range of partners and expertise, and considers how it could be adapted and make more impactful and sustainable by extending the collaboration to include developed country partners. PMID:24000780

  4. NGO-promoted microcredit programs and women's empowerment in rural Bangladesh: quantitative and qualitative evidence.

    PubMed

    Amin, R; Becker, S; Bayes, A

    1998-01-01

    Nongovernmental organizations (NGOs) in rural Bangladesh are reaching out to poor women with collateral-free credit programs aimed at both alleviating poverty and increasing women's status. The present study investigated the hypothesis that participation in credit-related activities by NGO credit members leads to greater empowerment of credit members compared to nonmembers. The sample was comprised of 1164 loanees and 1200 nonloanees from the five NGO areas in Bangladesh and of 1200 nonloanees from non-program areas of rural Bangladesh with no significant NGO presence. NGO credit members had significantly higher scores on all three indices of female empowerment: inter-spouse consultation, autonomy, and authority. Moreover, nonmembers within NGO program areas had higher autonomy and authority scores than nonmembers within the comparison areas. Even after background variables were controlled in the multivariate analysis, NGO credit membership and residence in an NGO program area remained significantly and positively associated with both the autonomy and authority indices. Other variables that exerted a significant positive effect on women's empowerment were concrete or corrugated buildings, area of residence outside the southern or eastern regions, nonagricultural occupation, respondent's education, and age. In focus group discussions, NGO credit loanees reported that the program made them more confident, assertive, intelligent, self-reliant, and aware of their rights. NGO credit programs that target poor women are likely to produce substantial improvements in women's social and economic status, without the long delays associated with education or employment opportunities in the formal sector. PMID:12294125

  5. Science-based health innovation in Uganda: creative strategies for applying research to development

    PubMed Central

    2010-01-01

    Background Uganda has a long history of health research, but still faces critical health problems. It has made a number of recent moves towards building science and technology capacity which could have an impact on local health, if innovation can be fostered and harnessed. Methods Qualitative case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 30 people from across the science-based health innovation system, including government officials, researchers in research institutes and universities, entrepreneurs, international donors, and non-governmental organization representatives. Results Uganda has a range of institutions influencing science-based health innovation, with varying degrees of success. However, the country still lacks a coherent mechanism for effectively coordinating STI policy among all the stakeholders. Classified as a least developed country, Uganda has opted for exemptions from the TRIPS intellectual property protection regime that include permitting parallel importation and providing for compulsory licenses for pharmaceuticals. Uganda is unique in Africa in taking part in the Millennium Science Initiative (MSI), an ambitious though early-stage $30m project, funded jointly by the World Bank and Government of Uganda, to build science capacity and encourage entrepreneurship through funding industry-research collaboration. Two universities – Makerere and Mbarara – stand out in terms of health research, though as yet technology development and commercialization is weak. Uganda has several incubators which are producing low-tech products, and is beginning to move into higher-tech ones like diagnostics. Its pharmaceutical industry has started to create partnerships which encourage innovation. Conclusions Science-based health product innovation is in its early stages in Uganda, as are policies for guiding its development

  6. Disruptive innovation: can health care learn from other industries? A conversation with Clayton M. Christensen. Interview by Mark D. Smith.

    PubMed

    Christensen, Clayton M

    2007-01-01

    Clayton Christensen is one of America's most influential business thinkers and writers. A professor at Harvard Business School, Christensen is perhaps best known for his writings on disruptive innovation in such books as The Innovator's Dilemma and The Innovator's Solution. In this interview with the California HealthCare Foundation's Mark Smith, he argues that the answer for more affordable health care will come not from an injection of more funding but, rather, from innovations that aim to make more and more areas of care cheaper, simpler, and more in the hands of patients. Christensen has been an adviser to several new companies in health care. PMID:17355981

  7. The UK National Health Service's 'innovation agenda': lessons on commercialisation and trust.

    PubMed

    Sterckx, Sigrid; Cockbain, Julian

    2014-01-01

    The UK National Health Service (the 'NHS'), encouraged by the 2011 report Innovation Health and Wealth, Accelerating Adoption and Diffusion in the NHS, and empowered by the Health and Social Care Act 2012, is in the process of adopting a new agenda for stimulating innovation in healthcare. For this, the bodies, body materials, and confidential health information of NHS patients may be co-opted. We explain why this brings the NHS into a moral conflict with its basic goal of providing a universal healthcare service. Putting NHS databases at the disposal of industry, without addressing ethical concerns regarding the privacy, autonomy, and moral integrity of patients and without requiring a 'kick-back' to enhance the service that the NHS provides, is inappropriate. As this article shows, with reference to the commercial arena of direct-to-consumer genetic testing, it is crucial that patient and public trust in the NHS is not eroded. PMID:24841528

  8. [Innovation in pharmaceutical and health biotechnology industries: challenges for a virtuous agenda].

    PubMed

    Vargas, Marco; Gadelha, Carlos Augusto Grabois; Costa, Laís Silveira; Maldonado, José

    2012-12-01

    Pharmaceutical and biotechnology industries comprise a major production subsystem of the health industrial complex in Brazil. It stands out for both its economic importance and its prominent role in developing new technologies in strategic areas. Strengthening the local production of generic drugs in the last decade has significantly increased the number of Brazilian companies in the local pharmaceutical market and has been an important turning point for this industry's growth. However, there remain major structural bottlenecks both in terms of production and continuous innovation. These bottlenecks reveal the high vulnerability of the Brazilian National Health System and point to the need of public policies that promote strengthening the production base and innovation in the pharmaceutical industry and that at the same time meet health-related social demands in health in Brazil. PMID:23532311

  9. A look at the ASEAN-NDI: building a regional health R&D innovation network.

    PubMed

    Montoya, Jaime C; Rebulanan, Carina L; Parungao, Nico Angelo C; Ramirez, Bernadette

    2014-01-01

    Globally, there are growing efforts to address diseases through the advancement in health research and development (R&D), strengthening of regional cooperation in science and technology (particularly on product discovery and development), and implementation of the World Health Assembly Resolution 61.21 (WHA61.21) on the Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property (GSPA-PHI). As such, the Association of Southeast Asian Nations (ASEAN) is responding to this through the establishment of the ASEAN-Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines Innovation (ASEAN-NDI). This is important in the ASEAN considering that infectious tropical diseases remain prevalent, emerging, and reemerging in the region. This paper looks into the evolution of the ASEAN-NDI from its inception in 2009, to how it is at present, and its plans to mitigate public health problems regionally and even globally. PMID:24834349

  10. Innovative generalist programs: academic health care centers respond to the shortage of generalist physicians.

    PubMed

    Urbina, C; Hickey, M; McHarney-Brown, C; Duban, S; Kaufman, A

    1994-04-01

    Academic health care centers increasingly are exploring innovative ways to increase the supply of generalist physicians. The authors review successful innovations at representative academic health centers in the areas of recruitment and admissions, undergraduate medical education, residency training, and practice support. Lessons learned focus on those areas that have demonstrated improvements in the number and quality of physicians trained in family practice, general pediatrics, and general internal medicine. Successful recruitment of generalism-oriented applicants requires identification and tracking of rural, minority, and other special groups of students at the high school and college levels. Academic health care centers that provide early, sustained, community-based, ambulatory experiences for medical students and residents encourage trainees to maintain and choose generalist careers. Finally, academic health care centers that link with community providers and with state government encourage the retention of generalist physicians through continuing education and teaching networks. PMID:8014749

  11. A look at the ASEAN-NDI: building a regional health R&D innovation network

    PubMed Central

    2014-01-01

    Globally, there are growing efforts to address diseases through the advancement in health research and development (R&D), strengthening of regional cooperation in science and technology (particularly on product discovery and development), and implementation of the World Health Assembly Resolution 61.21 (WHA61.21) on the Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property (GSPA-PHI). As such, the Association of Southeast Asian Nations (ASEAN) is responding to this through the establishment of the ASEAN-Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines Innovation (ASEAN-NDI). This is important in the ASEAN considering that infectious tropical diseases remain prevalent, emerging, and reemerging in the region. This paper looks into the evolution of the ASEAN-NDI from its inception in 2009, to how it is at present, and its plans to mitigate public health problems regionally and even globally. PMID:24834349

  12. Innovation in Medicare and Medicaid will be central to health reform's success.

    PubMed

    Guterman, Stuart; Davis, Karen; Stremikis, Kristof; Drake, Heather

    2010-06-01

    The health reform legislation signed into law by President Barack Obama contains numerous payment reform provisions designed to fundamentally transform the nation's health care system. Perhaps the most noteworthy of these is the establishment of a Center for Medicare and Medicaid Innovation within the Centers for Medicare and Medicaid Services. This paper presents recommendations that would maximize the new center's effectiveness in promoting reforms that can improve the quality and value of care in Medicare, Medicaid, and the Children's Health Insurance Program, while helping achieve health reform's goals of more efficient, coordinated, and effective care. PMID:20530353

  13. The challenge of nurse innovation in the Australian context of universal health care.

    PubMed

    Cashin, Andrew

    2015-01-01

    As nursing pushes further into the realm of primary health care in Australia, an understanding of the challenges to achieving reasonable federal funding of nursing services needs to be understood. This understanding is underpinned by a comprehensive understanding of the concept of universal health care, how the concept relates to the Australian health care context, and the resultant challenges to innovation in health care service delivery in Australia. Universal health care is a global mission and was the most recent theme for the International Council of Nurses Congress in Australia. Universal health care as a concept represents a fundamental shift from the development and funding of discrete interventions or programmes, to that of developing systems of health care. The three critical elements required are a clear definition of what is considered health care and funded for who, how the system is financed, and evaluation. Australia has a system of universal health care and all three elements are addressed. Organised medicine, a key objector to the introduction of the current approach to universal health care in Australia, soon adapted to it, and now fiercely resists change. Medico centricity poses challenges to sustainability as innovation is inhibited. This challenge is illustrated through consideration of the implementation of the financial policy that gave Nurse Practitioners access as providers and prescribers within Medicare funded services. PMID:26552203

  14. Community-based approaches and partnerships: innovations in health-service delivery in Bangladesh.

    PubMed

    El Arifeen, Shams; Christou, Aliki; Reichenbach, Laura; Osman, Ferdous Arfina; Azad, Kishwar; Islam, Khaled Shamsul; Ahmed, Faruque; Perry, Henry B; Peters, David H

    2013-12-14

    In Bangladesh, rapid advancements in coverage of many health interventions have coincided with impressive reductions in fertility and rates of maternal, infant, and childhood mortality. These advances, which have taken place despite such challenges as widespread poverty, political instability, and frequent natural disasters, warrant careful analysis of Bangladesh's approach to health-service delivery in the past four decades. With reference to success stories, we explore strategies in health-service delivery that have maximised reach and improved health outcomes. We identify three distinctive features that have enabled Bangladesh to improve health-service coverage and health outcomes: (1) experimentation with, and widespread application of, large-scale community-based approaches, especially investment in community health workers using a doorstep delivery approach; (2) experimentation with informal and contractual partnership arrangements that capitalise on the ability of non-governmental organisations to generate community trust, reach the most deprived populations, and address service gaps; and (3) rapid adoption of context-specific innovative technologies and policies that identify country-specific systems and mechanisms. Continued development of innovative, community-based strategies of health-service delivery, and adaptation of new technologies, are needed to address neglected and emerging health challenges, such as increasing access to skilled birth attendance, improvement of coverage of antenatal care and of nutritional status, the effects of climate change, and chronic disease. Past experience should guide future efforts to address rising public health concerns for Bangladesh and other underdeveloped countries. PMID:24268607

  15. Peer coaching: building collegial support for using innovative health programs.

    PubMed

    Gingiss, P L

    1993-02-01

    To ensure students achieve intended benefits from effective health programs, it is necessary to maximize program implementation and maintenance. Peer coaching provides a post-inservice staff development approach for health educators to strengthen teacher use of new health programs during implementation trials. While peer coaching positively influences teacher behavior and student outcomes, previous coaching programs have been limited in scope, have not been theoretically derived or adequately evaluated, and have not been systematically applied to health programs. This paper addresses teacher needs during trials, reviews peer coaching program features, and proposes a model to guide future planning, evaluation, and research. In this model, critical components of the coaching program include classroom assessments, coaching team cluster meetings, and administrative support. Strategies based on Social Learning Theory and Diffusion Theory are incorporated into the peer coaching program to influence teacher perceptions of their work roles, capability to implement a program, and commitment to the new instructional program. Interrelations among components are discussed and directions for future research and practice are suggested. PMID:8479163

  16. Business, Babies & the Bottom Line: Corporate Innovations and Best Practices in Maternal and Child Health.

    ERIC Educational Resources Information Center

    Jacobson, Miriam; Kolarek, Mary Hebert; Newton, Bonnie

    This publication presents the efforts and results of leading large employers to improve the health of mothers and children. Section 1 profiles the pioneering efforts and innovative practices of seven large employers and one business group: Haggar Clothing Co.; Honeywell Inc.; Los Angeles Department of Water and Power; Monfort, Inc.; First Chicago…

  17. YouTube: An Innovative Learning Resource for College Health Education Courses

    ERIC Educational Resources Information Center

    Burke, Sloane C.; Snyder, Shonna L.

    2008-01-01

    As college health education professors attempt to engage the Web 2.0 generation of learners, use of innovative video technology resources such as YouTube can be integrated to provide relevant and targeted information to supplement college course content, create a sense of "classroom community," and enrich the learning environment for all…

  18. Innovations to Enhance the Quality of Health Professions Education at the University of Zimbabwe College of Health Sciences -NECTAR Program

    PubMed Central

    Ndhlovu, Chiratidzo E; Nathoo, Kusum; Borok, Margaret; Chidzonga, Midion; Aagaard, Eva M.; Connors, Susan C.; Barry, Michele; Campbell, Thomas; Hakim, James

    2014-01-01

    The University of Zimbabwe College of Health Sciences (UZCHS) is Zimbabwe's premier health professions training institution. However, several concerns were raised during the past decade over the quality of health education at UZCHS. The number of faculty and students declined markedly until 2010, when there was a medical student intake of 147 while the faculty comprised only 122 (39%) of a possible 314 positions. The economic and political crises that the country experienced from 1999 to 2009 compounded the difficulties faced by the institution by limiting the availability of resources. The Medical Education Partnership Initiative (MEPI) funding opportunity has given UZCHS the stimulus to embark on reforms to improve the quality of health education it offers. UZCHS, in partnership with the University of Colorado School of Medicine (UCSOM), the University of Colorado Denver Evaluation Center (UCDEC), and Stanford University designed the Novel Education Clinical Trainees and Researchers (NECTAR) program to implement a series of health education innovations to meet this challenge. Between 2010 and 2013, innovations that have positively affected the quality of health professions education at UZCHS include the launch of comprehensive faculty development programs and mentored clinical and research programs for postgraduate students. A competency-based curriculum reform process has been initiated; a health professions department has been established; and the Research Support Center has been strengthened, providing critical resources to institutionalize health education and research implementation at the college. A core group of faculty trained in medical education has been assembled, helping to ensure the sustainability of these NECTAR activities. PMID:25072588

  19. An Innovative Program in the Science of Health Care Delivery: Workforce Diversity in the Business of Health.

    PubMed

    Essary, Alison C; Wade, Nathaniel L

    2016-01-01

    According to the most recent statistics from the National Center for Education Statistics, disparities in enrollment in undergraduate and graduate education are significant and not improving commensurate with the national population. Similarly, only 12% of graduating medical students and 13% of graduating physician assistant students are from underrepresented racial and ethnic groups. Established in 2012 to promote health care transformation at the organization and system levels, the School for the Science of Health Care Delivery is aligned with the university and college missions to create innovative, interdisciplinary curricula that meet the needs of our diverse patient and community populations. Three-year enrollment trends in the program exceed most national benchmarks, particularly among students who identify as Hispanic and American Indian/Alaska Native. The Science of Health Care Delivery program provides students a seamless learning experience that prepares them to be solutions-oriented leaders proficient in the business of health care, change management, innovation, and data-driven decision making. Defined as the study and design of systems, processes, leadership and management used to optimize health care delivery and health for all, the Science of Health Care Delivery will prepare the next generation of creative, diverse, pioneering leaders in health care. PMID:27262477

  20. Science-based health innovation in Tanzania: bednets and a base for invention

    PubMed Central

    2010-01-01

    Background Tanzania is East Africa’s largest country. Although it is socially diverse, it has experienced general political stability since independence in 1964. Despite gradual economic development and Tanzania’s status as one of the biggest recipients of aid in Africa, health status remains poor. This paper explores Tanzania’s science-based health innovation system, and highlights areas which can be strengthened. Methods Qualitative case study research methodology was used. Data were collected through reviews of academic literature and policy documents, and through open-ended, face-to-face interviews with 52 people from across the science-based health innovation system over two visits to Tanzania from July to October 2007. Results and discussion Tanzania has a rich but complex S&T governance landscape, with the public sector driving the innovation agenda through a series of different bodies which are not well-coordinated. It has some of the leading health research on the continent at the University of Dar es Salaam, Muhimbili University of Health and Applied Sciences, the National Institute for Medical Research and the Ifakara Medical Institute, with strong donor support. Tanzania has found developing an entrepreneurial culture difficult; nevertheless projects such as the clusters initiative at the University of Dar es Salaam are encouraging low-tech innovation and overcoming knowledge-sharing barriers. In the private sector, one generics company has developed a South-South collaboration to enable technology transfer and hence the local production of anti-retrovirals. Local textile company A to Z Textiles is now manufacturing 30 million insecticide impregnated bednets a year. Conclusions To have a coherent vision for innovation, Tanzania may wish to address some key issues: coordination across stakeholders involved with health research, increasing graduates in health-related disciplines, and building capabilities in biological testing, preclinical testing

  1. Apple Tree Dental: An Innovative Oral Health Solution.

    PubMed

    Jacobi, Deborah; Helgeson, Michael J

    2015-08-01

    The Surgeon General's Report on Oral Health called attention to the "silent epidemic" of dental disease. Older adults and other vulnerable people continue to suffer disproportionately from dental disease and inadequate access to care. As a society and as dental professionals, we face multiple challenges to care for our aging patients, parents and grandparents. Apple Tree Dental's community collaborative practice model illustrates a sustainable, patient-centered approach to overcoming barriers to care across the lifespan. PMID:26357816

  2. Measuring factors affecting implementation of health innovations: a systematic review of structural, organizational, provider, patient, and innovation level measures

    PubMed Central

    2013-01-01

    Background Two of the current methodological barriers to implementation science efforts are the lack of agreement regarding constructs hypothesized to affect implementation success and identifiable measures of these constructs. In order to address these gaps, the main goals of this paper were to identify a multi-level framework that captures the predominant factors that impact implementation outcomes, conduct a systematic review of available measures assessing constructs subsumed within these primary factors, and determine the criterion validity of these measures in the search articles. Method We conducted a systematic literature review to identify articles reporting the use or development of measures designed to assess constructs that predict the implementation of evidence-based health innovations. Articles published through 12 August 2012 were identified through MEDLINE, CINAHL, PsycINFO and the journal Implementation Science. We then utilized a modified five-factor framework in order to code whether each measure contained items that assess constructs representing structural, organizational, provider, patient, and innovation level factors. Further, we coded the criterion validity of each measure within the search articles obtained. Results Our review identified 62 measures. Results indicate that organization, provider, and innovation-level constructs have the greatest number of measures available for use, whereas structural and patient-level constructs have the least. Additionally, relatively few measures demonstrated criterion validity, or reliable association with an implementation outcome (e.g., fidelity). Discussion In light of these findings, our discussion centers on strategies that researchers can utilize in order to identify, adapt, and improve extant measures for use in their own implementation research. In total, our literature review and resulting measures compendium increases the capacity of researchers to conceptualize and measure implementation

  3. Psychological Science and Innovative Strategies for Informing Health Care Redesign: A Policy Brief.

    PubMed

    Rosenbaum Asarnow, Joan; Hoagwood, Kimberly E; Stancin, Terry; Lochman, John E; Hughes, Jennifer L; Miranda, Jeanne M; Wysocki, Tim; Portwood, Sharon G; Piacentini, John; Tynan, Douglas; Atkins, Marc; Kazak, Anne E

    2015-01-01

    Recent health care legislation and shifting health care financing strategies are transforming health and behavioral health (a broad term referring to mental health, substance use, and health behavior) care in the United States. Advances in knowledge regarding effective treatment and services coupled with incentives for innovation in health and behavioral health care delivery systems make this a unique time for mobilizing our science to enhance the success of health and behavioral health care redesign. To optimize the potential of our current health care environment, a team was formed composed of leaders from the Societies of Clinical Child & Adolescent Psychology, Pediatric Psychology, and Child and Family Policy and Practice (Divisions 53, 54, and 37 of the American Psychological Association). This team was charged with reviewing the scientific and policy literature with a focus on five major issues: (a) improving access to care and reducing health disparities, (b) integrating behavioral health care within primary care, (c) preventive services, (d) enhancing quality and outcomes of care, and (e) training and workforce development. The products of that work are summarized here, including recommendations for future research, clinical, training, and policy directions. We conclude that the current emphasis on accountable care and evaluation of the outcomes of care offer numerous opportunities for psychologists to integrate science and practice for the benefit of our children, families, and nation. The dramatic changes that are occurring in psychological and behavioral health care services and payment systems also require evolution in our practice and training models. PMID:26430948

  4. MEDWISE: an innovative public health information system infrastructure.

    PubMed

    Sahin, Yasar Guneri; Celikkan, Ufuk

    2012-06-01

    In this paper, we present MedWise, a high level design of a medical information infrastructure, and its architecture. The proposed system offers a comprehensive, modular, robust and extensible infrastructure to be used in public health care systems. The system gathers reliable and evidence based health data, which it then classifies, interprets and stores into a particular database. It creates a healthcare ecosystem that aids the medical community by providing for less error prone diagnoses and treatment of diseases. This system will be standards-compliant; therefore it would be complementary to the existing healthcare and clinical information systems. The key objective of the proposed system is to provide as much medical historical and miscellaneous data as possible about the patients with minimal consultation, thus allowing physicians to easily access Patients' Ancillary Data (PAD) such as hereditary, residential, travel, custom, meteorological, biographical and demographical data before the consultation. In addition, the system can help to diminish problems and misdiagnosis situations caused by language barriers-disorders and misinformation. MedWise can assist physicians to shorten time for diagnosis and consultations, therefore dramatically improving quality and quantity of the physical examinations of patients. Furthermore, since it intends to supply a significant amount of data, it may be used to improve skills of students in medical education. PMID:21110075

  5. An innovative national health care waste management system in Kyrgyzstan.

    PubMed

    Toktobaev, Nurjan; Emmanuel, Jorge; Djumalieva, Gulmira; Kravtsov, Alexei; Schüth, Tobias

    2015-02-01

    A novel low-cost health care waste management system was implemented in all rural hospitals in Kyrgyzstan. The components of the Kyrgyz model include mechanical needle removers, segregation using autoclavable containers, safe transport and storage, autoclave treatment, documentation, recycling of sterilized plastic and metal parts, cement pits for anatomical waste, composting of garden wastes, training, equipment maintenance, and management by safety and quality committees. The gravity-displacement autoclaves were fitted with filters to remove pathogens from the air exhaust. Operating parameters for the autoclaves were determined by thermal and biological tests. A hospital survey showed an average 33% annual cost savings compared to previous costs for waste management. All general hospitals with >25 beds except in the capital Bishkek use the new system, corresponding to 67.3% of all hospital beds. The investment amounted to US$0.61 per capita covered. Acceptance of the new system by the staff, cost savings, revenues from recycled materials, documented improvements in occupational safety, capacity building, and institutionalization enhance the sustainability of the Kyrgyz health care waste management system. PMID:25649402

  6. Overcoming Barriers in Kidney Health-Forging a Platform for Innovation.

    PubMed

    Linde, Peter G; Archdeacon, Patrick; Breyer, Matthew D; Ibrahim, Tod; Inrig, Jula K; Kewalramani, Reshma; Lee, Celeste Castillo; Neuland, Carolyn Y; Roy-Chaudhury, Prabir; Sloand, James A; Meyer, Rachel; Smith, Kimberly A; Snook, Jennifer; West, Melissa; Falk, Ronald J

    2016-07-01

    Innovation in kidney diseases is not commensurate with the effect of these diseases on human health and mortality or innovation in other key therapeutic areas. A primary cause of the dearth in innovation is that kidney diseases disproportionately affect a demographic that is largely disenfranchised, lacking sufficient advocacy, public attention, and funding. A secondary and likely consequent cause is that the existing infrastructure supporting nephrology research pales in comparison with those for other internal medicine specialties, especially cardiology and oncology. Citing such inequities, however, is not enough. Changing the status quo will require a coordinated effort to identify and redress the existing deficits. Specifically, these deficits relate to the need to further develop and improve the following: understanding of the disease mechanisms and pathophysiology, patient engagement and activism, clinical trial infrastructure, and investigational clinical trial designs as well as coordinated efforts among critical stakeholders. This paper identifies potential solutions to these barriers, some of which are already underway through the Kidney Health Initiative. The Kidney Health Initiative is unique and will serve as a current and future platform from which to overcome these barriers to innovation in nephrology. PMID:27127187

  7. The emergence of radically new health care technologies: inventive users as innovation networkers.

    PubMed

    Lettl, Christopher

    2005-01-01

    Besides a large body of research on user innovation, little is known which role users play in the emergence of radically new health care technologies. Such technologies are 'new-to-the-world', highly complex, shift market structures, and require user learning as they often induce significant behaviour changes on side of the users. In a multi-case-study-analysis we identified an 'entrepreneurial' role of inventive users. Those surgeons that were the original inventors of radically new health care technologies established and organized the required innovation networks. They identified relevant partners, formed a network of experts with complementary knowledge bases, and coordinated this network. These innovation networks were required to transform their radically new ideas into first physical prototypes. To better understand the observed phenomenon we analysed factors that might explain this exclusive role. We find that a high problem pressure, an active role of users in the idea generation phase, a high degree of innovativeness of the prospective product, and missing competencies as well as missing resources explain the networking activities of inventive users. The findings shed light on the role of users in the emergence of radically new health care technologies. PMID:15990420

  8. Engineering, global health, and inclusive innovation: focus on partnership, system strengthening, and local impact for SDGs

    PubMed Central

    Clifford, Katie L.; Zaman, Muhammad H.

    2016-01-01

    The recent drafting of the Sustainable Development Goals challenges the research community to rethink the traditional approach to global health and provides the opportunity for science, technology, engineering, and mathematical (STEM) disciplines, particularly engineering, to demonstrate their benefit to the field. Higher education offers a platform for engineering to intersect with global health research through interdisciplinary partnerships among international universities that provide excellence in education, attract nontraditional STEM students, and foster a sense of innovation. However, a traditional lack of engineering–global health collaborations, as well as limited faculty and inadequate STEM research funding in low-income countries, has stifled progress. Still, the impact of higher education on development efforts holds great potential. This value will be realized in low-income countries through strengthening local capacity, supporting innovation through educational initiatives, and encouraging the inclusion of women and minorities in STEM programs. Current international university-level partnerships are working towards integrating engineering into global health research and strengthening STEM innovation among universities in low-income countries, but more can be done. Global health research informs sustainable development, and through integrating engineering into research efforts through university partnerships, we can accelerate progress and work towards a healthier future for all. PMID:26790462

  9. Engineering, global health, and inclusive innovation: focus on partnership, system strengthening, and local impact for SDGs.

    PubMed

    Clifford, Katie L; Zaman, Muhammad H

    2016-01-01

    The recent drafting of the Sustainable Development Goals challenges the research community to rethink the traditional approach to global health and provides the opportunity for science, technology, engineering, and mathematical (STEM) disciplines, particularly engineering, to demonstrate their benefit to the field. Higher education offers a platform for engineering to intersect with global health research through interdisciplinary partnerships among international universities that provide excellence in education, attract nontraditional STEM students, and foster a sense of innovation. However, a traditional lack of engineering-global health collaborations, as well as limited faculty and inadequate STEM research funding in low-income countries, has stifled progress. Still, the impact of higher education on development efforts holds great potential. This value will be realized in low-income countries through strengthening local capacity, supporting innovation through educational initiatives, and encouraging the inclusion of women and minorities in STEM programs. Current international university-level partnerships are working towards integrating engineering into global health research and strengthening STEM innovation among universities in low-income countries, but more can be done. Global health research informs sustainable development, and through integrating engineering into research efforts through university partnerships, we can accelerate progress and work towards a healthier future for all. PMID:26790462

  10. Aesthetic, emotion and empathetic imagination: beyond innovation to creativity in the health and social care workforce.

    PubMed

    Munt, Deborah; Hargreaves, Janet

    2009-12-01

    The Creativity in Health and Care Workshops programme was a series of investigative workshops aimed at interrogating the subject of creativity with an over-arching objective of extending the understanding of the problems and possibilities of applying creativity within the health and care sector workforce. Included in the workshops was a concept analysis, which attempted to gain clearer understanding of creativity and innovation within this context. The analysis led to emergent theory regarding the central importance of aesthetics, emotion and empathetic imagination to the generation of creative and innovative outcomes that have the capacity to promote wellbeing in the health and social care workforce. Drawing on expertise in the field, this paper outlines the concept analysis and subsequent reflection. PMID:19813095

  11. Survival of the project: a case study of ICT innovation in health care.

    PubMed

    Andreassen, Hege K; Kjekshus, Lars Erik; Tjora, Aksel

    2015-05-01

    From twenty years of information and communication technology (ICT) projects in the health sector, we have learned one thing: most projects remain projects. The problem of pilotism in e-health and telemedicine is a growing concern, both in medical literature and among policy makers, who now ask for large-scale implementation of ICT in routine health service delivery. In this article, we turn the question of failing projects upside down. Instead of investigating the obstacles to implementing ICT and realising permanent changes in health care routines, we ask what makes the temporary ICT project survive, despite an apparent lack of success. Our empirical material is based on Norwegian telemedicine. Through a case study, we take an in-depth look into the history of one particular telemedical initiative and highlight how ICT projects matter on a managerial level. Our analysis reveals how management tasks were delegated to the ICT project, which thus contributed to four processes of organisational control: allocating resources, generating and managing enthusiasm, system correction and aligning local practice and national policies. We argue that the innovation project in itself can be considered an innovation that has become normalised in health care, not in clinical, but in management work. In everyday management, the ICT project appears to be a convenient tool suited to ease the tensions between state regulatory practices and claims of professional autonomy that arise in the wake of new public management reforms. Separating project management and funding from routine practice handles the conceptualised heterogeneity between innovation and routine within contemporary health care delivery. Whilst this separation eases the execution of both normal routines and innovative projects, it also delays expected diffusion of technology. PMID:25795426

  12. Drug delivery system innovation and Health Technology Assessment: Upgrading from Clinical to Technological Assessment.

    PubMed

    Panzitta, Michele; Bruno, Giorgio; Giovagnoli, Stefano; Mendicino, Francesca R; Ricci, Maurizio

    2015-11-30

    Health Technology Assessment (HTA) is a multidisciplinary health political instrument that evaluates the consequences, mainly clinical and economical, of a health care technology; the HTA aim is to produce and spread information on scientific and technological innovation for health political decision making process. Drug delivery systems (DDS), such as nanocarriers, are technologically complex but they have pivotal relevance in therapeutic innovation. The HTA process, as commonly applied to conventional drug evaluation, should upgrade to a full pharmaceutical assessment, considering the DDS complexity. This is useful to study more in depth the clinical outcome and to broaden its critical assessment toward pharmaceutical issues affecting the patient and not measured by the current clinical evidence approach. We draw out the expertise necessary to perform the pharmaceutical assessment and we propose a format to evaluate the DDS technological topics such as formulation and mechanism of action, physicochemical characteristics, manufacturing process. We integrated the above-mentioned three points in the Evidence Based Medicine approach, which is data source for any HTA process. In this regard, the introduction of a Pharmaceutics Expert figure in the HTA could be fundamental to grant a more detailed evaluation of medicine product characteristics and performances and to help optimizing DDS features to overcome R&D drawbacks. Some aspects of product development, such as manufacturing processes, should be part of the HTA as innovative manufacturing processes allow new products to reach more effectively patient bedside. HTA so upgraded may encourage resource allocating payers to invest in innovative technologies and providers to focus on innovative material properties and manufacturing processes, thus contributing to bring more medicines in therapy in a sustainable manner. PMID:26399633

  13. Models of biobanks and implications for reproductive health innovation.

    PubMed

    Capps, Benjamin

    2015-12-01

    Biobanks are designed with particular purposes in mind. These purposes are reflected in the governance frameworks that define the conditions for participation and access by researchers. In this paper, I analyse two different models: the commercially aligned deCODE biobank and the 'public good' framework of UK Biobank. These diametric models have both featured 'the public interest' as pivotal to their achievements. However, if properly understood, the public interest rhetoric of deCODE actually conflicts with any professed community interest. The reasons why are explained, and the effects this has on conditions for participation are critiqued, before reflecting on how each model might have an impact on reproductive health research. PMID:26670686

  14. [Community nutrition strategy project: an innovation in community health].

    PubMed

    Diallo, I; Ndiaye, B; Pouye, A; Gaye, I A; Sy, A; Sarr, R; Tall-Dia, A

    1998-01-01

    The strategy of the community nutrition project is based on the utilization of the community development structures to deliver the nutrition services. These structures, represented in Senegal by youth associations, women groups, GIEs and NGOs, are part of the decentralization process, and as such play an important role in health and health development activities in poor urban districts. The Community Nutrition Project (CNP), funded for five years by the World Bank, German Cooperation (KFW), World Food Program (WFP) and the Senegalese government aims to halt further deterioration in the nutrition status of the most vulnerable groups in the poorest urban districts of Senegal. All nutrition services and particularly the IEC services have been entirely contracted out the first year to 76 GIEs involving 323 unemployed persons, operating as micro-enterprises "MIC" and 17 "GIEs" of unemployed physicians, pharmacists, and social workers for a total of 34 persons, organized as "maître d'Oeuvre communautaires "MOC", in charge of the supervision tasks. Each community nutrition center recruits and monitors every six months 460 to 600 beneficiaries composed of women at six months of pregnancy, lactating mother of children under 6 months, and a group of children aged from 6 to 35 months old. An average of 87% of registered children in the nutrition centers are weekly or monthly weighted. Thus the proportion of malnourished children in cohort of children followed from January to July 1996 has decreased from 70% to 25% within six months. The malnutrition rate has been reduced up to 65% after six months. PMID:10797950

  15. Engine or Boat Anchor? The Health Professional Training Establishment in HHR Innovation

    PubMed Central

    Gilbert, John H.V.

    2011-01-01

    Educational institutions have largely failed to provide innovative responses to emerging health human resources (HHR) needs. Reasons include the prevailing ratio policy, which simply increases the supply of professionals; university funding protocols; a guild structure that isolates health professions rather than integrating them; and current credentialing for entry to practice, which both controls and further balkanizes the professions. Providing integrated health services will require (a) embedding interprofessional education and collaborative practice in accreditation requirements, (b) coordinating educational programs via intergovernmental committees and (c) embedding interprofessional collaborative learning in clinical training. PMID:22294987

  16. Teaching corner: the prospective case study : a pedagogical innovation for teaching global health ethics.

    PubMed

    Stewart, Kearsley A

    2015-03-01

    Over the past decade, global health has emerged as one of the fastest growing academic programs in the United States. Ethics training is cited widely as an essential feature of U.S. global health programs, but generally it is not deeply integrated into the global health teaching and training curricula. A discussion about the pedagogy of teaching global health ethics is long overdue; to date, only a few papers specifically engage with pedagogy rather than competencies or content. This paper explores the value of case study pedagogy for a full-semester graduate course in global health ethics at an American university. I address some of the pedagogical challenges of teaching global health ethics through my innovative use of case study methodology-the "prospective case study" (PSC). PMID:25630595

  17. Innovation waivers: an opportunity for states to pursue their own brand of health reform.

    PubMed

    Bachrach, Deborah; Ario, Joel; Davis, Hailey

    2015-04-01

    States have long been the testing ground for new models of health care and coverage. Section 1332 of the Affordable Care Act, which takes effect in less than two years, throws open the door to innovation by authorizing states to rethink the law's coverage designs. Under State Innovation Waivers, states can modify the rules regarding covered benefits, subsidies, insurance marketplaces, and individual and employer mandates. States may propose broad alternatives or targeted fixes, but all waivers must demonstrate that coverage will remain as accessible, comprehensive, and affordable as before the waiver and that the changes will not add to the federal deficit. This issue brief describes how states may use State Innovation Waivers to reallocate subsidies, expand or streamline their marketplaces, replace or modify the mandates, and otherwise pursue their own brand of reform tailored to local market conditions and political preferences. PMID:25915973

  18. Do entrepreneurial food systems innovations impact rural economies and health? Evidence and gaps

    PubMed Central

    Sitaker, Marilyn; Kolodinsky, Jane; Jilcott Pitts, Stephanie B.; Seguin, Rebecca A.

    2015-01-01

    A potential solution for weakened rural economies is the development of local food systems, which include affordable foods sources for consumers and economically feasible structures for producers. Local food systems are purported to promote sustainability, improve local economies, increase access to healthy foods, and improve the local diets. Four entrepreneurial food systems innovations that support local economies include farmers’ markets, community supported agriculture, farm to institution programs and food hubs. We review current literature to determine whether innovations for aggregation, processing, distribution and marketing in local food systems: 1) enable producers to make a living; 2) improve local economies; 3) provide local residents with greater access to affordable, healthy food; and 4) contribute to greater consumption of healthy food among residents. While there is some evidence for each, more transdisciplinary research is needed to determine whether entrepreneurial food systems innovations provide economic and public health benefits. PMID:26613066

  19. Innovative solutions to novel drug development in mental health

    PubMed Central

    Insel, T.R.; Voon, V.; Nye, J.S.; Brown, V.J.; Altevogt, B.M.; Bullmore, E.T.; Goodwin, G.M.; Howard, R.J.; Kupfer, D.J.; Malloch, G.; Marston, H.M.; Nutt, D.J.; Robbins, T.W.; Stahl, S.M.; Tricklebank, M.D.; Williams, J.H.; Sahakian, B.J.

    2013-01-01

    There are many new advances in neuroscience and mental health which should lead to a greater understanding of the neurobiological dysfunction in neuropsychiatric disorders and new developments for early, effective treatments. To do this, a biomarker approach combining genetic, neuroimaging, cognitive and other biological measures is needed. The aim of this article is to highlight novel approaches for pharmacological and non-pharmacological treatment development. This article suggests approaches that can be taken in the future including novel mechanisms with preliminary clinical validation to provide a toolbox for mechanistic studies and also examples of translation and back-translation. The review also emphasizes the need for clinician-scientists to be trained in a novel way in order to equip them with the conceptual and experimental techniques required, and emphasizes the need for private-public partnership and pre-competitive knowledge exchange. This should lead the way for important new holistic treatment developments to improve cognition, functional outcome and well-being of people with neuropsychiatric disorders. PMID:23563062

  20. Diffusion of e-health innovations in ‘post-conflict’ settings: a qualitative study on the personal experiences of health workers

    PubMed Central

    2014-01-01

    Background Technological innovations have the potential to strengthen human resources for health and improve access and quality of care in challenging ‘post-conflict’ contexts. However, analyses on the adoption of technology for health (that is, ‘e-health’) and whether and how e-health can strengthen a health workforce in these settings have been limited so far. This study explores the personal experiences of health workers using e-health innovations in selected post-conflict situations. Methods This study had a cross-sectional qualitative design. Telephone interviews were conducted with 12 health workers, from a variety of cadres and stages in their careers, from four post-conflict settings (Liberia, West Bank and Gaza, Sierra Leone and Somaliland) in 2012. Everett Roger’s diffusion of innovation-decision model (that is, knowledge, persuasion, decision, implementation, contemplation) guided the thematic analysis. Results All health workers interviewed held positive perceptions of e-health, related to their beliefs that e-health can help them to access information and communicate with other health workers. However, understanding of the scope of e-health was generally limited, and often based on innovations that health workers have been introduced through by their international partners. Health workers reported a range of engagement with e-health innovations, mostly for communication (for example, email) and educational purposes (for example, online learning platforms). Poor, unreliable and unaffordable Internet was a commonly mentioned barrier to e-health use. Scaling-up existing e-health partnerships and innovations were suggested starting points to increase e-health innovation dissemination. Conclusions Results from this study showed ICT based e-health innovations can relieve information and communication needs of health workers in post-conflict settings. However, more efforts and investments, preferably driven by healthcare workers within the post

  1. Rejection of an innovation: health information management training materials in east Africa.

    PubMed

    Gladwin, J; Dixon, R A; Wilson, T D

    2002-12-01

    A shift towards decentralization in many low-income countries has meant more skills are demanded of primary health care managers, including data and information handling at all levels of the health care system. Ministries of Health are changing their central reporting health information systems to health management information systems with emphasis on managers utilizing information at the point of collection. This paper reports on a research study to investigate the introduction of new information management strategies intended to promote an informational approach to management at the operational health service level in low-income countries. It aims to understand the process taking place when externally developed training materials (PHC MAP), which are intended to strengthen health management information systems, are introduced to potential users in an east African country. A case study has been undertaken and this research has demonstrated that the dynamic equilibrium approach to organizational change is applicable to the introduction of new information management strategies and management approaches in low-income countries. Although PHC MAP developers envisaged a technical innovation needing implementation, potential users saw the situation as one of organizational change. Contributions to theory have been made and many implications for introducing new information systems or the informational approach to management are identified. This theoretical framework could also facilitate the introduction of future information management innovations and would allow practitioners to perceive the introduction of information management innovations as one of organizational change that needs to be managed. Consequently, issues that may facilitate or inhibit adoption could be identified in advance. PMID:12424207

  2. Transformation of health care through innovative use of information technology: challenges for health and medical informatics education.

    PubMed

    Haux, R; Swinkels, W; Ball, M; Knaup, P; Lun, K C

    1998-06-01

    Information storage and processing continues to become increasingly important for health care, and offers enormous potential to be realised in the delivery of health care. Therefore, it is imperative that all health care professionals should learn skills and gain knowledge in the field of health informatics, or medical informatics, respectively. Working Group 1, Health and Medical Informatics Education, of the International Medical Informatics Association (IMIA WG1) seeks to advance the knowledge of how these skills are taught in courses for the various health care professions around the world, and includes physicians, nurses, administrators, and specialists in medical informatics. IMIA WG1 held its 6th International Conference on Health and Medical Education in Newcastle, Australia, in August 1997. The theme of the conference was 'Transformation of Healthcare through Innovative Use of Information Technology'. This special issue of the International Journal of Medical Informatics on Health and Medical Informatics Education contains selected papers presented at the conference. In addition to the central topic, Educating Health Care Professionals in Medical Informatics the topics telematics, distance education and computer based training were also discussed at the conference. PMID:9726487

  3. The promise of acceptance as an NGO security management approach.

    PubMed

    Fast, Larissa; Freeman, Faith; O'Neill, Michael; Rowley, Elizabeth

    2015-04-01

    This paper explores three questions related to acceptance as a security management approach. Acceptance draws upon relationships with community members, authorities, belligerents and other stakeholders to provide consent for the presence and activities of a non-governmental organisation (NGO), thereby reducing threats from these actors. Little is documented about how NGOs gain and maintain acceptance, how they assess and monitor the presence and degree of acceptance, or how they determine whether acceptance is effective in a particular context. Based on field research conducted in April 2011 in Kenya, South Sudan and Uganda, we address each of these three issues and argue that acceptance must be actively sought as both a programme and a security management strategy. In the paper we delineate elements common to all three contexts as well as missed opportunities, which identify areas that NGOs can and should address as part of an acceptance approach. PMID:25440000

  4. The eLISA/NGO Data Processing Centre

    NASA Astrophysics Data System (ADS)

    Beckmann, V.; Petiteau, A.; Porter, E.; Auger, G.; Plagnol, E.; Binétruy, P.

    2013-01-01

    Data analysis for the eLISA/NGO mission is going to be performed in several steps. The telemetry is unpacked and checked at ESA's Science Operations Centre (SOC). The instrument teams are providing the necessary calibration files for the SOC to process the Level 1 data. The next steps, the source identification, parameter extraction and construction of a catalogue of sources is performed at the Data Processing Centre (DPC). This includes determining the physical and astrophysical parameters of the sources and their strain time series. At the end of the processing, the produced Level 2 and Level 3 data are then transferred back to the SOC, which provides the data archive and the interface for the scientific community. The DPC is organised by the member states of the consortium. In this paper we describe a possible outline of the data processing centre, including the tasks to be performed, and the organisational structure.

  5. Partnering to proceed: scaling up adolescent sexual reproductive health programmes in Tanzania. Operational research into the factors that influenced local government uptake and implementation

    PubMed Central

    2010-01-01

    Background Little is known about how to implement promising small-scale projects to reduce reproductive ill health and HIV vulnerability in young people on a large scale. This evaluation documents and explains how a partnership between a non-governmental organization (NGO) and local government authorities (LGAs) influenced the LGA-led scale-up of an innovative NGO programme in the wider context of a new national multisectoral AIDS strategy. Methods Four rounds of semi-structured interviews with 82 key informants, 8 group discussions with 49 district trainers and supervisors (DTS), 8 participatory workshops involving 52 DTS, and participant observations of 80% of LGA-led and 100% of NGO-led meetings were conducted, to ascertain views on project components, flow of communication and decision-making and amount of time DTS utilized undertaking project activities. Results Despite a successful ten-fold scale-up of intervention activities in three years, full integration into LGA systems did not materialize. LGAs contributed significant human resources but limited finances; the NGO retained control over finances and decision-making and LGAs largely continued to view activities as NGO driven. Embedding of technical assistants (TAs) in the LGAs contributed to capacity building among district implementers, but may paradoxically have hindered project integration, because TAs were unable to effectively transition from an implementing to a facilitating role. Operation of NGO administration and financial mechanisms also hindered integration into district systems. Conclusions Sustainable intervention scale-up requires operational, financial and psychological integration into local government mechanisms. This must include substantial time for district systems to try out implementation with only minimal NGO support and modest output targets. It must therefore go beyond the typical three- to four-year project cycles. Scale-up of NGO pilot projects of this nature also need NGOs to be

  6. Biobanks in Oral Health: Promises and Implications of Post-Neoliberal Science and Innovation.

    PubMed

    Birch, Kean; Dove, Edward S; Chiappetta, Margaret; Gürsoy, Ulvi K

    2016-01-01

    While biobanks are established explicitly as scientific infrastructures, they are de facto political-economic ones too. Many biobanks, particularly population-based biobanks, are framed under the rubric of the bio-economy as national political-economic assets that benefit domestic business, while national populations are framed as a natural resource whose genomics, proteomics, and related biological material and national health data can be exploited. We outline how many biobanks epitomize this 'neoliberal' form of science and innovation in which research is driven by market priorities (e.g., profit, shareholder value) underpinned by state or government policies. As both scientific and political-economic infrastructures, biobanks end up entangled in an array of problems associated with market-driven science and innovation. These include: profit trumping other considerations; rentiership trumping entrepreneurship; and applied research trumping basic research. As a result, there has been a push behind new forms of 'post-neoliberal' science and innovation strategies based on principles of openness and collaboration, especially in relation to biobanks. The proliferation of biobanks and the putative transition in both scientific practice and political economy from neoliberalism to post-neoliberalism demands fresh social scientific analyses, particularly as biobanks become further established in fields such as oral health and personalized dentistry. To the best of our knowledge, this is the first analysis of biobanks with a view to what we can anticipate from biobanks and distributed post-genomics global science in the current era of oral health biomarkers. PMID:26584410

  7. [The Millennia 2015 Women and eHealth Study 2010-2012: networks and innovative programs].

    PubMed

    Thouvenot, Véronique Inès; Holmes, Kristie

    2014-11-01

    The Women and eHealth Study 2010-2012 is conducted with the vision to constitute a Millennia 2015 powerful demonstration of women empowerment in the arena of eHealth and telemedicine through digital solidarity and gender equity. The overall objective is to stimulate more women to use advanced technologies combined with innovative integrated collaborative leadership programs. The article describes the study and the subsequent networks WeTelemed and WeObservatory conducted by women in developing countries with the ambition to reach the populations living in isolated communities. PMID:25407453

  8. Driving Innovation in Health Systems through an Apps-Based Information Economy

    PubMed Central

    Mandel, Joshua C.; Kohane, Isaac S.

    2015-01-01

    Healthcare data will soon be accessible using standard, open software interfaces. Here, we describe how these interfaces could lead to improved healthcare by facilitating the development of software applications (apps) that can be shared across physicians, health care organizations, translational researchers, and patients. We provide recommendations for next steps and resources for the myriad stakeholders. If challenges related to efficacy, accuracy, utility, safety, privacy, and security can be met, this emerging apps model for health information technology will open up the point of care for innovation and connect patients at home to their healthcare data. PMID:26339683

  9. [Communication management of collaborative networks of science, technology and innovation in health].

    PubMed

    Martins, Wagner de Jesus; Artmann, Elizabeth; Rivera, Francisco Javier Uribe

    2012-12-01

    The objective of the article was to propose a model of communication management of networks for the Health Innovation System in Brazil. The health production complex and its relationship with the nation's development are addressed and some suggestions for operationalization of the proposed model are also presented. The discussion is based on Habermas' theory and similar cases from other countries. Communication strategies and approaches to commitment dialogue for concerted actions and consensus-building based on critical reasoning may help strengthen democratic networks. PMID:23223788

  10. Innovative approaches to using new media and technology in health promotion for adolescents and young adults.

    PubMed

    Hyden, Christel; Cohall, Alwyn

    2011-12-01

    Over the past decade, new technology and media have changed the way we communicate, access information, and share content with one another. Most 12- to 17-year-olds now own cell phones, and most adolescents and young adults spend several hours per day on computers and cell phones. The American Academy of Pediatrics now encourages all pediatricians to increase their knowledge of new media and technology. This article details technology access among adolescents and young adults, highlights several current and potential innovative applications for new technology and social networking in health promotion, and discusses issues to consider as practitioners move toward integrating new media into clinical and health education settings. PMID:22423462

  11. The right to health and medicines: the case of recent multilateral negotiations on public health, innovation and intellectual property.

    PubMed

    Velasquez, German

    2014-08-01

    The negotiations of the intergovernmental group known as the 'IGWG', undertaken by the Member States of the WHO, were the result of a deadlock in the World Health Assembly held in 2006 where the Member States of the WHO were unable to reach an agreement on what to do with the 60 recommendations in the report on 'Public Health, Innovation and Intellectual Property Rights submitted to the Assembly in the same year by a group of experts designated by the Director General of the WHO. The result of these negotiations was the 'Global strategy and plan of action on public health, innovation and intellectual property' which was approved by the World Health Assembly in 2008. The intention of the Global Strategy and Plan of Action (GSPOA) which was produced by the IGWG was to substantially reform the pharmaceuticals' research and development system in view of the findings that this system, whose purpose is to produce medicines for diseases which affect the greater part of the world population which lives in developing countries, had failed. The intellectual property rights imposed by the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and the recent trade agreements could become one of the main obstacles to access to medicines. The GSPOA makes a critical analysis of this reality, and opens the door to searching for new solutions to this problem. PMID:24813066

  12. The Palau AHEC--academizing the public health work plan: capacity development and innovation in Micronesia.

    PubMed

    Dever, Greg; Finau, Sitaleki; Kuartei, Stevenson; Durand, A Mark; Rykken, David; Yano, Victor; Untalan, Pedro; Withy, Kelley; Tellei, Patrick; Baravilala, Wame; Pierantozzi, Sandra; Tellei, Jullie

    2005-03-01

    The Palau Area Health Education Center (AHEC)--a program of the University of Hawaii's John A. Burns School of Medicine (JABSOM) and based at Palau Community College--was established in 2001 in response to the recommendations of the 1998 Institute of Medicine (IOM) report--Pacific Partnerships for Health--Charting a New Course for the 21st Century1. One of IOM's core recommendations was to promote the training of the primary health care workforce among the U.S.-Associated Pacific Islands. Since its inception in 2001, the Palau AHEC has coordinated overall 37 postgraduate and undergraduate courses in General Practice and Public Health taught by the University of Auckland Faculty of Medicine and Health Sciences and the Fiji School of Medicine's School of Public Health and Primary Care (SPH&PC) in Palau, Yap State, and the Republic of the Marshall Islands. Currently 139 physicians, nurses, health administrators, and environmental health workers are registered as active students in Palau (58), Yap State (22), and the RMI (59). Notably, the Palau AHEC and the SPH&PC have worked in an innovative partnership with the Palau Ministry of Health to operationalize the MOH's public health work plan to implement a comprehensive community health survey of all 4,376 households in Palau, interviewing 79% of the total population, to determine Palau's health indicators. To accomplish this, the SPH&PC developed and taught a curriculum for Palau physicians and public health nurses on how to design the survey, gather, and analyze data in order to develop and implement appropriately responsive intervention and treatment programs to address Palau's old and newer morbidities. In early FY2005, two other Micronesian AHECs--the Yap State and Commonwealth of the Northern Mariana Islands AHECs--were funded through JABSOM administered grants which will also address the primary care training needs of Micronesia's remote and isolated health workforce. PMID:18181474

  13. The democratization of health in Mexico: financial innovations for universal coverage.

    PubMed

    Frenk, Julio; Gómez-Dantés, Octavio; Knaul, Felicia Marie

    2009-07-01

    In 2003, the Mexican Congress approved a reform establishing the Sistema de Protección Social en Salud [System of Social Protection in Health], whereby public funding for health is being increased by one percent of the 2003 gross domestic product over seven years to guarantee universal health insurance. Poor families that had been excluded from traditional social security can now enrol in a new public insurance scheme known as Seguro Popular [People's Insurance], which assures legislated access to a comprehensive set of health-care entitlements. This paper describes the financial innovations behind the expansion of health-care coverage in Mexico to everyone and their effects. Evidence shows improvements in mobilization of additional public resources; availability of health infrastructure and drugs; service utilization; effective coverage; and financial protection. Future challenges are discussed, among them the need for additional public funding to extend access to costly interventions for non-communicable diseases not yet covered by the new insurance scheme, and to improve the technical quality of care and the responsiveness of the health system. Eventually, the progress achieved so far will have to be reflected in health outcomes, which will continue to be evaluated so that Mexico can meet the ultimate criterion of reform success: better health through equity, quality and fair financing. PMID:19649369

  14. The democratization of health in Mexico: financial innovations for universal coverage

    PubMed Central

    Frenk, Julio; Knaul, Felicia Marie

    2009-01-01

    Abstract In 2003, the Mexican Congress approved a reform establishing the Sistema de Protección Social en Salud [System of Social Protection in Health], whereby public funding for health is being increased by one percent of the 2003 gross domestic product over seven years to guarantee universal health insurance. Poor families that had been excluded from traditional social security can now enrol in a new public insurance scheme known as Seguro Popular [People’s Insurance], which assures legislated access to a comprehensive set of health-care entitlements. This paper describes the financial innovations behind the expansion of health-care coverage in Mexico to everyone and their effects. Evidence shows improvements in mobilization of additional public resources; availability of health infrastructure and drugs; service utilization; effective coverage; and financial protection. Future challenges are discussed, among them the need for additional public funding to extend access to costly interventions for non-communicable diseases not yet covered by the new insurance scheme, and to improve the technical quality of care and the responsiveness of the health system. Eventually, the progress achieved so far will have to be reflected in health outcomes, which will continue to be evaluated so that Mexico can meet the ultimate criterion of reform success: better health through equity, quality and fair financing. PMID:19649369

  15. Duty and destiny: psychometric properties and correlates of HIV-related stigma among youth NGO workers in Delhi, India.

    PubMed

    Nambiar, Devaki; Rimal, Rajiv N

    2012-01-01

    Nongovernmental organizations (NGOs) are increasingly providing critical health-related services to hard-to-reach populations. In India, stigma has been cited as a barrier to NGO participation in HIV-prevention activities with high-risk populations. Our study undertook to characterize and contextualize HIV-related stigma within HIV NGOs in Delhi, India. We investigated psychometric characteristics and correlates of HIV-related stigma in a sample of youth NGO practitioners (N=122) working on peer HIV prevention. Factor analyses revealed a "cultural inflection" of stigma in this population: assignment of blame on people living with HIV (PLWH) factored along with individual behaviors and care-taking (Dharma, or Duty), distinct from the perception of HIV as God's punishment, which was connected to ostracism from society (Karma, or Destiny). Exposure to HIV-related messages in newspapers was associated with 55.7% lower levels of Dharma-related stigma (p=0.07) and 58% lower levels of Karma-related stigma scores (p=0.01), respectively, while recall of HIV-related messages on the radio was associated with 57.3% lower Dharma-related (p=0.03) and 34.1% lower Karma-related stigma scores (p=0.06), respectively. The strongest correlate of lower HIV-related stigma was social proximity to PLWH (~76% reduction on both stigma factors, p<0.03). Future research on HIV-related stigma should consider the unique cultural properties and correlates of stigma among young NGO practitioners. PMID:22292453

  16. Using technological innovation as a tool to monitor nursing workers' health.

    PubMed

    Baptista, Patrícia Campos Pavan; Felli, Vanda Elisa Andres; Mininel, Vivian Aline; Karino, Márcia Eiko; Silva, Silmar Maria; Tito, Renata Santos; Peduzzi, Marina; Sarquis, Leila Maria Mansano

    2011-12-01

    The objective of the present study is to describe the development of the "Monitoring System for Nursing Workers' Health" software, a technological innovation designed to identify the health hazards caused to nursing workers' and their determinants, i.e., strain and/or strength potentials, monitoring their health using indicators. The software development comprises the phases of defining the objective, chosing the thoeoretical framework, organizing the content, and developing the system's architecture. It is important to socialize this process with researchers, managers, and workers interested in this subject, because monitoring the health of nursing workers is indispensible when planning strategies to minimize the occurrence of accidents and occupational illnesses, promoting better working conditions and improving their quality of life. PMID:22282071

  17. Beyond idealism and realism: Canadian NGO/government relations during the negotiation of the FCTC.

    PubMed

    Lencucha, Raphael; Labonté, Ronald; Rouse, Michael J

    2010-04-01

    The Framework Convention on Tobacco Control (FCTC) marks a unique point in the history of global health governance. This convention produced the first legally binding treaty under the auspices of the World Health Organization. Another first was the extent to which non-governmental organizations (NGOs) participated in the negotiation process. This article explores the relationship between one group of NGOs and their respective government during the negotiation of the FCTC. Documentary analyses and 18 individual in-depth interviews were conducted with both government and NGO representatives. In contrast to the polar perspectives of idealism (NGOs as unique and autonomous) and realism (NGOs as funded arms of the government), our findings suggest that neither opposition nor conformity on the part of the NGOs characterize the relationship between the NGOs and government. While specific to the case under study (the FCTC), our findings nonetheless indicate the need for a nuanced view of the relationship between governments and NGOs, at least during the process of multilateral health policy negotiations. PMID:20200527

  18. Effects of market, e-marketing, and technology orientations on innovativeness and performance in Turkish health organizations.

    PubMed

    Mutlu, Hanifi Murat; Sürer, Atilla

    2016-01-01

    This article investigates the effects of strategic orientation on innovativeness and performance in health organizations in Turkey. We test hypotheses that market, e-marketing, and technology orientations positively affect innovativeness and performance. Market and technology orientations are found not have a significant effect on performance, but e-marketing orientation and innovativeness have a significant and positive effect. We also investigate indirect effects on innovativeness and performance. The analyses of direct and indirect effects are an important contribution to understanding relationships among research variables. PMID:27191549

  19. Effects of Market, E-Marketing, and Technology Orientations on Innovativeness and Performance in Turkish Health Organizations.

    PubMed

    Mutlu, Hanifi Murat; Sürer, Atilla

    2015-01-01

    This article investigates the effects of strategic orientation on innovativeness and performance in health organizations in Turkey. We hypothesize that market, e-marketing, and technology orientations positively affect innovativeness and performance. Market and technology orientations are found not have a significant effect on performance, but e-marketing orientation and innovativeness have a significant and positive effect. We also investigate indirect effects on innovativeness and performance. The analyses of direct and indirect effects are an important contribution to understanding relationships among research variables. PMID:26674257

  20. Risk factors for neonatal mortality in rural areas of Bangladesh served by a large NGO programme.

    PubMed

    Mercer, Alex; Haseen, Fariha; Huq, Nafisa Lira; Uddin, Nowsher; Hossain Khan, Mobarak; Larson, Charles P

    2006-11-01

    Neonatal deaths account for about half of all deaths among children under 5 years of age in Bangladesh, making prevention a major priority. This paper reports on a study of neonatal deaths in 12 areas of Bangladesh served by a large NGO programme, which had high coverage of reproductive health outreach services and relatively low neonatal mortality in recent years. The study aimed to identify the main factors associated with neonatal mortality in these areas, with a view to developing appropriate strategies for prevention. A case-control design was adopted for collection of data from mothers whose children, born alive in 2003, died within 28 days postpartum (142 cases), or did not (617 controls). Crude and adjusted odds ratios (AOR) were calculated as estimates of relative risk for neonatal death, using 'neighbourhood' controls (241) and 'non-neighbourhood' controls (376). A similar proportion of case and control mothers had received NGO health education and maternal health services. The main risk factors for neonatal death among 122 singleton babies, based on the two sets of controls, were: complications during delivery [AOR, 2.6 (95% CI: 1.5-4.5) and 3.1 (95% CI: 1.8-5.3)], prematurity [AOR, 7.2 (95% CI: 3.6-14.4) and 8.3 (95% CI: 4.2-16.5)], care for a sick neonate from an unlicensed 'traditional healer' [AOR, 2.9 (95% CI 0.9-9.5 and 5.9 (95% CI: 1.3-26.3)], or care not sought at all [AOR, 23.3 (95% CI: 3.9-137.4)]. The strongest predictor of neonatal death was having a previous sibling not vaccinated against measles [AOR, 5.9 (95% CI: 2.2-15.5) and 12.0 (95% CI: 4.5-31.7)]. The findings of this study indicate the need for identification of babies at high risk and early postpartum interventions (40.2% of the deaths occurred within 24 hours of delivery). Relevant strategies include special counselling during pregnancy for mothers with risk characteristics, training birth attendants in resuscitation, immediate postnatal check-up in the home for high-risk babies

  1. A key to slower health spending growth worldwide will be unlocking innovation to reduce the labor-intensity of care.

    PubMed

    Macdonnell, Michael; Darzi, Ara

    2013-04-01

    Many factors combine to drive the growth in health spending worldwide, but the introduction of new technologies, drugs, and therapies is probably the most important. However, in contrast to other industries, innovations in health care have not tended to reduce the need for labor. In fact, labor still accounts for the largest proportion of expenditures in many health systems. But labor-saving technologies, workforce innovations, and patient self-care approaches are now emerging and altering health care's labor structure. For example, in Mexico more than one million households pay $5 per month to access a health advice hotline before setting foot in a physician's office. In India assembly line-style eye surgery has dramatically reduced cost without sacrificing quality. Policy makers should focus on such labor-saving innovations; reform reimbursement systems to encourage them; tackle professionals' resistance; and remove regulatory barriers. Bold experiments to redesign health services around patient self-care approaches are also warranted. PMID:23569044

  2. "No God and no Norway": collective resource loss among members of Tamil NGO's in Norway during and after the last phase of the civil war in Sri Lanka

    PubMed Central

    2011-01-01

    Background Studies on the mental health of refugees have tended to focus upon the impact of traumatic experiences in the country of origin, and acculturation processes in exile. The effects of crises in the country of origin on refugees living in exile have been little studied. This article examines how the final stages of the civil war in Sri Lanka in 2009 influenced members of pro-LTTE Tamil NGO's in Norway. Method Ethnographic fieldwork methods were employed within Tamil NGO's in the two largest cities in Norway between November 2008 and June 2011. Results The findings suggest that collective resources became severely drained as a result of the crisis, severely disrupting the fabric of social life. Public support from the majority community remained scarce throughout the crisis. Conclusions The study suggests that there is a need for public support to exile groups indirectly affected by man-made crises in their country of origin. PMID:21849029

  3. Innovation, Innovation, Innovation

    ERIC Educational Resources Information Center

    Schuller, Tom

    2007-01-01

    Innovation, Universities and Skills. The new title of the department offers much food for thought. The title is indeed an intriguing and important one. Bringing the idea of innovation right to the fore is, to use an overworked term, challenging. Pinning down what innovation means is not at all easy. There are three different lines of argument. The…

  4. [The permanence of access to health care: a tradition of hospitality and innovative organizational model].

    PubMed

    Georges-Tarragano, C

    2015-01-01

    The PASS ("Permanence d'Accès aux Soins de Santé") are hospital-based units providing primary care services to patients who lack health care coverage. Using a "whole person" approach and providing a combination of health and social care, the PASS offer an appropriately adapted response to complex health problems within a context of marked social vulnerability and contribute to reducing health inequalities. The PASS are an example of an interdisciplinary approach to health care which contrasts with the segmentary approach typical of conventional hospital departments. Operating at the interface between primary and secondary care, the PASS have the potential to become key players in developing models of patient pathways. Their presence reduces inappropriate emergency attendances and hospitalisation by offering medical care in a timely fashion, in an outpatient-type setting. The PASS can provide a resource for research into optimum models of health care, where the social context of health needs are fully recognized and inform medical treatment appropriately. According to their potential development, PASS are living labs of an innovative organizational model of care. PMID:25455953

  5. Little shop of errors: an innovative simulation patient safety workshop for community health care professionals.

    PubMed

    Tupper, Judith B; Pearson, Karen B; Meinersmann, Krista M; Dvorak, Jean

    2013-06-01

    Continuing education for health care workers is an important mechanism for maintaining patient safety and high-quality health care. Interdisciplinary continuing education that incorporates simulation can be an effective teaching strategy for improving patient safety. Health care professionals who attended a recent Patient Safety Academy had the opportunity to experience firsthand a simulated situation that included many potential patient safety errors. This high-fidelity activity combined the best practice components of a simulation and a collaborative experience that promoted interdisciplinary communication and learning. Participants were challenged to see, learn, and experience "ah-ha" moments of insight as a basis for error reduction and quality improvement. This innovative interdisciplinary educational training method can be offered in place of traditional lecture or online instruction in any facility, hospital, nursing home, or community care setting. PMID:23654294

  6. E-health in low- and middle-income countries: findings from the Center for Health Market Innovations

    PubMed Central

    Synowiec, Christina; Lagomarsino, Gina; Schweitzer, Julian

    2012-01-01

    Abstract Objective To describe how information communication technology (ICT) is being used by programmes that seek to improve private sector health financing and delivery in low- and middle-income countries, including the main uses of the technology and the types of technologies being used. Methods In-country partners in 16 countries directly searched systematically for innovative health programmes and compiled profiles in the Center for Health Market Innovations’ database. These data were supplemented through literature reviews and with self-reported data supplied by the programmes themselves. Findings In many low- and middle-income countries, ICT is being increasingly employed for different purposes in various health-related areas. Of ICT-enabled health programmes, 42% use it to extend geographic access to health care, 38% to improve data management and 31% to facilitate communication between patients and physicians outside the physician’s office. Other purposes include improving diagnosis and treatment (17%), mitigating fraud and abuse (8%) and streamlining financial transactions (4%). The most common devices used in technology-enabled programmes are phones and computers; 71% and 39% of programmes use them, respectively, and the most common applications are voice (34%), software (32%) and text messages (31%). Donors are the primary funders of 47% of ICT-based health programmes. Conclusion Various types of ICT are being employed by private organizations to address key health system challenges. For successful implementation, however, more sustainable sources of funding, greater support for the adoption of new technologies and better ways of evaluating impact are required. PMID:22589566

  7. Gender relations, "Hindu" nationalism, and NGO responses in India.

    PubMed

    Burlet, S

    1999-03-01

    This article explores the strategies employed by nongovernmental organizations (NGOs) to challenge the right wing nationalism that dominates Indian politics. The opposition of the NGOs to the current political climate has evolved a variety of strategies, depending on their links with northern NGOs or international organizations such as the UN, and their reliance on foreign funding. The organizations that have links with international NGO community primarily express their opposition through consciousness raising and networking strategies. Because NGOs activities at the national level have the potential to attract the attention and anger of nationalist actors, many choose to operate at local level for fear of harassment. Some get involved in initiatives such as direct-action campaigns which spring up when violence breaks out in a locality, or immediately afterwards. Another strategy being set up by NGOs is cooperative and cross-community initiatives to encourage as well as build on historic relationships of socioeconomic and political interdependence between Hindus and Muslims. These strategies seek to strengthen people's awareness of the distinction between personal spiritual beliefs, the true character of India's composite culture, and of the religious rhetoric being disseminated by nationalist for the purpose of securing political power. Although much effort has been exerted by these organizations, these strategies have limitations, which are discussed in this paper. PMID:12295340

  8. The impact of health care reform on innovation and new technology.

    PubMed

    Ganz, Robert A

    2012-01-01

    Health care reform has created special challenges and hurdles to the introduction of new technology and innovative medical devices in gastroenterology and other medical fields. The implication of new regulations will be enormous as we begin to see venture-capital funding flee our specialty for more lucrative and "sure bets." This article, written by an experienced entrepreneur and practicing gastroenterologist, outlines some of the implications of this emerging challenge. Few other sources of information are available that truly articulate the insider view of coming changes. PMID:22099717

  9. The clinical translation gap in child health exercise research: a call for disruptive innovation.

    PubMed

    Ashish, Naveen; Bamman, Marcas M; Cerny, Frank J; Cooper, Dan M; D'Hemecourt, Pierre; Eisenmann, Joey C; Ericson, Dawn; Fahey, John; Falk, Bareket; Gabriel, Davera; Kahn, Michael G; Kemper, Han C G; Leu, Szu-Yun; Liem, Robert I; McMurray, Robert; Nixon, Patricia A; Olin, J Tod; Pianosi, Paolo T; Purucker, Mary; Radom-Aizik, Shlomit; Taylor, Amy

    2015-02-01

    In children, levels of play, physical activity, and fitness are key indicators of health and disease and closely tied to optimal growth and development. Cardiopulmonary exercise testing (CPET) provides clinicians with biomarkers of disease and effectiveness of therapy, and researchers with novel insights into fundamental biological mechanisms reflecting an integrated physiological response that is hidden when the child is at rest. Yet the growth of clinical trials utilizing CPET in pediatrics remains stunted despite the current emphasis on preventative medicine and the growing recognition that therapies used in children should be clinically tested in children. There exists a translational gap between basic discovery and clinical application in this essential component of child health. To address this gap, the NIH provided funding through the Clinical and Translational Science Award (CTSA) program to convene a panel of experts. This report summarizes our major findings and outlines next steps necessary to enhance child health exercise medicine translational research. We present specific plans to bolster data interoperability, improve child health CPET reference values, stimulate formal training in exercise medicine for child health care professionals, and outline innovative approaches through which exercise medicine can become more accessible and advance therapeutics across the broad spectrum of child health. PMID:25109386

  10. Promoting the health of marginalized populations in Ecuador through international collaboration and educational innovations

    PubMed Central

    Spiegel, Jerry; Breilh, Jaime; Cabarcas, Fabio; Huish, Robert; Yassi, Annalee

    2009-01-01

    Abstract This paper examines two innovative educational initiatives for the Ecuadorian public health workforce: a Canadian-funded Masters programme in ecosystem approaches to health that focuses on building capacity to manage environmental health risks sustainably; and the training of Ecuadorians at the Latin American School of Medicine in Cuba (known as Escuela Latinoamericana de Medicina in Spanish). We apply a typology for analysing how training programmes address the needs of marginalized populations and build capacity for addressing health determinants. We highlight some ways we can learn from such training programmes with particular regard to lessons, barriers and opportunities for their sustainability at the local, national and international levels and for pursuing similar initiatives in other countries and contexts. We conclude that educational efforts focused on the challenges of marginalization and the determinants of health require explicit attention not only to the knowledge, attitudes and skills of graduates but also on effectively engaging the health settings and systems that will reinforce the establishment and retention of capacity in low- and middle-income settings where this is most needed. PMID:19551240

  11. THE CLINICAL TRANSLATION GAP IN CHILD HEALTH EXERCISE RESEARCH: A CALL FOR DISRUPTIVE INNOVATION

    PubMed Central

    2014-01-01

    In children, levels of play, physical activity, and fitness are key indicators of health and disease and closely tied to optimal growth and development. Cardiopulmonary exercise testing (CPET) provides clinicians with biomarkers of disease and effectiveness of therapy, and researchers with novel insights into fundamental biological mechanisms reflecting an integrated physiological response that is hidden when the child is at rest. Yet the growth of clinical trials utilizing CPET in pediatrics remains stunted despite the current emphasis on preventative medicine and the growing recognition that therapies used in children should be clinically tested in children. There exists a translational gap between basic discovery and clinical application in this essential component of child health. To address this gap, the NIH provided funding through the Clinical and Translational Science Award (CTSA) program to convene a panel of experts. This report summarizes our major findings and outlines next steps necessary to enhance child health exercise medicine translational research. We present specific plans to bolster data interoperability, improve child health CPET reference values, stimulate formal training in exercise medicine for child health care professionals, and outline innovative approaches through which exercise medicine can become more accessible and advance therapeutics across the broad spectrum of child health. PMID:25109386

  12. [Development of Human Health Discoveries. 10 years results of Young Innovative Company incubation].

    PubMed

    Marsac, Jean

    2014-01-01

    Medicine is evolving every day in its operating procedures and the services offered to patients, emphasizing personalized medicine, safety and medical benefits. The individual patient is more than ever the hub of healthcare organization. Medical innovation is thus a public health priority. However it requires an accurate assessment of medical utility and risk-benefit ratios, and in-depth analysis of economic and organizational impacts. Ten years of experience in the Paris Biotech Santé company incubator has identified key actions for effective support of research projects and the success of innovative companies. Strong expertise is needed to prepare development plans, ensure compliance with regulatory requirements and obtain research funding. During its first decade, this incubator has created 87 innovative companies employing 1500 people, raised more than 90 million euros of funding, and reached a cumulative company value of 1200 million euros. Key factors of success have been identified, but an analysis of the causes of failure shows that operational adjustments are mandatory, particularly a strong commitment from medical experts, in order to promote access to new and useful products for patients while at the same time assessing their social impact. PMID:26753415

  13. Innovations in the Delivery of Health Care Services to Rural Communities: Telemedicine and Limited-Service Hospitals.

    ERIC Educational Resources Information Center

    Capalbo, Susan M.; Heggem, Christine N.

    1999-01-01

    Presents an overview of the use of telemedicine technologies and critical access hospitals in rural areas. Discusses changes in rural population, hospital closures, and federal health care policy. Provides anecdotal evidence on the impact of these innovations in rural Montana, which suggests that different health care solutions are needed for…

  14. The Psychology School Mental Health Initiative: An Innovative Approach to the Delivery of School-Based Intervention Services

    ERIC Educational Resources Information Center

    Millar, Golden M.; Lean, Debra; Sweet, Susan D.; Moraes, Sabrina C.; Nelson, Victoria

    2013-01-01

    Evidence suggests that schools have, by default, become the primary mental health system for students in Canada. The goal of the present study was to design, implement, and evaluate the Psychology School Mental Health Initiative (PSMHI). The PSMHI is an innovative attempt to increase the capacity of school-based psychology staff to deliver…

  15. Health Promotion Efforts as Predictors of Physical Activity in Schools: An Application of the Diffusion of Innovations Model

    ERIC Educational Resources Information Center

    Glowacki, Elizabeth M.; Centeio, Erin E.; Van Dongen, Daniel J.; Carson, Russell L.; Castelli, Darla M.

    2016-01-01

    Background: Implementing a comprehensive school physical activity program (CSPAP) effectively addresses public health issues by providing opportunities for physical activity (PA). Grounded in the Diffusion of Innovations model, the purpose of this study was to identify how health promotion efforts facilitate opportunities for PA. Methods: Physical…

  16. Innovators and early adopters of population health in healthcare: real and present opportunities for healthcare-public health collaboration.

    PubMed

    Huynh, Tai M

    2013-01-01

    The population health approach - which has long been a cornerstone ideology for those in public health - is increasingly embraced by various actors in the healthcare sector, including but not limited to those in primary healthcare. There is much to be gained from public health's involvement in these early efforts, which could enable the pursuit of approaches that integrate both individual- and population-level interventions. These collaborative efforts could serve as the initial building blocks for transformative change, provided that others follow suit. Lessons from the study of the diffusion of innovation teach us that new ideas can spread or wither in unpredictable ways. However, the odds of success would be improved if we could (1) make population health concepts less complex and more actionable, (2) socialize early adopter activities and make them more observable to others so that they could help model the way, (3) invest in evaluation so that the benefits of the approach could be more clearly demonstrated and (4) address social and cultural barriers to adoption through opinion leaders within respective professional communities. PMID:24524572

  17. How to calculate the annual costs of NGO-implemented programmes to support orphans and vulnerable children: a six-step approach

    PubMed Central

    2011-01-01

    Background Information on the costs of implementing programmes designed to provide support of orphans and vulnerable children (OVC) in sub-Saharan Africa and elsewhere is increasingly being requested by donors for programme evaluation purposes. To date, little information exists to document the costs and structure of costs of OVC programmes as actually implemented "on the ground" by local non-governmental organizations (NGOs). This analysis provides a practical, six-step approach that NGOs can incorporate into routine operations to evaluate their costs of implementing their OVC programmes annually. This approach is applied to the Community-Based Care for Orphans and Vulnerable Children (CBCO) Program implemented by BIDII (a Kenyan NGO) in Eastern Province of Kenya. Methods and results The costing methodology involves the following six steps: accessing and organizing the NGO's annual financial report into logical sub-categories; reorganizing the sub-categories into input cost categories to create a financial cost profile; estimating the annual equivalent payment for programme equipment; documenting donations to the NGO for programme implementation; including a portion of NGO organizational costs not attributed to specific programmes; and including the results of Steps 3-5 into an expanded cost profile. Detailed results are provided for the CBCO programme. Conclusions This paper shows through a concrete example how NGOs implementing OVC programmes (and other public health programmes) can organize themselves for data collection and documentation prospectively during the implementation of their OVC programmes so that costing analyses become routine practice to inform programme implementation rather than a painful and flawed retrospective activity. Such information is required if the costs and outcomes achieved by OVC programmes will ever be clearly documented and compared across OVC programmes and other types of programmes (prevention, treatment, etc.). PMID:22182588

  18. Eliminating health disparities: innovative methods to improve cervical cancer screening in a medically underserved population.

    PubMed

    Bharel, Monica; Santiago, Emely R; Forgione, Sanju Nembang; León, Casey K; Weinreb, Linda

    2015-07-01

    Homeless women have disproportionately lower rates of cervical cancer screening and higher rates of cervical cancer. In 2008, only 19% of the homeless women seen by Boston Health Care for the Homeless Program (BHCHP) were screened for cervical cancer. To improve screening, BHCHP implemented a 6-part intervention that incorporates point-of-care service, multidisciplinary screening, improved health maintenance forms, population management, process improvement, and increased provider and patient education. This resulted in a significant increase in cervical cancer screening, from 19% in 2008 to 50% in 2013. When compared with national and local cervical cancer screening trends, BHCHP surpassed improvement rates seen in other vulnerable populations. Simple and innovative interventions proved to be the most effective and practical methods of improving screening. PMID:25905832

  19. Eliminating Health Disparities: Innovative Methods to Improve Cervical Cancer Screening in a Medically Underserved Population

    PubMed Central

    Bharel, Monica; Santiago, Emely R.; Forgione, Sanju Nembang; Weinreb, Linda

    2015-01-01

    Homeless women have disproportionately lower rates of cervical cancer screening and higher rates of cervical cancer. In 2008, only 19% of the homeless women seen by Boston Health Care for the Homeless Program (BHCHP) were screened for cervical cancer. To improve screening, BHCHP implemented a 6-part intervention that incorporates point-of-care service, multidisciplinary screening, improved health maintenance forms, population management, process improvement, and increased provider and patient education. This resulted in a significant increase in cervical cancer screening, from 19% in 2008 to 50% in 2013. When compared with national and local cervical cancer screening trends, BHCHP surpassed improvement rates seen in other vulnerable populations. Simple and innovative interventions proved to be the most effective and practical methods of improving screening. PMID:25905832

  20. Enhancing learning, innovation, adaptation, and sustainability in health care organizations: the ELIAS performance management framework.

    PubMed

    Persaud, D David

    2014-01-01

    The development of sustainable health care organizations that provide high-quality accessible care is a topic of intense interest. This article provides a practical performance management framework that can be utilized to develop sustainable health care organizations. It is a cyclical 5-step process that is premised on accountability, performance management, and learning practices that are the foundation for a continuous process of measurement, disconfirmation, contextualization, implementation, and routinization This results in the enhancement of learning, innovation, adaptation, and sustainability (ELIAS). Important considerations such as recognizing that health care organizations are complex adaptive systems and the presence of a dynamic learning culture are necessary contextual factors that maximize the effectiveness of the proposed framework. Importantly, the ELIAS framework utilizes data that are already being collected by health care organizations for accountability, improvement, evaluation, and strategic purposes. Therefore, the benefit of the framework, when used as outlined, would be to enhance the chances of health care organizations achieving the goals of ongoing adaptation and sustainability, by design, rather than by chance. PMID:25068873

  1. Harnessing Innovative Technologies to Advance Children’s Mental Health: Behavioral Parent Training As an Example

    PubMed Central

    Jones, Deborah J.; Forehand, Rex; Cuellar, Jessica; Kincaid, Carlye; Parent, Justin; Fenton, Nicole; Goodrum, Nada

    2012-01-01

    Disruptive behaviors of childhood are among the most common reasons for referral of children to mental health professionals. Behavioral parent training (BPT) is the most efficacious intervention for these problem behaviors, yet BPT is substantially underutilized beyond university research and clinic settings. With the aim of addressing this research-to-practice gap, this article highlights the considerable, but largely unrealized, potential for technology to overcome the two most pressing challenges hindering the diffusion of BPT: (1). The dearth of BPT training and supervision opportunities for therapists who work with families of children with disruptive behaviors and; (2). The failure to engage and retain families in BPT services when services are available. To this end, this review presents a theoretical framework to guide technological innovations in BPT and highlights examples of how technology is currently being harnessed to overcome these challenges. This review also discusses recommendations for using technology as a delivery vehicle to further advance the field of BPT and the potential implications of technological innovations in BPT for other areas of children’s mental health are discussed. PMID:23313761

  2. The School Health Innovative Programs: Integrating School Health and Managed Care in San Diego.

    ERIC Educational Resources Information Center

    Taras, Howard; Nader, Philip; Swiger, Holly; Fontanesi, John

    1998-01-01

    Describes the first two years of a San Diego-based collaborative involving managed care organizations (MCO's), school districts, and other health care agencies. By establishing trust, developing overriding principles, and creating an interagency communication infrastructure, this collaborative has encouraged shared management of many student…

  3. A Proactive Innovation for Health Care Transformation: Health and Wellness Nurse Coaching.

    PubMed

    Erickson, Helen Lorraine; Erickson, Margaret Elizabeth; Southard, Mary Elaine; Brekke, Mary E; Sandor, M Kay; Natschke, Mary

    2016-03-01

    A cohort of holistic nurses, recognizing opportunities inherent in health care transformation, organized and worked together from 2009 to 2012. The goal was to hold space for holistic nursing by developing a health and wellness coaching role and certification program for holistic nurses. The intent was to ensure that holistic nurses could work to the fullest of their ability within the evolving health care system, and others could discover the merit of holistic nursing as they explored the possibilities of nurse coaching. Challenges emerged that required the cohort plan strategies that would hold the space for nursing while also moving toward the intended goal. As they worked, this cohort demonstrated leadership skills, knowledge, values, and attitudes of holistic nursing that provide an example for others who follow in the wake of health care transformation. The American Holistic Credentialing Corporation's perspective of the events that unfolded and of the related decisions made by the coalition provides a record of the evolution of holistic nursing. PMID:25911026

  4. Innovative Training for Occupational Health and Infection Control Workplace Assessment in Health Care

    ERIC Educational Resources Information Center

    O'Hara, Lyndsay; Bryce, Elizabeth Ann; Scharf, Sydney; Yassi, Annalee

    2012-01-01

    A user-friendly, high quality workplace assessment field guide and an accompanying worksheet are invaluable tools for recognizing hazards in the hospital environment. These tools ensure that both front line workers as well as health and safety and infection control professionals can systematically evaluate hazards and formulate recommendations.…

  5. Sharing risk between payer and provider by leasing health technologies: an affordable and effective reimbursement strategy for innovative technologies?

    PubMed

    Edlin, Richard; Hall, Peter; Wallner, Klemens; McCabe, Christopher

    2014-06-01

    The challenge of implementing high-cost innovative technologies in health care systems operating under significant budgetary pressure has led to a radical shift in the health technology reimbursement landscape. New reimbursement strategies attempt to reduce the risk of making the wrong decision, that is, paying for a technology that is not good value for the health care system, while promoting the adoption of innovative technologies into clinical practice. The remaining risk, however, is not shared between the manufacturer and the health care payer at the individual purchase level; it continues to be passed from the manufacturer to the payer at the time of purchase. In this article, we propose a health technology payment strategy-technology leasing reimbursement scheme-that allows the sharing of risk between the manufacturer and the payer: the replacing of up-front payments with a stream of payments spread over the expected duration of benefit from the technology, subject to the technology delivering the claimed health benefit. Using trastuzumab (Herceptin) in early breast cancer as an exemplar technology, we show how a technology leasing reimbursement scheme not only reduces the total budgetary impact of the innovative technology but also truly shares risk between the manufacturer and the health care system, while reducing the value of further research and thus promoting the rapid adoption of innovative technologies into clinical practice. PMID:24969005

  6. Structured pluralism: towards an innovative model for health system reform in Latin America.

    PubMed

    Londoño, J L; Frenk, J

    1997-07-01

    Health systems throughout the world are searching for better ways of responding to present and future challenges. Latin America is no exception in this innovative process. Health systems in this region have to face a dual challenge: on the one hand, they must deal with a backlog of accumulated problems characteristic of underdeveloped societies; on the other hand, they are already facing a set of emerging problems characteristic of industrialized countries. This paper aims at analyzing the performance of current health systems in Latin America, while proposing an innovative model to promote equity, quality, and efficiency. We first develop a conceptualization of health systems in terms of the relationships between populations and institutions. In order to meet population needs, health systems must perform four basic functions. Two of these-financing and delivery-are conventional functions performed by every health system. The other two have often been carried out only in an implicit way or not at all. These neglected functions are 'modulation' (a broader concept than regulation, which involves setting transparent and fair rules of the game) and 'articulation' (which makes it possible to organize and manage a series of transactions among members of the population, financing agencies, and providers so that resources can flow into the production and consumption of services). Based on this conceptual framework, the paper offers a classification of current health system models in Latin America. The most frequent one, the segmented model, is criticized because it segregates the different social groups into three segments: the ministry of health, the social security institute(s), and the private sector. Each of these is vertically integrated, so that it performs all functions but only for a particular group. As an alternative, we propose a model of 'structured pluralism', which would turn the current system around by organizing it according to functions rather than social

  7. How big can small become? Building NGO networks through strategic planning.

    PubMed

    Hartigan, P

    1995-07-01

    Marking a dramatic change from the recent past, governments in Latin America and elsewhere are increasingly calling upon nongovernmental organizations (NGOs) to assist in efforts to prevent and control HIV/AIDS. This change has been fueled by shrinking public health sector budgets and has been spurred on by the use of NGOs to cope with the effects of structural adjustment programs. While the grassroots aspect of NGOs makes them sensitive service providers and clear-sighted policy definers, such a reliance on NGOs may exhaust their limited resources and sidetrack their larger goals. In Latin America and the Caribbean, NGOs have proliferated since their emergence in the past decade. This proliferation means that they compete for donor funds and, failing to cooperate with each other, are capable only of small-scale efforts with limited impact. A number of NGOs, however, have begun to collaborate to broaden the scope of their work, strengthen their capacity, and increase their negotiating ability. In recognition of the importance of NGOs, the Pan American Health Organization (PAHO) began systematically including NGOS in health strategy development. After identifying the NGOs which are working actively and effectively, PAHO uses strategic planning measures to help NGOs determine their strengths and weaknesses and collaborate with other NGOs. The strategic planning seminars which PAHO has conducted throughout the region have been met with high praise and have resulted in increased collaboration among NGOs. While the value of strategic planning on the individual NGO level remains unknown, strategic planning undertaken as a group of institutions which results in partnerships has allowed the NGOs to influence rather than be influenced and to act instead of reacting. These partnerships will prove to be a matter of life and death as they enhance the ability of NGOs to fight HIV/AIDS. PMID:12291830

  8. The community leaders institute: an innovative program to train community leaders in health research.

    PubMed

    Crosby, Lori E; Parr, William; Smith, Teresa; Mitchell, Monica J

    2013-03-01

    An emerging best practice of addressing health and improving health disparities in communities is ensuring that academic health centers (AHCs) are engaged with area schools, primary care practices, and community advocates as equal partners in research, services, and programs. The literature documents the importance of ensuring that academic-community collaboration is based on equity, trust, and respect and that there is capacity (time and resources) and a shared culture (language, skills, and applied knowledge) for accomplishing mutual goals in academic-community research partnerships. It is also essential that an academic-community collaboration result in tangible and measurable goals and outcomes for both the target community and the AHC. Currently, the models for implementing best practices in community health partnerships, especially training programs, are limited.This article summarizes the goals and outcomes for the Community Leaders Institute (CLI), a six-week innovative leadership development training program designed to enhance academic-community research, integrate the interests of community leaders and AHC researchers, and build research capacity and competencies within the community. On the basis of two years of outcome data, the CLI is achieving its intended goals of engaging faculty as trainer-scholars while promoting academic-community partnerships that align with community and AHC priorities. The training and collaborative research paradigm used by the CLI has served to accelerate AHC-community engagement and integration efforts, as CLI graduates are now serving on AHC steering, bioethics, and other committees. PMID:23348087

  9. Diabetes Health Information Technology Innovation to Improve Quality of Life for Health Plan Members in Urban Safety Net

    PubMed Central

    Ratanawongsa, Neda; Handley, Margaret A.; Sarkar, Urmimala; Quan, Judy; Pfeifer, Kelly; Soria, Catalina; Schillinger, Dean

    2014-01-01

    Safety net systems need innovative diabetes self-management programs for linguistically diverse patients. A low-income government-sponsored managed care plan implemented a 27-week automated telephone self-management support (ATSM) / health coaching intervention for English, Spanish-, and Cantonese-speaking members from four publicly-funded clinics in a practice-based research network. Compared to waitlist, immediate intervention participants had greater 6-month improvements in overall diabetes self-care behaviors (standardized effect size [ES] 0.29, p<0.01) and SF-12 physical scores (ES 0.25, p=0.03); changes in patient-centered processes of care and cardiometabolic outcomes did not differ. ATSM is a strategy for improving patient-reported self-management and may also improve some outcomes. PMID:24594561

  10. The challenge of benchmarking health systems: is ICT innovation capacity more systemic than organizational dependent?

    PubMed

    Lapão, Luís Velez

    2015-01-01

    The article by Catan et al. presents a benchmarking exercise comparing Israel and Portugal on the implementation of Information and Communication Technologies in the healthcare sector. Special attention was given to e-Health and m-Health. The authors collected information via a set of interviews with key stakeholders. They compared two different cultures and societies, which have reached slightly different implementation outcomes. Although the comparison is very enlightening, it is also challenging. Benchmarking exercises present a set of challenges, such as the choice of methodologies and the assessment of the impact on organizational strategy. Precise benchmarking methodology is a valid tool for eliciting information about alternatives for improving health systems. However, many beneficial interventions, which benchmark as effective, fail to translate into meaningful healthcare outcomes across contexts. There is a relationship between results and the innovational and competitive environments. Differences in healthcare governance and financing models are well known; but little is known about their impact on Information and Communication Technology implementation. The article by Catan et al. provides interesting clues about this issue. Public systems (such as those of Portugal, UK, Sweden, Spain, etc.) present specific advantages and disadvantages concerning Information and Communication Technology development and implementation. Meanwhile, private systems based fundamentally on insurance packages, (such as Israel, Germany, Netherlands or USA) present a different set of advantages and disadvantages - especially a more open context for innovation. Challenging issues from both the Portuguese and Israeli cases will be addressed. Clearly, more research is needed on both benchmarking methodologies and on ICT implementation strategies. PMID:26301085

  11. National Health Guidelines in I.R of Iran, an Innovative Approach for Developing Countries

    PubMed Central

    Esmaeil Akbari, Mohammad; Mohammadi, Gohar; Vosoogh-Moghaddam, Abbas; Rabanikhah, Fahimeh; Javadi, Hamideh; Rostami-Gooran, Narges; Safaei, Asal; Akbari, Atieh

    2015-01-01

    Background Guidelines have produced and used in complex environment of health care system with its ethical, economical, legal and other aspects; that should be taken into account in any country. Modifying the format and content of guidelines might facilitate their usage and lead to improved quality of care and cost containment. We have produced this tool for explained above purpose. Methods A coordinating national team has settled at the office of minster of health and medical education, supported by a guideline review committee. An innovative and appropriate approach for adapting national health guidelines has consisted of eight steps, have defined For preparing the draft of each guideline a technical team which, including main author, her/his co-workers have nominated. The authors of each topic have systematically searched databases of the proposed Twenty-two International Sites, and then have selected at least five sources of them that were more relevant. The final recommendations have proposed by agreement of technical team and Guideline Review Committee. Results In less than 5 months, more than 500 authors in whole country have selected to prepare guidelines and, approximately 150 guidelines have provided in three volumes of the published and distributed book. Each guideline had a national ID number, constant forever; all topics should be reviewed every 3-5 years. Conclusion National health guideline(s) would be essential means for policy making in health system and increased the cost containment and quality of care. Ministry of Health and Medical Education should provide and distribute the guidelines based on its accountability to legal responsibility. PMID:25960845

  12. Innovations in health and demographic surveillance systems to establish the causal impacts of HIV policies

    PubMed Central

    Herbst, Kobus; Law, Matthew; Geldsetzer, Pascal; Tanser, Frank; Harling, Guy; Bärnighausen, Till

    2016-01-01

    Purpose of Review Health and Demographic Surveillance Systems (HDSS), in conjunction with HIV treatment cohorts, have made important contributions to our understanding of the impact of HIV treatment and treatment-related interventions in sub-Saharan Africa. The purpose of this review is to describe and discuss innovations in data collection and data linkage that will create new opportunities to establish the impacts of HIV treatment, as well as policies affecting the treatment cascade, on population health, economic and social outcomes. Recent Findings Novel approaches to routine collection of (i) biomarkers, (ii) behavioural data, (iii) spatial data, (iv) social network information, (v) migration events and (vi) mobile phone records can significantly strengthen the potential of HDSS to generate exposure and outcome data for causal analysis of HIV treatment impact and policies affecting the HIV treatment cascade. Additionally, by linking HDSS data to health service administration, education, and welfare service records, researchers can substantial broaden opportunities to establish how HIV treatment affects health and economic outcomes, when delivered through public-sector health systems and at scale. Summary As the HIV treatment scale-up in sub-Saharan Africa enters its second decade, it is becoming increasingly important to understand the long-term causal impacts of large-scale HIV treatment and related policies on broader population health outcomes, such as non-communicable diseases, as well as on economic and social outcomes, such as family welfare and children’s educational attainment. By collecting novel data and linking existing data to public-sector records, HDSS can create near-unique opportunities to contribute to this research agenda. PMID:26371462

  13. [Interdisciplinary Bachelor's degree in Health: an innovative proposal in higher education in Health in Brazil].

    PubMed

    Teixeira, Carmen Fontes de Souza; Coelho, Maria Thereza Ávila Dantas; Rocha, Marcelo Nunes Dourado

    2013-06-01

    This article describes and analyzes the political and institutional context and the process of implementation of the Interdisciplinary Bachelor's degree in Health (IBH) during the 2006-2011 period. The methodology included document review and analysis of personnel records of the researchers involved. By using the concepts of "window of opportunity" and "hypercomplex organization," it was revealed that managerial and organizational structures were created and master-documents were prepared. In addition to this, actions for implementation of the course, related to the structure of the faculty and the academic council, preparation of the pedagogical project, planning, implementation and monitoring of the teaching-learning process in the various curriculum components offered since 2009 was conducted. Analysis of the challenges and prospects of the course indicates that the major problem is the tension between the traditional model of vocational and discipline-based higher education existing hitherto and the interdisciplinary model proposed by IBH. This tension can be overcome by the full implementation of learning cycles with the institutionalization of IBH as the first cycle of professional health education. PMID:23752530

  14. Patient Perceptions of a Personal Health Record: A Test of the Diffusion of Innovation Model

    PubMed Central

    2012-01-01

    Background Personal health records (PHRs) have emerged as an important tool with which patients can electronically communicate with their doctors and doctor’s offices. However, there is a lack of theoretical and empirical research on how patients perceive the PHR and the differences in perceptions between users and non-users of the PHR. Objective To apply a theoretical model, the diffusion of innovation model, to the study of PHRs and conduct an exploratory empirical study on the applicability of the model to the study of perceptions of PHRs. A secondary objective was to assess whether perceptions of PHRs predict the perceived value of the PHR for communicating with the doctor’s office. Methods We first developed a survey capturing perceptions of PHR use and other factors such as sociodemographic characteristics, access and use of technology, perceived innovativeness in the domain of information technology, and perceptions of privacy and security. We then conducted a cross-sectional survey (N = 1500). Patients were grouped into five groups of 300: PHR users (innovators, other users, and laggards), rejecters, and non-adopters. We applied univariate statistical analysis (Pearson chi-square and one-way ANOVA) to assess differences among groups and used multivariate statistical techniques (factor analysis and multiple regression analysis) to assess the presence of factors identified by the diffusion of innovation model and the predictors of our dependent variable (value of PHR for communicating with the doctor’s office). Results Of the 1500 surveys, 760 surveys were returned for an overall response rate of 51%. Computer use among non-adopters (75%) was lower than that among PHR users (99%) and rejecters (92%) (P < .001). Non-adopters also reported a lower score on personal innovativeness in information technology (mean = 2.8) compared to 3.6 and 3.1, respectively, for users and rejecters (P < .001). Four factors identified by the diffusion of innovation model

  15. Sustainable clinical research, health economic aspects and medical marketing: drivers of product innovation.

    PubMed

    Haschke, Ferdinand; Klassen-Wigger, Petra

    2010-01-01

    Marketing-driven innovation in the field of pediatric nutrition, in particular in the infant formula segment is not sustainable. New benefits of products must be scientifically proven and safety and efficacy of new formulae established in clinical trials. The scientific innovation process of three infant formulae is described. Improvement in protein quality allowed to reduce the protein concentration in whey-based infant formula. Weight gain and BMI of infants fed those formulae corresponds to breastfed infants and is lower than in infants fed traditional formulae with higher protein concentration. A meta-analysis indicates associations between rapid weight gain in infancy and obesity later in life. If infants cannot be exclusively breastfed until 4-6 months of age, feeding low-protein formulae may contribute to positive long-term health outcome with potentially important health economic effects. A partially hydrolyzed whey based formula for prevention of allergic symptoms in children with hereditary risk for allergic diseases was developed more than 25 years ago. The most recent meta-analysis which included 15 randomized clinical trials indicates that the risk of all allergic diseases and atopic dermatitis/eczema is significantly reduced in infants at risk when the partially hydrolyzed formula is fed. The partially hydrolyzed formula had the same protective effect as casein-based high-degree extensively hydrolyzed formula. Because of substantial price differences between the two formulae, feeding the partially hydrolyzed whey formula is cost saving. Hypoallergenic claims can be made in many countries, and international nutrition committees have positively commented the preventive effect of those formulae. Acidified formulae have been widely used during the last decade in replacement feeding programs for infants whose mothers are HIV positive. The formula was innovated by improving whey protein quality and lowering protein concentration. The bacteriostatic

  16. Innovative information visualization of electronic health record data: a systematic review

    PubMed Central

    West, Vivian L; Borland, David; Hammond, W Ed

    2015-01-01

    Objective This study investigates the use of visualization techniques reported between 1996 and 2013 and evaluates innovative approaches to information visualization of electronic health record (EHR) data for knowledge discovery. Methods An electronic literature search was conducted May–July 2013 using MEDLINE and Web of Knowledge, supplemented by citation searching, gray literature searching, and reference list reviews. General search terms were used to assure a comprehensive document search. Results Beginning with 891 articles, the number of articles was reduced by eliminating 191 duplicates. A matrix was developed for categorizing all abstracts and to assist with determining those to be excluded for review. Eighteen articles were included in the final analysis. Discussion Several visualization techniques have been extensively researched. The most mature system is LifeLines and its applications as LifeLines2, EventFlow, and LifeFlow. Initially, research focused on records from a single patient and visualization of the complex data related to one patient. Since 2010, the techniques under investigation are for use with large numbers of patient records and events. Most are linear and allow interaction through scaling and zooming to resize. Color, density, and filter techniques are commonly used for visualization. Conclusions With the burgeoning increase in the amount of electronic healthcare data, the potential for knowledge discovery is significant if data are managed in innovative and effective ways. We identify challenges discovered by previous EHR visualization research, which will help researchers who seek to design and improve visualization techniques. PMID:25336597

  17. [Industry, Academia and Government Partnership through the Global Health Innovative Technology Fund (GHIT)].

    PubMed

    Hinoshita, Eiji

    2016-01-01

    In developing countries, many people are unable to access basic healthcare services, resulting in many avoidable deaths and/or disabilities. The United Nations adopted the Millennium Development Goals in order to resolve this problem, and Japan has been contributing greatly to the achievement of these goals. In this context, in 2013 the Government of Japan proposed its Strategy on Global Health Diplomacy, and since then has been promoting Universal Health Coverage. Since the beginning of the 21st century, the particular importance of addressing neglected tropical diseases (NTDs) has been stressed by the international community. Nevertheless, of the 1 billion people world-wide who are currently living with NTDs, about three-fourths of these are living in poverty, and of these, nearly 65% are unable to acquire or access drugs for the prevention and treatment of these diseases. Under these circumstances, Japan decided to support the Global Health Innovative Technology (GHIT) Fund in order to support the research and development of drugs for people in developing countries, as well as the manufacture, supply and administration of these drugs. Over the last two years, the GHIT Fund has been supporting the research and development of five new candidate drugs for three NTDs (Chagas disease, leishmaniasis and malaria). Japan also hopes to stimulate domestic pharmaceutical industries in developing countries, as well as to increase international cooperation through various activities such the utilization of our capacity to research and develop new drugs. PMID:26831799

  18. National Institutes of Health phase I, Small Business Innovation Research applications: fiscal year 1983 results.

    PubMed

    Vener, K J

    1985-08-01

    A review of the 356 disapproved Small Business Innovation Research (SBIR) proposals submitted to the National Institutes of Health (NIH) for fiscal year 1983 funding was undertaken to identify the most common shortcomings of those disapproved applications. The shortcomings were divided into four general classes by using the scheme developed by other authors when describing the reasons for the disapproval of regular NIH research applications. Comparison of the reasons for disapproval of SBIR applications with regular applications suggests comparable difficulties in the areas of the problem and the approach. There is some indication, however, that the SBIR proposals may have been weaker in the category of the principal investigator (PI). In general, it is the responsibility of the PI to demonstrate that the work is timely and can be performed with available technology and expertise, and that the guidelines for the NIH SBIR program have been satisfied. PMID:4018273

  19. Innovations in graduate public health education: the Instituto Nacional de Salud Pública.

    PubMed

    Valladares, Laura Magaña; Ávila, Mauricio Hernández

    2015-03-01

    During the past 10 years, the Instituto Nacional de Salud Pública (National Institute of Public Health) in Mexico has meticulously revised its educational model. This analysis resulted in the transformation of its educational model by tracing a new path in the pedagogical structure and faculty development to meet current challenges and students' needs. The first stage dealt with the national and international accreditation standards that came with the 21st century. The second stage responded to evidence of cognitive research showing that students are better prepared when they are engaged, active, and responsible for their own learning. This transformation was grounded on the use of information and communication technologies and on a competency-based educational approach that has led the expansion and innovation of educational practice. PMID:25706028

  20. Numerical simulation of time delay interferometry for eLISA/NGO

    NASA Astrophysics Data System (ADS)

    Wang, Gang; Ni, Wei-Tou

    2013-03-01

    eLISA/NGO is a new gravitational wave detection proposal with arm length of 106 km and one interferometer down-scaled from LISA. Just like LISA and ASTROD-GW, in order to attain the requisite sensitivity for eLISA/NGO, laser frequency noise must be suppressed to below the secondary noises such as the optical path noise, acceleration noise, etc. In previous papers, we have performed the numerical simulation of the time delay interferometry (TDI) for LISA and ASTROD-GW with one arm dysfunctional by using the CGC 2.7 ephemeris. The results are well below their respective limits in which the laser frequency noise is required to be suppressed. In this paper, we follow the same procedure to simulate the time delay interferometry numerically. To do this, we work out a set of 1000-day optimized mission orbits of the eLISA/NGO spacecraft starting on 1 January 2021 using the CGC 2.7 ephemeris framework. We then use the numerical method to calculate the residual optical path differences in the second-generation TDI solutions as in our previous papers. The maximum path length difference, for all configurations calculated, is below 13 mm (43 ps). It is well below the limit in which the laser frequency noise is required to be suppressed for eLISA/NGO. We compare and discuss the resulting differences due to the different arm lengths for various mission proposals—eLISA/NGO, an NGO-LISA-type mission with a nominal arm length of 2 × 106 km, LISA and ASTROD-GW.

  1. [Facilitating access to care for most-at-risk populations : the Bamako night sexual health clinic experience (Mali)].

    PubMed

    Coulibaly, Alou; Dembelé Keita, Bintou; Henry, Emilie; Trenado, Emmanuel

    2014-01-01

    The estimated prevalence of HIV in Mali is 1.3 % of the general population. The epidemic is concentrated in certain groups, particularly men who have sex with men (MSM) and sex workers (SW). Access to care is limited for these populations, notably because of structural obstacles (e.g. marked social rejection ; health care services poorly adapted to the real needs of these people). Innovative strategies must be envisaged to ensure access to care services and retention in care for these populations. As part of a health promotion process, ARCAD-SIDA, a Malian NGO involved in the fight against AIDS since 1995, set up a night sexual health clinic in 2010 as part of a strategy to more adequately respond to the health needs of these populations. This clinic adapts health service timetables to match the lifestyles of the targeted populations, brings services in closer physical proximity to the places in which these populations live, proposes patient-tailored consultations, works to improve the patients' psychosocial skills, and promotes community-based peer mobilization. In an environment which is generally hostile to MSM and SW, ARCAD-SIDA also works in advocacy, targeting political decision-makers, defense forces and journalists. The NGO has also played a key role in ensuring that these populations are taken into account in the national strategy for the fight against HIV. Since opening in 2010, the clinic has helped reach a large number of MSM and SW and has improved retention in care. This innovative strategy has also enabled the NGO to improve its professional practices in terms of an individual-based approach to prevention. Interventions that are better adapted to the needs and environment of the populations for whom they are intented to have a positive effect on access to and use of healthcare services. PMID:25380379

  2. The Public Health Reach of High Fluoride Vehicles: Examples of Innovative Approaches.

    PubMed

    Tellez, Marisol; Wolff, Mark S

    2016-01-01

    Fluorides and sealants have been shown to reduce caries in populations, making fluoride interventions a large part of the dental public health effort. Although public health programs have traditionally focused on fluoride vehicles delivering less than 1,000 ppm of fluoride, more recent efforts have shifted toward the use of high fluoride vehicles such as varnishes and prescription toothpastes. In the USA, states are developing innovative strategies to increase access to dental services by using primary care medical providers to deliver early preventive services as part of well-child care visits. Currently, Medicaid programs in 43 states reimburse medical providers for preventive services including varnish application. Still, there is uncertainty about the cost-effectiveness of such interventions. In many resource-strained environments, with shortages of dental health care providers, lack of fluoridated water and lower dental awareness, it is necessary to develop sustainable programs utilizing already established programs, like primary school education, where caries prevention may be set as a priority. Dental caries among the elderly is an ongoing complex problem. The 5,000-ppm F toothpaste may be a reasonable approach for developing public health programs where root caries control is the main concern. Fluoride varnish and high concentration fluoride toothpaste are attractive because they can easily be incorporated into well-child visits and community-based geriatric programs. Additional research on the effectiveness and costs associated with population-based programs of this nature for high risk groups is needed, especially in areas where a community-based fluoride delivery program is not available. PMID:27099929

  3. Establishing a health information workforce: innovation for low- and middle-income countries

    PubMed Central

    2013-01-01

    Background To address the shortage of health information personnel within Botswana, an innovative human resources approach was taken. University graduates without training or experience in health information or health sciences were hired and provided with on-the-job training and mentoring to create a new cadre of health worker: the district Monitoring and Evaluation (M&E) Officer. This article describes the early outcomes, achievements, and challenges from this initiative. Methods Data were collected from the district M&E Officers over a 2-year period and included a skills assessment at baseline and 12 months, pre- and post-training tests, interviews during stakeholder site visits, a survey of achievements, focus group discussions, and an attrition assessment. Results An average of 2.7 mentoring visits were conducted for M&E Officers in each district. There were five training sessions over 18 months. Knowledge scores significantly increased (p < 0.05) during the three trainings in which pre/post tests were administered. Over 1 year, there were significant improvements (p < 0.05) in self-rated skills related to computer literacy, checking data validity, implementing data quality procedures, using data to support program planning, proposing indicators, and writing M&E reports. Out of the 34 district M&E Officers interviewed during site visits, most were conducting facility visits to review data (27/34; 79%), comparing data sets over time (31/34; 91%), backing up data (32/34; 94%), and analyzing data (32/34; 94%). Common challenges included late facility reports (28/34; 82%), lack of transportation (22/34; 65%), inaccurate facility reports (10/34; 29%), and colleagues’ misunderstanding of M&E (10/34; 29%). Six posts were vacated in the first year (6/51; 12%). A total of 49 Officers completed the achievements survey; of these, common accomplishments related to improvements in data management (35/49; 71%), data quality (31/49; 63%), data use (29/49; 59%), and capacity

  4. Care Groups I: An Innovative Community-Based Strategy for Improving Maternal, Neonatal, and Child Health in Resource-Constrained Settings.

    PubMed

    Perry, Henry; Morrow, Melanie; Borger, Sarah; Weiss, Jennifer; DeCoster, Mary; Davis, Thomas; Ernst, Pieter

    2015-09-01

    In view of the slow progress being made in reducing maternal and child mortality in many priority countries, new approaches are urgently needed that can be applied in settings with weak health systems and a scarcity of human resources for health. The Care Group approach uses facilitators, who are a lower-level cadre of paid workers, to work with groups of 12 or so volunteers (the Care Group), and each volunteer is responsible for 10-15 households. The volunteers share messages with the mothers of the households to promote important health behaviors and to use key health services. The Care Groups create a multiplying effect, reaching all households in a community at low cost. This article describes the Care Group approach in more detail, its history, and current NGO experience with implementing the approach across more than 28 countries. A companion article also published in this journal summarizes the evidence on the effectiveness of the Care Group approach. An estimated 1.3 million households—almost entirely in rural areas—have been reached using Care Groups, and at least 106,000 volunteers have been trained. The NGOs with experience implementing Care Groups have achieved high population coverage of key health interventions proven to reduce maternal and child deaths. Some of the essential criteria in applying the Care Group approach include: peer-to-peer health promotion (between mothers), selection of volunteers by mothers, limited workload for the volunteers, limited number of volunteers per Care Group, frequent contact between the volunteers and mothers, use of visual teaching tools and participatory behavior change methods, and regular supervision of volunteers. Incorporating Care Groups into ministries of health would help sustain the approach, which would require creating posts for facilitators as well as supervisors. Although not widely known about outside the NGO child survival and food security networks, the Care Group approach deserves broader

  5. Care Groups I: An Innovative Community-Based Strategy for Improving Maternal, Neonatal, and Child Health in Resource-Constrained Settings

    PubMed Central

    Morrow, Melanie; Borger, Sarah; Weiss, Jennifer; DeCoster, Mary; Davis, Thomas; Ernst, Pieter

    2015-01-01

    In view of the slow progress being made in reducing maternal and child mortality in many priority countries, new approaches are urgently needed that can be applied in settings with weak health systems and a scarcity of human resources for health. The Care Group approach uses facilitators, who are a lower-level cadre of paid workers, to work with groups of 12 or so volunteers (the Care Group), and each volunteer is responsible for 10–15 households. The volunteers share messages with the mothers of the households to promote important health behaviors and to use key health services. The Care Groups create a multiplying effect, reaching all households in a community at low cost. This article describes the Care Group approach in more detail, its history, and current NGO experience with implementing the approach across more than 28 countries. A companion article also published in this journal summarizes the evidence on the effectiveness of the Care Group approach. An estimated 1.3 million households—almost entirely in rural areas—have been reached using Care Groups, and at least 106,000 volunteers have been trained. The NGOs with experience implementing Care Groups have achieved high population coverage of key health interventions proven to reduce maternal and child deaths. Some of the essential criteria in applying the Care Group approach include: peer-to-peer health promotion (between mothers), selection of volunteers by mothers, limited workload for the volunteers, limited number of volunteers per Care Group, frequent contact between the volunteers and mothers, use of visual teaching tools and participatory behavior change methods, and regular supervision of volunteers. Incorporating Care Groups into ministries of health would help sustain the approach, which would require creating posts for facilitators as well as supervisors. Although not widely known about outside the NGO child survival and food security networks, the Care Group approach deserves broader

  6. A Crisis Mental Health Intervention Service: An Innovative Model for Working Intensively with Young People on the Edge of Care

    ERIC Educational Resources Information Center

    Witkon, Yael

    2012-01-01

    This paper describes the setting up and the first year of running of an innovative outreach service for adolescents on the edge of care that aimed at redressing family breakdown and preventing placements in the care system. It was a collaborative endeavour between social services and a child and adolescent mental health provision to facilitate the…

  7. The Practice: An Analysis of the Factors Influencing the Training of Health Care Participants through Innovative Technology

    ERIC Educational Resources Information Center

    Gattoni, Ali; Tenzek, Kelly E.

    2010-01-01

    The aim of this paper is to develop a theoretical framework for understanding how new technologies become a part of culture and change our traditional images of health care and providers. Using the diffusion of innovations theory provides an understanding of how providers can adopt technology into practice. More specifically, this paper focuses on…

  8. Smart systems and personalized health: the real challenge of bridging the innovation gap.

    PubMed

    Lymberis, Andreas

    2014-01-01

    Smart miniaturized systems, emerging from the integration of heterogeneous technologies like micro- and nano electronics, photonics, biotechnology, materials and information & communication technologies are considered today, after two decades of intensive public support, proven concepts and functional prototypes, as key enablers opening up new opportunities for healthcare and in particular personalized health. They offer an enhanced ability to sense, detect, analyze, communicate, respond, and monitor phenomena from macro (e.g. body, tissues) to nano scale (e.g. molecules, genes). For the majority of these projects, planning for the next phase of prototype validation, product design, supply chain, user targeting, clinical validation and commercial roll-out are now taking full attention. The new EU Framework Program for Research and Innovation, Horizon 2020, is focusing on technology transfer support and building ecosystems and value chains to ensure better time to market and higher impact of knowledge-based technologies. The state-of-the-art and upcoming challenges for the implementation of H2020 and new opportunities in smart systems for pHealth are discussed in the paper. PMID:24851956

  9. Gym for Free: The Short-Term Impact of an Innovative Public Health Policy on the Health and Wellbeing of Residents in a Deprived Constituency in Birmingham, UK

    ERIC Educational Resources Information Center

    Rabiee, Fatemeh; Robbins, Anne; Khan, Maryam

    2015-01-01

    Background: This paper describes the process, impact and outcomes of an innovative health policy project entitled Gym for Free in Birmingham, UK. Objectives: To explore the short-term effectiveness of the pilot scheme in relation to access, utilisation, perceived benefits and sustainability. Design: Cross-sectional study using survey and focus…

  10. Innovative health service delivery models in low and middle income countries - what can we learn from the private sector?

    PubMed Central

    2010-01-01

    Background The poor in low and middle income countries have limited access to health services due to limited purchasing power, residence in underserved areas, and inadequate health literacy. This produces significant gaps in health care delivery among a population that has a disproportionately large burden of disease. They frequently use the private health sector, due to perceived or actual gaps in public services. A subset of private health organizations, some called social enterprises, have developed novel approaches to increase the availability, affordability and quality of health care services to the poor through innovative health service delivery models. This study aims to characterize these models and identify areas of innovation that have led to effective provision of care for the poor. Methods An environmental scan of peer-reviewed and grey literature was conducted to select exemplars of innovation. A case series of organizations was then purposively sampled to maximize variation. These cases were examined using content analysis and constant comparison to characterize their strategies, focusing on business processes. Results After an initial sample of 46 studies, 10 case studies of exemplars were developed spanning different geography, disease areas and health service delivery models. These ten organizations had innovations in their marketing, financing, and operating strategies. These included approaches such a social marketing, cross-subsidy, high-volume, low cost models, and process reengineering. They tended to have a narrow clinical focus, which facilitates standardizing processes of care, and experimentation with novel delivery models. Despite being well-known, information on the social impact of these organizations was variable, with more data on availability and affordability and less on quality of care. Conclusions These private sector organizations demonstrate a range of innovations in health service delivery that have the potential to better

  11. CASALUD: an innovative health-care system to control and prevent non-communicable diseases in Mexico.

    PubMed

    Tapia-Conyer, Roberto; Gallardo-Rincón, Héctor; Saucedo-Martinez, Rodrigo

    2015-07-01

    Mexico and other Latin American countries are currently facing a dramatic increase in the number of adults suffering from non-communicable diseases (NCDs) such as diabetes, cardiovascular disease (CVD) and chronic kidney disease (CKD), which require prolonged, continuous care. This epidemiological shift has created new challenges for health-care systems. Both the World Health Organization (WHO) and the United Nations (UN) have recognised the growing human and economic costs of NCDs and outlined an action plan, recognising that NCDs are preventable, often with common preventable risk factors linked to risky health behaviours. In line with international best practices, Mexico has applied a number of approaches to tackle these diseases. However, challenges remain for the Mexican health-care system, and in planning a strategy for combating and preventing NCDs, it must consider how best to integrate these strategies with existing health-care infrastructure. Shifting the paradigm of care in Mexico from a curative, passive approach to a preventive, proactive model will require an innovative and replicable system that guarantees availability of medicines and services, strengthens human capital through ongoing professional education, expands early and continuous access to care through proactive prevention strategies and incorporates technological innovations in order to do so. Here, we describe CASALUD: an innovative model in health-care that leverages international best practices and uses innovative technology to deliver NCD care, control and prevention. In addition, we describe the lessons learned from the initial implementation of the model for its effective use in Mexico, as well as the plans for wider implementation throughout the country, in partnership with the Mexican Ministry of Health. PMID:24285554

  12. Meaningful Learning? Gendered Experiences with an NGO-Sponsored Literacy Program in Rural Mali

    ERIC Educational Resources Information Center

    Fuhriman, Addie; Ballif-Spanvill, Bonnie; Ward, Carol; Solomon, Yodit; Widdison-Jones, Kacey

    2006-01-01

    This paper examines the effectiveness of an NGO-sponsored literacy program in rural Mali. The study employs ethnographic techniques to examine the type of literacy instruction provided, the level of participation, the meanings of literacy to participants, and the contextual factors that influence the social and personal effects of literacy. The…

  13. Advocacy in Action: Annual 2006 DPI/NGO Conference at the United Nations

    ERIC Educational Resources Information Center

    Brown, Nancy

    2007-01-01

    The Association for Childhood Education International (ACEI) was again represented at the annual 2006 DPI/NGO conference, along with 1,600 participants from around the world. The mood this year was somber and quite serious, possibly in response to the uncertainty created by the Middle East crisis that was raging while the conference was taking…

  14. NGO Provision of Basic Education: Alternative or Complementary Service Delivery to Support Access to the Excluded?

    ERIC Educational Resources Information Center

    Rose, Pauline

    2009-01-01

    This paper focuses on approaches by non-government organisations (NGOs) to reach primary school-aged children excluded from access to the conventional state education system. It highlights recent shifts in international literature and agency priorities from the portrayal of NGO provision as a (non-formal) "alternative" to (formal) state schooling,…

  15. Investigation of Organizational Interaction and Support in an NGO through Computer-Mediated Discussions

    ERIC Educational Resources Information Center

    Chang, Yao-Jen; Chang, Yao-Sheng

    2011-01-01

    Discussion forums have been used to support organizational communication and they have become a candidate for study of organizational behaviors. However, online behaviors of NGOs have been insufficiently studied compared to those studies conducted in education and industries. Our empirical study examined how social workers in one NGO used an…

  16. Probiotics for human health –new innovations and emerging trends

    PubMed Central

    2012-01-01

    The role of the gut microbiome in human health and disease with a particular emphasis on therapeutic use of probiotics under specific medical conditions was mainly highlighted in 1st Annual conference of Probiotic Association of India (PAi) and International Symposium on “Probiotics for Human Health - New Innovations and Emerging Trends” held on 27th-28th August, 2012 at New Delhi, India. There is increasing recognition of the fact that dysbiosis or alteration of this gut microbiome may be implicated in gastro-intestinal disorders including diarrheal diseases, ulcerative colitis, inflammatory bowel diseases, life style diseases viz. Diabetes Mellitus-2 and obesity etc. This report summarizes the proceedings of the conference and the symposium comprehensively. Although, research on probiotics has been continuing for the past few decades, the subject has been currently the major focus of attention across the world due to recent advances and new developments in genomics, transcriptomics, proteomics, metabolomics and emergence of new generation of high through put sequencing technologies that have immensely helped in understanding the probiotic functionality and mode of action from nutritional and health perspectives. There is now sufficient evidence backed up with good quality scientific clinical data to suggest that probiotic interventions could indeed be effective in various types of diarrheal diseases, other chronic gastrointestinal inflammatory disorders like pouchitis, necrotizing entero-colitis, allergic responses and lactose intolerance etc. This report makes a modest attempt to give all the stake holders involved in development of probiotic based functional/health foods an overview of the current status of probiotics research at the Global and National level. The most crucial issues that emerged from the lead talks delivered by the eminent speakers from India and abroad were the major focus of discussions in different plenary and technical sessions. By

  17. Innovations to enhance the quality of health professions education at the University of Zimbabwe College of Health Sciences--NECTAR program.

    PubMed

    Ndhlovu, Chiratidzo E; Nathoo, Kusum; Borok, Margaret; Chidzonga, Midion; Aagaard, Eva M; Connors, Susan C; Barry, Michele; Campbell, Thomas; Hakim, James

    2014-08-01

    The University of Zimbabwe College of Health Sciences (UZCHS) is Zimbabwe's premier health professions training institution. However, several concerns were raised during the past decade over the quality of health education at UZCHS. The number of faculty and students declined markedly until 2010, when there was a medical student intake of 147 while the faculty comprised only 122 (39%) of a possible 314 positions. The economic and political crises that the country experienced from 1999 to 2009 compounded the difficulties faced by the institution by limiting the availability of resources. The Medical Education Partnership Initiative funding opportunity has given UZCHS the stimulus to embark on reforms to improve the quality of health education it offers. UZCHS, in partnership with the University of Colorado School of Medicine, the University of Colorado Denver Evaluation Center, and Stanford University, designed the Novel Education Clinical Trainees and Researchers (NECTAR) program to implement a series of health education innovations to meet this challenge. Between 2010 and 2013, innovations that have positively affected the quality of health professions education at UZCHS include the launch of comprehensive faculty development programs and mentored clinical and research programs for postgraduate students. A competency-based curriculum reform process has been initiated, a health professions department has been established, and the Research Support Center has been strengthened, providing critical resources to institutionalize health education and research implementation at the college. A core group of faculty trained in medical education has been assembled, helping to ensure the sustainability of these NECTAR activities. PMID:25072588

  18. A New Business Model for Problem Solving-Infusing Open Collaboration and Innovation Health and Human Services

    NASA Technical Reports Server (NTRS)

    Davis, Jeffrey R.; Richard, Eliabeth E.; Fogarty, Jennifer A.; Rando, Cynthia M.

    2011-01-01

    This slide presentation reviews the Space Life Sciences Directorate (SLSD) new business model for problem solving, with emphasis on open collaboration and innovation. The topics that are discussed are: an overview of the work of the Space Life Sciences Directorate and the strategic initiatives that arrived at the new business model. A new business model was required to infuse open collaboration/innovation tools into existing models for research, development and operations (research announcements, procurements, SBIR/STTR etc). This new model involves use of several open innovation partnerships: InnoCentive, Yet2.com, TopCoder and NASA@work. There is also a new organizational structure developed to facilitate the joint collaboration with other NASA centers, international partners, other U.S. Governmental organizations, Academia, Corporate, and Non-Profit organizations: the NASA Human Health and Performance Center (NHHPC).

  19. [Opportunity for the integration of the gender perspective in health research and innovation in Europe: COST Network genderSTE].

    PubMed

    Sánchez de Madariaga, Inés; Ruiz Cantero, María Teresa

    2014-01-01

    The European Commission supports several routes for incorporating the gender perspective. The Commission currently supports the new Horizon 2020 program, and also funds projects such as "gendered innovations", which show how gender innovations increase the quality of research and professional practice for health and welfare. One of the policy instruments is the Recommendation on Gender, Science and Innovation. Against this background, the international European Cooperation in Science and Technology (COST) network genderSTE (Gender, Science, Technology and Environment) was created, which seeks to: 1) promote structural changes in institutions to increase the number of women researchers; 2) identify the gender dimensions relevant to the environment; and 3) improve the integration of a gender perspective in research and technology. COST GenderSTE supports networking and the dissemination of knowledge with a gender perspective. All these tools provide an opportunity to incorporate a gender perspective in research in Europe. PMID:24852090

  20. Building Interdisciplinary Leadership Skills among Health Practitioners in the Twenty-First Century: An Innovative Training Model

    PubMed Central

    Negandhi, Preeti; Negandhi, Himanshu; Tiwari, Ritika; Sharma, Kavya; Zodpey, Sanjay P.; Quazi, Zahiruddin; Gaidhane, Abhay; Jayalakshmi N.; Gijare, Meenakshi; Yeravdekar, Rajiv

    2015-01-01

    Transformational learning is the focus of twenty-first century global educational reforms. In India, there is a need to amalgamate the skills and knowledge of medical, nursing, and public health practitioners and to develop robust leadership competencies among them. This initiative proposed to identify interdisciplinary leadership competencies among Indian health practitioners and to develop a training program for interdisciplinary leadership skills through an Innovation Collaborative. Medical, nursing, and public health institutions partnered in this endeavor. An exhaustive literature search was undertaken to identify leadership competencies in these three professions. Published evidence was utilized in searching for the need for interdisciplinary training of health practitioners, including current scenarios in interprofessional health education and the key competencies required. The interdisciplinary leadership competencies identified were self-awareness, vision, self-regulation, motivation, decisiveness, integrity, interpersonal communication skills, strategic planning, team building, innovation, and being an effective change agent. Subsequently, a training program was developed, and three training sessions were piloted with 66 participants. Each cohort comprised a mix of participants from different disciplines. The pilot training guided the development of a training model for building interdisciplinary leadership skills and organizing interdisciplinary leadership workshops. The need for interdisciplinary leadership competencies is recognized. The long-term objective of the training model is integration into the regular medical, nursing, and public health curricula, with the aim of developing interdisciplinary leadership skills among them. Although challenging, formal incorporation of leadership skills into health professional education is possible within the interdisciplinary classroom setting using principles of transformative learning. PMID:26501046

  1. Building Interdisciplinary Leadership Skills among Health Practitioners in the Twenty-First Century: An Innovative Training Model.

    PubMed

    Negandhi, Preeti; Negandhi, Himanshu; Tiwari, Ritika; Sharma, Kavya; Zodpey, Sanjay P; Quazi, Zahiruddin; Gaidhane, Abhay; Jayalakshmi N; Gijare, Meenakshi; Yeravdekar, Rajiv

    2015-01-01

    Transformational learning is the focus of twenty-first century global educational reforms. In India, there is a need to amalgamate the skills and knowledge of medical, nursing, and public health practitioners and to develop robust leadership competencies among them. This initiative proposed to identify interdisciplinary leadership competencies among Indian health practitioners and to develop a training program for interdisciplinary leadership skills through an Innovation Collaborative. Medical, nursing, and public health institutions partnered in this endeavor. An exhaustive literature search was undertaken to identify leadership competencies in these three professions. Published evidence was utilized in searching for the need for interdisciplinary training of health practitioners, including current scenarios in interprofessional health education and the key competencies required. The interdisciplinary leadership competencies identified were self-awareness, vision, self-regulation, motivation, decisiveness, integrity, interpersonal communication skills, strategic planning, team building, innovation, and being an effective change agent. Subsequently, a training program was developed, and three training sessions were piloted with 66 participants. Each cohort comprised a mix of participants from different disciplines. The pilot training guided the development of a training model for building interdisciplinary leadership skills and organizing interdisciplinary leadership workshops. The need for interdisciplinary leadership competencies is recognized. The long-term objective of the training model is integration into the regular medical, nursing, and public health curricula, with the aim of developing interdisciplinary leadership skills among them. Although challenging, formal incorporation of leadership skills into health professional education is possible within the interdisciplinary classroom setting using principles of transformative learning. PMID:26501046

  2. Innovative Graduate Research Education for Advancement of Implementation Science in Adolescent Behavioral Health.

    PubMed

    Burton, Donna L; Levin, Bruce Lubotsky; Massey, Tom; Baldwin, Julie; Williamson, Heather

    2016-04-01

    An innovative approach to research education that integrates the theory and principles of implementation science, participatory research, and service learning in the area of adolescent behavioral health is presented. Qualitative interviews and surveys of program participants have been conducted to assess the program's curricula, service-learning partnerships, student (scholar) satisfaction, and views of community partnerships and academic mentors. The Institute has experienced the successful completion of its first and second cohorts and enrollment of a third cohort of scholars. Community partners are utilizing results of service-learning projects to influence agency operations. Institute scholars have identified research and service learning experiences as key factors in the decision to apply to the Institute graduate certificate program. The availability of tuition support is identified as valuable but not ranked as the most important reason for scholar interest in the program. Academic mentors report positive relationships with community agencies. Future iterations of the program will expand options for distance learning and alternatives to traditional graduate education for community-based scholars. Community partner agency capacity for participation is expected to change over time. Methods are being identified to both sustain existing partnerships and develop new community partnership relationships. PMID:26746638

  3. Health economic value of an innovation: delimiting the scope and framework of future market entry agreements

    PubMed Central

    Launois, Robert; Navarrete, Lucia Fiestas; Ethgen, Olivier; Le Moine, Jean-Gabriel; Gatsinga, René

    2014-01-01

    Background and objectives The objective of our paper is to offer a new, payer-friendly taxonomy of market entry agreements (MEAs) that aims to twin contracts with their methodological designs in an effort to clarify the distinction between contracts that are based on performance and those that are based on demonstrated effect. Methods Our analysis proceeds in two stages: First, we delimit the scope and framework of pay for performance (P4P) and pay for demonstrated effect (P4E) agreements. Second, we distinguish the methodological designs supporting the implementation of each of these contracts. Results We elucidate why P4P contracts prevent the payer from funding the true effectiveness of an innovation by expanding on their limitations. These include: 1) the normative nature of comparisons, 2) the impossibility of true effect imputability for each individual, and 3) the use of intermediary outcome measures. We then explore three main criticisms that payers must take into account when reasoning in terms of performance rather than in terms of the product effectiveness. Conclusion The potential effect that performance-based reimbursements may have on dissociating the components of the cost-effectiveness ratio constitutes an obstacle to a true health economic reasoning. PMID:27226844

  4. Movin' On Up: An Innovative Nurse-Led Interdisciplinary Health Care Transition Program.

    PubMed

    Betz, Cecily L; Smith, Kathryn A; Van Speybroeck, Alexander; Hernandez, Francisco V; Jacobs, Robert A

    2016-01-01

    This article provides an overview of an innovative nurse-led interdisciplinary health care transition (HCT) model of care entitled Movin' On Up for adolescents and emerging adults (AEAs) with spina bifida (SB) that was originally implemented in 2011. The components of the HCT service model include an HCT nursing specialist, who is an advanced practice nurse; interdisciplinary health care transition plans based on the individualized needs of AEAs; an interdisciplinary HCT team that meets on a weekly basis; direct HCT services provided in the weekly SB clinic; and telephonic follow-up with AEAs, families, and providers. The characteristics of this nurse-led HCT program can be described as an integrated, interdisciplinary, and comprehensive model of care based on a life span approach. To date, a total of 210 AEAs with SB, ages 10 to 20 years, have been enrolled into the program. An important feature of this HCT service model is that it is self-supporting; it generates the revenue needed for sustainability and, unlike other HCT programs, is not reliant on extramural programmatic support. Other accomplishments of Movin' On Up include the development of a transfer protocol wherein 35 AEAs with SB have been supported in their transfer to adult care; implementation of a standardized process to ensure that service referrals to community-based services for postsecondary education, employment, training, and initiation of conservatorships are made; timely performance of evaluations; close tracking of needs and outcomes of self-management knowledge and skills instruction; and attention to equipment needs prior to transfer. PMID:26483330

  5. Innovation in the role of the Office of the Ombudsman of the Unified Health System (SUS) - reflections and potential benefits.

    PubMed

    Fernandes, Fernando Manuel Bessa; Moreira, Marcelo Rasga; Ribeiro, José Mendes; Ouverney, Assis Mafort; Oliveira, Flávio José Fonseca de; Moro, Maria Francisca Abritta

    2016-08-01

    This article seeks to reflect on the potential of innovative practices in the design and work of the government bodies that comprise the National System of Offices of the Ombudsman of the Unified Health System. It is divided into two parts, seeking to answer the following question: How to think of and implement innovative practices - which include sustainability - when the people are voicing their urgent demands and these are being heard by the public authorities? These grievances are all the more urgent as they involve the area of Health and can they be promptly discussed, attended and resolved? In the first part, the article discusses the polysemic concept of innovation, focusing on its application in the three spheres of public administration, and highlights the importance of its close correlation with the different notions of information and knowledge in a society such as the one we live in. In the second, it develops a task-force of ideas for the office of the ombudsman and based on this, a draft operational concept of innovation in the role of the office of the ombudsman, considering the context of high speed change and transformations and the complexity inherent to contemporary life and the need for resource management and expertise development in information management. PMID:27557027

  6. The George W. Comstock Center for Public Health Research and Prevention: A Century of Collaboration, Innovation, and Translation.

    PubMed

    Coresh, Josef; Platz, Elizabeth A

    2016-03-01

    The Johns Hopkins Bloomberg School of Public Health has been engaged in public health research and practice in Washington County, Maryland, nearly since its inception a century ago. In 2005, the center housing this work was renamed the George W. Comstock Center for Public Health Research and Prevention to honor its pioneering leader. Principles that guided innovation and translation well in the past included: research synergies and opportunities for translation realized through longstanding connection with the community; integration of training with public health research; lifelong learning, mentorship, and teamwork; and efficiency through economies of scale. These principles are useful to consider as we face the challenges of improving the health of the population over the next 100 years. PMID:26872712

  7. An Innovative Smartphone-Based Otorhinoendoscope and Its Application in Mobile Health and Teleotolaryngology

    PubMed Central

    Wu, Cheng-Jung; Wu, Sheng-Yu; Chen, Po-Chun

    2014-01-01

    Background The traditional otorhinoendoscope is widely used in the diagnosis of a variety of ear and nose diseases, but only one doctor can use it at a time. It is also very difficult to share observations from one doctor with another doctor. With advances in electronic health technology, the extended potential application of smartphones to support medical practice or mobile health has grown steadily. Objective The first phase of the study discussed how smartphones may be used for otorhinoscopic imaging and image management via an innovative adaptor. The second phase of the study was to evaluate the diagnostic capability of the smartphone-based otorhinoendoscope, as compared to the traditional otorhinoendoscope, and its application in mobile health and teleotolaryngology. Methods We designed a unique adaptor to connect the otorhinoendoscope and smartphone in order to perform smartphone-based otorhinoendoscopy. The main aim was to transform the smartphone into an otorhinoendoscope. We devised a method that would allow us to use the smartphone’s camera to capture otorhinoscopic images. Using a freely available Web-based real-time communication application platform and the 3G (or WIFI) network, the smartphone-based otorhinoendoscope could synchronize the smartphone-based otorhinoscopic image with smartphones, tablet PCs, computer notebooks, or personal computers. Results We investigated the feasibility of telemedicine using a smartphone, tablet PC, and computer notebook. Six types of clinical otorhinoscopic images were acquired via the smartphone-based otorhinoendoscope from six patients, which were examined in this study. Three teleconsultants (doctors A, B, and C) reviewed the six types of clinical otorhinoscopic images and made a telediagnosis. When compared to the face-to-face diagnosis, which was made in-person via a traditional otorhinoendoscope, the three teleconsultants obtained scores of a correct primary telediagnosis 83% (5/6), 100% (6/6), and 100% (6

  8. Gamification: An Innovative Teaching-Learning Strategy for the Digital Nursing Students in a Community Health Nursing Course.

    PubMed

    Day-Black, Crystal; Merrill, Earline B; Konzelman, Lois; Williams, Tammie T; Hart, Natalie

    2015-01-01

    Serious games have "re-emerged" as innovative teaching-learning strategies that researchers have shown to be effective in improving student learning outcomes. "Serious games" refer to games that are driven by educational goals, not entertainment. The use of serious games as part of the teaching-learning experience in nursing education fits into the philosophy and strategies of active learning. The "digital" nursing student needs engagement, stimulation, realism, and entertainment not more readings and Powerpoint supplements in the classroom to support learning. Nursing faculty at a mid-Atlantic Historical Black College and University introduced "serious gaming" technology into a Community Health Nursing course by using two web-based gamed simulations, Outbreak at WatersEdge: A Public Health Discovery Game, and EnviroRisk. This innovation proved to be effective in reinforcing learning and improving student learning outcomes. PMID:26665503

  9. Innovations in Primary Health Care: the use of communications technology and information tools to support local management.

    PubMed

    Pinto, Luiz Felipe; Rocha, Cristianne Maria Famer

    2016-05-01

    Social media has been used in different contexts as a way to streamline the flow of data and information for decision making. This has contributed to the issue of knowledge production in networks and the expansion of communication channels so that there is greater access to health services. This article describes the results of research done on 16 Information Technology and Communications Observatories in Health Care - OTICS Network in Rio - covering the Municipal Health Secretariat in Rio de Janeiro which supported the integration of primary health care and promoted the monitoring of health. It is a descriptive case study. The results relate to the support given to employees in training covering the dissemination of information, communication, training and information management in primary health care. This innovative means of communication in public health, with very little cost to the Unified Health System (SUS), allowed for a weekly registering of work processes for teams that worked in 193 primary health care units (APS) using blogs, whose total accesses reached the seven million mark in mid-2015. In the future there is a possibility that distance learning tools could be used to assist in training processes and in the continuing education of professionals in family health teams. PMID:27166893

  10. [Boundaries of the autonomy of local health administration: innovation, creativity and evidence-based decision-making].

    PubMed

    Silva, Silvio Fernandes da; Souza, Nathan Mendes; Barreto, Jorge Otávio Maia

    2014-11-01

    The scope of this article was to identify the boundaries of the autonomy of local administration in the context of the federal pact in the Brazilian Unified Health System and the importance and potential for promoting innovation, creativity and evidence-based decision-making by local governments. The methodology used was to ask questions that favored dialogue with the specific literature to identify the influence of centrally-formulated policies in spaces of local autonomy and then to identify strategies to foster innovation, creativity and the systematic use of evidence-based research in health policy implementation. A gradual reduction in municipal decision-making autonomy was detected due to increased financial commitment of the municipalities resulting from responsibilities assumed, albeit with the possibility of reverting this trend in the more recent context. Some determinants and challenges for the dissemination of innovative practices were analyzed and some relevant national and international experiences in this respect were presented. The conclusion drawn is that it is possible to make local decision-making more effective provided that initiatives are consolidated to promote this culture and the formulation and implementation of evidence-based health policies. PMID:25351309

  11. 78 FR 53789 - Technology Innovations for Substance Abuse and Mental Health Treatment Conference & Related...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ... advances in health information technologies (HIT) for behavioral health, and promote technology advances... Health Information Technology (HIT) Meeting AGENCY: Office of National Drug Control Policy. ACTION... (SAMHSA) in partnership with the Office of the National Coordinator for Health Information Technology,...

  12. Magnetic Back Action Effect of Magnetic Sensors for eLISA/NGO

    NASA Astrophysics Data System (ADS)

    Mateos, I.; Diaz-Aguiló, M.; Gibert, F.; Lloro, I.; Lobo, A.; Nofrarias, M.; Ramos-Castro, J.

    2013-01-01

    The fluxgate magnetometers used in LISA Pathfinder mission are able to perform very low noise measurements at milli-Hertz frequency, however they need to be kept somehow away from the Test Masses (TMs) due to the quantity of ferromagnetic material contained in the fluxgate's core, which constitutes a potential source of disturbance to the performance. As a result, the estimation of the magnetic field and gradient in the TMs is very problematic, despite the excellent quality of the readout data. The design of a magnetic diagnostic measuring system able to deal with the magnetic constraints for eLISA/NGO will imply the magnetic characterization of the sensors in order to estimate the magnetic back action effect on their environment. The magnetic impact caused by the magnetometers also depends on the noise reduction techniques used in the signal conditioning circuit, which is being studied to develop criteria for the best choice of magnetic sensors for eLISA/NGO.

  13. Numerical simulation of time delay interferometry for NGO/eLISA

    NASA Astrophysics Data System (ADS)

    Ni, Wei-Tou; Wang, Gang

    2012-07-01

    NGA/eLISA is a new mission proposal with arm length 106 km and one interferometer down-scaled from LISA (http://elisa-ngo.org/). Just like LISA and ASTROD-GW, in order to attain the requisite sensitivity for NGO/eLISA, laser frequency noise must be suppressed below the secondary noises such as the optical path noise, acceleration noise etc. In previous papers, we have used the CGC 2.7 ephemeris to numerically simulate the time delay interferometry for LISA and ASTROD-GW with one arm dysfunctional and found that they are both well below the limit under which the laser frequency noise is required to be suppressed. In this paper, we follow the same procedure to simulate the time delay interferometry numerically. To do this, we work out a set of 3-year optimized mission orbits of NGO/eLISA spacecraft starting at January 1, 2021 using the CGC2.7 ephemeris framework. We then use this numerical solution to calculate the residual optical path differences in the second-generation solutions as in our previous papers. The accuracy of this calculation for path differences is better than 0.01 mm (about 0.03 ps). The maximum path length difference, for all configuration calculated, is below 12 mm (40 ps). This is well below the limit under which the laser frequency noise is required to be suppressed for NGO/eLISA. We compare and discuss the resulting differences due to arm lengths for various mission proposals.

  14. Public health imperative of the 21st century: innovations in palliative care systems, services, and supports to improve health and well-being of older americans.

    PubMed

    Morrissey, Mary Beth; Herr, Keela; Levine, Carol

    2015-04-01

    A primary aim of federal aging and health policy must be promoting innovations in palliative care systems, services, and supports that improve the experience of growing old in America. Older adults must contend today with increasing burden over the life course often as the result of life-limiting chronic pain and chronic illnesses as well as social and economic factors beyond their control. These burdens are frequently shared with unpaid family caregivers who provide significant uncompensated medical care and social support to their loved ones. Enjoyment of the highest attainable standard of physical and mental health, recognized as a fundamental human right under international law, remains a goal for all older adults and encompasses the right to palliative care. For many older Americans, especially vulnerable subgroups who face health and pain disparities, however, this goal remains elusive. A public health strategy for implementing palliative care policy interventions will help to build age-friendly environments, assure the availability and accessibility of palliative systems of care, essential medicines, and an adequate generalist-level workforce, and sustain diffusion of innovation across all levels of health and social provision. The 2015 White House Conference on Aging must make these realignments a policy priority in order to foster social and economic development for all older Americans. PMID:26035600

  15. Sharing innovation: the case for technology standards in health professions education.

    PubMed

    Smothers, Valerie; Greene, Peter; Ellaway, Rachel; Detmer, Don E

    2008-01-01

    Information technologies have provided fertile ground for innovation in healthcare education, but too often these innovations have been limited in scope and impact. One way of addressing these limitations is the development of common and open technology standards to scale innovation across organizational boundaries. Research on the diffusion of standards indicates that environmental forces, such as regulatory changes, top-down management support, and feasibility are key determinants of standards adoption. This paper describes the perspective and work of MedBiquitous, the only internationally recognized standards body in healthcare education. Many innovators are implementing MedBiquitous healthcare education standards to effect change within and across organizations. In a resource-constrained and knowledge intensive domain such as healthcare education, collaboration is an imperative. Technology standards are essential to raise the quality of healthcare education and assessment in a cost-effective manner. PMID:18464138

  16. University-NGO connections for earthquake and tsunami risk reduction: lessons learned in West Sumatra

    NASA Astrophysics Data System (ADS)

    McCaughey, J.; Dewi, P. R.

    2013-12-01

    Scientists have information that is critical to policy and public education, yet lack field staff of their own to put this into practice. NGOs have field staff as well as connections with policymakers and the community, yet lack a direct connection to the latest scientific research. Scientists face pressure to obtain grants and publish; NGOs face pressure to deliver programs to as many people as possible. Lacking institutional incentives that recognize efforts to bridge the science-practice gap, it is often out of personal convictions that scientists seek to share their results with NGOs, and NGO practitioners seek to deepen their own scientific knowledge. Such individual efforts are impactful; however, more can be achieved with institutional commitments to closer collaboration. Science communication is dialogue, not a one-way transfer of knowledge from science to practice. On the university side, listening to our NGO partners has inspired faculty, staff, and students, identified new areas of fundamental scientific research inspired by practical use, and helped prioritize and clarify the scientific information that is most useful for disaster-risk-reduction practice. On the NGO side, connections to scientists have informed the content of public education and policy advocacy programs and clarified technical information; this new understanding has been incorporated in advocacy and community engagement programs.

  17. Innovations on a shoestring: a study of a collaborative community-based Aboriginal mental health service model in rural Canada

    PubMed Central

    2009-01-01

    Background Collaborative, culturally safe services that integrate clinical approaches with traditional Aboriginal healing have been hailed as promising approaches to ameliorate the high rates of mental health problems in Aboriginal communities in Canada. Overcoming significant financial and human resources barriers, a mental health team in northern Ontario is beginning to realize this ideal. We studied the strategies, strengths and challenges related to collaborative Aboriginal mental health care. Methods A participatory action research approach was employed to evaluate the Knaw Chi Ge Win services and their place in the broader mental health system. Qualitative methods were used as the primary source of data collection and included document review, ethnographic interviews with 15 providers and 23 clients; and 3 focus groups with community workers and managers. Results The Knaw Chi Ge Win model is an innovative, community-based Aboriginal mental health care model that has led to various improvements in care in a challenging rural, high needs environment. Formal opportunities to share information, shared protocols and ongoing education support this model of collaborative care. Positive outcomes associated with this model include improved quality of care, cultural safety, and integration of traditional Aboriginal healing with clinical approaches. Ongoing challenges include chronic lack of resources, health information and the still cursory understanding of Aboriginal healing and outcomes. Conclusions This model can serve to inform collaborative care in other rural and Indigenous mental health systems. Further research into traditional Aboriginal approaches to mental health is needed to continue advances in collaborative practice in a clinical setting. PMID:20017919

  18. Scaling-up a public health innovation: a comparative study of post-abortion care in Bolivia and Mexico.

    PubMed

    Billings, Deborah L; Crane, Barbara B; Benson, Janie; Solo, Julie; Fetters, Tamara

    2007-06-01

    Post-abortion care (PAC), an innovation for treating women with complications of unsafe abortion, has been introduced in public health systems around the world since the 1994 International Conference on Population and Development (ICPD). This article analyzes the process of scaling-up two of the three key elements of the original PAC model: providing prompt clinical treatment to women with abortion complications and offering post-abortion contraceptive counseling and methods in Bolivia and Mexico. The conceptual framework developed from this comparative analysis includes the environmental context for PAC scale-up; the major influences on start-up, expansion, and institutionalization of PAC; and the health, financial, and social impacts of institutionalization. Start-up in both Bolivia and Mexico was facilitated by innovative leaders or catalyzers who were committed to introducing PAC services into public health care settings, collaboration between international organizations and public health institutions, and financial resources. Important processes for successful PAC expansion included strengthening political commitment to PAC services through research, advocacy, and partnerships; improving health system capacity through training, supervision, and development of service guidelines; and facilitating health system access to essential technologies. Institutionalization of PAC has been more successful in Bolivia than Mexico, as measured by a series of proposed indicators. The positive health and financial impacts of PAC institutionalization have been partially measured in Bolivia and Mexico. Other hypotheses--that scaling-up PAC will significantly reduce maternal mortality and morbidity, decrease abortion-related stigma, and prepare the way for efforts to reform restrictive abortion laws and policies--have yet to be tested. PMID:17408826

  19. Indian NGO features Kama Sutra in safe sex campaign.

    PubMed

    1993-01-01

    Many different positions in which sexual intercourse may be enjoyed are depicted in the Kama Sutra, an ancient Sanskrit treatise on the art of physical love. If 65 sex positions are practiced between lovers, the tendency toward growing bored with having sex with only one person will be challenged. To that end, the Indian Health Organization, a nongovernmental organization founded 11 years ago in Bombay, is promoting the teachings of the Kama Sutra as an alternative to condom use in preventing HIV/AIDS and other sexually transmitted diseases. The basic message that sex with one partner in many positions is safer than sex in one position with many partners is proclaimed on T-shirts and in a series of explicit postcards. This approach is promoting openness, communication, and equality between the sexes. PMID:12287434

  20. Pathways to economic opportunity: an overview of innovative career pathway collaborations for Latinos into frontline health care occupations.

    PubMed

    De Jesús, Anthony; Torres, Andrés; Rivera, Carmen Vivian

    2014-01-01

    Extraordinary Latino population growth has created demand for bilingual and culturally competent frontline health care providers to address the "culture gap" in health care delivery meeting the linguistic and cultural needs of Latino communities (Cohen, Gabriel, & Terrell, 2002). This article reviews career pathway programs that serve as workforce development models for Latinos seeking opportunity within frontline health care occupations, a sector with high-projected employment growth in the coming decade. The programs examined reflect innovative approaches that target Latino participants for entrance into some of these occupations including registered nurses (RNs), licensed practical nurses (LPNs), human service assistants, and bachelor's level social worker positions that offer low-wage Latinos the possibility of entering a profession where they may earn a livable wage. Implications for policy, research, and practice are discussed. PMID:24871914

  1. Innovation in veterans' health care and assistance: the Department of Veterans Affairs 10 years after the Gulf War.

    PubMed

    Brown, Mark A; Murphy, Frances M; Mather, Susan H

    2002-03-01

    The Department of Veterans Affairs (VA) has responded to significant challenges in treating and compensating Persian Gulf War veterans by adapting existing programs and developing new ones. The VA established a Gulf War health examination registry and expanded existing "Vet Centers" to provide assistance to Gulf War veterans. Health care eligibility income limitations were eliminated. Outreach efforts included a national newsletter, veterans' organization briefings, and other products. The VA is developing targeted training programs and continuing medical education for health care providers. Numerous major research initiatives have begun. Innovations include the establishment of environmental hazards research centers, clinical demonstration projects, and centers for the study of war-related illness. These efforts required increased coordination among federal agencies and collaboration with other countries. In a precedent-setting development, Congress gave the VA authority to compensate certain veterans with undiagnosed illnesses. Veterans from future conflicts and peacekeeping missions can expect improved services from the VA as a result of these initiatives. PMID:11901564

  2. Lean Six Sigma applied to a process innovation in a mexican health institute's imaging department.

    PubMed

    Garcia-Porres, J; Ortiz-Posadas, M R; Pimentel-Aguilar, A B

    2008-01-01

    Delivery of services to a patient has to be given with an acceptable measure of quality that can be monitored through the patient's satisfaction. The objective of this work was to innovate processes eliminating waste and non value-added work in processes done at the Imaging Department in the National Institute of Respiratory Diseases (INER for its Spanish acronym) in Mexico City, to decrease the time a patient spends in a study and increase satisfaction. This innovation will be done using Lean Six Sigma tools and applied in a pilot program. PMID:19163870

  3. New technologies and surgical innovation: five years of a local health technology assessment program in a surgical department.

    PubMed

    Poulin, Paule; Austen, Lea; Kortbeek, John B; Lafrenière, René

    2012-06-01

    There is pressure for surgical departments to introduce new and innovative health technologies in an evidence-based manner while ensuring that they are safe and effective and can be managed with available resources. A local health technology assessment (HTA) program was developed to systematically integrate research evidence with local operational management information and to make recommendations for subsequent decision by the departmental executive committee about whether and under what conditions the technology will be used. The authors present a retrospective analysis of the outcomes of this program as used by the Department of Surgery & Surgical Services in the Calgary Health Region over a 5-year period from December 2005 to December 2010. Of the 68 technologies requested, 15 applications were incomplete and dropped, 12 were approved, 3 were approved for a single case on an urgent/emergent basis, 21 were approved for "clinical audit" for a restricted number of cases with outcomes review, 14 were approved for research use only, and 3 were referred to additional review bodies. Subsequent outcome reports resulted in at least 5 technologies being dropped for failure to perform. Decisions based on local HTA program recommendations were rarely "yes" or "no." Rather, many technologies were given restricted approval with full approval contingent on satisfying certain conditions such as clinical outcomes review, training protocol development, or funding. Thus, innovation could be supported while ensuring safety and effectiveness. This local HTA program can be adapted to a variety of settings and can help bridge the gap between evidence and practice. PMID:21949011

  4. Advanced technology care innovation for older people in Italy: necessity and opportunity to promote health and wellbeing.

    PubMed

    Lattanzio, Fabrizia; Abbatecola, Angela M; Bevilacqua, Roberta; Chiatti, Carlos; Corsonello, Andrea; Rossi, Lorena; Bustacchini, Silvia; Bernabei, Roberto

    2014-07-01

    Even though there is a constant and accelerating growth of the aging population worldwide, such a rapid rise is negatively impacting available home and community services not able to encompass the necessities associated with the increased number of older people. In particular, there are increasing demands on e-health care services and smart technologies needed for frail elders with chronic diseases and also for those experiencing active aging. Advanced Technology Care Innovation for older persons encompasses all sectors (assistive technology, robotics, home automation, and home care- and institution-based healthcare monitoring, telemedicine) dedicated to promoting health and wellbeing in all types of living environments. Considering that there is a large concern and demand by older persons to remain in familiar social living surroundings, study projects joined with industries have been currently initiated, especially across Europe to improve health and wellbeing. This article will highlight the latest updates in Europe and, in particular in Italy, regarding scientific projects dedicated to unraveling how diverse needs can be translated into an up-to-date technology innovation for the growing elder population. We will provide information regarding advanced technology designed for those with specific geriatric-correlated conditions in familiar living settings and for individuals aging actively. This is an important action because numerous emerging developments are based on user needs identified by geriatricians, thus, underlining the indispensable role of geriatric medicine toward future guidelines on specific technology. PMID:24836715

  5. An innovative model of culturally tailored health promotion groups for Cambodian survivors of torture.

    PubMed

    Berkson, Sarah Y; Tor, Svang; Mollica, Richard; Lavelle, James; Cosenza, Carol

    2014-01-01

    Cambodians living in the U.S.A. suffer from depression, posttraumatic stress disorder (PTSD), and chronic medical disease at rates far in excess of national averages. The Harvard Program in Refugee Trauma's Cambodian Health Promotion Program seeks to address this burden of disease by offering them culturally tailored health education in a group setting. A health professional and a bicultural health educator co-facilitated a five-session health promotion group for Cambodian survivors of torture from 2007 to 2011. The program covered five major topics from Western and Cambodian worldviews. They included the meaning of health promotion, nutrition, exercise, stress management and sleep hygiene, and health practitioner-patient communication. The bicultural worker administered Pre and Post semi-structured Health Promotion Questionnaires. The data presented here are the results from 126 participants. Changes between the Pre and Post health promotion groups demonstrated significant improvements in health status, lifestyle activities, sleep, and depression. Participants revealed greater confidence in communicating with their primary health care practitioner. Culturally tailored Cambodian health promotion education administered in a small group setting may improve health and mental health behaviors. Culturally tailored health promotion education in a small group setting may promote healing in survivors of torture. It is an intervention worthy of further research and development. PMID:25047082

  6. Population Aging in the European Information Societies: Towards a Comprehensive Research Agenda in eHealth Innovations for Elderly

    PubMed Central

    Vancea, Mihaela; Solé-Casals, Jordi

    2016-01-01

    Population ageing is one of the major social and economic challenges of our contemporary societies. With the advent of the information society, new research and technological developments have been promoted in the field of assistive technologies and information and communication technologies of benefit to elderly people. This article examines the potentialities of new informatics developments in generating solutions to better address elderly people’s daily-life, especially those with chronic illness and/or low autonomy. The authours attempt to propose a research agenda, by exposing various strengts and weaknesses of eHealth innovations for elderly, mainly grounded in secondary sources analysis. PMID:27493837

  7. Population Aging in the European Information Societies: Towards a Comprehensive Research Agenda in eHealth Innovations for Elderly.

    PubMed

    Vancea, Mihaela; Solé-Casals, Jordi

    2016-08-01

    Population ageing is one of the major social and economic challenges of our contemporary societies. With the advent of the information society, new research and technological developments have been promoted in the field of assistive technologies and information and communication technologies of benefit to elderly people. This article examines the potentialities of new informatics developments in generating solutions to better address elderly people's daily-life, especially those with chronic illness and/or low autonomy. The authours attempt to propose a research agenda, by exposing various strengts and weaknesses of eHealth innovations for elderly, mainly grounded in secondary sources analysis. PMID:27493837

  8. New academic partnerships in global health: innovations at Mount Sinai School of Medicine.

    PubMed

    Landrigan, Philip J; Ripp, Jonathan; Murphy, Ramon J C; Claudio, Luz; Jao, Jennifer; Hexom, Braden; Bloom, Harrison G; Shirazian, Taraneh; Elahi, Ebby; Koplan, Jeffrey P

    2011-01-01

    Global health has become an increasingly important focus of education, research, and clinical service in North American universities and academic health centers. Today there are at least 49 academically based global health programs in the United States and Canada, as compared with only one in 1999. A new academic society, the Consortium of Universities for Global Health, was established in 2008 and has grown significantly. This sharp expansion reflects convergence of 3 factors: (1) rapidly growing student and faculty interest in global health; (2) growing realization-powerfully catalyzed by the acquired immune deficiency syndrome epidemic, the emergence of other new infections, climate change, and globalization-that health problems are interconnected, cross national borders, and are global in nature; and (3) rapid expansion in resources for global health. This article examines the evolution of the concept of global health and describes the driving forces that have accelerated interest in the field. It traces the development of global health programs in academic health centers in the United States. It presents a blueprint for a new school-wide global health program at Mount Sinai School of Medicine. The mission of that program, Mount Sinai Global Health, is to enhance global health as an academic field of study within the Mount Sinai community and to improve the health of people around the world. Mount Sinai Global Health is uniting and building synergies among strong, existing global health programs within Mount Sinai; it is training the next generation of physicians and health scientists to be leaders in global health; it is making novel discoveries that translate into blueprints for improving health worldwide; and it builds on Mount Sinai's long and proud tradition of providing medical and surgical care in places where need is great and resources few. PMID:21598272

  9. New Academic Partnerships in Global Health: Innovations at Mount Sinai School of Medicine

    PubMed Central

    Landrigan, Philip J.; Ripp, Jonathan; Murphy, Ramon J. C.; Claudio, Luz; Jao, Jennifer; Hexom, Braden; Bloom, Harrison G.; Shirazian, Taraneh; Elahi, Ebby; Koplan, Jeffrey P.

    2011-01-01

    Global health has become an increasingly important focus of education, research, and clinical service in North American universities and academic health centers. Today there are at least 49 academically based global health programs in the United States and Canada, as compared with only one in 1999. A new academic society, the Consortium of Universities for Global Health, was established in 2008 and has grown significantly. This sharp expansion reflects convergence of 3 factors: (1) rapidly growing student and faculty interest in global health; (2) growing realization–powerfully catalyzed by the acquired immune deficiency syndrome epidemic, the emergence of other new infections, climate change, and globalization–that health problems are interconnected, cross national borders, and are global in nature; and (3) rapid expansion in resources for global health. This article examines the evolution of the concept of global health and describes the driving forces that have accelerated interest in the field. It traces the development of global health programs in academic health centers in the United States. It presents a blueprint for a new school-wide global health program at Mount Sinai School of Medicine. The mission of that program, Mount Sinai Global Health, is to enhance global health as an academic field of study within the Mount Sinai community and to improve the health of people around the world. Mount Sinai Global Health is uniting and building synergies among strong, existing global health programs within Mount Sinai; it is training the next generation of physicians and health scientists to be leaders in global health; it is making novel discoveries that translate into blueprints for improving health worldwide; and it builds on Mount Sinai’s long and proud tradition of providing medical and surgical care in places where need is great and resources few. PMID:21598272

  10. Effect of an innovative community based health program on maternal health service utilization in north and south central Ethiopia: a community based cross sectional study

    PubMed Central

    2014-01-01

    Background Among Millennium Development Goals, achieving the fifth goal (MDG-5) of reducing maternal mortality poses the greatest challenge in Sub-Saharan Africa. Ethiopia has one of the highest maternal mortality ratios in the world with unacceptably low maternal health service utilization. The Government of Ethiopia introduced an innovative community-based intervention as a national strategy under the Health Sector Development Program. This new approach, known as the Health Extension Program, aims to improve access to and equity in essential health services through community based Health Extension Workers. Objective The objective of the study is to assess the role of Health Extension Workers in improving women’s utilization of antenatal care, delivery at health facility and postnatal care services. Methods A cross sectional household survey was conducted in early 2012 in two districts of northern and south central parts of Ethiopia. Data were collected from 4949 women who had delivered in the two years preceding the survey. Logistic regression analysis was performed to determine the association between visit by Health Extension Workers during pregnancy and use of maternal health services, controlling for the effect of other confounding factors. Results The non–adjusted analysis showed that antenatal care attendance at least four times during pregnancy was significantly associated with visit by Health Extension Workers [Odds Ratio 3.46(95% CI 3.07,3.91)], whereas health facility delivery (skilled attendance at birth) was not significantly associated with visit by Health Extension Workers during pregnancy [Odds Ratio 0.87(95% CI 0.25,2.96)]. When adjusted for other factors the association of HEWs visit during pregnancy was weaker for antenatal care attendance [Adjusted Odds Ratio: 1.35(95% CI: 1.05, 1.72)] but positively and significantly associated with health facility delivery [Adjusted Odds Ratio 1.96(1.25,3.06)]. Conclusion In general HEWs visit during

  11. HIMSS Venture+ Forum and HX360 Provide Industry View of Health Technology Innovation, Startup and Investment Activity; Advancing the New Model of Care.

    PubMed

    Burde, Howard A; Scarfo, Richard

    2015-01-01

    Presented by HIMSS, the Venture+ Forum program and pitch competition provides a 360-degree view on health technology investing and today's top innovative companies. It features exciting 3-minute pitch presentations from emerging and growth-stage companies, investor panels and a networking reception. Recent Venture+ Forum winners include TowerView Health, Prima-Temp, ActuaiMeds and M3 Clinician. As an industry catalyst for health IT innovation and business-building resource for growing companies and emerging technology solutions, HIMSS has co-developed with A VIA, a new initiative that addresses how emerging technologies, health system business model changes and investment will transform the delivery of care. HX360 engages senior healthcare leaders, innovation teams, investors and entrepreneurs around the vision of transforming healthcare delivery by leveraging technology, process and structure. PMID:26571634

  12. Key factors influencing adoption of an innovation in primary health care: a qualitative study based on implementation theory

    PubMed Central

    2010-01-01

    Background Bridging the knowledge-to-practice gap in health care is an important issue that has gained interest in recent years. Implementing new methods, guidelines or tools into routine care, however, is a slow and unpredictable process, and the factors that play a role in the change process are not yet fully understood. There is a number of theories concerned with factors predicting successful implementation in various settings, however, this issue is insufficiently studied in primary health care (PHC). The objective of this article was to apply implementation theory to identify key factors influencing the adoption of an innovation being introduced in PHC in Sweden. Methods A qualitative study was carried out with staff at six PHC units in Sweden where a computer-based test for lifestyle intervention had been implemented. Two different implementation strategies, implicit or explicit, were used. Sixteen focus group interviews and two individual interviews were performed. In the analysis a theoretical framework based on studies of implementation in health service organizations, was applied to identify key factors influencing adoption. Results The theoretical framework proved to be relevant for studies in PHC. Adoption was positively influenced by positive expectations at the unit, perceptions of the innovation being compatible with existing routines and perceived advantages. An explicit implementation strategy and positive opinions on change and innovation were also associated with adoption. Organizational changes and staff shortages coinciding with implementation seemed to be obstacles for the adoption process. Conclusion When implementation theory obtained from studies in other areas was applied in PHC it proved to be relevant for this particular setting. Based on our results, factors to be taken into account in the planning of the implementation of a new tool in PHC should include assessment of staff expectations, assessment of the perceived need for the

  13. 75 FR 29560 - Identifying Unmet Public Health Needs and Facilitating Innovation in Medical Device Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-26

    ... HUMAN SERVICES Food and Drug Administration Identifying Unmet Public Health Needs and Facilitating... Administration (FDA) is announcing a public workshop entitled ``Identifying Unmet Public Health Needs and... on what are the most important unmet public health needs and what are the barriers to the...

  14. Creative Contributory Contests to Spur Innovation in Sexual Health: 2 Cases and a Guide for Implementation.

    PubMed

    Zhang, Ye; Kim, Julie A; Liu, Fengying; Tso, Lai Sze; Tang, Weiming; Wei, Chongyi; Bayus, Barry L; Tucker, Joseph D

    2015-11-01

    Sexual health campaigns are often designed "top-down" by public health experts, failing to engage key populations. Using the power of crowdsourcing to shape a "bottom-up" approach, this note describes 2 creative contributory contests to enhance sexual health campaigns. We provide guidance for designing creative contributory contests to improve HIV and other sexually transmitted disease testing. PMID:26462186

  15. Innovation in Health Policy Education: Project-Based Service Learning at a Distance for Graduate Midwifery Students.

    PubMed

    Van Hoover, Cheri

    2015-01-01

    Core competencies for midwifery practice include an understanding of systems of health care delivery and advocacy for legislation and policy initiatives that promote quality in health care. Today's rapidly changing health care environment, due in part to the implementation of the Patient Protection and Affordable Care Act, mandates that midwives possess greater literacy in health policy and comfort with political action than ever before. Frequently disinterested in politics and intimidated by the policymaking process, student midwives lack the foundational knowledge and practical skills needed to meet this professional obligation. The Midwifery Institute of Philadelphia University graduate program educates both student nurse-midwives and student midwives in health policy using an innovative, project-based service-learning approach featuring real-world collaborative experiences. This novel teaching style is ideally suited for instruction at a distance because of the diversity of experience brought to the virtual classroom by students in widely disparate geopolitical locations. As students accomplish measurable objectives within their individually developed projects and reflect with classmates about their experiences, they feel empowered to effect change and report lower perceived barriers to future political engagement. PMID:26381734

  16. Neisseria gonorrhoeae filamentous phage NgoΦ6 is capable of infecting a variety of Gram-negative bacteria.

    PubMed

    Piekarowicz, Andrzej; Kłyż, Aneta; Majchrzak, Michał; Szczêsna, Ewa; Piechucki, Marcin; Kwiatek, Agnieszka; Maugel, Timothy K; Stein, Daniel C

    2014-01-01

    We constructed a phagemid consisting of the whole genome of the Neisseria gonorrhoeae bacteriophage NgoΦ6 cloned into a pBluescript plasmid derivative lacking the f1 origin of replication (named pBS::Φ6). Escherichia coli cells harboring pBS::Φ6 were able to produce a biologically active phagemid, NgoΦ6fm, capable of infecting, integrating its DNA into the chromosome of, and producing progeny phagemids in, a variety of taxonomically distant Gram-negative bacteria, including E. coli, Haemophilus influenzae, Neisseria sicca, Pseudomonas sp., and Paracoccus methylutens. A derivative of pBS::Φ6 lacking the phage orf7 gene, a positional homolog of filamentous phage proteins that mediate the interaction between the phage and the bacterial pilus, was capable of producing phagemid particles that were able to infect E. coli, Haemophilus influenzae, N. sicca, Pseudomonas sp., and Paracoccus methylutens, indicating that NgoΦ6 infects cells of these species using a mechanism that does not involve the Orf7 gene product and that NgoΦ6 initiates infection through a novel process in these species. We further demonstrate that the establishment of the lysogenic state does not require an active phage integrase. Since phagemid particles were capable of infecting diverse hosts, this indicates that NgoΦ6 is the first broad-host-range filamentous bacteriophage described. PMID:24198404

  17. A model for scale up of family health innovations in low-income and middle-income settings: a mixed methods study

    PubMed Central

    Bradley, Elizabeth H; Curry, Leslie A; Taylor, Lauren A; Pallas, Sarah Wood; Talbert-Slagle, Kristina; Yuan, Christina; Fox, Ashley; Minhas, Dilpreet; Ciccone, Dana Karen; Berg, David; Pérez-Escamilla, Rafael

    2012-01-01

    Background Many family health innovations that have been shown to be both efficacious and cost-effective fail to scale up for widespread use particularly in low-income and middle-income countries (LMIC). Although individual cases of successful scale-up, in which widespread take up occurs, have been described, we lack an integrated and practical model of scale-up that may be applicable to a wide range of public health innovations in LMIC. Objective To develop an integrated and practical model of scale-up that synthesises experiences of family health programmes in LMICs. Data sources We conducted a mixed methods study that included in-depth interviews with 33 key informants and a systematic review of peer-reviewed and grey literature from 11 electronic databases and 20 global health agency web sites. Study eligibility criteria, participants and interventions We included key informants and studies that reported on the scale up of several family health innovations including Depo-Provera as an example of a product innovation, exclusive breastfeeding as an example of a health behaviour innovation, community health workers (CHWs) as an example of an organisational innovation and social marketing as an example of a business model innovation. Key informants were drawn from non-governmental, government and international organisations using snowball sampling. An article was excluded if the article: did not meet the study's definition of the innovation; did not address dissemination, diffusion, scale up or sustainability of the innovation; did not address low-income or middle-income countries; was superficial in its discussion and/or did not provide empirical evidence about scale-up of the innovation; was not available online in full text; or was not available in English, French, Spanish or Portuguese, resulting in a final sample of 41 peer-reviewed articles and 30 grey literature sources. Study appraisal and synthesis methods We used the constant comparative method of

  18. From smallpox eradication to the future of global health: innovations, application and lessons for future eradication and control initiatives.

    PubMed

    Tomori, Oyewale

    2011-12-30

    Technological advancements, including landmark innovations in vaccinology through molecular virology, and significant transformation and changes in the society have taken place since the eradication of smallpox thirty years ago. The success with eradicating smallpox gave confidence for initiating the eradication of other diseases, such as malaria and polio. However, these efforts have not been as effective, as recorded for small pox, for a variety of reasons. There is now a debate within the global health community as to whether eradication campaigns should be abandoned in favor of less costly and perhaps more effective primary health and containment or control programmes. Significant changes that have taken place in the last thirty years, since the eradication of smallpox include, among others, (i) post-colonial political changes, with varying commitment to disease eradication initiatives, especially in the parts of the world most burdened by infectious and vaccine preventable diseases, (ii) innovations leading to the development of new and highly effective vaccines, targeted to specific diseases, (iii) the transformation brought about by improvement in education and the new global access to information (cell phones, internet, etc.), leading to an unlimited access to different types of information, subject to either positive or negative use. At the onset of eradication of smallpox, global health was confined in its operation. Today, global health is at the intersection of medical and social science disciplines-including demography, economics, epidemiology, political economy and sociology. Therefore, in considering the issue of disease eradication, medical and social perspectives must be brought into play, if future eradication programmes must succeed. The paper discusses the roles of these disciplines in disease control and eradication, especially as it affects sub Saharan Africa, the melting pot and verdant pasture of infectious diseases. PMID:22185830

  19. Precision Laser Development for Interferometric Space Missions NGO, SGO, and GRACE Follow-On

    NASA Technical Reports Server (NTRS)

    Numata, Kenji; Camp, Jordan

    2011-01-01

    Optical fiber and semiconductor laser technologies have evolved dramatically over the last decade due to the increased demands from optical communications. We are developing a laser (master oscillator) and optical amplifier based on those technologies for interferometric space missions, including the gravitational-wave missions NGO/SGO (formerly LISA) and the climate monitoring mission GRACE Follow-On, by fully utilizing the matured wave-guided optics technologies. In space, where simpler and more reliable system is preferred, the wave-guided components are advantageous over bulk, crystal-based, free-space laser, such as NPRO (Nonplanar Ring Oscillator) and bulk-crystal amplifier.

  20. Precision laser development for interferometric space missions NGO, SGO, and GRACE Follow-On

    NASA Astrophysics Data System (ADS)

    Numata, K.; Camp, J.

    2012-06-01

    Optical fiber and semiconductor laser technologies have evolved dramatically over the last decade due to the increased demands from optical communications. We are developing a laser (master oscillator) and optical amplifier based on those technologies for interferometric space missions, including the gravitational-wave missions NGO/SGO (formerly LISA) and the climate monitoring mission GRACE Follow-On, by fully utilizing the matured wave-guided optics technologies. In space, where simpler and more reliable system is preferred, the wave-guided components are advantageous over bulk, crystal-based, free-space laser, such as NPRO (Non-planar Ring Oscillator) and bulk-crystal amplifier.

  1. An eHealth Platform to Manage Chronic Disease in Primary Care: An Innovative Approach

    PubMed Central

    Verdijk, Noortje A; Harmans, Lara M; Numans, Mattijs E; Chavannes, Niels H

    2016-01-01

    The number of individuals with chronic illness and multimorbidity is growing due to the rapid ageing of the population and the greater longevity of individuals. This causes an increasing workload in care, which results in a growing need for structural changes of the health care system. In recent years this led to a strong focus on promoting “self-management” in chronically ill patients. Research showed that patients who understand more about their disease, health, and lifestyle have better experiences and health outcomes, and often use less health care resources; the effect is even more when these patients are empowered to and responsible for managing their health and disease. In addition to the skills of patients, health care professionals need to shift to a role of teacher, partner, and professional supervisor of their patients. One way of supervising patients is by the use of electronic health (eHealth), which helps patients manage and control their disease. The application of eHealth solutions can provide chronically ill patients high-quality care, to the satisfaction of both patients and health care professionals, alongside a reduction in health care consumption and costs. PMID:26860333

  2. Ten Years of a National Oral Health Policy in Brazil: Innovation, Boldness, and Numerous Challenges.

    PubMed

    Pucca, G A; Gabriel, M; de Araujo, M E; de Almeida, F C S

    2015-10-01

    Brazil is the only country in the world to propose a universal health care system with the aim of guaranteeing delivery of all levels of health care, free of charge, to a population of over 200 million inhabitants by means of a unified health system ("Sistema Único de Saúde" [SUS]). The national policy of oral health, also known as Smiling Brazil ("Brasil Sorridente"), was implemented in 2004. Oral health was designated as 1 of the 4 priority areas of the SUS, transforming oral health care in Brazil, with the objective that the SUS achieve the integrality of care envisaged at its creation. The aim of this article is to share part of this experience in order to prompt reflection about the inclusion of oral health care in other health care systems around the world. The most significant results of Smiling Brazil can be seen in 3 areas: (1) oral health epidemiological indicators, (2) financial investment and professional development, and (3) the building of an oral health care network throughout the 10 y of the policy. The "Discovery!" article presented here portrays 10 y of evolution; however, it is important to point out that this is a process undergoing construction and that the oral health care network needs to be further expanded, refined, and solidified so that over time and through changes in the political parties in power, Smiling Brazil prevails as a perennial policy and not merely an action by a single government. PMID:26316461

  3. An eHealth Platform to Manage Chronic Disease in Primary Care: An Innovative Approach.

    PubMed

    Talboom-Kamp, Esther Pwa; Verdijk, Noortje A; Harmans, Lara M; Numans, Mattijs E; Chavannes, Niels H

    2016-01-01

    The number of individuals with chronic illness and multimorbidity is growing due to the rapid ageing of the population and the greater longevity of individuals. This causes an increasing workload in care, which results in a growing need for structural changes of the health care system. In recent years this led to a strong focus on promoting "self-management" in chronically ill patients. Research showed that patients who understand more about their disease, health, and lifestyle have better experiences and health outcomes, and often use less health care resources; the effect is even more when these patients are empowered to and responsible for managing their health and disease. In addition to the skills of patients, health care professionals need to shift to a role of teacher, partner, and professional supervisor of their patients. One way of supervising patients is by the use of electronic health (eHealth), which helps patients manage and control their disease. The application of eHealth solutions can provide chronically ill patients high-quality care, to the satisfaction of both patients and health care professionals, alongside a reduction in health care consumption and costs. PMID:26860333

  4. Strengthening public health education in population and reproductive health through an innovative academic partnership in Africa: the Gates partners experience.

    PubMed

    Oni, Gbolahan; Fatusi, Adesegun; Tsui, Amy; Enquselassie, Fikre; Ojengbede, Oladosu; Agbenyega, Tsiri; Ojofeitimi, Ebenezer; Taulo, Frank; Quakyi, Isabella

    2011-01-01

    Poor reproductive health constitutes one of the leading public health problems in the world, particularly in sub-Saharan Africa (SSA). We report here an academic partnership that commenced in 2003 between a US institution and six universities in SSA. The partnership addresses the human resources development challenge in Africa by strengthening public health education and research capacity to improve population and reproductive health (PRH) outcomes in low-resource settings. The partnership's core activities focused on increasing access to quality education, strengthening health research capacity and translating scholarship and science into policy and practices. Partnership programmes focused on the educational dimension of the human resources equation provide students with improved learning facilities and enhanced work environments and also provide faculty with opportunities for professional development and an enhanced capacity for curriculum delivery. By 2007, 48 faculty members from the six universities in SSA attended PRH courses at Johns Hopkins University, 93 PRH courses were offered across the six universities, 625 of their master's students elected PRH concentrations and 158 had graduated. With the graduation of these and future student cohorts, the universities in SSA will systematically be expanding the number of public health practitioners and strengthening programme effectiveness to resolve reproductive health needs. Some challenges facing the partnership are described in this article. PMID:20614360

  5. HOBE+, a case study: a virtual community of practice to support innovation in primary care in Basque Public Health Service

    PubMed Central

    2013-01-01

    Background A virtual professional community of practice (VCoP), HOBE+, has been set up to foster and facilitate innovation in primary care. It is aimed at all primary care professionals of the Basque Public Health Service (Osakidetza) in the provinces of Biscay and Araba. HOBE + is a VCoP that incorporates innovation management from the generation of ideas to their implementation in primary care practice. Methods We used a case study method, based on the data provided by the technology platform that supports the VCoP, and from a survey completed by HOBE + users. The target population was all primary care staff (including all professional categories) from Araba and Biscay provinces of the Basque Country (Spain), who represent the target users of the VCoP. Results From a total of 5190 professionals across all the professional categories invited to join, 1627 (31.3%) actually registered in the VCoP and, during the study period, 90 (5.5% of the registered users) participated actively in some way. The total number of ideas proposed by the registered users was 133. Of these, 23 ideas (17.2%) are being implemented. Finally, 80% of the users who answered the satisfaction survey about their experience with HOBE + considered the initiative useful in order to achieve continuous improvement and real innovation in clinical and managerial processes. Conclusions The experience shows that it is possible to create a virtual CoP for innovation in primary care where professionals from different professional categories propose ideas for innovation that are ultimately implemented. This manuscript objectives are to assess the process of developing and implementing a VCoP open to all primary care professionals in Osakidetza, including the take-up, participation and use of this VCoP in the first 15 months after its launch in October 2011. In addition, the usefulness of the VCoP was assessed through a survey gathering the opinions of the professionals involved. PMID:24188617

  6. Reproductive health in the adolescent and young adult cancer patient: an innovative training program for oncology nurses.

    PubMed

    Vadaparampil, Susan T; Hutchins, Nicole M; Quinn, Gwendolyn P

    2013-03-01

    In 2008, approximately 69,200 adolescents and young adults (AYAs) were diagnosed with cancer, second only to heart disease for males in this age group. Despite recent guidelines from professional organizations and clinical research that AYA oncology patients want information about reproductive health topics and physician support for nurses to address these issues with patients, existing research finds few oncology nurses discuss this topic with patients due to barriers such as lack of training. This article describes an innovative eLearning training program, entitled Educating Nurses about Reproductive Issues in Cancer Healthcare. The threefold purpose of this article is to: (1) highlight major reproductive health concerns relevant to cancer patients, (2) describe the current status of reproductive health and oncology communication and the target audience for the training, and (3) present a systematic approach to curriculum development, including the content analysis and design stages as well as the utilization of feedback from a panel of experts. The resulting 10-week curriculum contains a broad-based approach to reproductive health communication aimed at creating individual- and practice-level change. PMID:23225072

  7. Reproductive Health in the Adolescent and Young Adult Cancer Patient: An Innovative Training Program for Oncology Nurses

    PubMed Central

    Vadaparampil, Susan T.; Hutchins, Nicole M.; Quinn, Gwendolyn P.

    2012-01-01

    In 2008, approximately 69,200 AYAs were diagnosed with cancer, second only to heart disease for males in this age group. Despite recent guidelines from professional organizations and clinical research that AYA oncology patients want information about reproductive health topics and physician support for nurses to address these issues with patients, existing research finds few oncology nurses discuss this topic with patients due to barriers such as lack of training. This article describes an innovative eLearning training program, entitled Educating Nurses about Reproductive Issues in Cancer Healthcare (ENRICH). The threefold purpose of this article is to: (1) highlight major reproductive health concerns relevant to cancer patients, (2) describe the current status of reproductive health and oncology communication and the target audience for the training, and (3) present a systematic approach to curriculum development, including the content analysis and design stages as well as the utilization of feedback from a panel of experts. The resulting 10-week curriculum contains a broad-based approach to reproductive health communication aimed at creating individual- and practice-level change. PMID:23225072

  8. Investing in nursing and midwifery enterprise: Empowering women and strengthening health systems--A landscaping study of innovations in low- and middle-income countries.

    PubMed

    Krubiner, Carleigh B; Salmon, Marla; Synowiec, Christina; Lagomarsino, Gina

    2016-01-01

    Women's empowerment and global health promotion are both central aims in the development agenda, with positive associations and feedback loops between empowerment and health outcomes. To date, most of the work exploring connections between health and empowerment has focused on women as health consumers. This article summarizes a much longer landscape review that examines ways in which various health programs can empower women as providers, specifically nurses and midwives. We conducted a scan of the Center for Health Market Innovations database to identify how innovative health programs can create empowerment opportunities for nurses and midwives. We reviewed 94 programs, exploring nurses' and midwives' roles and inputs that contribute to their empowerment. There were four salient models: provider training, information and communications technologies, cooperatives, and clinical franchises. By documenting these approaches and their hallmarks for empowering female health workers, we hope to stimulate greater uptake of health innovations coupled with gender-empowerment opportunities globally. The full report with expanded methodology and findings is available online. PMID:26652587

  9. The politics of NGO registration in international protectorates: the cases of Bosnia and Iraq.

    PubMed

    Bolton, Matthew; Jeffrey, Alex

    2008-12-01

    Following international interventions in Bosnia-Herzegovina(1) and Iraq, non-governmental organisations (NGOs) have played a central role in delivering humanitarian relief, encouraging participation in new systems of government, and advocating on behalf of marginalised groups. Although intervening agencies have framed such autonomous organisations as unquestionably virtuous, scholars have increasingly questioned the agency of NGOs, pointing to the constraining effects of funding and regulatory mechanisms. This paper contributes to this body of work by offering a detailed examination of legislation requiring NGOs to register with nascent state institutions. Drawing on case study material from Bosnia and Iraq, it argues that NGO registration should not be dismissed as a technical or legal matter, but that it should be embraced as a significant political practice embedded in relations of power. Registration legislation has increased the transparency of NGO funding origins and institutional practices, yet it has simultaneously acted as a barrier to smaller organisations and led to the transmission of international objectives through civil society entities. PMID:18479474

  10. Innovative Services Offered by School-Based Health Centers in New York City

    ERIC Educational Resources Information Center

    Sisselman, Amanda; Strolin-Goltzman, Jessica; Auerbach, Charles; Sharon, Lisa

    2012-01-01

    School-based health centers (SBHCs) continue to provide essential health care services to children and families in underserved neighborhoods across the country. Preliminary studies show that students who use SBHCs have better attendance rates as well as higher rates of academic achievement and attachment to the learning environment. Few studies,…

  11. The Development of an Innovative Health Educational Program for the Well Elderly.

    ERIC Educational Resources Information Center

    Mahoney, Diane Feeney

    This paper describes a nurse practitioner directed health center education program for senior citizens in Medford, Massachusetts. The planning process, including needs and location decisions, is defined, and a summary of needs survey data on the population is offered, including health problems (medication problems, lack of exercise, depression,…

  12. Prevention, innovation and implementation science in mental health: the next wave of reform.

    PubMed

    McGorry, Patrick

    2013-01-01

    Although the corrosive effect of mental ill health on human health and happiness has long been recognised, it is only relatively recently that mental illness has been acknowledged as one of the major threats to economic productivity worldwide. This is because the major mental disorders most commonly have their onset during adolescence and early adulthood, and therefore have a disproportionate impact on the most productive decades of life. With the costs associated with mental ill health estimated to double over the next two decades, a greater emphasis on prevention and early intervention has become even more imperative. Although prevention largely remains aspirational for many reasons, early intervention is well within our current reach and offers the potential to significantly reduce the impact of mental ill health on our health, happiness and prosperity in the immediate future. PMID:23288498

  13. Design and implementation of a health management information system in Malawi: issues, innovations and results.

    PubMed

    Chaulagai, Chet N; Moyo, Christon M; Koot, Jaap; Moyo, Humphrey B M; Sambakunsi, Thokozani C; Khunga, Ferdinand M; Naphini, Patrick D

    2005-11-01

    As in many developing countries, lack of reliable data and grossly inadequate appreciation and use of available information in planning and management of health services were two main weaknesses of the health information systems in Malawi. Malawi began strengthening its health management information system with an analysis of the strengths and weaknesses of existing information systems, sharing findings with all stakeholders. All were agreed on the need for reformation of various, vertical programme-specific information systems into a comprehensive, integrated, decentralized and action-oriented simple system. As a first step towards conceptualization and design of the system, a minimum set of indicators was identified and a strategy was formulated for establishing a system in the country. The design focused only on the use of information in planning, management and the improvement of quality and coverage of services. All health and support personnel were trained, employing a training of trainers cascade approach. Information management and use was incorporated into the pre-service training curriculum and the job description of all health workers and support personnel. Quarterly feedback, supportive supervision visits and annual reviews were institutionalized. Civil society organizations were involved in monitoring coverage of health services at local levels. A mid-term review of the achievements of the health information system judged it to be one of the best in Africa. For the first time in Malawi, the health sector has information by facility by month. Yet very little improvement has been noted in use of information in rationalizing decisions. The conclusion is that, no matter how good the design of an information system, it will not be effective unless there is internal desire, dedication and commitment of leadership to have an effective and efficient health service management system. PMID:16143590

  14. The Role of Mental Health Professionals Contributes to Mental Health Promotion and Prevention: Innovative Programmes in Serbia

    ERIC Educational Resources Information Center

    Milovancevic, Milica Pejovic; Jovicic, Milica

    2013-01-01

    It has been estimated that 9 to 13% of children and adolescents have a mental disorder that causes significant functioning impairment and that only one fifth of those who need mental health services actually receive them. The majority of children and adolescents are enrolled in schools, where they spend a considerable amount of time, and this is…

  15. Passport to health: an innovative tool to enhance healthy lifestyle choices.

    PubMed

    Vaczy, Elizabeth; Seaman, Brenda; Peterson-Sweeney, Kathleen; Hondorf, Carol

    2011-01-01

    Obesity in children and adolescents has become an epidemic in the United States. The ramifications of obesity at a young age are longstanding and affect physical health, emotional health, and the economics of the health care industry. The Strong Pediatric Practice at Golisano Children's Hospital is a large inner-city practice serving more than 14,000 urban children and adolescents, the majority living below the poverty level. The Obesity Task Force, which comprises four nurse practitioners, two nurses, a nutritionist, and one physician, developed and implemented the "Passport to Health" tool in an attempt to encourage providers to assess and work with families around the issues of weight and activity, a need that was identified through chart audits. The Passport to Health supports the policy statements on prevention of overweight and obesity by the Centers for Disease Control and Prevention, National Association of Pediatric Nurse Practitioners, and American Academy of Pediatrics. Quality assurance standards for managed care that mandate body mass index (BMI) assessment and nutrition counseling in all children and adolescents also is supported by this tool. The Passport to Health also provides the same message as a current community initiative in the Rochester area that has received widespread media coverage. This tool includes a visual color-coded indicator of the child's BMI status and a synopsis of specific healthy eating and activity goals, and it permits an individualized goal to be established. The Passport to Health translates information that the provider knows about the BMI status into information that the family and child can embrace and understand. Chart audits as well as exit interviews have demonstrated that use of the Passport to Health has increased the assessment, identification, and counseling by providers in relation to healthy eating and activity. Chart audits found that nurse practitioners embraced this practice change more readily than did

  16. Exploring Ayurvedic Knowledge on Food and Health for Providing Innovative Solutions to Contemporary Healthcare

    PubMed Central

    Payyappallimana, Unnikrishnan; Venkatasubramanian, Padma

    2016-01-01

    Ayurveda, a traditional system of medicine that originated over three millennia ago in the South Asian region, offers extensive insights about food and health based on certain unique conceptual as well as theoretical positions. Health is defined as a state of equilibrium with one’s self (svasthya) but which is inextricably linked to the environment. Ayurvedic principles, such as the tridosa (three humors) theory, provide the relationship between the microcosm and the macrocosm that can be applied in day-to-day practice. Classical Ayurveda texts cover an array of themes on food ranging from diversity of natural sources, their properties in relation to seasons and places and to their specific function both in physiological and pathological states. The epistemic perspective on health and nutrition in Ayurveda is very different from that of biomedicine and modern nutrition. However, contemporary knowledge is reinventing and advancing several of these concepts in an era of systems biology, personalized medicine, and the broader context of a more holistic transition in sciences in general. Trans-disciplinary research could be important not only for pushing the boundaries of food and health sciences but also for providing practical solutions for contemporary health conditions. This article briefly reviews the parallels in Ayurveda and biomedicine and draws attention to the need for a deeper engagement with traditional knowledge systems, such as Ayurveda. It points out that recreation of the methodologies that enabled the holistic view point about health in Ayurveda may unravel some of the complex connections with Nature. PMID:27066472

  17. Developing and theoretically justifying innovative organizational practices in health information assurance

    NASA Astrophysics Data System (ADS)

    Collmann, Jeff R.

    2003-05-01

    This paper justifies and explains current efforts in the Military Health System (MHS) to enhance information assurance in light of the sociological debate between "Normal Accident" (NAT) and "High Reliability" (HRT) theorists. NAT argues that complex systems such as enterprise health information systems display multiple, interdependent interactions among diverse parts that potentially manifest unfamiliar, unplanned, or unexpected sequences that operators may not perceive or immediately understand, especially during emergencies. If the system functions rapidly with few breaks in time, space or process development, the effects of single failures ramify before operators understand or gain control of the incident thus producing catastrophic accidents. HRT counters that organizations with strong leadership support, continuous training, redundant safety features and "cultures of high reliability" contain the effects of component failures even in complex, tightly coupled systems. Building highly integrated, enterprise-wide computerized health information management systems risks creating the conditions for catastrophic breaches of data security as argued by NAT. The data security regulations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) implicitly depend on the premises of High Reliability Theorists. Limitations in HRT thus have implications for both safe program design and compliance efforts. MHS and other health care organizations should consider both NAT and HRT when designing and deploying enterprise-wide computerized health information systems.

  18. Exploring Ayurvedic Knowledge on Food and Health for Providing Innovative Solutions to Contemporary Healthcare.

    PubMed

    Payyappallimana, Unnikrishnan; Venkatasubramanian, Padma

    2016-01-01

    Ayurveda, a traditional system of medicine that originated over three millennia ago in the South Asian region, offers extensive insights about food and health based on certain unique conceptual as well as theoretical positions. Health is defined as a state of equilibrium with one's self (svasthya) but which is inextricably linked to the environment. Ayurvedic principles, such as the tridosa (three humors) theory, provide the relationship between the microcosm and the macrocosm that can be applied in day-to-day practice. Classical Ayurveda texts cover an array of themes on food ranging from diversity of natural sources, their properties in relation to seasons and places and to their specific function both in physiological and pathological states. The epistemic perspective on health and nutrition in Ayurveda is very different from that of biomedicine and modern nutrition. However, contemporary knowledge is reinventing and advancing several of these concepts in an era of systems biology, personalized medicine, and the broader context of a more holistic transition in sciences in general. Trans-disciplinary research could be important not only for pushing the boundaries of food and health sciences but also for providing practical solutions for contemporary health conditions. This article briefly reviews the parallels in Ayurveda and biomedicine and draws attention to the need for a deeper engagement with traditional knowledge systems, such as Ayurveda. It points out that recreation of the methodologies that enabled the holistic view point about health in Ayurveda may unravel some of the complex connections with Nature. PMID:27066472

  19. CKD screening and management in the Veterans Health Administration: the impact of system organization and an innovative electronic record.

    PubMed

    Patel, Thakor G; Pogach, Leonard M; Barth, Robert H

    2009-03-01

    At the beginning of this decade, Healthy People 2010 issued a series of objectives to "reduce the incidence, morbidity, mortality and health care costs of chronic kidney disease." A necessary feature of any program to reduce the burden of kidney disease in the US population must include mechanisms to screen populations at risk and institute early the aspects of management, such as control of blood pressure, management of diabetes, and, in patients with advanced chronic kidney disease (CKD), preparation for dialysis therapy and proper vascular access management, that can retard CKD progression and improve long-term outcome. The Department of Veterans Affairs and the Veterans Health Administration is a broad-based national health care system that is almost uniquely situated to address these issues and has developed a number of effective approaches using evidence-based clinical practice guidelines, performance measures, innovative use of a robust electronic medical record system, and system oversight during the past decade. In this report, we describe the application of this systems approach to the prevention of CKD in veterans through the treatment of risk factors, identification of CKD in veterans, and oversight of predialysis and dialysis care. The lessons learned and applicability to the private sector are discussed. PMID:19231765

  20. 'Scaling-up is a craft not a science': Catalysing scale-up of health innovations in Ethiopia, India and Nigeria.

    PubMed

    Spicer, Neil; Bhattacharya, Dipankar; Dimka, Ritgak; Fanta, Feleke; Mangham-Jefferies, Lindsay; Schellenberg, Joanna; Tamire-Woldemariam, Addis; Walt, Gill; Wickremasinghe, Deepthi

    2014-11-01

    Donors and other development partners commonly introduce innovative practices and technologies to improve health in low and middle income countries. Yet many innovations that are effective in improving health and survival are slow to be translated into policy and implemented at scale. Understanding the factors influencing scale-up is important. We conducted a qualitative study involving 150 semi-structured interviews with government, development partners, civil society organisations and externally funded implementers, professional associations and academic institutions in 2012/13 to explore scale-up of innovative interventions targeting mothers and newborns in Ethiopia, the Indian state of Uttar Pradesh and the six states of northeast Nigeria, which are settings with high burdens of maternal and neonatal mortality. Interviews were analysed using a common analytic framework developed for cross-country comparison and themes were coded using Nvivo. We found that programme implementers across the three settings require multiple steps to catalyse scale-up. Advocating for government to adopt and finance health innovations requires: designing scalable innovations; embedding scale-up in programme design and allocating time and resources; building implementer capacity to catalyse scale-up; adopting effective approaches to advocacy; presenting strong evidence to support government decision making; involving government in programme design; invoking policy champions and networks; strengthening harmonisation among external programmes; aligning innovations with health systems and priorities. Other steps include: supporting government to develop policies and programmes and strengthening health systems and staff; promoting community uptake by involving media, community leaders, mobilisation teams and role models. We conclude that scale-up has no magic bullet solution - implementers must embrace multiple activities, and require substantial support from donors and governments in

  1. Did Prohibition Really Work? Alcohol Prohibition as a Public Health Innovation

    PubMed Central

    Blocker, Jack S.

    2006-01-01

    The conventional view that National Prohibition failed rests upon an historically flimsy base. The successful campaign to enact National Prohibition was the fruit of a century-long temperance campaign, experience of which led prohibitionists to conclude that a nationwide ban on alcohol was the most promising of the many strategies tried thus far. A sharp rise in consumption during the early 20th century seemed to confirm the bankruptcy of alternative alcohol-control programs. The stringent prohibition imposed by the Volstead Act, however, represented a more drastic action than many Americans expected. Nevertheless, National Prohibition succeeded both in lowering consumption and in retaining political support until the onset of the Great Depression altered voters’ priorities. Repeal resulted more from this contextual shift than from characteristics of the innovation itself. PMID:16380559

  2. NGO-provided free HIV treatment and services in Burkina Faso: scarcity, therapeutic rationality and unfair process

    PubMed Central

    2012-01-01

    Until 2010, Burkina Faso was an exception to the international trend of abolishing user fees for antiretroviral treatment (ART). Patients were still expected to pay 1,500F CFA (2 Euros) per month for ART. Nevertheless, many non-governmental organizations (NGOs) exempted patients from payment. The objective of this study was to investigate how NGOs selected the beneficiaries of payment exemptions for government-provided ART and rationed out complementary medical and psychosocial services. For this qualitative study, we conducted 13 individual interviews and three focus group discussions (n = 13 persons) with program staff in nine NGOs (4,000 patients), two NGO coordinating structures and one national program. These encounters were recorded and transcribed, and their content was thematically analyzed. The results were presented to the NGOs for feedback. Results indicate that there are no concrete guidelines for identifying patients warranting payment exemptions. Formerly, ART was scarce in Burkina Faso and the primary criterion for treatment selection was clinical. Our results suggest that this scarcity, mediated by an approach we call sociotherapeutic rationality (i.e. maximization of clinical success), may have led to inequities in the provision of free ART. This approach may be detrimental to assuring equity since the most impoverished lack resources to pay for services that maximize clinical success (e.g. viral load) that would increase their chances of being selected for treatment. However, once selected into treatment, attempts were made to ration-out complementary services more equitably. This study demonstrates the risks entailed by medication scarcity, which presents NGOs and health professionals with impossible choices that run counter to the philosophy of equity in access to treatment. Amid growing concerns of an international funding retreat for ART, it is important to learn from the past in order to better manage the potentially inequitable consequences

  3. An empowerment-based approach to developing innovative e-health tools for self-management.

    PubMed

    Alpay, Laurence; van der Boog, Paul; Dumaij, Adrie

    2011-12-01

    E-health is seen as an important technological tool in achieving self-management; however, there is little evidence of how effective e-health is for self-management. Example tools remain experimental and there is limited knowledge yet about the design, use, and effects of this class of tools. By way of introducing a new view on the development of e-health tools dedicated to self-management we aim to contribute to the discussion for further research in this area. Our assumption is that patient empowerment is an important mechanism of e-health self-management and we suggest incorporating it within the development of self-management tools. Important components of empowerment selected from literature are: communication, education and health literacy, information, self-care, decision aids and contact with fellow patients. All components require skills of both patients and the physicians. In this discussion paper we propose how the required skills can be used to specify effective self-management tools. PMID:22193825

  4. Targeted agenda program: an innovative approach to facilitate progress in disaster health.

    PubMed

    Bierens, Joost J L M; Nooij, Brigitte; Sturmans, Ferd

    2008-01-01

    The Targeted Agenda Program (TAP) has been introduced for the first time during the 15th World Congress on Disaster and Emergency Medicine (15WCDEM) in Amsterdam in 2007 to stimulate interaction between the participants before, during and after the congress. A TAP process consists of 11 steps, starting with defining a relevant issue and ending with the publication of a TAP report based on expert opinions. Seven TAP groups participated during the 15WCDEM. The TAP issues referred to: (1) the need for health impact assessment of disasters; (2) the golden standard for preparedness for a chemical, biological, radiological and nuclear disasters; (3) the role of acute psychosocial first aid; (4) the 10 most important issues for policymakers to minimize health effects of floods; (5) the search for a golden standard in the treatment of wounded combatants; (6) the preparedness of health organizations for consequences of extreme weather conditions; and (7) the health problems of high-vulnerability groups during disasters. This article describes the motivation and operational aspects of the TAP and advocates that this concept can play an important facilitating role in focus, networking and enhancement of knowledge in the field of disaster health. PMID:18935958

  5. [Qualitative dimensions of the scientific, technological and innovation production at Public Health].

    PubMed

    Luz, Madel Therezinha; Mattos, Rafael da Silva

    2010-07-01

    This article shows the results of a qualitative evaluation on the expansion of the Collective Health area according with the production of the triennial Collective Health Congresses Annals which happen between 1997 to 2006, promoted by Abrasco - Brazilian Association of Collective Health. The specific objective was to estimate the growth of importance of the area in the scientific as well as in the social Brazilian scenario in the last decennary through the analysis of aspects and substantive dimensions. The methodological strategy of the study was to consider the complexity and data profusion referred to the dimensions of this multidisciplinary field (more and more interdisciplinary) of knowledge and intervention. From this perspective, analysis and interpretations of document sources were done, applying theoretical, methodological and analytical referential of the social science and X statistics techniques. It could be observed that: (1) in the last decade, the Collective Health area expanded into its three subareas (Epidemiology, Planning/Management and Health Services and, Human Sciences); (2) there is a tendency of more interactivity among the programs and with their communities and the institutions; (3) there is a growth in the quantity of authors writing about the field and different authors by article; (4) it is being elaborated a big internal specialization into the subareas. PMID:20694318

  6. [School of Public Health of Mexico: educational and technological innovation in the new millennium].

    PubMed

    Magaña-Valladares, Laura; Suárez-Conejero, Juana Elvira; Hernández-Ávila, Mauricio; Gudiño-Cejudo, María Rosa

    2014-01-01

    This article was conceived to analyze the work of the School of Public Health of Mexico (ESPM for is acronym in Spanish) from the year 2000 to the present day. One of the highlights that we will examine is the reorientation of the educational work of the school in order to meet the challenges in health and education that emerged during the end of the twentieth century. In order to explain the evolution of this process, we will describe the three main guiding principles that characterize the present work of the school: the pedagogical model's change, the incorporation of the information and communication technologies, and the professionalization in teaching. The purpose of this work is to define those guiding principles, and to expose, through the contrast between past and present, the complete history of uninterrupted work of the School of Public Health of Mexico during its ninety-two years of existence, that has gone beyond the boundaries of the country. PMID:25604419

  7. Innovations in Health Value and Functional Food Development of Quinoa (Chenopodium quinoa Willd.)

    PubMed Central

    Graf, Brittany L.; Rojas-Silva, Patricio; Rojo, Leonel E.; Delatorre-Herrera, Jose; Baldeón, Manuel E.; Raskin, Ilya

    2016-01-01

    Quinoa (Chenopodium quinoa Willd., Amaranthaceae) is a grain-like, stress-tolerant food crop that has provided subsistence, nutrition, and medicine for Andean indigenous cultures for thousands of years. Quinoa contains a high content of health-beneficial phytochemicals, including amino acids, fiber, polyunsaturated fatty acids, vitamins, minerals, saponins, phytosterols, phytoecdysteroids, phenolics, betalains, and glycine betaine. Over the past 2 decades, numerous food and nutraceutical products and processes have been developed from quinoa. Furthermore, 4 clinical studies have demonstrated that quinoa supplementation exerts significant, positive effects on metabolic, cardiovascular, and gastrointestinal health in humans. However, vast challenges and opportunities remain within the scientific, agricultural, and development sectors to optimize quinoa's role in the promotion of global human health and nutrition. PMID:27453695

  8. New hope for correctional officers: an innovative program for reducing stress and health risks.

    PubMed

    McCraty, Rollin; Atkinson, Mike; Lipsenthal, Lee; Arguelles, Lourdes

    2009-12-01

    This study investigated the impact of a new stress management program on physiological and psychological stress and health risk factors among 75 correctional officers. The experimental group received training in emotion self-regulation techniques intended to reduce stress and health risk factors. Practice of the techniques was enhanced by heart rate variability feedback, which helped participants learn and sustain use of the self-management tools. Measures of physiological stress included cortisol, DHEA, cholesterol, triglycerides, fasting glucose levels, 10-min resting electrocardiogram, heart rate variability, and blood pressure. Three psychological questionnaires assessed emotional stress and work-related variables. There were significant improvements in the experimental group in cholesterol, glucose, heart rate, blood pressure and positive outlook and significant reductions in overall psychological distress. There were significant increases in productivity, motivation, goal clarity, and perceived support. The mean difference between pre- and post-intervention projected health care costs was calculated to be $1,179 per employee per year. PMID:19466540

  9. Innovation in collaborative health research training: the role of active learning.

    PubMed

    Poole, Gary; Egan, John P; Iqbal, Isabeau

    2009-03-01

    This paper describes and discusses the essential pedagogical elements of the Partnering in Community Health Research (PCHR) program, which was designed to address the training needs of researchers who participate in collaborative, interdisciplinary health research. These elements were intended to foster specific skills that helped learners develop research partnerships featuring knowledge, capabilities, values and attitudes needed for successful research projects. By establishing research teams called "clusters", PCHR provided research training and experience for graduate students and post-doctoral fellows, as well as for community health workers and professionals. Pedagogical elements relied on active learning approaches such as inquiry-based and experience-based learning. Links between these elements and learning approaches are explained. Through their work in cluster-based applied research projects, the development of learning plans, and cross-cluster learning events, trainees acquired collaborative research competencies that were valuable, relevant and theoretically informed. PMID:19283545

  10. [An innovative training experience in public health at the Cheikh Anta Diop University of Dakar].

    PubMed

    Diallo, I; Fall, C; Tal Dia, A; Wone, I; Ndoye, R

    2000-06-01

    The Institute for Health and Development (ISED) at the University of Dakar, was created in 1987. Its mission is to fulfill the public health training needs of Senegalese health care professionals. ISED is responsible for a training program entitled "Certificat d'études Spéciales" (CES), the equivalent of a Masters of Public Health degree. The "CES" is a two-year program comprised of six modules, which last four months each. The ISED training approach stresses trainee responsibility above all. It is based on the trainee's professional tasks and is oriented toward the problems identified by the trainees themselves. In this sense it is highly adaptive and flexible. Each module is implemented in the same way; initially there is a 15 day residential phase for intensive theoretical courses, followed by an application period of 75 days in the trainee's work place, and then a final residential phase of 15 days for writing and presenting a technical report on the work in the field. This model allows trainees to bring together the theoretical and the practical. The trainers directly supervise each of these three phases. The two residential phases are conducted in the ISED training center, located in Mbour, 80 Km south of Dakar. 103 trainees are enrolled in the program in seven different classes. Of these trainees, 93 are health care specialists (85 physicians 7 pharmacists, 1 dentist). Ninety percent of previous graduates have been civil servants who work for the Ministry of Health in Senegal and the remaining 10% were from Burkina Faso and Togo. The training program is considered by all stockholders, beneficiaries, and relevant financial institutions, to be appropriate, beneficial and successful. PMID:11026793

  11. A Conceptual Model for Supporting Para-Teacher Learning in an Indian Non-Governmental Organization (NGO)

    ERIC Educational Resources Information Center

    Raval, Harini; McKenney, Susan; Pieters, Jules

    2010-01-01

    Non-governmental organizations (NGOs) are being recognized globally for their influential role in realizing the UN Millennium Development Goal of education for all in developing countries. NGOs mostly employ untrained para-educators for grassroots activities. The professional development of these teachers is critical for NGO effectiveness, yet…

  12. WomanKind: an innovative model of health care response to domestic abuse.

    PubMed

    Hadley, S M; Short, L M; Lezin, N; Zook, E

    1995-01-01

    This article focuses on the role of the WomanKind program in creating opportunities for discussing domestic violence and training health professionals. The WomanKind program is based on the belief that without such discussion, health care providers will continue to treat the medical and mental health problems that bring women to their doors without addressing the underlying pattern of abuse that is the root cause. WomanKind has evolved to integrate case management/advocacy services for victims of domestic abuse, in addition to education and consultation for health professionals. It also provides case management and advocacy services, including crisis intervention, assessment and evaluation, and ongoing assistance to battered women who suffer from physical, emotional, or sexual abuse by a current or former partner. The WomanKind staff consists of a director who oversees the program, including marketing and public relations, education and training, as well as assisting the full-time program coordinators at each of the three hospital sites. An intensive 40-hour training program provides the new WomanKind volunteers with an understanding of the issues of domestic abuse and violence, as well as knowledge of community resources. The program goals are elaborated in this article as well as the program marketing techniques. PMID:8574114

  13. The Wallingford Wellness Project--An Innovative Health Promotion Program with Older Adults. Monograph No. 2.

    ERIC Educational Resources Information Center

    FallCreek, Stephanie, Ed.; Stam, Sue Bailey, Ed.

    This monograph discusses the Wallingford Wellness Project, a 3-year Administration on Aging model project designed to develop, demonstrate, and evaluate the effectiveness of health promotion and training with older adults. (The program in the Wallingford Senior Center offered classes focusing on exercise, nutrition, stress management, and…

  14. Learning from the Innovative Open Practices of Three International Health Projects: IACAPAP, VCPH and Physiopedia

    ERIC Educational Resources Information Center

    Coughlan, Tony; Perryman, Leigh-Anne

    2015-01-01

    Open educational resources and open educational practices are being increasingly used around the globe to train and support professionals in areas where funding and resources are scarce. This paper evaluates the open educational practices (OEP) of three global health projects operating outside academia--the International Association for Child and…

  15. An Innovative Strategy for Teaching Health-Related Fitness Knowledge in Elementary Physical Education Classes

    ERIC Educational Resources Information Center

    Hodges, Michael

    2015-01-01

    For many decades, children and adolescents have had a deficient level of health-related fitness knowledge (HRFK). This is worrisome, since HRFK acquisition has been found to be fundamental for individuals' decision-making as it relates to healthy living. Consequently, Knowledge in Action (KIA) fitness was developed to offer elementary teachers an…

  16. An Innovative Dialogue about College Drinking: Developing an Immediate Response Technology Model for Health Promotion

    ERIC Educational Resources Information Center

    LeGreco, Marianne; Hess, Aaron; Lederman, Linda C.; Schuwerk, Tara; LaValley, Angela G.

    2010-01-01

    New communication technologies, including personal response "clickers," have become increasingly popular across college campuses as a way to promote a wide range of practices. This paper calls attention to the need for communication models that account for the usefulness of these new technologies, especially as they relate to health promotion,…

  17. Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya.

    PubMed

    Waweru, Evelyn; Goodman, Catherine; Kedenge, Sarah; Tsofa, Benjamin; Molyneux, Sassy

    2016-03-01

    In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility's bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user fee reduction and improve equity in access. We conducted a process evaluation of HSSF implementation based on a theory of change underpinning the intervention. Methods included interviews at national, district and facility levels, facility record reviews, a structured exit survey and a document review. We found impressive achievements: HSSF funds were reaching facilities; funds were being overseen and used in a way that strengthened transparency and community involvement; and health workers' motivation and patient satisfaction improved. Challenges or unintended outcomes included: complex and centralized accounting requirements undermining efficiency; interactions between HSSF and user fees leading to difficulties in accessing crucial user fee funds; and some relationship problems between key players. Although user fees charged had not increased, national reduction policies were still not being adhered to. Finance mechanisms can have a strong positive impact on peripheral facilities, and HFMCs can play a valuable role in managing facilities. Although fiduciary oversight is essential, mechanisms should allow for local decision-making and ensure that unmanageable paperwork is avoided. There are also limits to what can be achieved with relatively small funds in

  18. Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya

    PubMed Central

    Waweru, Evelyn; Goodman, Catherine; Kedenge, Sarah; Tsofa, Benjamin; Molyneux, Sassy

    2016-01-01

    In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility’s bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user fee reduction and improve equity in access. We conducted a process evaluation of HSSF implementation based on a theory of change underpinning the intervention. Methods included interviews at national, district and facility levels, facility record reviews, a structured exit survey and a document review. We found impressive achievements: HSSF funds were reaching facilities; funds were being overseen and used in a way that strengthened transparency and community involvement; and health workers’ motivation and patient satisfaction improved. Challenges or unintended outcomes included: complex and centralized accounting requirements undermining efficiency; interactions between HSSF and user fees leading to difficulties in accessing crucial user fee funds; and some relationship problems between key players. Although user fees charged had not increased, national reduction policies were still not being adhered to. Finance mechanisms can have a strong positive impact on peripheral facilities, and HFMCs can play a valuable role in managing facilities. Although fiduciary oversight is essential, mechanisms should allow for local decision-making and ensure that unmanageable paperwork is avoided. There are also limits to what can be achieved with relatively small funds in

  19. Type III Methyltransferase M.NgoAX from Neisseria gonorrhoeae FA1090 Regulates Biofilm Formation and Interactions with Human Cells.

    PubMed

    Kwiatek, Agnieszka; Mrozek, Agnieszka; Bacal, Pawel; Piekarowicz, Andrzej; Adamczyk-Popławska, Monika

    2015-01-01

    Neisseria gonorrhoeae is the etiological factor of the sexually transmitted gonorrhea disease that may lead, under specific conditions, to systemic infections. The gonococcal genome encodes many restriction modification (RM) systems, which main biological role is to defend the pathogen from potentially harmful foreign DNA. However, RM systems seem also to be involved in several other functions. In this study, we examined the effect of inactivation the N. gonorrhoeae FA1090 ngoAXmod gene encoding M.NgoAX methyltransferase on the global gene expression, biofilm formation, interactions with human epithelial host cells and overall bacterial growth. Expression microarrays showed at least a twofold deregulation of a total of 121 genes in the NgoAX knock-out mutant compared to the wild-type (wt) strain under standard grow conditions. Genes with changed expression levels encoded mostly proteins involved in cell metabolism, DNA replication and repair or regulating cellular processes and signaling (such as cell wall/envelop biogenesis). As determined by the assay with crystal violet, the NgoAX knock-out strain formed a slightly larger biofilm biomass per cell than the wt strain. Live biofilm observations showed that the biofilm formed by the gonococcal ngoAXmod gene mutant is more relaxed, dispersed and thicker than the one formed by the wt strain. This more relaxed feature of the biofilm, in respect to adhesion and bacterial interactions, can be involved in pathogenesis. Moreover, the overall adhesion of mutant bacterial cells to human cells was lower than adhesion of the wt gonococci [adhesion index = 0.672 (±0.2) and 2.15 (±1.53), respectively]; yet, a higher number of mutant than wt bacteria were found inside the Hec-1-B epithelial cells [invasion index = 3.38 (±0.93) × 10(5) for mutant and 4.67 (±3.09) × 10(4) for the wt strain]. These results indicate that NgoAX knock-out cells have lower ability to attach to human cells, but more easily penetrate inside the host

  20. Type III Methyltransferase M.NgoAX from Neisseria gonorrhoeae FA1090 Regulates Biofilm Formation and Interactions with Human Cells

    PubMed Central

    Kwiatek, Agnieszka; Mrozek, Agnieszka; Bacal, Pawel; Piekarowicz, Andrzej; Adamczyk-Popławska, Monika

    2015-01-01

    Neisseria gonorrhoeae is the etiological factor of the sexually transmitted gonorrhea disease that may lead, under specific conditions, to systemic infections. The gonococcal genome encodes many restriction modification (RM) systems, which main biological role is to defend the pathogen from potentially harmful foreign DNA. However, RM systems seem also to be involved in several other functions. In this study, we examined the effect of inactivation the N. gonorrhoeae FA1090 ngoAXmod gene encoding M.NgoAX methyltransferase on the global gene expression, biofilm formation, interactions with human epithelial host cells and overall bacterial growth. Expression microarrays showed at least a twofold deregulation of a total of 121 genes in the NgoAX knock-out mutant compared to the wild-type (wt) strain under standard grow conditions. Genes with changed expression levels encoded mostly proteins involved in cell metabolism, DNA replication and repair or regulating cellular processes and signaling (such as cell wall/envelop biogenesis). As determined by the assay with crystal violet, the NgoAX knock-out strain formed a slightly larger biofilm biomass per cell than the wt strain. Live biofilm observations showed that the biofilm formed by the gonococcal ngoAXmod gene mutant is more relaxed, dispersed and thicker than the one formed by the wt strain. This more relaxed feature of the biofilm, in respect to adhesion and bacterial interactions, can be involved in pathogenesis. Moreover, the overall adhesion of mutant bacterial cells to human cells was lower than adhesion of the wt gonococci [adhesion index = 0.672 (±0.2) and 2.15 (±1.53), respectively]; yet, a higher number of mutant than wt bacteria were found inside the Hec-1-B epithelial cells [invasion index = 3.38 (±0.93) × 105 for mutant and 4.67 (±3.09) × 104 for the wt strain]. These results indicate that NgoAX knock-out cells have lower ability to attach to human cells, but more easily penetrate inside the host

  1. The potential of health sector non-governmental organizations: policy options.

    PubMed

    Gilson, L; Sen, P D; Mohammed, S; Mujinja, P

    1994-03-01

    Non-governmental organizations (NGOs) have increasingly been promoted as alternative health care providers to the state, furthering the same goals but less hampered by government inefficiencies and resource constraints. However, the reality of NGO health care provision is more complex. Not only is the distinction between government and NGO providers sometimes difficult to determine because of their operational integration, but NGOs may also suffer from resource constraionts and management inefficiencies similar to those of government providers. Some registered NGOs operate as for-profit providers in practice. Policy development must reflect the strengths and weaknesses of NGOs in particular settings and should be built on NGO advantages over government in terms of resource mobilization, efficiency and/or quality. Policy development will always require a strong government presence in co-ordinating and regulating health care provision, and an NGO sector responsive to the policy goals of government. PMID:10133097

  2. Reaching the Unreachable: Barriers of the Poorest to Accessing NGO Healthcare Services in Bangladesh

    PubMed Central

    Alam, Mohammed M.; Sultana, Fadia; Sayeed, Shahana N.; Pressman, Aliza M.; Powers, Mary Beth

    2006-01-01

    The NGO Service Delivery Program (NSDP), a USAID-funded programme, is the largest NGO programme in Bangladesh. Its strategic flagship activity is the essential services package through which healthcare services are administered by NGOs in Bangladesh. The overall goal of the NSDP is to increase access to essential healthcare services by communities, especially the poor. Recognizing that the poorest in the community often have no access to essential healthcare services due to various barriers, a study was conducted to identify what the real barriers to access by the poor are. This included investigations to further understand the perceptions of the poor of real or imagined barriers to accessing healthcare; ways for healthcare centres to maximize services to the poor; how healthcare providers can maximize service-use; inter-personal communication between healthcare providers and those seeking healthcare among the poor; and ways to improve the capacity of service providers to reach the poorest segment of the community. The study, carried out in two phases, included 24 static and satellite clinics within the catchment areas of eight NGOs under the NSDP in Bangladesh, during June-September 2003. Participatory urban and rural appraisal techniques, focus-group discussions, and in-depth interviews were employed as research methods in the study. The target populations in the study included males and females, service-users and non-users, and special groups, such as fishermen, sex workers, potters, Bedes (river gypsies), and lower-caste people—all combined representing a heterogeneous community. The following four major categories of barriers emerged as roadblocks to accessing quality healthcare for the poor: (a) low income to be able to afford healthcare, (b) lack of awareness of the kind of healthcare services available, (c) deficiencies and inconsistencies in the quality of services, and (d) lack of close proximity to the healthcare facility. Those interviewed perceived

  3. IEEE 802.14.5/ZigBee Based WSNs - WPANs and Innovative Application in Medical Health Care Systems.

    PubMed

    Zhang, Zhongwei

    2014-01-01

    With recent developments in wireless networks field and in sensing technology, new and innovative medical applications based on the wireless sensor networks (WSN) technology are being developed in the research lab or commercial sectors. The key problem of WSN based application in the medical and health care domain is to get the message with the bounded delays and/or real-time data such as the signal of falls, the alarm of heart attacks traversed to the cluster at where the emergence unit located while delivering the steady flows of data with a certain level of Quality of Service (QoS). In this paper, we address this problem by proposing to use a periodic scheduling-Time Division Cluster Schedule (TDCS), to avoid the flow collision while meeting the end-to-end delay deadlines. The proposed scheduling mechanism has been studied on simulated Wireless sensor networks with a cluster tree topology on which the OPEN-ZB simulation model is adopted. The preliminary results shown that it is feasible to guarantee the real time medical data delivered on time over the low data rate wireless sensor networks when deployed at medical and/or health care domain, under the governance of the TDCS mechanism. PMID:25488218

  4. Curriculum information models in health professions education in Australia: an innovative approach to efficient curriculum design, development, and maintenance.

    PubMed

    Kruger, Estie; Tennant, Marc

    2012-03-01

    Over the last decade, there has been a significant increase in attention to the overall accountability of higher education in Australia, and this is expected to continue. Increased accountability has led to the need for more explicitly documented curricula. The curricula from ten health-related disciplines developed over the last five years in Australia were the basis of this study. Curriculum information modeling is an approach that allows for the dynamic nature of curricula since elements and their linkages can be moved about and reconnected into meaningful patterns. In addition, the models give disciplines and institutions the ability to effectively monitor curricula and draw comparisons in a more unified manner. Curriculum information models are an efficient innovation in the design and management of curricula in higher education and particularly in the health care disciplines. They rest on the principles of reusable elements and linkages independent of content that were first used in the design, construction, and maintenance of buildings. The translation of this approach to the higher education sector provides a higher level of interoperability of resources and a clearer pathway for content design within a curriculum. PMID:22383604

  5. Innovations in nutrition education and global health: the Bangalore Boston nutrition collaborative

    PubMed Central

    2014-01-01

    Background India has a wide range of nutrition and health problems which require professionals with appropriate skills, knowledge and trans-disciplinary collaborative abilities to influence policy making at the national and global level. Methods The Bangalore Boston Nutrition Collaborative (BBNC) was established as collaboration between St. John’s Research Institute (SJRI), Harvard School of Public Health and Tufts University, with a focus on nutrition research and training. The goals of the BBNC were to conduct an interdisciplinary course, develop web-based courses and identify promising Indian students and junior faculty for graduate training in Boston. Results From 2010, an annual two-week short course in nutrition research methods was conducted on the SJRI campus taught by international faculty from Indian and US universities. More than 100 students applied yearly for approximately 30 positions. The course had didactic lectures in the morning and practical hands-on sessions in the afternoon. Student rating of the course was excellent and consistent across the years. The ratings on the design and conduct of the course significantly improved (p <0.001) from 2010 to 2012. Through open-ended questions, students reported the main strengths of the course to be the excellent faculty and practical “hands-on” sessions. A web based learning system TYRO, was developed, which can be used for distance learning. Four faculty members/graduate students from SJRI have visited Boston for collaborative research efforts. Conclusion The BBNC has become a well-established capacity building and research training program for young professionals in nutrition and global health. Efforts are ongoing to secure long term funding to sustain and expand this collaboration to deliver high quality nutrition and global health education enabled by information and communication technologies. PMID:24400811

  6. Championing mental health at work: emerging practice from innovative projects in the UK.

    PubMed

    Robinson, Mark; Tilford, Sylvia; Branney, Peter; Kinsella, Karina

    2014-09-01

    This paper examines the value of participatory approaches within interventions aimed at promoting mental health and wellbeing in the workplace. Specifically the paper explores data from the thematic evaluation of the Mental Health and Employment project strand within the Altogether Better programme being implemented in England in the Yorkshire and Humber region, which was funded through the BIG Lottery and aimed to empower people across the region to lead better lives. The evaluation combined a systematic evidence review with semi-structured interviews across mental health and employment projects. Drawing on both evaluation elements, the paper examines the potential of workplace-based 'business champions' to facilitate organizational culture change within enterprises within a deprived regional socio-economic environment. First, the paper identifies key policy drivers for interventions around mental health and employment, summarizes evidence review findings and describes the range of activities within three projects. The role of the 'business champion' emerged as crucial to these interventions and therefore, secondly, the paper examines how champions' potential to make a difference depends on the work settings and their existing roles, skills and motivation. In particular, champions can proactively coordinate project strands, embed the project, encourage participation, raise awareness, encourage changes to work procedures and strengthen networks and partnerships. The paper explores how these processes can facilitate changes in organizational culture. Challenges of implementation are identified, including achieving leverage with senior management, handover of ownership to fellow employees, assessing impact and sustainability. Finally, implications for policy and practice are discussed, and conclusions drawn concerning the roles of champions within different workplace environments. PMID:23300189

  7. Deletion of one nucleotide within the homonucleotide tract present in the hsdS gene alters the DNA sequence specificity of type I restriction-modification system NgoAV.

    PubMed

    Adamczyk-Poplawska, Monika; Lower, Michal; Piekarowicz, Andrzej

    2011-12-01

    As a result of a frameshift mutation, the hsdS locus of the NgoAV type IC restriction and modification (RM) system comprises two genes, hsdS(NgoAV1) and hsdS(NgoAV2). The specificity subunit, HsdS(NgoAV), the product of the hsdS(NgoAV1) gene, is a naturally truncated form of an archetypal specificity subunit (208 N-terminal amino acids instead of 410). The presence of a homonucleotide tract of seven guanines (poly[G]) at the 3' end of the hsdS(NgoAV1) gene makes the NgoAV system a strong candidate for phase variation, i.e., stochastic addition or reduction in the guanine number. We have constructed mutants with 6 guanines instead of 7 and demonstrated that the deletion of a single nucleotide within the 3' end of the hsdS(NgoAV1) gene restored the fusion between the hsdS(NgoAV1) and hsdS(NgoAV2) genes. We have demonstrated that such a contraction of the homonucleotide tract may occur in vivo: in a Neisseria gonorrhoeae population, a minor subpopulation of cells appeared to have only 6 guanines at the 3' end of the hsdS(NgoAV1) gene. Escherichia coli cells carrying the fused gene and expressing the NgoAVΔ RM system were able to restrict λ phage at a level comparable to that for the wild-type NgoAV system. NgoAV recognizes the quasipalindromic interrupted sequence 5'-GCA(N(8))TGC-3' and methylates both strands. NgoAVΔ recognizes DNA sequences 5'-GCA(N(7))GTCA-3' and 5'-GCA(N(7))CTCA-3', although the latter sequence is methylated only on the complementary strand within the 5'-CTCA-3' region of the second recognition target sequence. PMID:21984785

  8. Innovative Methods for the Benefit of Public Health Using Space Technologies for Disaster Response.

    PubMed

    Dinas, Petros C; Mueller, Christian; Clark, Nathan; Elgin, Tim; Nasseri, S Ali; Yaffe, Etai; Madry, Scott; Clark, Jonathan B; Asrar, Farhan

    2015-06-01

    Space applications have evolved to play a significant role in disaster relief by providing services including remote sensing imagery for mitigation and disaster damage assessments; satellite communication to provide access to medical services; positioning, navigation, and timing services; and data sharing. Common issues identified in past disaster response and relief efforts include lack of communication, delayed ordering of actions (eg, evacuations), and low levels of preparedness by authorities during and after disasters. We briefly summarize the Space for Health (S4H) Team Project, which was prepared during the Space Studies Program 2014 within the International Space University. The S4H Project aimed to improve the way space assets and experiences are used in support of public health during disaster relief efforts. We recommend an integrated solution based on nano-satellites or a balloon communication system, mobile self-contained relief units, portable medical scanning devices, and micro-unmanned vehicles that could revolutionize disaster relief and disrupt different markets. The recommended new system of coordination and communication using space assets to support public health during disaster relief efforts is feasible. Nevertheless, further actions should be taken by governments and organizations in collaboration with the private sector to design, test, and implement this system. PMID:25869234

  9. Oral histories of HIV/AIDS support group members, NGO workers and home-based carers in KwaZulu-Natal.

    PubMed

    Denis, Philippe

    2016-01-01

    The purpose of this paper is to bring to the attention of the AIDS research community the existence of an oral history project known as the Memories of AIDS Project. The project focused on HIV/AIDS support group members, non-governmental organisation (NGO) workers and home-based carers in the Umgungundlovu (Pietermaritzburg) District Municipality, South Africa. The project was carried out by the Sinomlando Centre for Oral History and Memory Work, a research and community development centre of the University of KwaZulu-Natal, over a period of three years (2011-2013). Sixty-five individual oral history interviews of 1 to 4 hours duration and 11 focus group sessions were recorded, transcribed and translated from isiZulu into English when necessary. The life stories of community workers and support group members documented in the interviews show, on the part of the informants, a remarkable degree of agency and assertiveness in matters of sexuality, gender relations and religious beliefs. They found innovative ways of navigating through the conflicting claims of biomedicine, Christianity and African traditional religion. As much as the epidemic caused grief and suffering, it opened the door to new knowledge and new opportunities. PMID:27002356

  10. User-Centered Design and Usability Testing of an Innovative Health-Related Quality of Life Module

    PubMed Central

    Jordan, M.; Quitoriano, J.; Ciro, C.A.; Mold, J.W.

    2014-01-01

    Summary Objectives Various computerized health risk appraisals (HRAs) are available, but few of them assess health-related quality of life (HRQoL) in a goal-directed framework. This study describes the user-centered development and usability testing of an innovative HRQoL module that extends a validated HRA tool in primary care settings. Methods Systematic user-centered design, usability testing, and qualitative methods were used to develop the HRQoL module in primary care practices. Twenty two patients and 5 clinicians participated in two rounds of interactive technology think-out-loud sessions (TOLs) and semi-structured interviews (SSIs) to iteratively develop a four-step, computerized process that collects information on patient goals for meaningful life activities and current level of disability and presents a personalized and prioritized list of preventive recommendations linked to online resources. Results Analysis of TOLs and SSIs generated 5 categories and 11 sub-categories related to facilitators and barriers to usability and human-technology interaction. The categories included: Understanding the Purpose, Usability, Perceived Value, Literacy, and Participant Motivation. Some categories were inter-connected. The technology was continually and iteratively improved between sessions until saturation of positive feedback was achieved in 4 categories (addressing motivation will require more research). Usability of all screen units of the module was improved substantially. Clinician feedback emphasized the importance of the module’s ability to translate the patient-centered HRQoL Report into actionable items for clinicians to facilitate shared decision-making. Complete integration of the HRQoL module into the existing HRA will require further development and testing. Conclusions Systematic application of user-centered design and human factors principles in technology development and testing may significantly improve the usability and clinical value of health

  11. AIDS/HIV crisis in developing countries: the need for greater understanding and innovative health promotion approaches.

    PubMed Central

    Livingston, I. L.

    1992-01-01

    Epidemiologic data on morbidity and mortality have shown that the acquired immunodeficiency syndrome/human immunodeficiency virus (AIDS/HIV) epidemic is relatively widespread in the developing countries of the world, especially in the already economically deprived regions of Sub-Saharan Africa. Africa is estimated to have approximately 5 million seropositive individuals, and by the year 2000, this number is expected to include 10 million HIV-infected children. Improved control over this epidemic can only come through a greater understanding of the specifics of the disease and, eventually, the introduction of more effective and innovative health promotion campaigns targeted at medical personnel, traditional healers, families, and persons with AIDS. Comprehensive health promotion campaigns, carefully using mass media strategies in addition to more community-based programs, all operating under "decentralized" AIDS control programs, are reasoned to be the most efficacious approach that African and other developing countries can use to successfully contain the AIDS/HIV epidemic. Given the reality of the following factors: Pattern II (ie, transmission of AIDS via heterosexual sexual activity) is the main mode of HIV transmission in Africa, the traditional dominant roles males have in sexual relations, and the positive relationship between sexually transmitted diseases and AIDS, health promotion campaigns must focus specifically on addressing at-risk culturally related sexual values and behaviors in African communities. Failure to address these and other related factors will certainly lead to an escalation of the AIDS/HIV epidemic in Africa and, therefore, concomitant devastation in the human and societal realms of the region. PMID:1404473

  12. Working together to make Indigenous health care curricula everybody's business: a graduate attribute teaching innovation report.

    PubMed

    Virdun, Claudia; Gray, Joanne; Sherwood, Juanita; Power, Tamara; Phillips, Angela; Parker, Nicola; Jackson, Debra

    2013-12-01

    Previously there has been commitment to the idea that Indigenous curricula should be taught by Indigenous academic staff, whereas now there is increasing recognition of the need for all academic staff to have confidence in enabling Indigenous cultural competency for nursing and other health professional students. In this way, Indigenous content can be threaded throughout a curriculum and raised in many teaching and learning situations, rather than being siloed into particular subjects and with particular staff. There are many sensitivities around this change, with potential implications for Indigenous and non-Indigenous students and staff, and for the quality of teaching and learning experiences. This paper reports on a collaborative process that was used to reconceptualise how Indigenous health care curricula would be positioned throughout a programme and who would or could work with students in this area. Effective leadership, establishing a truly collaborative environment, acknowledging fears and perceived inadequacies, and creating safe spaces for sharing and learning were crucial in effecting this change. PMID:24621295

  13. Rochester’s Healthy Home: A community-based innovation to promote environmental health action

    PubMed Central

    Kuholski, Kate

    2010-01-01

    Environmental hazards in the home can contribute significantly to disease. These hazards disproportionately affect low income, urban, and minority children. Childhood lead poisoning and asthma are prime examples of health concerns to which poor housing conditions may contribute significantly. A community-academic partnership in Rochester, New York created a model Healthy Home, an interactive museum in a typical city home, to help residents, property owners, contractors, and community groups reduce environmental hazards. The Healthy Home project educates visitors about home environmental health hazards, demonstrates low-cost methods for reducing home hazards, and helps visitors develop individualized strategies for action. In its first year of operation, over 700 people visited the Healthy Home. Evaluation surveys indicate that the Healthy Home experience motivated visitors to take action to reduce environmental hazards in their homes. Follow-up phone interviews indicate that most visitors took some action to reduce home environmental hazards. The Healthy Home has established a diverse Advisory Council to share its messages more broadly, invite input into future directions, and recruit visitors. This paper presents experiences from the Healthy Home’s first year, highlighting the partnership principles that guided its development and lessons learned from the process. PMID:20634943

  14. MERIS (Medical Error Reporting Information System) as an innovative patient safety intervention: a health policy perspective.

    PubMed

    Riga, Marina; Vozikis, Athanassios; Pollalis, Yannis; Souliotis, Kyriakos

    2015-04-01

    The economic crisis in Greece poses the necessity to resolve problems concerning both the spiralling cost and the quality assurance in the health system. The detection and the analysis of patient adverse events and medical errors are considered crucial elements of this course. The implementation of MERIS embodies a mandatory module, which adopts the trigger tool methodology for measuring adverse events and medical errors an intensive care unit [ICU] environment, and a voluntary one with web-based public reporting methodology. A pilot implementation of MERIS running in a public hospital identified 35 adverse events, with approx. 12 additional hospital days and an extra healthcare cost of €12,000 per adverse event or of about €312,000 per annum for ICU costs only. At the same time, the voluntary module unveiled 510 reports on adverse events submitted by citizens or patients. MERIS has been evaluated as a comprehensive and effective system; it succeeded in detecting the main factors that cause adverse events and discloses severe omissions of the Greek health system. MERIS may be incorporated and run efficiently nationally, adapted to the needs and peculiarities of each hospital or clinic. PMID:25554702

  15. An Innovative Method to Involve Community Health Workers as Partners in Evaluation Research

    PubMed Central

    Issel, L. Michele; Townsell, Stephanie J.; Chapple-McGruder, Theresa; Handler, Arden

    2011-01-01

    Objectives. We developed a process through which community outreach workers, whose role is not typically that of a trained researcher, could actively participate in collection of qualitative evaluation data. Methods. Outreach workers for a community-based intervention project received training in qualitative research methodology and certification in research ethics. They used a Voice over Internet Protocol phone-in system to provide narrative reports about challenges faced by women they encountered in their outreach activities as well as their own experiences as outreach workers. Results. Qualitative data contributed by outreach workers provided insights not otherwise available to the evaluation team, including details about the complex lives of underserved women at risk for poor pregnancy outcomes and the challenges and rewards of the outreach worker role. Conclusions. Lay health workers can be a valuable asset as part of a research team. Training in research ethics and methods can be tailored to their educational level and preferences, and their insights provide important information and perspectives that may not be accessible via other data collection methods. Challenges encountered in the dual roles of researcher and lay health worker can be addressed in training. PMID:22021290

  16. Guiding the design of evaluations of innovations in health informatics: a framework and a case study of the SMArt SHARP evaluation.

    PubMed

    Ramly, Edmond; Brennan, Patricia Flatley

    2012-01-01

    Development of health information systems innovations is necessary to create a better future for health and health care, but evaluating them is challenging. This paper examines the problem of evaluating health IT projects in which innovation is agile, adaptive, and emergent, and in which innovation diffusion and production are interlinked. We introduce a typology of mindsets for evaluation design that are typically used in health informatics: optimality, contingency, and usefulness, and make the case for a modularity mindset. We propose a model that shifts the unit of analysis from an evaluation as a whole, to specific modules of an evaluation, such as purpose, target, and methods. We then use retrospective participant observation to illustrate the approach using a case study: the ONC SHARP Harvard project developing the SMArt platform (smartplaforms.org). We find that the proposed modular approach to evaluation design provides a balanced alternative to standard archetypical designs on the one hand, and fully custom-made designs, on the other hand. PMID:23304417

  17. Guiding the Design of Evaluations of Innovations in Health Informatics: a Framework and a Case Study of the SMArt SHARP Evaluation

    PubMed Central

    Ramly, Edmond; Brennan, Patricia Flatley

    2012-01-01

    Development of health information systems innovations is necessary to create a better future for health and health care, but evaluating them is challenging. This paper examines the problem of evaluating health IT projects in which innovation is agile, adaptive, and emergent, and in which innovation diffusion and production are interlinked. We introduce a typology of mindsets for evaluation design that are typically used in health informatics: optimality, contingency, and usefulness, and make the case for a modularity mindset. We propose a model that shifts the unit of analysis from an evaluation as a whole, to specific modules of an evaluation, such as purpose, target, and methods. We then use retrospective participant observation to illustrate the approach using a case study: the ONC SHARP Harvard project developing the SMArt platform (smartplaforms.org). We find that the proposed modular approach to evaluation design provides a balanced alternative to standard archetypical designs on the one hand, and fully custom-made designs, on the other hand. PMID:23304417

  18. It’s Your Game…Keep It Real: Can innovative public health prevention research thrive within a comparative effectiveness research framework?

    PubMed Central

    Shegog, Ross; Markham, Christine M.; Peskin, Melissa F.; Johnson, Kimberly; Cuccaro, Paula; Tortolero, Susan R.

    2013-01-01

    The federal comparative effectiveness research (CER) initiative is designed to evaluate best practices in health care settings where they can be disseminated for immediate benefit to patients. The CER strategic framework comprises four categories (research, human and scientific capital, data infrastructure, and dissemination) with three crosscutting themes (conditions, patient populations, and types of intervention). The challenge for the field of public health has been accommodating the CER framework within prevention research. Applying a medicine-based, research-to-practice CER approach to public health prevention research has raised concerns regarding definitions of acceptable evidence (an evidence challenge), effective intervention dissemination within heterogeneous communities (a dissemination and implementation challenge), and rewards for best practice at the cost of other promising but high-risk approaches (an innovation challenge). Herein, a dynamic operationalization of the CER framework is described that is compatible with the development, evaluation, and dissemination of innovative public health prevention interventions. An effective HIV, STI, and pregnancy prevention program, It’s Your Game…Keep It Real, provides a case study of this application, providing support that the CER framework can compatibly coexist with innovative, community-based public health prevention research. PMID:23344633

  19. Solutions that stick: activating cross-disciplinary collaboration in a graduate-level public health innovations course at the University of California, Berkeley.

    PubMed

    Sandhu, Jaspal S; Hosang, Robert Nap; Madsen, Kristine A

    2015-03-01

    Since 2011 we have taught a public health innovations course at the University of California, Berkeley. Students gain skills in systematic innovation, or human-centered design, while working in small interdisciplinary teams on domestic and global health projects with client organizations. To support acquisition of meaningful problem-solving skills, we structured the course so that the majority of learning happens in scenarios that do not involve faculty. Taken by students representing 26 graduate programs (as diverse as epidemiology, city planning, and mechanical engineering), it is one of the 10 highest-rated courses offered by the School of Public Health. We present the blueprints for our course with the hope that other institutions whose students could benefit will borrow from our model. PMID:25706024

  20. Medicare and Rural Health

    MedlinePlus

    ... Health Gateway Evidence-based Toolkits Rural Health Models & Innovations Supporting Rural Community Health Tools for Success Am ... in rural areas. Center for Medicare and Medicaid Innovation (CMMI) – CMMI, also known as the CMS Innovation ...

  1. A+ Asthma Rural Partnership coloring for health: an innovative rural asthma teaching strategy.

    PubMed

    Naumann, Phyllis Luers; Huss, Karen; Calabrese, Barbara; Smith, Teresa; Quartey, Ruth; Van de Castle, Barbara; Lewis, Cassia; Hill, Kimberly; Walker, Jennifer; Winkelstein, Marilyn

    2004-01-01

    Asthma is the leading chronic illness in children, affecting about 4.8 million children in the United States. Recent reports indicate a lack of asthma educational resources for rural school health nurses to use in their practice. This article describes the development of the My Asthma Coloring Book educational tool for children and their families living in rural communities. My Asthma Coloring Book was developed to provide asthma information in a short-story format for children with asthma. The coloring book content is described, including its utilization as part of the A+ Asthma Rural Partnership research project funded by the National Institute of Nursing Research (R01NR05062-01). PMID:15704600

  2. Bracing in Ponseti Clubfoot Treatment: Improving Parental Adherence Through an Innovative Health Education Intervention.

    PubMed

    Seegmiller, Laura; Burmeister, Rebecca; Paulsen-Miller, Maria; Morcuende, Jose

    2016-01-01

    Clubfoot is the most common musculoskeletal birth defect, characterized by abnormal tendon and muscle development, leading to abnormal bone alignment of the feet. The Ponseti method is considered the gold standard in clubfoot treatment, and consists of a series of plaster castings, followed by 4 years of brace use. The most common cause of clubfoot relapse is nonadherence with the bracing protocol by the child's caretakers. The purpose of this study was to design, implement, and evaluate an educational bracing program for parents of children with clubfoot in an effort to improve bracing adherence. The educational bracing program for parents of children with clubfoot was designed with incorporation of findings from previous research, adult teaching methodology, and parental feedback. An educational brochure and a practice doll were created for use in educational sessions with parents during routine treatment visits. Two educational sessions were conducted with a health educator, employing identical questionnaires to assess changes in parental knowledge and skills upon completion of the program. Thirty parents completed the educational bracing program, and the majority reported increased knowledge and self-efficacy regarding the bracing protocol of the Ponseti method. In addition, the health practitioners who conducted the educational sessions witnessed an improved ability of all parents to apply the brace as directed, and to recognize and correct improper fit. Completion of the educational program by the parents resulted in immediate improvements in knowledge and skills related to clubfoot bracing. Given that noncompliance to the bracing protocol is the most common cause of clubfoot relapse, these immediate effects of the educational program are promising not only because they encourage proper brace use, but because these immediate improvements have the potential to reduce future rates of clubfoot relapse. PMID:27028684

  3. A typology of intellectual property management for public health innovation and access: design considerations for policymakers.

    PubMed

    Taubman, Antony

    2010-01-01

    This paper seeks to set the practical discipline of public interest intellectual property (IP) management in public health into its broader policy context. The most immediate and direct impact of IP systems on public welfare results not from international standards nor from national legislation - though these norms are fundamentally important - but rather from the accumulated impact of numerous practical choices whether or not to seek IP protection; where and where not; and how any exclusive rights are deployed, by whom, and to what end. IP management is the essentially practical exercise of limited exclusive rights over protected subject matter, the judicious use of those rights to leverage outcomes that advance an institution's or a firm's objectives. Exclusive rights are used to construct and define knowledge-based relationships, to leverage access to technology and other necessary resources, and to enhance market-based incentives. IP management choices range across a broad spectrum, spanning public domain strategies, open or exclusive licensing, and strong exclusivity. The idea of 'exclusive rights', as a specific legal mechanism, can run counter to expectations of greater openness and accessibility, but actual outcomes will depend very much on how these mechanisms are used in practice. For public interest or public sector institutions concerned with health research and development, particularly the development of new medicines, IP management choices can be just as critical as they are for private firms, although a predominant institutional concentration on advancing direct public interest objectives may lead to significantly different approaches in weighing and exercising practical choices for IP management: even so, a private sector approach should not be conflated with exclusivity as an end in itself, nor need public interest IP management eschew all leverage over IP. This paper offers a tentative framework for a richer typology of those choices, to give a

  4. Rochester’s Lead Law: Evaluation of a Local Environmental Health Policy Innovation

    PubMed Central

    Ayoob, Maria; Morley, Rebecca

    2011-01-01

    Background: Significant progress has been made in reducing the incidence of childhood lead poisoning in the United States in the past three decades. However, the prevalence of elevated blood lead in children (≥ 10 μg/dL) remains high in some communities, particularly those with high proportions of pre-1978 housing in poor condition. Increasingly, municipalities are using local policy tools to reduce lead poisoning in high-risk areas, but little is known about the effectiveness of such policies. Objectives: In this article, we evaluated the effectiveness of a comprehensive rental housing–based lead law adopted in Rochester, New York, in 2005. Methods: This policy evaluation integrates analyses of city inspections data, a survey of landlords, landlord focus groups, and health department data on children’s blood lead levels from the first 4 years of implementation of the 2005 law. Results: Implementation has proceeded consistent with projected numbers of inspections with nearly all target units inspected in the first 4 years. Higher than expected inspection passage rates suggest that landlords have reduced lead hazards in rental housing affected by the law. Implementation of the lead law does not appear to have had a significant impact on the housing market. Conclusions: Although many uncertainties remain, our analysis suggests that the lead law has had a positive impact on children’s health. Strong enforcement, support for community-based lead programs, and ongoing intergovernmental coordination will be necessary to maintain lead-safe housing in Rochester. Lessons learned from the Rochester experience may inform future local lead poisoning prevention policies in other communities. PMID:22001644

  5. Disruptive Innovation: Implementation of Electronic Consultations in a Veterans Affairs Health Care System

    PubMed Central

    Clark, Justice

    2016-01-01

    Background Electronic consultations (e-consults) offer rapid access to specialist input without the need for a patient visit. E-consult implementation began in 2011 at VA Boston Healthcare System (VABHS). By early 2013, e-consults were available for all clinical services. In this implementation, the requesting clinician selects the desired consultation within the electronic health record (EHR) ordering menu, which creates an electronic form that is pre-populated with patient demographic information and allows free-text entry of the reason for consult. This triggers a message to the requesting clinician and requested specialty, thereby enabling bidirectional clinician-clinician communication. Objective The aim of this study is to examine the utilization of e-consults in a large Veterans Affairs (VA) health care system. Methods Data from the electronic health record was used to measure frequency of e-consult use by provider type (physician or nurse practitioner (NP) and/or physician assistant), and by the requesting and responding specialty from January 2012 to December 2013. We conducted chart reviews for a purposive sample of e-consults and semi-structured interviews with a purposive sample of clinicians and hospital leaders to better characterize the process, challenges, and usability of e-consults. Results A total of 7097 e-consults were identified, 1998 from 2012 and 5099 from 2013. More than one quarter (27.56%, 1956/7097) of the e-consult requests originated from VA facilities in New England other than VABHS and were excluded from subsequent analysis. Within the VABHS e-consults (72.44%, 5141/7097), variability in frequency and use of e-consults across provider types and specialties was found. A total of 64 NPs requested 2407 e-consults (median 12.5, range 1-415). In contrast, 448 physicians (including residents and fellows) requested 2349 e-consults (median 2, range 1-116). More than one third (37.35%, 1920/5141) of e-consults were sent from primary care to

  6. Innovation in Surgery

    PubMed Central

    Riskin, Daniel J.; Longaker, Michael T.; Gertner, Michael; Krummel, Thomas M.

    2006-01-01

    Objective: To describe the field of surgical innovation from a historical perspective, applying new findings from research in technology innovation. Background: While surgical innovation has a rich tradition, as a field of study it is embryonic. Only a handful of academic centers of surgical innovation exist, all of which have arisen within the last 5 years. To this point, the field has not been well defined, nor have future options to promote surgical innovation been thoroughly explored. It is clear that surgical innovation is fundamental to surgical progress and has significant health policy implications. A process of systematically evaluating and promoting innovation in surgery may be critical in the evolving practice of medicine. Methods: A review of the academic literature in technology innovation was undertaken. Articles and books were identified through technical, medical, and business sources. Luminaries in surgical innovation were interviewed to develop further relevance to surgical history. The concepts in technology innovation were then applied to innovation in surgery, using the historical example of surgical endoscopy as a representative area, which encompasses millennia of learning and spans multiple specialties of care. Results: The history of surgery is comprised largely of individual, widely respected surgeon innovators. While respecting individual accomplishments, surgeons as a group have at times hindered critical innovation to the detriment of our profession and patients. As a clinical discipline, surgery relies on a tradition of research and attracting the brightest young minds. Innovation in surgery to date has been impressive, but inconsistently supported. Conclusion: A body of knowledge on technology innovation has been developed over the last decade but has largely not been applied to surgery. New surgical innovation centers are working to define the field and identify critical aspects of surgical innovation promotion. It is our

  7. Improving System Integration: The Art and Science of Engaging Small Community Practices in Health System Innovation

    PubMed Central

    Pus, Laura; Stanaitis, Ian; Ivers, Noah; Baker, G. Ross; Lockhart, Elizabeth; Hawker, Gillian

    2016-01-01

    This paper focuses on successful engagement strategies in recruiting and retaining primary care physicians (PCPs) in a quality improvement project, as perceived by family physicians in small practices. Sustained physician engagement is critical for quality improvement (QI) aiming to enhance health system integration. Although there is ample literature on engaging physicians in hospital or team-based practice, few reports describe factors influencing engagement of community-based providers practicing with limited administrative support. The PCPs we describe participated in SCOPE: Seamless Care Optimizing the Patient Experience, a QI project designed to support their care of complex patients and reduce both emergency department (ED) visits and inpatient admissions. SCOPE outcome measures will inform subsequent papers. All the 30 participating PCPs completed surveys assessing perceptions regarding the importance of specific engagement strategies. Project team acknowledgement that primary care is challenging and new access to patient resources were the most important factors in generating initial interest in SCOPE. The opportunity to improve patient care via integration with other providers was most important in their commitment to participate, and a positive experience with project personnel was most important in their continued engagement. Our experience suggests that such providers respond well to personalized, repeated, and targeted engagement strategies. PMID:26904284

  8. An innovative electronic health records system for rare and complex diseases

    PubMed Central

    2015-01-01

    Background There exists a large number of rare and complex diseases that are neglected due to the difficulty in diagnosis and treatment. Being rare, they normally do not justify the costs of developing an especialized Electronic Health Record (EHR) system to assist doctors and patients of these diseases. In this work we propose the use of Computer applications known as Laboratory Information Management Systems (LIMS) to address this issue. Results In this work we describe a fully customizable EHR system that uses a workflow based LIMS with an easy to adapt interface for data collection and retrieval. This system can easily be customized to manage different types of medical data. The customization for a new disease can be done in a few hours with the help of a specialist. Conclusion We have used the proposed system to manage data from patients of three complex diseases: neuromyelitis optica, paracoccidioidomycosis and adrenoleukodistrofy. These diseases have very different symptoms, exams, diagnostics and treatments, but the FluxMED system is able to manage these data in a highly specialized manner without any modifications to its code. PMID:26695733

  9. Review of innovations in digital health technology to promote weight control.

    PubMed

    Thomas, J Graham; Bond, Dale S

    2014-01-01

    Advances in technology have contributed to the obesity epidemic and worsened health by reducing opportunities for physical activity and by the proliferation of inexpensive calorie-dense foods. However, much of the same technology can be used to counter these troublesome trends by fostering the development and maintenance of healthy eating and physical activity habits. In contrast to intensive face-to-face treatments, technology-based interventions also have the potential to reach large numbers of individuals at low cost. The purpose of this review is to discuss studies in which digital technology has been used for behavioral weight control, report on advances in consumer technology that are widely adopted but insufficiently tested, and explore potential future directions for both. Web-based, mobile (eg, smartphone), virtual reality, and gaming technologies are the focus of discussion. The best evidence exists to support the use of digital technology for self-monitoring of weight-related behaviors and outcomes. However, studies are underway that will provide additional, important information regarding how best to apply digital technology for behavioral weight control. PMID:24664797

  10. Cuba's Urban Landscape Needs a Second Round of Innovation for Health.

    PubMed

    Peña, Jorge

    2015-07-01

    Cuba's economy spiraled downward in the 1990s, reeling from the collapse of European socialism and a tightened US embargo. To mitigate the crash's drastic effects, measures were adopted that transformed our urban landscape, especially in large cities such as Havana, paradoxically linking the period to nascent health-promoting options. One of the most important was the introduction of bicycle lanes on city streets, paths daily ridden by people on the over one million bicycles imported to offset the nearly nonexistent public transport caused by fuel shortages. Second, urban gardens began to sprout up, involving urban dwellers in production of their own food, particularly vegetables. Without minimizing the impact of the crisis, these two seemingly disparate phenomena meant people were getting more exercise, consuming fewer fats and carbohydrates and more fresh vegetables. People were even breathing fresher air, with fewer CO2-belching trucks, old cars and buses on the streets and less diesel used to transport produce in from afar. PMID:26947159

  11. Case management for dementia in primary health care: a systematic mixed studies review based on the diffusion of innovation model

    PubMed Central

    Khanassov, Vladimir; Vedel, Isabelle; Pluye, Pierre

    2014-01-01

    Background The purpose of this study was to examine factors associated with the implementation of case management (CM) interventions in primary health care (PHC) and to develop strategies to enhance its adoption by PHC practices. Methods This study was designed as a systematic mixed studies review (including quantitative and qualitative studies) with synthesis based on the diffusion of innovation model. A literature search was performed using MEDLINE, PsycInfo, EMBASE, and the Cochrane Database (1995 to August 2012) to identify quantitative (randomized controlled and nonrandomized) and qualitative studies describing the conditions limiting and facilitating successful CM implementation in PHC. The methodological quality of each included study was assessed using the validated Mixed Methods Appraisal Tool. Results Twenty-three studies (eleven quantitative and 12 qualitative) were included. The characteristics of CM that negatively influence implementation are low CM intensity (eg, infrequent follow-up), large caseload (more than 60 patients per full-time case manager), and approach, ie, reactive rather than proactive. Case managers need specific skills to perform their role (eg, good communication skills) and their responsibilities in PHC need to be clearly delineated. Conclusion Our systematic review supports a better understanding of factors that can explain inconsistent evidence with regard to the outcomes of dementia CM in PHC. Lastly, strategies are proposed to enhance implementation of dementia CM in PHC. PMID:24959072

  12. Accelerated resolution therapy: an innovative mental health intervention to treat post-traumatic stress disorder.

    PubMed

    Finnegan, Alan; Kip, K; Hernandez, D; McGhee, S; Rosenzweig, L; Hynes, C; Thomas, M

    2016-04-01

    Post-traumatic stress disorder (PTSD) is a disabling trauma and stress-related disorder that may occur after a person experiences a traumatic event, and evokes a combination of intrusion and avoidance symptoms, negative alterations in cognitions and mood, and alterations in arousal and reactivity. Accelerated resolution therapy (ART) is an emerging psychotherapy that provides fast and lasting resolution for mental health problems such as PTSD. ART has been shown to achieve a positive result in one to five sessions, typically over a 2-week period, and requires no homework, skills practice or repeated exposure to targeted events. Initial research, including one randomised control trial, has demonstrated that ART interventions can significantly reduce symptoms of psychological trauma in both civilians and US service members and veterans. These results suggest that ART be considered as either a primary treatment option or for refractory PTSD in those with a suboptimal response to endorsed first-line therapies. Conservative estimates indicate substantial potential cost savings in PTSD treatment. Despite the need for more definitive clinical trials, there is increasing interest in ART in the USA, including in the US Army. The growing positive empirical evidence is compelling, and there appears to be sufficient evidence to warrant UK researchers undertaking ART research. The armed forces offer the potential for comparative international trials. However, equally important are veterans, emergency services personnel and those subjected to violence. ART appears to also have application in other conditions, including depression, anxiety disorders, and alcohol or drug misuse. ART can potentially help personnel traumatised by the unique challenges of war and conflict zones by providing brief psychotherapy in a readily accessible and culturally competent manner. ART facilitates the provision of interventions and resolutions in theatre, thus enhancing forces' fighting capability

  13. Nurturing 21st century physician knowledge, skills and attitudes with medical home innovations: the Wright Center for Graduate Medical Education teaching health center curriculum experience

    PubMed Central

    Palamaner Subash Shantha, Ghanshyam; Gollamudi, Lakshmi Rani; Sheth, Jignesh; Ebersole, Brian; Gardner, Katlyn J.; Nardella, Julie; Ruddy, Meaghan P.; Meade, Lauren

    2015-01-01

    Purpose. The effect of patient centered medical home (PCMH) curriculum interventions on residents’ self-reported and demonstrated knowledge, skills and attitudes in PCMH competency arenas (KSA) is lacking in the literature. This study aimed to assess the impact of PCMH curricular innovations on the KSA of Internal Medicine residents. Methods. Twenty four (24) Internal Medicine residents—12 Traditional (TR) track residents and 12 Teaching Health Center (THC) track residents—began training in Academic Year (AY) 2011 at the Wright Center for Graduate Medical Education (WCGME). They were followed through AY2013, covering three years of training. PCMH curricular innovations were focally applied July 2011 until May 2012 to THC residents. These curricular innovations were spread program-wide in May 2012. Semi-annual, validated PCMH Clinician Assessments assessing KSA were started in AY2011 and were completed by all residents. Results. Mean KSA scores of TR residents were similar to those of THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than TR residents for most KSA. After program-wide implementation of PCMH innovations, mean scores of TR residents for all KSA improved and most became equalized to those of THC residents. Globally improved KSA scores of THC and TR residents were maintained through May 2014, with the majority of improvements above baseline and reaching statistical significance. Conclusions. PCMH curricular innovations inspired by Health Resources and Services Administration (HRSA’s) Teaching Health Center funded residency program expansion quickly and consistently improved the KSA of Internal Medicine residents. PMID:25699213

  14. Nurturing 21st century physician knowledge, skills and attitudes with medical home innovations: the Wright Center for Graduate Medical Education teaching health center curriculum experience.

    PubMed

    Thomas-Hemak, Linda; Palamaner Subash Shantha, Ghanshyam; Gollamudi, Lakshmi Rani; Sheth, Jignesh; Ebersole, Brian; Gardner, Katlyn J; Nardella, Julie; Ruddy, Meaghan P; Meade, Lauren

    2015-01-01

    Purpose. The effect of patient centered medical home (PCMH) curriculum interventions on residents' self-reported and demonstrated knowledge, skills and attitudes in PCMH competency arenas (KSA) is lacking in the literature. This study aimed to assess the impact of PCMH curricular innovations on the KSA of Internal Medicine residents. Methods. Twenty four (24) Internal Medicine residents-12 Traditional (TR) track residents and 12 Teaching Health Center (THC) track residents-began training in Academic Year (AY) 2011 at the Wright Center for Graduate Medical Education (WCGME). They were followed through AY2013, covering three years of training. PCMH curricular innovations were focally applied July 2011 until May 2012 to THC residents. These curricular innovations were spread program-wide in May 2012. Semi-annual, validated PCMH Clinician Assessments assessing KSA were started in AY2011 and were completed by all residents. Results. Mean KSA scores of TR residents were similar to those of THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than TR residents for most KSA. After program-wide implementation of PCMH innovations, mean scores of TR residents for all KSA improved and most became equalized to those of THC residents. Globally improved KSA scores of THC and TR residents were maintained through May 2014, with the majority of improvements above baseline and reaching statistical significance. Conclusions. PCMH curricular innovations inspired by Health Resources and Services Administration (HRSA's) Teaching Health Center funded residency program expansion quickly and consistently improved the KSA of Internal Medicine residents. PMID:25699213

  15. Functional loading test for expert estimation of health candidates in cosmonauts (the innovative approach)

    NASA Astrophysics Data System (ADS)

    Voronkov, Yury; Skedina, Marina; Degterenkova, Natalia; Stepanova, Galina

    Long stay of cosmonauts in conditions of International Space Station demands the increased medical control over their health during selection. Various parameters of cardiovascular system (CVS) undergo significant changes both during adaptation to space flight (period of removing into an orbit), directly under conditions of weightlessness and during readaptation to terrestrial environment. The CVS is sensitive indicator of adaptation reaction of total organism. Therefore much attention is given to the research of CVS regulation, its opportunities to adapt to various stress conditions, detection of pre-nozological changes in mechanisms of its regulation. One of the informative methods for detecting problems in CVS regulation is a postural orthostatic test. This work was designed to research regulation of hemodynamics during passive orthostatic test. 21 practically healthy people in the age from 18 to 36 years old have passed the test. During test the following parameters were registered: 12 Lead ECG and the BP, parameters of a myocardium by means of "CardioVisor-06" (CV) device, and also a condition of microcirculatory bloodstream (MCB) was estimated by means of ultrasonic high-frequency dopplerograph "Minimax-Doppler-K" with 20 MHz sensor. The impedance method of rheoencephalography (REG) by means of the "Encephalan-EEGR-13103" device was used to research a cerebral blood circulation. All subjects had normal parameters of ECG during test. However, during analysis data of CV, REG and MCB high tolerability to the test was observed in 14 test subjects. In other 7 subjects dynamics of parameters during test reflected problems in mechanisms of CVS regulation in its separate parts. Changes in parameters of REG and ultrasound in 4 test subjects reflected a hypotensive reaction. The parameter of a tone of arterioles in carotid and vertebral arteries system decreased for 15,3 % and 55,2 % accordingly. The parameters of MCB: average speed, vascular tone and peripheric

  16. Extending Adoption of Innovation Theory with Consumer Influence the Case of Personal Health Records (PHRs) and Patient Portals

    ERIC Educational Resources Information Center

    Baird, Aaron

    2012-01-01

    A long tradition of adoption of innovations research in the information systems context suggests that innovative information systems are typically adopted by the largest companies, with the most slack resources and the most management support within competitive markets. Additionally, five behavioral characteristics (relative advantage,…

  17. Development of an Optical Read-Out System for the LISA/NGO Gravitational Reference Sensor: A Status Report

    NASA Astrophysics Data System (ADS)

    Di Fiore, L.; De Rosa, R.; Garufi, F.; Grado, A.; Milano, L.; Spagnuolo, V.; Russano, G.

    2013-01-01

    The LISA group in Napoli is working on the development of an Optical Read-Out (ORO) system, based on optical levers and position sensitive detectors, for the LISA gravitational reference sensor. ORO is not meant as an alternative, but as an addition, to capacitive readout, that is the reference solution for LISA/NGO and will be tested on flight by LISA-Pathfinder. The main goal is the introduction of some redundancy with consequent mission risk mitigation. Furthermore, the ORO system is more sensitive than the capacitive one and its usage would allow a significant relaxation of the specifications on cross-couplings in the drag free control loops. The reliability of the proposed ORO device and the fulfilment of the sensitivity requirements have been already demonstrated in bench-top measurements and tests with the four mass torsion pendulum developed in Trento as a ground testing facility for LISA-Pathfinder and LISA hardware. In this paper we report on the present status of this activity presenting the last results and perspectives on some relevant aspects. 1) System design, measured sensitivity and noise characterization. 2) Possible layouts for integration in LISA/NGO and bench-top tests on real scale prototypes. 3) Search for space compatible components and preliminary tests. We will also discuss next steps in view of a possible application in LISA/NGO.

  18. Low-Frequency Gravitational-Wave Science with eLISA/ NGO

    NASA Technical Reports Server (NTRS)

    Amaro-Seoane, Pau; Aoudia, Sofiane; Babak, Stanislav; Binetruy, Pierre; Berti, Emanuele; Bohe, Alejandro; Caprini, Chiara; Colpi, Monica; Cornish, Neil J.; Danzmann, Karsten; Dufaux, Jean-Francois; Gair, Jonathan; Jennrich, Oliver; Jetzer, Philippe; Klein, Antoine; Lang, Ryan N.; Lobo, Alberto; Littenberg, Tyson; McWilliams, Sean T.; Nelemans, Gijs; Petiteau, Antoine; Porter, Edward K.; Schutz, Bernard F.; Stebbins, Robin; Vallisneri, Michele

    2011-01-01

    We review the expected science performance of the New Gravitational-Wave Observatory (NGO, a.k.a. eLISA), a mission under study by the European Space Agency for launch in the early 2020s. eLISA will survey the low-frequency gravitational-wave sky (from 0.1 mHz to 1 Hz), detecting and characterizing a broad variety of systems and events throughout the Universe, including the coalescences of massive black holes brought together by galaxy mergers; the inspirals of stellar-mass black holes and compact stars into central galactic black holes; several millions of ultracompact binaries, both detached and mass transferring, in the Galaxy; and possibly unforeseen sources such as the relic gravitational-wave radiation from the early Universe. eLISA's high signal-to-noise measurements will provide new insight into the structure and history of the Universe, and they will test general relativity in its strong-field dynamical regime.

  19. Post-disaster housing reconstruction: Perspectives of the NGO and local authorities on delay issues

    NASA Astrophysics Data System (ADS)

    Khalid, Khairin Norhashidah; Nifa, Faizatul Akmar Abdul; Ismail, Risyawati Mohamed; Lin, Chong Khai

    2016-08-01

    Post disaster reconstruction is complex, dynamic and chaotic in nature and as such represents many challenges because it is unlike normal construction. However, the time scale of reconstruction is shorter than the normal construction, but it often deals with uncertainties and the scale of the construction activities required is relatively high. After a disaster impacts a country, many governments, institutions and aid organizations cooperate and involved with the reconstruction process. This is seen as a tool for applying policies and programs designed to remedy the weakness in developmental policies, infrastructure and institutional arrangements. This paper reports a part of an on-going research on post-disaster housing reconstruction in Malaysia. An extensive literature review and pilot interviews were undertaken to establish the factors that contribute to the delay in post-disaster reconstruction project. Accordingly, this paper takes the perspective of recovery from non-government organization (NGO) and local authorities which act as providers of social services, builders of infrastructure, regulators of economic activity and managers of the natural environment. As a result, it is important on how those decisions are made, who is involved in the decision-making, and what are the consequences of this decision.

  20. LISA Pathfinder Discharge Working Group: Activities, Results, and Lessons Learned for LISA/NGO

    NASA Astrophysics Data System (ADS)

    Ziegler, T.; Bergner, P.; Hechenblaikner, G.; Brandt, N.

    2013-01-01

    In 2011, the European Space Agency (ESA) entrusted Astrium GmbH to identify the root cause and corrective measures for the shortcomings of the LISA Pathfinder discharge system baseline that were identified during the system level testing in the torsion pendulum at the University of Trento. The main goal was to maximize the discharge system robustness under the given constraint to minimize the impact on manufacturing and the AIT process of the existing flight hardware. Astrium GmbH set-up a dedicated discharge working group (DWG) for 9 months, bringing together the expertise of surface scientists (DLR Stuttgart, Uni Würzburg, Uni Modena, BEAR Trieste) with the existing significant knowledge in the LTP community (Uni Trento, Imperial College London, CGS, Selex Galileo, TWT GmbH, ESA). The findings resulted in a recommendation to modify the baseline discharge system of LISA Pathfinder, including the definition of dedicated manufacturing and AIT requirements. These findings have relevance also for LISA/NGO, since they allow for a significantly more robust discharge system design.

  1. Hydro operational restrictions forum: Agency and NGO workshop summary. Final report

    SciTech Connect

    Ebrahim, S.; Monahan, C.K.; Pistor, B.; West, A.

    1998-09-01

    Relicensing reviews and other regulatory activities associated with continued operation of hydro generation projects have drawn increased attention to hydro resources. This attention has typically resulted in imposition of conditions having a substantial cost impact without, necessarily, reflecting a full appreciation of the resource`s benefits and attributes. With the extensive countrywide effort in relicensing and regulation, there is an opportunity to collect and compile lessons learned. This is particularly true with respect to preferred practices, technologies, and techniques applicable to required studies and mitigation measures. Such compilation will enable the industry and related stakeholders to improve quality and effectiveness while reducing costs of relicensing and mitigation for continued hydro operations. As a technology leader for the industry, EPRI is in a unique position to identify and document these techniques and practices. The objectives were to determine and document preferred practices, technologies, and techniques for studies and mitigation measures required for hydropower facility licensing and compliance. This report comprises the proceedings of the agency and NGO workshop. Thirteen representatives from federal and state resource agencies and environmental interest groups participated in the workshop and discussed their experience with hydro relicensing process. Attendees identified areas of the process where buy-in could be achieved for preferred practices; they also noted certain other areas where it was highly unlikely this could be accomplished.

  2. Low-frequency gravitational-wave science with eLISA/NGO

    NASA Astrophysics Data System (ADS)

    Amaro-Seoane, Pau; Aoudia, Sofiane; Babak, Stanislav; Binétruy, Pierre; Berti, Emanuele; Bohé, Alejandro; Caprini, Chiara; Colpi, Monica; Cornish, Neil J.; Danzmann, Karsten; Dufaux, Jean-François; Gair, Jonathan; Jennrich, Oliver; Jetzer, Philippe; Klein, Antoine; Lang, Ryan N.; Lobo, Alberto; Littenberg, Tyson; McWilliams, Sean T.; Nelemans, Gijs; Petiteau, Antoine; Porter, Edward K.; Schutz, Bernard F.; Sesana, Alberto; Stebbins, Robin; Sumner, Tim; Vallisneri, Michele; Vitale, Stefano; Volonteri, Marta; Ward, Henry

    2012-06-01

    We review the expected science performance of the New Gravitational-Wave Observatory (NGO, a.k.a. eLISA), a mission under study by the European Space Agency for launch in the early 2020s. eLISA will survey the low-frequency gravitational-wave sky (from 0.1 mHz to 1 Hz), detecting and characterizing a broad variety of systems and events throughout the Universe, including the coalescences of massive black holes brought together by galaxy mergers; the inspirals of stellar-mass black holes and compact stars into central galactic black holes; several millions of ultra-compact binaries, both detached and mass transferring, in the Galaxy; and possibly unforeseen sources such as the relic gravitational-wave radiation from the early Universe. eLISA’s high signal-to-noise measurements will provide new insight into the structure and history of the Universe, and they will test general relativity in its strong-field dynamical regime.

  3. Attributes of innovations and approaches to scalability – lessons from a national program to extend the scope of practice of health professionals

    PubMed Central

    Masso, Malcolm; Thompson, Cristina

    2016-01-01

    The context for the paper was the evaluation of a national program in Australia to investigate extended scopes of practice for health professionals (paramedics, physiotherapists, and nurses). The design of the evaluation involved a mixed-methods approach with multiple data sources. Four multidisciplinary models of extended scope of practice were tested over an 18-month period, involving 26 organizations, 224 health professionals, and 36 implementation sites. The evaluation focused on what could be learned to inform scaling up the extended scopes of practice on a national scale. The evaluation findings were used to develop a conceptual framework for use by clinicians, managers, and policy makers to determine appropriate strategies for scaling up effective innovations. Development of the framework was informed by the literature on the diffusion of innovations, particularly an understanding that certain attributes of innovations influence adoption. The framework recognizes the role played by three groups of stakeholders: evidence producers, evidence influencers, and evidence adopters. The use of the framework is illustrated with four case studies from the evaluation. The findings demonstrate how the scaling up of innovations can be influenced by three quite distinct approaches – letting adoption take place in an uncontrolled, unplanned, way; actively helping the process of adoption; or taking deliberate steps to ensure that adoption takes place. Development of the conceptual framework resulted in two sets of questions to guide decisions about scalability, one for those considering whether to adopt the innovation (evidence adopters), and the other for those trying to decide on the optimal strategy for dissemination (evidence influencers).

  4. Attributes of innovations and approaches to scalability - lessons from a national program to extend the scope of practice of health professionals.

    PubMed

    Masso, Malcolm; Thompson, Cristina

    2016-01-01

    The context for the paper was the evaluation of a national program in Australia to investigate extended scopes of practice for health professionals (paramedics, physiotherapists, and nurses). The design of the evaluation involved a mixed-methods approach with multiple data sources. Four multidisciplinary models of extended scope of practice were tested over an 18-month period, involving 26 organizations, 224 health professionals, and 36 implementation sites. The evaluation focused on what could be learned to inform scaling up the extended scopes of practice on a national scale. The evaluation findings were used to develop a conceptual framework for use by clinicians, managers, and policy makers to determine appropriate strategies for scaling up effective innovations. Development of the framework was informed by the literature on the diffusion of innovations, particularly an understanding that certain attributes of innovations influence adoption. The framework recognizes the role played by three groups of stakeholders: evidence producers, evidence influencers, and evidence adopters. The use of the framework is illustrated with four case studies from the evaluation. The findings demonstrate how the scaling up of innovations can be influenced by three quite distinct approaches - letting adoption take place in an uncontrolled, unplanned, way; actively helping the process of adoption; or taking deliberate steps to ensure that adoption takes place. Development of the conceptual framework resulted in two sets of questions to guide decisions about scalability, one for those considering whether to adopt the innovation (evidence adopters), and the other for those trying to decide on the optimal strategy for dissemination (evidence influencers). PMID:27616889

  5. What Online User Innovation Communities Can Teach Us about Capturing the Experiences of Patients Living with Chronic Health Conditions. A Scoping Review

    PubMed Central

    Amann, Julia; Zanini, Claudia; Rubinelli, Sara

    2016-01-01

    Background In order to adapt to societal changes, healthcare systems need to switch from a disease orientation to a patient-centered approach. Virtual patient networks are a promising tool to favor this switch and much can be learned from the open and user innovation literature where the involvement of online user communities in the innovation process is well-documented. Objectives The objectives of this study were 1) to describe the use of online communities as a tool to capture and harness innovative ideas of end users or consumers; and 2) to point to the potential value and challenges of these virtual platforms to function as a tool to inform and promote patient-centered care in the context of chronic health conditions. Methods A scoping review was conducted. A total of seven databases were searched for scientific articles published in English between 1995 and 2014. The search strategy was refined through an iterative process. Results A total of 144 studies were included in the review. Studies were coded inductively according to their research focus to identify groupings of papers. The first set of studies focused on the interplay of factors related to user roles, motivations, and behaviors that shape the innovation process within online communities. Studies of the second set examined the role of firms in online user innovation initiatives, identifying different organizational strategies and challenges. The third set of studies focused on the idea selection process and measures of success with respect to online user innovation initiatives. Finally, the findings from the review are presented in the light of the particularities and challenges discussed in current healthcare research. Conclusion The present paper highlights the potential of virtual patient communities to inform and promote patient-centered care, describes the key challenges involved in this process, and makes recommendations on how to address them. PMID:27272912

  6. 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

  7. World Health Organization's Innovative Direct Disbursement Mechanism for Payment of Grassroots Immunization Personnel and Operations in Nigeria: 2004–2015

    PubMed Central

    Yehualashet, Yared G.; Wadda, Alieu; Agblewonu, Koffi B.; Zhema, Theophilus; Ibrahim, Al-asi A.; Corr, Alhagie; Linkins, Jennifer; Mkanda, Pascal; Vaz, Rui G.; Nsubuga, Peter; Ashogbon, Daniel

    2016-01-01

    Background. Following the 1988 World Health Assembly resolution to eradicate polio, the government of Nigeria, with support from partners, has been implementing several rounds of supplementary immunization activities (SIAs) each year. In addition to the technical requirements, the success of the polio eradication initiative depends on timely provision of adequate financial resources. Disbursement of funds for SIAs and payment of allowances to numerous vaccination personnel at the grassroots level are enormous operational challenges in a country the size of Nigeria. Upon donors' request for a transparent and effective payment mechanism, the World Health Organization (WHO), in consultation with national counterparts, created the innovative direct disbursement mechanism (DDM) in 2004. The objective of the DDM was to timely deploy operational funds at the field level and directly pay vaccination personnel allowances at the grassroots level. Methods. A detailed operational guideline for funds disbursement was developed in close consultation with central and field stakeholders. Multiyear financial resource requirements and operational budgets for every campaign were produced by an interagency-coordinated finance subcommittee. The WHO engaged a bank and an accounting firm as DDM partners to support disbursement of and accounting for the SIA funds, respectively. The 37 WHO field offices were equipped with electronic financial systems to support the DDM process, and temporary payment sites were set up to facilitate payment to vaccination personnel at the grassroots level. Coordination meetings among DDM partners were held regularly to reconcile financial records and address operational challenges. Results. Between 2004 and 2014, DDM supported 99 polio and nonpolio vaccination campaigns, disbursing more than $370 million to about 16 million beneficiaries across 280 temporary payment sites. To mitigate security risks and reduce operational costs, the WHO and DDM

  8. Implementing Role-Changing Versus Time-Changing Innovations in Health Care: Differences in Helpfulness of Staff Improvement Teams, Management, and Network for Learning.

    PubMed

    Nembhard, Ingrid M; Morrow, Christopher T; Bradley, Elizabeth H

    2015-12-01

    Health care organizations often fail in their effort to implement care-improving innovations. This article differentiates role-changing innovations, altering what workers do, from time-changing innovations, altering when tasks are performed or for how long. We examine our hypothesis that the degree to which access to groups that can alter organizational learning--staff, management, and external network--facilitates implementation depends on innovation type. Our longitudinal study using ordinal logistic regression and survey data on 517 hospitals' implementation of evidence-based practices for treating heart attack confirmed our thesis for factors granting access to each group: improvement team's representativeness (of affected staff), senior management engagement, and network membership. Although team representativeness and network membership were positively associated with implementing role-changing practices, senior management engagement was not. In contrast, senior management engagement was positively associated with implementing time-changing practices, whereas team representativeness was not, and network membership was not unless there was limited management engagement. These findings advance implementation science by explaining mixed results across past studies: Nature of change for workers alters potential facilitators' effects on implementation. PMID:26116611

  9. Comparing private sector family planning services to government and NGO services in Ethiopia and Pakistan: how do social franchises compare across quality, equity and cost?

    PubMed Central

    Shah, Nirali M; Wang, Wenjuan; Bishai, David M

    2011-01-01

    Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific. PMID:21729919

  10. Innovating team-based outpatient mental health care in the Veterans Health Administration: Staff-perceived benefits and challenges to pilot implementation of the Behavioral Health Interdisciplinary Program (BHIP).

    PubMed

    Barry, Catherine N; Abraham, Kristen M; Weaver, Kendra R; Bowersox, Nicholas W

    2016-05-01

    In the past decade, the demand for Veterans Health Administration (VHA) mental health care has increased rapidly. In response to the increased demand, the VHA developed the Behavioral Health Interdisciplinary Program (BHIP) team model as an innovative approach to transform VHA general outpatient mental health delivery. The present formative evaluation gathered information about pilot implementation of BHIP to understand the struggles and successes that staff experienced during facility transitions to the BHIP model. Using a purposive, nonrandom sampling approach, we conducted 1-on-1, semistructured interviews with 37 licensed and nonlicensed clinical providers and 13 clerical support staff assigned to BHIP teams in 21 facilities across the VHA. Interviews revealed that having actively involved facility mental health leaders, obtaining adequate staffing for teams to meet the requirements of the BHIP model, creating clear descriptions and expectations for team member roles within the BHIP framework, and allocating designated time for BHIP team meetings challenged many VHA sites but are crucial for successful BHIP implementation. Despite the challenges, staff reported that the transition to BHIP improved team work and improved patient care. Staff specifically highlighted the potential for the BHIP model to improve staff working relationships and enhance communication, collaboration, morale, and veteran treatment consistency. Future evaluations of the BHIP implementation process and BHIP team functioning focusing on patient outcomes, organizational outcomes, and staff functioning are recommended for fully understanding effects of transitioning to the BHIP model within VHA general mental health clinics and to identify best practices and areas for improvement. (PsycINFO Database Record PMID:27148949

  11. DNA cleavage by CgII and NgoAVII requires interaction between N- and R-proteins and extensive nucleotide hydrolysis.

    PubMed

    Zaremba, Mindaugas; Toliusis, Paulius; Grigaitis, Rokas; Manakova, Elena; Silanskas, Arunas; Tamulaitiene, Giedre; Szczelkun, Mark D; Siksnys, Virginijus

    2014-12-16

    The stress-sensitive restriction-modification (RM) system CglI from Corynebacterium glutamicum and the homologous NgoAVII RM system from Neisseria gonorrhoeae FA1090 are composed of three genes: a DNA methyltransferase (M.CglI and M.NgoAVII), a putative restriction endonuclease (R.CglI and R.NgoAVII, or R-proteins) and a predicted DEAD-family helicase/ATPase (N.CglI and N.NgoAVII or N-proteins). Here we report a biochemical characterization of the R- and N-proteins. Size-exclusion chromatography and SAXS experiments reveal that the isolated R.CglI, R.NgoAVII and N.CglI proteins form homodimers, while N.NgoAVII is a monomer in solution. Moreover, the R.CglI and N.CglI proteins assemble in a complex with R2N2 stoichiometry. Next, we show that N-proteins have ATPase activity that is dependent on double-stranded DNA and is stimulated by the R-proteins. Functional ATPase activity and extensive ATP hydrolysis (∼170 ATP/s/monomer) are required for site-specific DNA cleavage by R-proteins. We show that ATP-dependent DNA cleavage by R-proteins occurs at fixed positions (6-7 nucleotides) downstream of the asymmetric recognition sequence 5'-GCCGC-3'. Despite similarities to both Type I and II restriction endonucleases, the CglI and NgoAVII enzymes may employ a unique catalytic mechanism for DNA cleavage. PMID:25429977

  12. Rural Health Information Hub

    MedlinePlus

    ... Health Gateway Evidence-based Toolkits Rural Health Models & Innovations Supporting Rural Community Health Tools for Success Am ... rural project examples in Rural Health Models and Innovations and proven strategies for strong rural programs with ...

  13. Medicaid and Rural Health

    MedlinePlus

    ... Health Gateway Evidence-based Toolkits Rural Health Models & Innovations Supporting Rural Community Health Tools for Success Am ... Websites & Tools Funding & Opportunities News Events Models and Innovations About This Guide Rural Health > Topics & States > Topics ...

  14. Rural Mental Health

    MedlinePlus

    ... Health Gateway Evidence-based Toolkits Rural Health Models & Innovations Supporting Rural Community Health Tools for Success Am ... Tools Maps Funding & Opportunities News Events Models and Innovations About This Guide Rural Health > Topics & States > Topics ...

  15. Innovation in a backwater: The Harpurhey Resettlement Team and the mental health services of North Manchester, 1982–1987

    PubMed Central

    Harrington, Val

    2009-01-01

    This paper explores the circumstances around the setting up of the Harpurhey Resettlement Team, an innovative project which, in the late 1980s, resettled around 20 long-stay patients from Springfield Hospital in North Manchester into ordinary tenancies within the same neighbourhood. It argues that Springfield's position as a marginalised and neglected institution produced the conditions for such innovation; while the particular and unexpected convergence of national policies, local structures and institutional politics created space for a process of change which, in both form and outcome, could not have occurred in the more regulated psychiatric environments elsewhere in Manchester. PMID:19307145

  16. Cosmological backgrounds of gravitational waves and eLISA/NGO: phase transitions, cosmic strings and other sources

    SciTech Connect

    Binétruy, Pierre; Dufaux, Jean-François; Caprini, Chiara E-mail: bohe@iap.fr E-mail: dufaux@apc.univ-paris7.fr

    2012-06-01

    We review several cosmological backgrounds of gravitational waves accessible to direct-detection experiments, with a special emphasis on those backgrounds due to first-order phase transitions and networks of cosmic (super-)strings. For these two particular sources, we revisit in detail the computation of the gravitational wave background and improve the results of previous works in the literature. We apply our results to identify the scientific potential of the NGO/eLISA mission of ESA regarding the detectability of cosmological backgrounds.

  17. Increased Utilization of Primary Health Care Centers for Birthing Care in Tamil Nadu, India: A Visible Impact of Policies, Initiatives, and Innovations

    PubMed Central

    Pandian, Jayanthi; Suresh, Saradha; Desikachari, B. R.; Padmanaban, P.

    2013-01-01

    Background: Tamil Nadu has been showing an increasing trend in institutional deliveries since early 1990's and has now achieved near 100%. Among the institutional deliveries, a change was observed since 2006, wherein primary health centers (PHCs) showed a four-fold increase in deliveries, while other public and private health facilities showed a decline, despite equal access to all categories of health facilities. What led to this increased utilization of PHCs for birthing care? Material and Methods: Policies, documents, and published reports of the Government of Tamil Nadu (GoTN) were reviewed and interviews were conducted with the various stakeholders involved in providing birthing care in the PHCs. This study analyzes the impact of the policies and supply side initiatives and innovations which led to increase utilization of the PHCs for birthing care. Results: Scaling up of 24 × 7 services in all PHCs, upgrading PHCs with good infrastructure, human resources, and women friendly services have helped to boost the image of the PHCs. Pro-women policies like maternity benefit schemes, birth companionship, providing food, and compulsory stay for 48 h following delivery have attracted women towards PHC. Innovative strategies like maternity picnics and use of expected date of delivery (EDD) chart for follow-up have made women choose PHCs, while periodic reviews and support to staff has improved service delivery. Conclusion: Women centered policies, efficient managerial systems, quality care, and innovative marketing of services have together contributed to increased utilization of PHCs for birthing. Other states could explore the possibility of replicating this model to make optimal use the PHC facilities. PMID:26664836

  18. Innovations in mental health services implementation: a report on state-level data from the U.S. Evidence-Based Practices Project

    PubMed Central

    Magnabosco, Jennifer L

    2006-01-01

    Background The Evidence-Based Practice (EBP) Project has been investigating the implementation of evidence-based mental health practices (Assertive Community Treatment, Family Psychoeducation, Integrated Dual Diagnosis Treatment, Illness Management and Recovery, and Supported Employment) in state public mental health systems in the United States since 2001. To date, Project findings have yielded valuable insights into implementation strategy characteristics and effectiveness. This paper reports results of an effort to identify and classify state-level implementation activities and strategies employed across the eight states participating in the Project. Methods Content analysis and Greenhalgh et al's (2004) definition of innovation were used to identify and classify state-level activities employed during three phases of EBP implementation: Pre-Implementation, Initial Implementation and Sustainability Planning. Activities were coded from site visit reports created from documents and notes from key informant interviews conducted during two periods, Fall 2002 – Spring 2003, and Spring 2004. Frequency counts and rank-order analyses were used to examine patterns of implementation activities and strategies employed across the three phases of implementation. Results One hundred and six discreet implementation activities and strategies were identified as innovative and were classified into five categories: 1) state infrastructure building and commitment, 2) stakeholder relationship building and communications, 3) financing, 4) continuous quality management, and 5) service delivery practices and training. Implementation activities from different categories were employed at different phases of implementation. Conclusion Insights into effective strategies for implementing EBPs in mental health and other health sectors require qualitative and quantitative research that seeks to: a) empirically test the effects of tools and methods used to implement EBPs, and b) establish a

  19. JUST in time health emergency interventions: an innovative approach to training the citizen for emergency situations using virtual reality techniques and advanced IT tools (the VR Tool).

    PubMed

    Manganas, A; Tsiknakis, M; Leisch, E; Ponder, M; Molet, T; Herbelin, B; Magnetat-Thalmann, N; Thalmann, D; Fato, M; Schenone, A

    2004-01-01

    This paper reports the results of the second of the two systems developed by JUST, a collaborative project supported by the European Union under the Information Society Technologies (IST) Programme. The most innovative content of the project has been the design and development of a complementary training course for non-professional health emergency operators, which supports the traditional learning phase, and which purports to improve the retention capability of the trainees. This was achieved with the use of advanced information technology techniques, which provide adequate support and can help to overcome the present weaknesses of the existing training mechanisms. PMID:15747937

  20. JUST in time health emergency interventions: an innovative approach to training the citizen for emergency situations using virtual reality techniques and advanced IT tools (the Web-CD).

    PubMed

    Manganas, A; Tsiknakis, M; Leisch, E; Karefilaki, L; Monsieurs, K; Bossaert, L L; Giorgini, F

    2004-01-01

    This paper reports the results of the first of the two systems developed by JUST, a collaborative project supported by the European Union under the Information Society Technologies (IST) Programme. The most innovative content of the project has been the design and development of a complementary training course for non-professional health emergency operators, which supports the traditional learning phase, and which purports to improve the retention capability of the trainees. This was achieved with the use of advanced information technology techniques, which provide adequate support and can help to overcome the present weaknesses of the existing training mechanisms. PMID:15747936

  1. Alta FT-150: The Thruster for LISA Pathfinder and LISA/NGO Missions

    NASA Astrophysics Data System (ADS)

    Paita, L.; Cesari, U.; Nania, F.; Priami, L.; Rossodivita, A.; Giusti, N.; Andrenucci, M.; Estublier, D.

    2013-01-01

    FT-150© FEEP thruster has successfully completed an endurance test at Alta's Micropropulsion laboratory. The updated thruster design dramatically enhances performance with respect to previous FEEP devices and marks a major step forward in the LISA Pathfinder and NGO programmes as well as space propulsion capability in general. The test campaign took place in two parts. Firstly, the new design was tested to validate that the new configuration was compliant with the requirements of the Lisa Pathfinder mission with particular emphasis on the achievement of required total impulse and minimum and maximum thrust levels.The second part of the campaign was aimed at testing a worst-case DFACS profile of the LISA Pathfinder mission using the Elegant Breadboard Power Control Unit (EBB PCU) commanding at 10 Hz and acquiring at 50 Hz. Both purposes of the campaign were successfully met. A total impulse of more than 1080 Ns and a firing time of more than 3500 hours were achieved. No degradation of efficiency and performance was recorded over the entire test. During the first part, more then 600 Ns of total impulse and about 2000 hours of firing time were achieved. Different thrust profiles were commanded with an average thrust of about 87 μN. The minimum and maximum thrust were 1 μN and 150 μN respectively. Short periods at zero N (i.e. thruster switched-off) were also commanded. The measured mass efficiency and specific impulse, 60% and 8000 s respectively, demonstrated that the current design of the thruster is fully compatible with the much larger impulse requirement of LISA mission. The simulation of the worst-case DFACS cycles at 10 Hz was also successfully performed. Three different DFACS cycles representative of the worst cases were performed. These cycles highlighted one of the main advantages of this technology: the controllability and response time that can be verified immediately with electrical feedback parameters like total voltage and beam current (data

  2. Validation and in vivo assessment of an innovative satellite-based solar UV dosimeter for a mobile app dedicated to skin health.

    PubMed

    Morelli, M; Masini, A; Simeone, E; Khazova, M

    We present an innovative satellite-based solar UV (ultraviolet) radiation dosimeter with a mobile app interface that has been validated by exploiting both ground-based measurements and an in vivo assessment of the erythemal effects on some volunteers having controlled exposure to solar radiation. The app with this satellite-based UV dosimeter also includes other related functionalities such as the provision of safe sun exposure time updated in real-time and end exposure visual/sound alert. Both validations showed that the system has a good accuracy and reliability needed for health-related applications. This app will be launched on the market by siHealth Ltd in May 2016 under the name of "HappySun" and is available for both Android and iOS devices (more info on ). Extensive R&D activities are on-going for the further improvement of the satellite-based UV dosimeter's accuracy. PMID:27480452

  3. Innovative method for prioritizing emerging disinfection by-products (DBPs) in drinking water on the basis of their potential impact on public health.

    PubMed

    Hebert, Armelle; Forestier, Delphine; Lenes, Dorothée; Benanou, David; Jacob, Severine; Arfi, Catherine; Lambolez, Lucie; Levi, Yves

    2010-05-01

    Providing microbiologically safe drinking water is a major public health issue. However, chemical disinfection can produce unintended health hazards involving disinfection by-products (DBPs). In an attempt to clarify the potential public health concerns associated with emerging disinfection by-products (EDBPs), this study was intended to help to identify those suspected of posing potential related health effects. In view of the ever-growing list of EDBPs in drinking water and the lack of consensus about them, we have developed an innovative prioritization method that would allow us to address this issue. We first set up an exhaustive database including all the current published data relating to EDBPs in drinking water (toxicity, occurrence, epidemiology and international or local guidelines/regulations). We then developed a ranking method intended to prioritize the EDBPs. This method, which was based on a calculation matrix with different coefficients, was applied to the data regarding their potential contribution to the health risk assessment process. This procedure allowed us to identify and rank three different groups of EDBPs: Group I, consisting of the most critical EDBPs with regard to their potential health effects, has moderate occurrence but the highest toxicity. Group II has moderate to elevated occurrence and is associated with relevant toxicity, and Group III has very low occurrence and unknown or little toxicity. The EDBPs identified as posing the greatest potential risk using this method were as follows: NDMA and other nitrosamines, MX and other halofuranones, chlorate, formaldehyde and acetaldehyde, 2,4,6-trichlorophenol and pentachlorophenol, hydrazine, and two unregulated halomethanes, dichloromethane and tetrachloromethane. Our approach allowed us to define the EDBPs that it is most important to monitor in order to assess population exposure and related public health issues, and thus to improve drinking water treatment and distribution. It is also

  4. The Impact of an Innovative Mindfulness-Based Stress Reduction Program on the Health and Well-Being of Nurses Employed in a Corporate Setting

    PubMed Central

    Bazarko, Dawn; Cate, Rebecca A.; Azocar, Francisca; Kreitzer, Mary Jo

    2013-01-01

    This study implemented an innovative new model of delivering a Mindfulness-Based Stress Reduction (MBSR) program that replaces six of the eight traditional in-person sessions with group telephonic sessions (tMBSR) and measured the program's impact on the health and well-being of nurses employed within a large health care organization. As part of a nonrandomized pre–post intervention study, 36 nurses completed measures of health, stress, burnout, self-compassion, serenity, and empathy at three points in time. Between baseline (Time 1) and the end of the 8-week tMBSR intervention (Time 2), participants showed improvement in general health, t(37) = 2.8, p < .01, decreased stress, t(37) = 6.8, p < .001, decreased work burnout, t(37) = 4.0, p < .001, and improvement in several other areas. Improvements were sustained 4 months later (Time 3), and individuals who continued their MBSR practice after the program demonstrated better outcomes than those that did not. Findings suggest that the tMBSR program can be a low cost, feasible, and scalable intervention that shows positive impact on health and well-being, and could allow MBSR to be delivered to employees who are otherwise unable to access traditional, on-site programs. PMID:23667348

  5. The Impact of an Innovative Mindfulness-Based Stress Reduction Program on the Health and Well-Being of Nurses Employed in a Corporate Setting.

    PubMed

    Bazarko, Dawn; Cate, Rebecca A; Azocar, Francisca; Kreitzer, Mary Jo

    2013-04-01

    This study implemented an innovative new model of delivering a Mindfulness-Based Stress Reduction (MBSR) program that replaces six of the eight traditional in-person sessions with group telephonic sessions (tMBSR) and measured the program's impact on the health and well-being of nurses employed within a large health care organization. As part of a nonrandomized pre-post intervention study, 36 nurses completed measures of health, stress, burnout, self-compassion, serenity, and empathy at three points in time. Between baseline (Time 1) and the end of the 8-week tMBSR intervention (Time 2), participants showed improvement in general health, t(37) = 2.8, p < .01, decreased stress, t(37) = 6.8, p < .001, decreased work burnout, t(37) = 4.0, p < .001, and improvement in several other areas. Improvements were sustained 4 months later (Time 3), and individuals who continued their MBSR practice after the program demonstrated better outcomes than those that did not. Findings suggest that the tMBSR program can be a low cost, feasible, and scalable intervention that shows positive impact on health and well-being, and could allow MBSR to be delivered to employees who are otherwise unable to access traditional, on-site programs. PMID:23667348

  6. Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana’s Community-based Health Planning and Services (CHPS)

    PubMed Central

    2014-01-01

    Background Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. Methods This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. Results The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban

  7. Identifying Consumer’s Needs of Health Information Technology through an Innovative Participatory Design Approach among English- and Spanish-speaking Urban Older Adults

    PubMed Central

    Sheehan, B.; Yen, P.; Velez, O.; Nobile-Hernandez, D.; Tiase, V.

    2014-01-01

    Summary Objectives We describe an innovative community-centered participatory design approach, Consumer-centered Participatory Design (C2PD), and the results of applying C2PD to design and develop a web-based fall prevention system. Methods We conducted focus groups and design sessions with English- and Spanish-speaking community-dwelling older adults. Focus group data were summarized and used to inform the context of the design sessions. Descriptive content analysis methods were used to develop categorical descriptions of design session informant’s needs related to information technology. Results The C2PD approach enabled the assessment and identification of informant’s needs of health information technology (HIT) that informed the development of a falls prevention system. We learned that our informants needed a system that provides variation in functions/content; differentiates between actionable/non-actionable information/structures; and contains sensory cues that support wide-ranging and complex tasks in a varied, simple, and clear interface to facilitate self-management. Conclusions The C2PD approach provides community-based organizations, academic researchers, and commercial entities with a systematic theoretically informed approach to develop HIT innovations. Our community-centered participatory design approach focuses on consumer’s technology needs while taking into account core public health functions. PMID:25589909

  8. An Appeal to the Global Health Community for a Tripartite Innovation: An "Essential Diagnostics List," "Health in All Policies," and "See-Through 21(st) Century Science and Ethics".

    PubMed

    Dove, Edward S; Barlas, I Ömer; Birch, Kean; Boehme, Catharina; Borda-Rodriguez, Alexander; Byne, William M; Chaverneff, Florence; Coşkun, Yavuz; Dahl, Marja-Liisa; Dereli, Türkay; Diwakar, Shyam; Elbeyli, Levent; Endrenyi, Laszlo; Eroğlu-Kesim, Belgin; Ferguson, Lynnette R; Güngör, Kıvanç; Gürsoy, Ulvi; Hekim, Nezih; Huzair, Farah; Kaushik, Kabeer; Kickbusch, Ilona; Kıroğlu, Olcay; Kolker, Eugene; Könönen, Eija; Lin, Biaoyang; Llerena, Adrian; Malhan, Faruk; Nair, Bipin; Patrinos, George P; Şardaş, Semra; Sert, Özlem; Srivastava, Sanjeeva; Steuten, Lotte M G; Toraman, Cengiz; Vayena, Effy; Wang, Wei; Warnich, Louise; Özdemir, Vural

    2015-08-01

    Diagnostics spanning a wide range of new biotechnologies, including proteomics, metabolomics, and nanotechnology, are emerging as companion tests to innovative medicines. In this Opinion, we present the rationale for promulgating an "Essential Diagnostics List." Additionally, we explain the ways in which adopting a vision for "Health in All Policies" could link essential diagnostics with robust and timely societal outcomes such as sustainable development, human rights, gender parity, and alleviation of poverty. We do so in three ways. First, we propose the need for a new, "see through" taxonomy for knowledge-based innovation as we transition from the material industries (e.g., textiles, plastic, cement, glass) dominant in the 20(th) century to the anticipated knowledge industry of the 21st century. If knowledge is the currency of the present century, then it is sensible to adopt an approach that thoroughly examines scientific knowledge, starting with the production aims, methods, quality, distribution, access, and the ends it purports to serve. Second, we explain that this knowledge trajectory focus on innovation is crucial and applicable across all sectors, including public, private, or public-private partnerships, as it underscores the fact that scientific knowledge is a co-product of technology, human values, and social systems. By making the value systems embedded in scientific design and knowledge co-production transparent, we all stand to benefit from sustainable and transparent science. Third, we appeal to the global health community to consider the necessary qualities of good governance for 21st century organizations that will embark on developing essential diagnostics. These have importance not only for science and knowledge-based innovation, but also for the ways in which we can build open, healthy, and peaceful civil societies today and for future generations. PMID:26161545

  9. Development of a web-based tool for the assessment of health and economic outcomes of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA)

    PubMed Central

    2015-01-01

    Background The European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) is a European Commission led policy initiative to address the challenges of demographic change in Europe. For monitoring the health and economic impact of the social and technological innovations carried out by more than 500 stakeholder's groups ('commitments') participating in the EIP on AHA, a generic and flexible web-based monitoring and assessment tool is currently being developed. Aim This paper describes the approach for developing and implementing this web-based tool, its main characteristics and capability to provide specific outcomes that are of value to the developers of an intervention, as well as a series of case studies planned before wider rollout. Methods The tool builds up from a variety of surrogate endpoints commonly used across the diverse set of EIP on AHA commitments in order to estimate health and economic outcomes in terms of incremental changes in quality adjusted life years (QALYs) as well as health and social care utilisation. A highly adaptable Markov model with initially three mutually exclusive health states ('baseline health', 'deteriorated health' and 'death') provides the basis for the tool which draws from an extensive database of epidemiological, economic and effectiveness data; and also allows further customisation through remote data entry enabling more accurate and context specific estimation of intervention impact. Both probabilistic sensitivity analysis and deterministic scenario analysis allow assessing the impact of parameter uncertainty on intervention outcomes. A set of case studies, ranging from the pre-market assessment of early healthcare technologies to the retrospective analysis of established care pathways, will be carried out before public rollout, which is envisaged end 2015. Conclusion Monitoring the activities carried out within the EIP on AHA requires an approach that is both flexible and consistent in the way health and

  10. California's "5 a day--for better health!" campaign: an innovative population-based effort to effect large-scale dietary change.

    PubMed

    Foerster, S B; Kizer, K W; Disogra, L K; Bal, D G; Krieg, B F; Bunch, K L

    1995-01-01

    The annual toll of diet-related diseases in the United States is similar to that taken by tobacco, but less progress has been achieved in reaching the Public Health Service's Healthy People 2000 objectives for improving food consumption than for reducing tobacco use. In 1988, the California Department of Health Services embarked upon an innovative multi-year social marketing program to increase fruit and vegetable consumption. The 5 a Day--for Better Health! Campaign had several distinctive features, including its simple, positive, behavior-specific message to eat 5 servings of fruits and vegetables every day as part of a low-fat, high fiber diet; its use of mass media; its partnership between the state health department and the produce and supermarket industries; and its extensive use of point-of-purchase messages. Over its nearly three years of operation in California, the 5 a Day Campaign appears to have raised public awareness that fruits and vegetables help reduce cancer risk, increased fruit and vegetable consumption in major population segments, and created an ongoing partnership between public health and agribusiness that has allowed extension of the campaign to other population segments, namely children and Latino adults. In 1991 the campaign was adopted as a national initiative by the National Cancer Institute and the Produce for Better Health Foundation. By 1994, over 700 industry organizations and 48 states, territories, and the District of Columbia were licensed to participate. Preventive medicine practitioners and others involved in health promotion may build upon the 5 a Day Campaign experience in developing and implementing efforts to reach the nation's dietary goals. PMID:7632448

  11. Outreach services to improve access to health care in South Africa: lessons from three community health worker programmes

    PubMed Central

    Nxumalo, Nonhlanhla; Goudge, Jane; Thomas, Liz

    2013-01-01

    Introduction In South Africa, there are renewed efforts to strengthen primary health care and community health worker (CHW) programmes. This article examines three South African CHW programmes, a small local non-governmental organisation (NGO), a local satellite of a national NGO, and a government-initiated service, that provide a range of services from home-based care, childcare, and health promotion to assist clients in overcoming poverty-related barriers to health care. Methods The comparative case studies, located in Eastern Cape and Gauteng, were investigated using qualitative methods. Thematic analysis was used to identify factors that constrain and enable outreach services to improve access to care. Results The local satellite (of a national NGO), successful in addressing multi-dimensional barriers to care, provided CHWs with continuous training focused on the social determinants of ill-health, regular context-related supervision, and resources such as travel and cell-phone allowances. These workers engaged with, and linked their clients to, agencies in a wide range of sectors. Relationships with participatory structures at community level stimulated coordinated responses from service providers. In contrast, an absence of these elements curtailed the ability of CHWs in the small NGO and government-initiated service to provide effective outreach services or to improve access to care. Conclusion Significant investment in resources, training, and support can enable CHWs to address barriers to care by negotiating with poorly functioning government services and community participation structures. PMID:23364101

  12. The Development of Innovative Online Problem-Based Learning: A Leadership Course for Leaders in European Public Health

    ERIC Educational Resources Information Center

    de Jong, Nynke; Könings, Karen D.; Czabanowska, Katarzyna

    2014-01-01

    The shift to a knowledge information society has given rise to a need for lifelong learning programmes. Such programmes are especially relevant for public health professionals, whose dynamic field of practice is subject to changes due to rapidly developing technologies, evolving expectations of the labour market and new health treats. Lifelong…

  13. I Sing the Body Electric: Description of an Innovative Health Promotion and Fine Arts Program for Adolescents

    ERIC Educational Resources Information Center

    Phillips, Kathleen; Dietz, Julie; Borzi, Mark; Harrison, Gaye

    2006-01-01

    I Sing the Body Electric (BODY ELECTRIC) is a fine arts and health promotion program that supports communication of healthy lifestyle choices among youth. BODY ELECTRIC connects youth in 27 high schools with health and education communities in the largest rural geographic education region in a Midwestern state. The three-phase prevention plan…

  14. The World Leader in Health Information and Innovation Celebrates 175 Years | NIH MedlinePlus the Magazine

    MedlinePlus

    ... information for the betterment of American–and global–human health. Creating Information Resources for Researchers Since the dawn of the computer ... dimensional representations of the normal male and female human bodies. ... health information resources when disasters occur. Within a week of the ...

  15. mPneumonia: Development of an Innovative mHealth Application for Diagnosing and Treating Childhood Pneumonia and Other Childhood Illnesses in Low-Resource Settings

    PubMed Central

    Ginsburg, Amy Sarah; Delarosa, Jaclyn; Brunette, Waylon; Levari, Shahar; Sundt, Mitch; Larson, Clarice; Tawiah Agyemang, Charlotte; Newton, Sam; Borriello, Gaetano; Anderson, Richard

    2015-01-01

    Pneumonia is the leading infectious cause of death in children worldwide. Each year, pneumonia kills an estimated 935,000 children under five years of age, with most of these deaths occurring in developing countries. The current approach for pneumonia diagnosis in low-resource settings—using the World Health Organization Integrated Management of Childhood Illness (IMCI) paper-based protocols and relying on a health care provider’s ability to manually count respiratory rate—has proven inadequate. Furthermore, hypoxemia—a diagnostic indicator of the presence and severity of pneumonia often associated with an increased risk of death—is not assessed because pulse oximetry is frequently not available in low-resource settings. In an effort to address childhood pneumonia mortality and improve frontline health care providers’ ability to diagnose, classify, and manage pneumonia and other childhood illnesses, PATH collaborated with the University of Washington to develop “mPneumonia,” an innovative mobile health application using an Android tablet. mPneumonia integrates a digital version of the IMCI algorithm with a software-based breath counter and a pediatric pulse oximeter. We conducted a design-stage usability field test of mPneumonia in Ghana, with the goal of creating a user-friendly diagnostic and management tool for childhood pneumonia and other childhood illnesses that would improve diagnostic accuracy and facilitate adherence by health care providers to established guidelines in low-resource settings. The results of the field test provided valuable information for understanding the usability and acceptability of mPneumonia among health care providers, and identifying approaches to iterate and improve. This critical feedback helped ascertain the common failure modes related to the user interface design, navigation, and accessibility of mPneumonia and the modifications required to improve user experience and create a tool aimed at decreasing mortality

  16. mPneumonia: Development of an Innovative mHealth Application for Diagnosing and Treating Childhood Pneumonia and Other Childhood Illnesses in Low-Resource Settings.

    PubMed

    Ginsburg, Amy Sarah; Delarosa, Jaclyn; Brunette, Waylon; Levari, Shahar; Sundt, Mitch; Larson, Clarice; Tawiah Agyemang, Charlotte; Newton, Sam; Borriello, Gaetano; Anderson, Richard

    2015-01-01

    Pneumonia is the leading infectious cause of death in children worldwide. Each year, pneumonia kills an estimated 935,000 children under five years of age, with most of these deaths occurring in developing countries. The current approach for pneumonia diagnosis in low-resource settings--using the World Health Organization Integrated Management of Childhood Illness (IMCI) paper-based protocols and relying on a health care provider's ability to manually count respiratory rate--has proven inadequate. Furthermore, hypoxemia--a diagnostic indicator of the presence and severity of pneumonia often associated with an increased risk of death--is not assessed because pulse oximetry is frequently not available in low-resource settings. In an effort to address childhood pneumonia mortality and improve frontline health care providers' ability to diagnose, classify, and manage pneumonia and other childhood illnesses, PATH collaborated with the University of Washington to develop "mPneumonia," an innovative mobile health application using an Android tablet. mPneumonia integrates a digital version of the IMCI algorithm with a software-based breath counter and a pediatric pulse oximeter. We conducted a design-stage usability field test of mPneumonia in Ghana, with the goal of creating a user-friendly diagnostic and management tool for childhood pneumonia and other childhood illnesses that would improve diagnostic accuracy and facilitate adherence by health care providers to established guidelines in low-resource settings. The results of the field test provided valuable information for understanding the usability and acceptability of mPneumonia among health care providers, and identifying approaches to iterate and improve. This critical feedback helped ascertain the common failure modes related to the user interface design, navigation, and accessibility of mPneumonia and the modifications required to improve user experience and create a tool aimed at decreasing mortality from

  17. The Women's Studies Center--A Women's-Led NGO Deepening Democracy in Chile: Educating Women through Personal Empowerment and Political Agency.

    ERIC Educational Resources Information Center

    King, Caroline

    This paper explores how the Women's Studies Center (Centro de Estudios de la Mujer, CEM), a feminist, women-led nongovernmental organization (NGO), is contributing to socio-cultural change in Chile 11 years after the country's democratic transition. CEM merges the theoretical and the practical, and the personal and the political through education…

  18. eHealth promotion and social innovation with youth: using social and visual media to engage diverse communities.

    PubMed

    Norman, Cameron D; Yip, Andrea L

    2012-01-01

    Social media and the multimedia networks that they support provide a platform for engaging youth and young adults across diverse contexts in a manner that supports different forms of creative expression. Drawing on more than 15 years of experience using eHealth promotion strategies to youth engagement, the Youth Voices Research Group (YVRG) and its partners have created novel opportunities for young people to explore health topics ranging from tobacco use, food security, mental health, to navigation of health services. Through applying systems and design thinking, the YVRG approach to engaging youth will be presented using examples from its research and practice that combine social organizing with arts-informed methods for creative expression using information technology. This presentation focuses on the way in which the YVRG has introduced interactive blogging, photographic elicitation, and video documentaries, alongside real-world social action projects, to promote youth health and to assist in research and evaluation. Opportunities and barriers including literacy and access to technology are discussed and presented along with emerging areas of research including more effective use of smartphones and social networking platforms such as Twitter, Facebook, and YouTube in health promotion and public health. PMID:22910502

  19. Data Lakes and Data Visualization: An Innovative Approach to Address the Challenges of Access to Health Care in Mississippi

    PubMed Central

    Krause, Denise D.

    2015-01-01

    Background: There are a variety of challenges to developing strategies to improve access to health care, but access to data is critical for effective evidence-based decision-making. Many agencies and organizations throughout Mississippi have been collecting quality health data for many years. However, those data have historically resided in data silos and have not been readily shared. A strategy was developed to build and coordinate infrastructure, capacity, tools, and resources to facilitate health workforce and population health planning throughout the state. Objective: Realizing data as the foundation upon which to build, the primary objective was to develop the capacity to collect, store, maintain, visualize, and analyze data from a variety of disparate sources -- with the ultimate goal of improving access to health care. Specific aims were to: 1) build a centralized data repository and scalable informatics platform, 2) develop a data management solution for this platform and then, 3) derive value from this platform by facilitating data visualization and analysis. Methods: A managed data lake was designed and constructed for health data from disparate sources throughout the state of Mississippi. A data management application was developed to log and track all data sources, maps and geographies, and data marts. With this informatics platform as a foundation, a variety of tools are used to visualize and analyze data. To illustrate, a web mapping application was developed to examine the health workforce geographically and attractive data visualizations and dynamic dashboards were created to facilitate health planning and research. Results: Samples of data visualizations that aim to inform health planners and policymakers are presented. Many agencies and organizations throughout the state benefit from this platform. Conclusion: The overarching goal is that by providing timely, reliable information to stakeholders, Mississippians in general will experience improved

  20. Innovative Universities.

    ERIC Educational Resources Information Center

    Barsi, Louis M.; Kaebnick, Gweneth W.

    1989-01-01

    The phenomenon of innovation within the university is examined, noting the possibility of innovation as a key to college vitality. A study was conducted using a group of institutions that demonstrated recent innovative spirit. Members of the American Association of State Colleges and Universities (AASCU), each has been recognized in an annual…

  1. Skilled craftswomen or cheap labour? Craft-based NGO projects as an alternative to female urban migration in northern Thailand.

    PubMed

    Humphreys, R

    1999-07-01

    This article presents a craft-based nongovernmental organization (NGO) project designed as an alternative to female urban migration in northern Thailand. ThaiCraft works with over 60 community-based artisan groups including members of minority and refugee groups. Activities include supporting community groups in their move toward self-reliance, coordination of producers' activities for ensuring fair payment, and maximizing marketing opportunities to increase producers' income. One of the project¿s aims is to form dynamic educational partnerships among producers, volunteers, and the public through the provision of training. Still, it is doubtful whether craft-based NGOs and other organizations can constitute a viable long-term alternative to urban migration. No proposed solution can respond to all issues associated with the emigration of rural Thai women for employment; however, the recognition of women's skills and knowledge is of importance to the fight against gender inequality in development. PMID:12349218

  2. Innovation in Medicine: It's Not Rocket Science

    NASA Technical Reports Server (NTRS)

    Polk, J. D.

    2009-01-01

    This slide presentation reviews some of the tenets and outcomes from the innovation that has come from NASA. In particular attention is paid to the innovations that NASA has produced in the field of health and medicine.

  3. The Personal Emergency Response System as a Technology Innovation in Primary Health Care Services: An Integrative Review

    PubMed Central

    2016-01-01

    Background Most western countries are experiencing greater pressure on community care services due to increased life expectancy and changes in policy toward prioritizing independent living. This has led to a demand for change and innovation in caring practices with an expected increased use of technology. Despite numerous attempts, it has proven surprisingly difficult to implement and adopt technological innovations. The main established technological innovation in home care services for older people is the personal emergency response system (PERS), which is widely adopted and used throughout most western countries aiming to support “aging safely in place.” Objective This integrative review examines how research literature describes use of the PERS focusing on the users’ perspective, thus exploring how different actors experience the technology in use and how it affects the complex interactions between multiple actors in caring practices. Methods The review presents an overview of the body of research on this well-established telecare solution, indicating what is important for different actors in regard to accepting and using this technology in community care services. An integrative review, recognized by a systematic search in major databases followed by a review process, was conducted. Results The search resulted in 33 included studies describing different actors’ experiences with the PERS in use. The overall focus was on the end users’ experiences and the consequences of having and using the alarm, and how the technology changes caring practices and interactions between the actors. Conclusions The PERS contributes to safety and independent living for users of the alarm, but there are also unforeseen consequences and possible improvements in the device and the integrated service. This rather simple and well-established telecare technology in use interacts with the actors involved, creating changes in daily living and even affecting their identities

  4. Prevention is Better than Cure: A Hands-On, Play-Based, Innovative, Health and Well-Being Program in Remote Australia

    PubMed Central

    Mathiasen, Lis

    2014-01-01

    A key to improving the quality of life in remote communities is the empowerment of children who are at health and educational risk. Between 2002 and 2009, at a remote Aboriginal school, students and community members participated in an innovative, play-based health and well-being program aimed at helping children to become self-determining and responsible for their own health and well-being. Holistic in its approach, and broad in its scope, the multi-faceted program encompassed the fundamentals of personal hygiene; understanding of body systems; the importance of nutrition, hydration, sleep and exercise; brain care; the biology of emotions, with particular emphasis on anger management and the critical interplay between emotions and behavior; the impact of substances of abuse on the brain; as well as the Hospital Familiarization Program (HFP) which prepares children for planned and unplanned hospitalization. Program outcomes included improved school attendance and student engagement; increased community awareness of the importance of a healthy lifestyle; improved self-concept, self-esteem and self-confidence; as well as increased respect and caring for self and others. A reduction in children’s fear and anxiety when facing hospitalization and visits to the doctor was also evident. Each year, 12,500 children throughout Western Australia enjoy the benefits of the HFP. PMID:27417482

  5. Prevention is Better than Cure: A Hands-On, Play-Based, Innovative, Health and Well-Being Program in Remote Australia.

    PubMed

    Mathiasen, Lis

    2014-01-01

    A key to improving the quality of life in remote communities is the empowerment of children who are at health and educational risk. Between 2002 and 2009, at a remote Aboriginal school, students and community members participated in an innovative, play-based health and well-being program aimed at helping children to become self-determining and responsible for their own health and well-being. Holistic in its approach, and broad in its scope, the multi-faceted program encompassed the fundamentals of personal hygiene; understanding of body systems; the importance of nutrition, hydration, sleep and exercise; brain care; the biology of emotions, with particular emphasis on anger management and the critical interplay between emotions and behavior; the impact of substances of abuse on the brain; as well as the Hospital Familiarization Program (HFP) which prepares children for planned and unplanned hospitalization. Program outcomes included improved school attendance and student engagement; increased community awareness of the importance of a healthy lifestyle; improved self-concept, self-esteem and self-confidence; as well as increased respect and caring for self and others. A reduction in children's fear and anxiety when facing hospitalization and visits to the doctor was also evident. Each year, 12,500 children throughout Western Australia enjoy the benefits of the HFP. PMID:27417482

  6. "Is there nothing more practical than a good theory?": Why innovations and advances in health behavior change will arise if interventions are used to test and refine theory.

    PubMed

    Rothman, Alexander J

    2004-07-27

    Theoretical and practical innovations are needed if we are to advance efforts to persuade and enable people to make healthy changes in their behavior. In this paper, I propose that progress in our understanding of and ability to promote health behavior change depends upon greater interdependence in the research activities undertaken by basic and applied behavioral scientists. In particular, both theorists and interventionists need to treat a theory as a dynamic entity whose form and value rests upon it being rigorously applied, tested and refined in both the laboratory and the field. To this end, greater advantage needs to be taken of the opportunities that interventions afford for theory-testing and, moreover, the data generated by these activities need to stimulate and inform efforts to revise, refine, or reject theoretical principles. PMID:15279674

  7. Promoting drug discovery by collaborative innovation: a novel risk- and reward-sharing partnership between the German Cancer Research Center and Bayer HealthCare.

    PubMed

    Wellenreuther, Ruth; Keppler, Dietrich; Mumberg, Dominik; Ziegelbauer, Karl; Lessl, Monika

    2012-11-01

    As a result of the increasing cost pressure on healthcare systems, the depletion of easily addressable and well-validated target groups in drug development and the requirement of public research to contribute to innovative treatment paradigms, broad partnerships between industry and academia are becoming increasingly important. However, owing to different goals and drivers, hurdles have to be overcome to exploit the full potential of such alliances. The factors that need to be taken into account during set-up and management of such alliances and the result and impact all of this has on drug discovery have not been analyzed in a systematic manner until now. This will be the focus of this review, using the strategic alliance between the German Cancer Research Center and Bayer HealthCare as an example. PMID:22521665

  8. Epidemiology and public health in 1906 England: Arthur Newsholme's methodological innovation to study breastfeeding and fatal diarrhea.

    PubMed

    Morabia, Alfredo; Rubenstein, Beth; Victora, Cesar G

    2013-07-01

    In 1906 Arthur Newsholme linked artificial feeding and fatal diarrhea in infants aged one year and younger on the basis of two independent sources of information: mortality registration and a three-year (1903-1905) census of infants from Brighton, United Kingdom. Artificial feeding was more common in the infants who had died (89.3%) than in those in the survey (22.3%). However, boldly assuming the two data sources were nested, Newsholme computed the risks of fatal diarrhea: these were 48 times greater for infants fed fresh cow's milk and 94 times greater for those fed condensed milk than for infants who were exclusively breastfed. This mode of computing risks and risk ratios before the invention of the cohort study design was more innovative than was the usual investigation techniques of his contemporary epidemiologists. Newsholme's conclusions were consistent with the current knowledge that breastfeeding protects against fatal diarrhea. PMID:23678939

  9. Epidemiology and Public Health in 1906 England: Arthur Newsholme’s Methodological Innovation to Study Breastfeeding and Fatal Diarrhea

    PubMed Central

    Rubenstein, Beth; Victora, Cesar G.

    2013-01-01

    In 1906 Arthur Newsholme linked artificial feeding and fatal diarrhea in infants aged one year and younger on the basis of two independent sources of information: mortality registration and a three-year (1903–1905) census of infants from Brighton, United Kingdom. Artificial feeding was more common in the infants who had died (89.3%) than in those in the survey (22.3%). However, boldly assuming the two data sources were nested, Newsholme computed the risks of fatal diarrhea: these were 48 times greater for infants fed fresh cow’s milk and 94 times greater for those fed condensed milk than for infants who were exclusively breastfed. This mode of computing risks and risk ratios before the invention of the cohort study design was more innovative than was the usual investigation techniques of his contemporary epidemiologists. Newsholme’s conclusions were consistent with the current knowledge that breastfeeding protects against fatal diarrhea. PMID:23678939

  10. An Innovative Project Breaks Down Barriers to Oral Health Care for Vulnerable Young Children in Los Angeles County.

    PubMed

    Crall, James J; Illum, Jackie; Martinez, Ana; Pourat, Nadereh

    2016-06-01

    Despite the high rate of untreated tooth decay, many young children in California under six years of age have never been to a dentist. Numerous and complex barriers to access to oral health care for young children exist, and a multifaceted approach is required to improve receipt of preventive and treatment services that could improve the oral health of this population. This policy brief describes the UCLA-First 5 LA 21st Century Dental Homes Project, which was designed to improve oral health care for young children in 12 Federally Qualified Health Center (FQHC) clinic sites with co-located dental and primary care services and its accessibility in their service areas throughout Los Angeles County. The project funded infrastructure and staffing, provided technical assistance to improve operations, trained clinical personnel to provide oral health care to young children, implemented a quality improvement learning collaborative, trained parents and child care providers in oral hygiene and healthy habits, and disseminated information to promote effective policies. Early data on the project indicated twofold increases in delivery of both diagnostics and treatment visits for young children, and a threefold increase in preventive services for young children during the program. PMID:27416646

  11. Creativity and innovation: thought and action.

    PubMed

    Pesut, Daniel J

    2013-01-01

    The purpose of this article is to discuss the significance of creativity and innovation in contemporary health care contexts, and to provide nurses and other health care professionals with models, resources, and ways of thinking about creativity that informs the development of an innovation-action and creative thinking mind-set. As the complexity of health care and nursing escalates, health care providers are challenged to think more creatively and develop innovations that advance the knowledge, learning, and service contributions of their discipline to the health care enterprise. Nursing requires creative thought and innovative action in service of the greater good. PMID:24400465

  12. Strengthening Screening for HIV, Hepatitis C, and STIs: An Innovative Partnership Between the Health Department and Community Health Centers in New York City.

    PubMed

    Terranova, Elizabeth; Tsoi, Benjamin; Laraque, Fabienne; Washburn, Kate; Fuld, Jennifer

    2016-01-01

    In New York City, federally qualified health centers (FQHCs) are ideal partners for health departments because of their location in neighborhoods with high rates of HIV, hepatitis C virus (HCV) infection, and gonorrhea. Providers have experienced many barriers to following screening and treatment recommendations. In 2013, the New York City Department of Health and Mental Hygiene partnered with six FQHCs, representing 14 clinics, to make screening for HIV and HCV routine and increase adherence to gonorrhea treatment guidelines through education, electronic health record modification, and progress tracking. After one year, 12 of 14 clinics documented improvement in their HIV offer rate, and 11 clinics documented improvement in their HIV screening rate. Patients who were offered HIV screening increased from 26% at baseline to 56% at follow-up, and patients screened for HIV increased from 25% at baseline to 38% at follow-up. Most clinics improved their HIV screening rate, and progress suggests that local health departments can help FQHCs increase their HIV screening rates. PMID:26862225

  13. Innovation to improve health care provision and health systems in sub-Saharan Africa - promoting agency in mid-level workers and district managers.

    PubMed

    Fonn, Sharon; Ray, Sunanda; Blaauw, Duane

    2011-01-01

    Initiatives to address the human resource crisis in African health systems have included expanded training of mid-level workers (MLWs). Currently, MLWs are the backbone of many health systems in Africa but they are often de-motivated and they often operate in circumstances in which providing high quality care is challenging. Therefore, assuming that introducing additional people will materially change health system performance is unrealistic. We briefly critique such unifocal interventions and review the literature to understand the factors that affect the motivation and performance of MLWs. Three themes emerge: the low status and inadequate recognition of MLWs, quality of care issues and working in poorly managed systems. In response we propose three interrelated interventions: a regional association of MLWs to enhance their status and recognition, a job enrichment and mentoring system to address quality and a district managers' association to improve health systems management. The professionalisation of MLWs and district managers to address confidence, self-esteem and value is considered. The paper describes the thinking behind these interventions, which are currently being tested in Kenya, Nigeria, South Africa and Uganda for their acceptability and appropriateness. We offer the policy community a complementary repertoire to existing human resource strategies in order to effect real change in African health systems. PMID:20582782

  14. Partnering With Community-Dwelling Individuals With Diabetes for Health Behavior Change Using Action Plans: An Innovation in Health Professionals Education and Practice.

    PubMed

    Barry Hultquist, Teresa; Brown, Sara Goomis; Geske, Jenenne; Kaiser, Katherine Laux; Waibel-Rycek, Denise

    2015-11-01

    Health care practitioners support or hinder an individual's attempts to self-manage health behavior. Practitioners must understand an individual's health needs and goals to effectively partner for behavior change. Self-management support (SMS) promote efforts toward positive health behavior change. Practitioners need training to provide effective SMS, beginning with their formal education. The purpose of this educational practice project was to integrate an evidence-based intervention (SMS using action plans) into a nursing curriculum. Three sequential steps included (1) providing foundational SMS education, (2) SMS application with students' personal action plans, and (3) implementing SMS with community-dwelling individuals with diabetes. Students (n = 130) partnered with participants (n = 85), developing short- (n = 240) and long-term (n = 99) action plans during home visits. The average baseline Diabetes Empowerment Scale score measuring participant's perceived psychosocial diabetes management self-efficacy was 4.3 (1-5 scale, SD = 0.51, n = 83). Most common short-term actions related to physical activity (n = 100, 42%) and healthy eating (n = 61, 25%). Average participant confidence level was 7.7 (SD = 1.9, 0-10 scale). Short-term goal evaluation (n = 209) revealed 66% (n = 137) were met more than 50% of the time. Both participants (99%) and students (99%) expressed satisfaction with home visit and action plan experiences. This teaching-learning experience is replicable and applicable to any professional health care student. PMID:26220279

  15. Electronic Health Records: Applying Diffusion of Innovation Theory to the Relationship between Multifactor Authentication and EHR Adoption

    ERIC Educational Resources Information Center

    Lockett, Daeron C.

    2014-01-01

    Electronic Health Record (EHR) systems are increasingly becoming accepted as future direction of medical record management systems. Programs such as the American Recovery and Reinvestment Act have provided incentives to hospitals that adopt EHR systems. In spite of these incentives, the perception of EHR adoption is that is has not achieved the…

  16. Innovative Treatment for Children With Serious Emotional Disturbance: Preliminary Outcomes for a School-Based Intensive Mental Health Program

    ERIC Educational Resources Information Center

    Vernberg, Eric M.; Jacobs, Anne K.; Nyre, Joseph E.; Puddy, Richard W.; Roberts, Michael C.

    2004-01-01

    This article describes the development, implementation, and preliminary evaluation of a school-based Intensive Mental Health Program (IMHP) for 50 children (42 boys, 8 girls) with severe, early-onset, serious emotional disturbances (SED). Eighty-four percent of the children showed clinically significant improvement in overall functioning as…

  17. Social network recruitment for Yo Puedo - an innovative sexual health intervention in an underserved urban neighborhood: sample and design implications

    PubMed Central

    Minnis, Alexandra M.; vanDommelen-Gonzalez, Evan; Luecke, Ellen; Cheng, Helen; Dow, William; Bautista-Arredondo, Sergio; Padian, Nancy S.

    2016-01-01

    Most existing evidence-based sexual health interventions focus on individual-level behavior, even though there is substantial evidence that highlights the influential role of social environments in shaping adolescents’ behaviors and reproductive health outcomes. We developed Yo Puedo, a combined conditional cash transfer (CCT) and life skills intervention for youth to promote educational attainment, job training, and reproductive health wellness that we then evaluated for feasibility among 162 youth aged 16–21 years in a predominantly Latino community in San Francisco, CA. The intervention targeted youth’s social networks and involved recruitment and randomization of small social network clusters. In this paper we describe the design of the feasibility study and report participants’ baseline characteristics. Furthermore, we examined the sample and design implications of recruiting social network clusters as the unit of randomization. Baseline data provide evidence that we successfully enrolled high risk youth using a social network recruitment approach in community and school-based settings. Nearly all participants (95%) were high risk for adverse educational and reproductive health outcomes based on multiple measures of low socioeconomic status (81%) and/or reported high risk behaviors (e.g., gang affiliation, past pregnancy, recent unprotected sex, frequent substance use) (62%). We achieved variability in the study sample through heterogeneity in recruitment of the index participants, whereas the individuals within the small social networks of close friends demonstrated substantial homogeneity across sociodemographic and risk profile characteristics. Social networks recruitment was feasible and yielded a sample of high risk youth willing to enroll in a randomized study to evaluate a novel sexual health intervention. PMID:25358834

  18. The University of Illinois at Chicago School of Public Health Doctor of Public Health program: an innovative approach to doctoral-level practice leadership development.

    PubMed

    Lenihan, Patrick; Welter, Christina; Brandt-Rauf, Paul; Neuberger, Babette; Pinsker, Eve; Petros, Michael; Risley, Kristine

    2015-03-01

    The University of Illinois at Chicago, School of Public Health, Doctor of Public Health degree is designed to build leadership skills and an ability to contribute to the evidence base of practice. The competency-based, distance-format, doctoral-level program for midcareer professionals features an action learning approach in which students apply leadership principles from the virtual classroom to real-world problems at their work sites. Students demonstrate mastery of the competencies and readiness to advance to the dissertation stage through completing a portfolio by using a process of systematic reflection. The practice-oriented dissertation demonstrates the ability to contribute to the evidence base of public health practice in an area of emphasis. Preliminary evaluation data indicate that the program is meeting its intended purposes. PMID:25706020

  19. DESI-MS2: a rapid and innovative method for trace analysis of six cytostatic drugs in health care setting.

    PubMed

    Fabrizi, Giovanni; Fioretti, Marzia; Rocca, Lucia Mainero; Curini, Roberta

    2012-05-01

    With the aim of establishing exposure levels for hospital personnel preparing and administering cytostatic drugs (CDs), here, we present an innovative screening method based on the use of the desorption electrospray ionization (DESI) interface coupled with a hybrid quadrupole linear ion trap mass spectrometer. A rapid, simple, and sensitive procedure was developed for the simultaneous surface monitoring of cyclophosphamide, dacarbazine, methotrexate, vincristine, gemcitabine, and cytarabine. Since analytes were in the solid state, a novel approach based on the use of passive samplers was combined with the direct analysis of wipes. A PTFE-printed glass slide was used as a passive sampler, while hydrophobic centers of Swiffer® cloths were judged extremely efficient as wipe samplers. After the sampling period, the CD collectors were directly processed with the DESI-MS system without any further treatment. MS/MS confirmatory analysis was conducted using selected reaction monitoring in the positive ion mode and detection limits were evaluated. Values were at the picograms per square millimeter levels on the passive collector and at the picograms per square centimeter levels for the wipe ones. Direct determination on solid-state samples combined with mass spectrometry selectivity provided a powerful tool so far unapplied to occupational hygiene. PMID:22200922

  20. The Health Innovations Scholars Program: A Model for Accelerating Preclinical Medical Students' Mastery of Skills for Leading Improvement of Clinical Systems.

    PubMed

    Sweigart, Joseph R; Tad-Y, Darlene; Pierce, Read; Wagner, Emilie; Glasheen, Jeffrey J

    2016-07-01

    Dramatic changes in health care require physician leadership. Efforts to instill necessary skills often occur late in training. The Heath Innovations Scholars Program (HISP) provided preclinical medical students with experiential learning focused on process improvement. Students led initiatives to improve the discharge process for stroke patients. All students completed an aptitude survey and Quality Improvement Knowledge Assessment Test (QIKAT) before and after the program. Significant improvements occurred across subject areas of leadership (18.4%, P < .001), quality and safety (14.7%, P < .001), and health care systems operations (21.2%, P < .008), and in the domains of knowledge (25.9%, P < .001) and skills (25.2%, P < .001). Average cumulative QIKAT results improved significantly (8.33 to 9.83, P = .04). Three of 4 recommended interventions were implemented. Furthermore, students engaged in other process improvement work on return to their home institutions. The HISP successfully advanced preclinical medical students' ability to lead clinical systems improvement. PMID:25855673

  1. An Innovative Model: Undergraduate Poster Sessions by Health Professional Majors as a Method for Communicating Chemistry in Context

    NASA Astrophysics Data System (ADS)

    Dunstan, Marie; Bassinger, Pat

    1997-09-01

    This paper develops the methods used to conduct poster sessions for undergraduate health professional majors. There are two main goals of the project. The first goal is to learn chemistry in the context of health professions, everyday activities and contemporary issues. The second goal is to continue to develop research and written and oral communication skills. The topics are chosen after a classroom discussion of organic chemistry. The students then attend a library instruction class for introduction to appropriate research tools. Students are also taught the mechanics of poster preparation. The sessions are presented during a laboratory class period and are open to the college and public at large. Evaluation criteria include comprehension of the chemistry, the level and accuracy of the discussion and the appropriateness of the poster design for information exchange, All levels of the college community are invited to participate and greatly contribute to the success of the poster sessions.

  2. Innovative interventions to promote positive dental health behaviors and prevent dental caries in preschool children: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Dental caries (tooth decay) is highly prevalent and is largely attributable to unhealthy self-care behaviors (diet and oral hygiene). The conventional (health) education (CE), focusing on disseminating information and giving normative advice, often fails to achieve sustained behavioral changes. This study incorporates two innovative elements into CE: (i) motivational interviewing (MI), a client-centered counseling for changing behaviors, and (ii) an interactive caries risk assessment (RA) tool, which is devised to facilitate dental counseling and may enhance MI in several ways. Through a randomized, controlled, evaluator-blinded trial, three intervention schemes (CE, CE + MI, and CE + MI + RA) will be compared for their effectiveness in eliciting dentally healthy behaviors and preventing caries in preschool children. Methods/Design This study targets 3-year-old children who are at a critical stage for embedding health habits. Children with unfavorable dental behaviors (insufficient toothbrushing and/or frequent snacking) and their parents will be recruited from 12 participating kindergartens. Parent-child dyads (n = 690) will be randomly assigned into three groups. In the first group (CE), oral health information and advice will be delivered to parents through pamphlets. In the second group (CE + MI), in addition to the pamphlets, individual MI counseling with each parent will be performed by one of two trained dental hygienists. In the third group (CE + MI + RA), besides pamphlets and MI, interactive RA will be integrated into MI to motivate parents and facilitate their informed decision making and goal planning. At baseline and after 12 and 24 months, parents will complete a questionnaire and children will undergo a dental examination. The effectiveness of the intervention schemes will be compared over 12 and 24 months. The primary outcome will be caries increment in children and proportion of caries-free children. Secondary outcomes will be changes in

  3. Innovation @ NASA

    NASA Technical Reports Server (NTRS)

    Roman, Juan A.

    2014-01-01

    This presentation provides an overview of the activities National Aeronautics and Space Administration (NASA) is doing to encourage innovation across the agency. All information provided is available publicly.

  4. Introducing vouchers for malaria prevention in Ghana and Tanzania: context and adoption of innovation in health systems.

    PubMed

    de Savigny, Don; Webster, Jayne; Agyepong, Irene Akua; Mwita, Alex; Bart-Plange, Constance; Baffoe-Wilmot, Aba; Koenker, Hannah; Kramer, Karen; Brown, Nick; Lengeler, Christian

    2012-10-01

    There are striking similarities in health system and other contexts between Tanzania and Ghana that are relevant to the scaling up of continuous delivery of insecticide treated nets (ITNs) for malaria prevention. However, specific contextual factors of relevance to ITN delivery have led implementation down very different pathways in the two countries. Both countries have made major efforts and investments to address this intervention through integrating consumer discount vouchers into the health system. Discount vouchers require arrangements among the public, private and non-governmental sectors and constitute a complex intervention in both health systems and business systems. In Tanzania, vouchers have moved beyond the planning agenda, had policies and programmes formulated, been sustained in implementation at national scale for many years and have become as of 2012 the main and only publicly supported continuous delivery system for ITNs. In Ghana national-scale implementation of vouchers never progressed beyond consideration on the agenda and piloting towards formulation of policy; and the approach was replaced by mass distribution campaigns with less dependency on or integration with the health system. By 2011, Ghana entered a phase with no publicly supported continuous delivery system for ITNs. To understand the different outcomes, we compared the voucher programme timelines, phases, processes and contexts in both countries in reference to the main health system building blocks (governance, human resources, financing, informatics, technologies and service delivery). Contextual factors which provided an enabling environment for the voucher scheme in Tanzania did not do so in Ghana. The voucher scheme was never seen as an appropriate national strategy, other delivery systems were not complementary and the private sector was under-developed. The extensive time devoted to engagement and consensus building among all stakeholders in Tanzania was an important and

  5. What Does the United Nations Mean to Women? An NGO View.

    ERIC Educational Resources Information Center

    Pietila, Hilkka

    Efforts put forth by the United Nations (UN) and specialized agencies and organs of the UN system to improve the status, nutrition, health, and education of women worldwide are the focus of this publication. The first of five sections, "Human Rights for Women," examines women's rights in the job field; UN steps to bring equality to the sexes…

  6. Innovation in Evaluating the Impact of Integrated Service-Delivery: The Integra Indexes of HIV and Reproductive Health Integration

    PubMed Central

    Mayhew, Susannah H.; Ploubidis, George B.; Sloggett, Andy; Church, Kathryn; Obure, Carol D.; Birdthistle, Isolde; Sweeney, Sedona; Warren, Charlotte E.; Watts, Charlotte; Vassall, Anna

    2016-01-01

    Background The body of knowledge on evaluating complex interventions for integrated healthcare lacks both common definitions of ‘integrated service delivery’ and standard measures of impact. Using multiple data sources in combination with statistical modelling the aim of this study is to develop a measure of HIV-reproductive health (HIV-RH) service integration that can be used to assess the degree of service integration, and the degree to which integration may have health benefits to clients, or reduce service costs. Methods and Findings Data were drawn from the Integra Initiative’s client flow (8,263 clients in Swaziland and 25,539 in Kenya) and costing tools implemented between 2008–2012 in 40 clinics providing RH services in Kenya and Swaziland. We used latent variable measurement models to derive dimensions of HIV-RH integration using these data, which quantified the extent and type of integration between HIV and RH services in Kenya and Swaziland. The modelling produced two clear and uncorrelated dimensions of integration at facility level leading to the development of two sub-indexes: a Structural Integration Index (integrated physical and human resource infrastructure) and a Functional Integration Index (integrated delivery of services to clients). The findings highlight the importance of multi-dimensional assessments of integration, suggesting that structural integration is not sufficient to achieve the integrated delivery of care to clients—i.e. “functional integration”. Conclusions These Indexes are an important methodological contribution for evaluating complex multi-service interventions. They help address the need to broaden traditional evaluations of integrated HIV-RH care through the incorporation of a functional integration measure, to avoid misleading conclusions on its ‘impact’ on health outcomes. This is particularly important for decision-makers seeking to promote integration in resource constrained environments. PMID:26800517

  7. An Innovative Method of Measuring Changes in Access to Healthful Foods in School Lunch Programs: Findings from a Pilot Evaluation

    PubMed Central

    Hawkes, Allison P.; Weinberg, Stacy L.; Janusz, Ruth; Demont-Heinrich, Christine; Vogt, Richard L.

    2016-01-01

    Introduction A large local health department in Colorado partnered with 15 school districts to develop an approach to evaluate changes in access to healthy foods in reimbursable school lunches and a la carte offerings. Materials and Methods School district nutrition managers were engaged at the start of this project. Health department dietitians developed criteria to classify food items as “Lower Fat and less added Sugar” (LFS) and “Higher Fat and more added Sugar” (HFS) based on the percentage of calories from fat and grams of added sugar. Lunch production sheets were obtained for two time periods, food items and the number of planned servings recorded. LFS and HFS planned servings were summed for each time period, and a LFS to HFS ratio calculated by dividing LFS planned servings by HFS planned servings. Additional analyses included calculating LFS: HFS ratios by school district, and for a la carte offerings. Results In 2009, the LFS: HFS ratio was 2.08, in 2011, 3.71 (P<0.0001). The method also detected changes in ratios at the school district level. For a la carte items, in 2009 the ratio of LFS: HFS was 0.53, and in 2011, 0.61 (not statistically significant). Conclusions This method detected an increase in the LFS: HFS ratio over time and demonstrated that the school districts improved access to healthful food/drink by changing the contents of reimbursable school lunches. The evaluation method discussed here can generate information that districts can use in helping sustain and expand their efforts to create healthier environments for children and adults. Although federal regulations now cover all food and beverages served during the school day, there are still opportunities to improve and measure changes in food served in other settings such as child care centers, youth correction facilities, or in schools not participating in the National School Lunch Program. PMID:26800523

  8. Addressing Breast Cancer Health Disparities in the Mississippi Delta Through an Innovative Partnership for Education, Detection, and Screening.

    PubMed

    Mayfield-Johnson, Susan; Fastring, Danielle; Fortune, Melody; White-Johnson, Freddie

    2016-06-01

    Projects to reduce disparities in cancer treatment and research include collaborative partnerships and multiple strategies to promote community awareness, education, and engagement. This is especially needed in underserved areas such as the Mississippi Delta where more women are diagnosed at regional and distant stages of breast cancer. The purpose for this project was to increase the relatively low screening rate for African American women in the Mississippi Delta through a partnership between the Mississippi Network for Cancer Control and Prevention at The University of Southern Mississippi, The Fannie Lou Hamer Cancer Foundation and the Mississippi State Department of Health to decrease health disparities in breast cancer through increased awareness on self-early detection methods, leveraging resources to provide mammography screenings, and adequate follow-up with services and treatment for abnormal findings. Through this collaborative effort, over 500 women in three rural Mississippi Delta counties were identified, provided community education on early self-detection, and given appointments for mammography screenings within one fiscal year. PMID:26578349

  9. Sequence analysis of the NgoPII methyltransferase gene from Neisseria gonorrhoeae P9: homologies with other enzymes recognizing the sequence 5'-GGCC-3'.

    PubMed Central

    Sullivan, K M; Saunders, J R

    1988-01-01

    Recombinant plasmids harbouring the functional M.NgoPII methyltransferase (specificity 5'-GGCC-3') were isolated from amplified gene libraries of gonococcal chromosomal DNA cloned in pBR322 and in Escherichia coli RR1. The M.NgoPII gene was localized by sub-cloning and the nucleotide sequence of a cloned 1.6 kb segment of Neisseria gonorrhoeae DNA harbouring the methylase gene was determined. This data, coupled with sub-cloning experiments and in vitro transcription-translation studies, indicates a theoretical size of 38.5 kd for the methylase protein. The predicted amino acid sequence of the methylase contains significant regions of homology with the projected sequences of other cytosine-modifying methylases, upon which the activity of these enzymes is likely to depend. Images PMID:2837733

  10. Case studies in public-private-partnership in health with the focus of enhancing the accessibility of health interventions.

    PubMed

    Njau, R J A; Mosha, F W; De Savigny, D

    2009-10-01

    Various definitions have been framed for public-private partnerships (PPPs) in health depending on the desired relationship and the characteristics of the respective sectors. These relationships span from a continuum of loose relationships with narrow objectives, lack of a legal status and an absence of a formalized membership or governing body to high level institutionalization. The latter includes concrete objectives, the presence of a legal status and permanent multi-sectoral membership. The study used qualitative research methods including case studies, literature review and interview with key informants. The research undertakes an extensive literature review of various PPP models in health in scale and in scope which are aimed at advancing public health goals in developing countries. The major emphasis is on a qualitative description of some of the PPPs in the planning and implementation phases, including the challenges encountered. This background is used to analyse in-depth two case studies which are both health oriented; the first one is a national level NGO consortium with a focus on malaria and the second one is an international advocacy group with an overarching goal of protecting children against malaria through an innovative mechanism. The case study approach is used to analyze why the PPP approach was used to address malaria control and how it was implemented. Both PPPs demonstrated that relationships between the public and private sector may begin from very humble and loose beginnings. However, with perseverance from committed individuals, a vision and trustworthiness may become powerful advocates for meeting prescribed health agendas. In conclusion, three key themes (trust, sacrifice and championship) run vividly through the case studies and are significant for developing countries to emulate. PMID:20734704

  11. Accion solidaria. A Venezuelan NGO confronts the Herculean task of providing drug access.

    PubMed

    Dougherty, S

    1997-05-01

    Venezuela does not currently recognize AIDS as a major public health problem, therefore, it does not fund AIDS services. It is estimated by the World Health Organization that Venezuela may have up to 250,000 HIV-infected citizens. Accion Solidaria (Action for Solidarity) is currently acting as a buyer's club, and as a source of medications from charitable groups in the United States such as the United Against AIDS International, for people living with HIV. Accion Solidaria is an entirely voluntary organization that receives monthly contributions from 41 people, just barely enough to purchase medications for 10 HIV-infected people. These efforts have been hindered by successive devaluations of Venezuelan currency. PMID:11364337

  12. The Challenges of Establishing and Sustaining an Overseas Enterprise: One Haitian NGO's Perspective.

    PubMed

    Greig, Elizabeth; Cornely, Cheryl Clark; Green, Barth A

    2015-06-01

    This article describes the creation of Project Medishare for Haiti, Inc, a US 501(c)3 nonprofit organization and its counterpart in Haiti, Project Medishare in Haiti, a nongovernmental organization that provides health care resources and training and education in Haiti. It summarizes the strategy for fundraising and sustaining such an enterprise in a developing country and discusses the lessons learned and goals achieved during the last 20 years. PMID:26080123

  13. Integrating research data capture into the electronic health record workflow: real-world experience to advance innovation.

    PubMed

    Laird-Maddox, Marsha; Mitchell, Susan B; Hoffman, Mark

    2014-01-01

    As the adoption of electronic health records (EHRs) increases, more opportunities are available for leveraging the system and the data to facilitate research. Historically, for patients enrolled in clinical research trials or studies, data have been documented in the medical record, and then study-related data are manually reentered into an electronic case report form in a research system. By utilizing data collected in the EHR to prepopulate electronic case report forms, manual transcription is reduced, data quality is improved, and the workflow for capturing research data is streamlined. Past efforts to integrate EHRs and research systems for the purposes of data capture have demonstrated that interoperability is possible. This article highlights how Cerner Corporation and Florida Hospital collaborated to extend an existing standard to implement a workflow called Integrated Data Capture. PMID:25593571

  14. How can innovative forms of clinical research contribute to deliver affordable cancer care in an evolving health care environment?

    PubMed

    Burock, Susen; Meunier, Françoise; Lacombe, Denis

    2013-09-01

    As health care costs are constantly rising and governments are reforming their healthcare systems there is an urgent need to reshape the European clinical research landscape. To bridge the translational gap extensive research to understand the mechanism of the agents and of the disease has to be performed and the real benefit of drugs needs to be assessed independently. Furthermore, meaningful data for reimbursement strategies will be a major goal of future clinical trials as well. Therefore, a new integrated model of clinical cancer research is needed to optimise the R&D process. Strategies to ensure that we can gather robust and relevant data about the effectiveness of various healthcare interventions have to be developed to provide optimal patient care within the limits of a healthcare budget. PMID:23777742

  15. Integrating Research Data Capture into the Electronic Health Record Workflow: Real-World Experience to Advance Innovation

    PubMed Central

    Laird-Maddox, Marsha; Mitchell, Susan B.; Hoffman, Mark

    2014-01-01

    As the adoption of electronic health records (EHRs) increases, more opportunities are available for leveraging the system and the data to facilitate research. Historically, for patients enrolled in clinical research trials or studies, data have been documented in the medical record, and then study-related data are manually reentered into an electronic case report form in a research system. By utilizing data collected in the EHR to prepopulate electronic case report forms, manual transcription is reduced, data quality is improved, and the workflow for capturing research data is streamlined. Past efforts to integrate EHRs and research systems for the purposes of data capture have demonstrated that interoperability is possible. This article highlights how Cerner Corporation and Florida Hospital collaborated to extend an existing standard to implement a workflow called Integrated Data Capture. PMID:25593571

  16. A Typology of Intellectual Property Management for Public Health Innovation and Access: Design Considerations for Policymakers§

    PubMed Central

    Taubman, Antony

    2010-01-01

    This paper seeks to set the practical discipline of public interest intellectual property (IP) management in public health into its broader policy context. The most immediate and direct impact of IP systems on public welfare results not from international standards nor from national legislation – though these norms are fundamentally important - but rather from the accumulated impact of numerous practical choices whether or not to seek IP protection; where and where not; and how any exclusive rights are deployed, by whom, and to what end. IP management is the essentially practical exercise of limited exclusive rights over protected subject matter, the judicious use of those rights to leverage outcomes that advance an institution's or a firm's objectives. Exclusive rights are used to construct and define knowledge-based relationships, to leverage access to technology and other necessary resources, and to enhance market-based incentives. IP management choices range across a broad spectrum, spanning public domain strategies, open or exclusive licensing, and strong exclusivity. The idea of ‘exclusive rights’, as a specific legal mechanism, can run counter to expectations of greater openness and accessibility, but actual outcomes will depend very much on how these mechanisms are used in practice. For public interest or public sector institutions concerned with health research and development, particularly the development of new medicines, IP management choices can be just as critical as they are for private firms, although a predominant institutional concentration on advancing direct public interest objectives may lead to significantly different approaches in weighing and exercising practical choices for IP management: even so, a private sector approach should not be conflated with exclusivity as an end in itself, nor need public interest IP management eschew all leverage over IP. This paper offers a tentative framework for a richer typology of those choices, to

  17. Interprofessional teamwork innovations for primary health care practices and practitioners: evidence from a comparison of reform in three countries

    PubMed Central

    Harris, Mark F; Advocat, Jenny; Crabtree, Benjamin F; Levesque, Jean-Frederic; Miller, William L; Gunn, Jane M; Hogg, William; Scott, Cathie M; Chase, Sabrina M; Halma, Lisa; Russell, Grant M

    2016-01-01

    Context A key aim of reforms to primary health care (PHC) in many countries has been to enhance interprofessional teamwork. However, the impact of these changes on practitioners has not been well understood. Objective To assess the impact of reform policies and interventions that have aimed to create or enhance teamwork on professional communication relationships, roles, and work satisfaction in PHC practices. Design Collaborative synthesis of 12 mixed methods studies. Setting Primary care practices undergoing transformational change in three countries: Australia, Canada, and the USA, including three Canadian provinces (Alberta, Ontario, and Quebec). Methods We conducted a synthesis and secondary analysis of 12 qualitative and quantitative studies conducted by the authors in order to understand the impacts and how they were influenced by local context. Results There was a diverse range of complex reforms seeking to foster interprofessional teamwork in the care of patients with chronic disease. The impact on communication and relationships between different professional groups, the roles of nursing and allied health services, and the expressed satisfaction of PHC providers with their work varied more within than between jurisdictions. These variations were associated with local contextual factors such as the size, power dynamics, leadership, and physical environment of the practice. Unintended consequences included deterioration of the work satisfaction of some team members and conflict between medical and nonmedical professional groups. Conclusion The variation in impacts can be understood to have arisen from the complexity of interprofessional dynamics at the practice level. The same characteristic could have both positive and negative influence on different aspects (eg, larger practice may have less capacity for adoption but more capacity to support interprofessional practice). Thus, the impacts are not entirely predictable and need to be monitored, and so that

  18. Scaling up of facility-based neonatal care: a district health system experience.

    PubMed

    Shantharam Baliga, B; Raghuveera, K; Vivekananda Prabhu, B; Shenoy, Rathika; Rajeev, A

    2007-04-01

    With proportion of neonatal mortality increasing within under-five deaths, innovative approaches and stronger health systems are needed in neonatal care. We present data of a scaled-up neonatal facility in a District Government Headquarters hospital in Southern India. The special care neonatal unit (SCNU) was a community propelled, public private partnership worked out on the principles of private funding of public institutions and effective budgeting of the public health care system. In the first phase the unit was optimized over 3 years with non-governmental organizations (NGO) and government support from a basic nursery to a SCNU. The unit was operational through fixed maintenance budget from government and mobilized funds from NGOs and beneficiaries. Community health workers were motivated for effective utilization. In the second phase the unit's performance was studied and statistically analyzed in two time frames before and 5 years into the upgradation process. Neonatal admissions from the district increased by 14.65%. Hospital stillbirth, early neonatal and perinatal mortality rates showed significant decline (p < 0.05). There was a 48.59% (CI: 25.46-77.80) increase in antenatal referrals from community health centers. Caesarian sections for neonatal parameters that affect obstetric decisions showed percent changes of 163.25 (CI: 31.18-430.45) and 73.4 (CI: 14.15-164.39) for prematurity and low birth weight (LBW), respectively. Significant decline in case fatality rates for LBW, sepsis and birth asphyxia (p < 0.001) were observed. The district perinatal mortality rate showed a decline. Within the purview of financial constraints of the public health system, private funding, public-private cooperation and effective budgeting may become significant. Motivation of health workers and community to effectively utilize public health care services sets an evolutionary process of referral and vertical linkage of health care system. PMID:17166935

  19. User preferences and usability of iVitality: optimizing an innovative online research platform for home-based health monitoring

    PubMed Central

    van Osch, Mara; Rövekamp, AJM; Bergman-Agteres, Stephanie N; Wijsman, Liselotte W; Ooms, Sharon J; Mooijaart, Simon P; Vermeulen, Joan

    2015-01-01

    Background The iVitality online research platform has been developed to gain insight into the relationship between early risk factors (ie, poorly controlled hypertension, physical or mental inactivity) and onset and possibly prevention of dementia. iVitality consists of a website, a smartphone application, and sensors that can monitor these indicators at home. Before iVitality can be implemented, it should fit the needs and preferences of users, ie, offspring of patients with dementia. This study aimed to explore users’ motivation to participate in home-based health monitoring research, to formulate requirements based on users’ preferences to optimize iVitality, and to test usability of the smartphone application of iVitality. Methods We recruited 13 participants (aged 42–64 years, 85% female), who were offspring of patients with dementia. A user-centered methodology consisting of four iterative phases was used. Three semistructured interviews provided insight into motivation and acceptance of using iVitality (phase 1). A focus group with six participants elaborated on expectations and preferences regarding iVitality (phase 2). Findings from phase 1 and 2 were triangulated by two semistructured interviews (phase 3). Four participants assessed the usability of the smartphone application (phase 4) using a think aloud procedure and a questionnaire measuring ease and efficiency of use (scale 1–7; higher scores indicated better usability). Results All participants were highly motivated to contribute to dementia research. However, the frequency of home-based health monitoring should not be too high. Participants preferred to receive feedback about their measurements and information regarding the relationship between these measurements and dementia. Despite minor technical errors, iVitality was considered easy and efficient to use (mean score 5.50, standard deviation 1.71). Conclusion Offspring of patients with dementia are motivated to contribute to home

  20. Application of activity-based costing (ABC) for a Peruvian NGO healthcare provider.

    PubMed

    Waters, H; Abdallah, H; Santillán, D

    2001-01-01

    This article describes the application of activity-based costing (ABC) to calculate the unit costs of the services for a health care provider in Peru. While traditional costing allocates overhead and indirect costs in proportion to production volume or to direct costs, ABC assigns costs through activities within an organization. ABC uses personnel interviews to determine principal activities and the distribution of individual's time among these activities. Indirect costs are linked to services through time allocation and other tracing methods, and the result is a more accurate estimate of unit costs. The study concludes that applying ABC in a developing country setting is feasible, yielding results that are directly applicable to pricing and management. ABC determines costs for individual clinics, departments and services according to the activities that originate these costs, showing where an organization spends its money. With this information, it is possible to identify services that are generating extra revenue and those operating at a loss, and to calculate cross subsidies across services. ABC also highlights areas in the health care process where efficiency improvements are possible. Conclusions about the ultimate impact of the methodology are not drawn here, since the study was not repeated and changes in utilization patterns and the addition of new clinics affected applicability of the results. A potential constraint to implementing ABC is the availability and organization of cost information. Applying ABC efficiently requires information to be readily available, by cost category and department, since the greatest benefits of ABC come from frequent, systematic application of the methodology in order to monitor efficiency and provide feedback for management. The article concludes with a discussion of the potential applications of ABC in the health sector in developing countries. PMID:11326572

  1. Unveiling health attitudes and creating good-for-you foods: the genomics metaphor, consumer innovative web-based technologies.

    PubMed

    Moskowitz, H R; German, J B; Saguy, I S

    2005-01-01

    This article presents an integrated analysis of three emerging knowledge bases in the nutrition and consumer products industries, and how they may effect the food industry. These knowledge bases produce new vistas for corporate product development, especially with respect to those foods that are positioned as 'good for you.' Couched within the current thinking of state-of-the-art knowledge and information, this article highlights how today's thinking about accelerated product development can be introduced into the food and health industries to complement these three research areas. The 3 knowledge bases are: the genomics revolution, which has opened new insights into understanding the interactions of personal needs of individual consumers with nutritionally relevant components of the foods; the investigation of food choice by scientific studies; the development of large scale databases (mega-studies) about the consumer mind. These knowledge bases, combined with new methods to understand the consumer through research, make possible a more focused development. The confluence of trends outlined in this article provides the corporation with the beginnings of a new path to a knowledge-based, principles-grounded product-development system. The approaches hold the potential to create foods based upon people's nutritional requirements combined with their individual preferences. Integrating these emerging knowledge areas with new consumer research techniques may well reshape how the food industry develops new products to satisfy consumer needs and wants. PMID:16048147

  2. Red fresh vegetables smoothies with extended shelf life as an innovative source of health-promoting compounds.

    PubMed

    Castillejo, Noelia; Martínez-Hernández, Ginés Benito; Gómez, Perla A; Artés, Francisco; Artés-Hernández, Francisco

    2016-03-01

    Two fresh red vegetables smoothies based on tomato, carrots, pepper and broccoli and rich in health-promoting compounds were developed. The smoothies showed a viscoelastic behaviour. According to sensory analyses, a shelf life of 28 days at 5 °C for fresh blended smoothies was established while thermally-treated ones (3 min, 80 °C) reached up to 40 days at 20 °C and 58 days at 5 °C. For those mild heat treated smoothies, total vitamin C degradation was 2-fold reduced during storage at 5 °C compared to samples stored at 20 °C while the initial total carotenoids, lycopene and total chlorophylls contents were not greatly affected. A 250-g portion of such smoothies covers in a great extend the established recommended daily nutrient intakes for dietary fibre, minerals and vitamin C of different population groups. As main conclusion, a mild thermal treatment and low temperature storage greatly increased the shelf life of red fresh vegetables smoothies and reduced total vitamin C degradation. PMID:27570272

  3. Shift work: health, performance and safety problems, traditional countermeasures, and innovative management strategies to reduce circadian misalignment

    PubMed Central

    Smith, Mark R; Eastman, Charmane I

    2012-01-01

    There are three mechanisms that may contribute to the health, performance, and safety problems associated with night-shift work: (1) circadian misalignment between the internal circadian clock and activities such as work, sleep, and eating, (2) chronic, partial sleep deprivation, and (3) melatonin suppression by light at night. The typical countermeasures, such as caffeine, naps, and melatonin (for its sleep-promoting effect), along with education about sleep and circadian rhythms, are the components of most fatigue risk-management plans. We contend that these, while better than nothing, are not enough because they do not address the underlying cause of the problems, which is circadian misalignment. We explain how to reset (phase-shift) the circadian clock to partially align with the night-work, day-sleep schedule, and thus reduce circadian misalignment while preserving sleep and functioning on days off. This involves controlling light and dark using outdoor light exposure, sunglasses, sleep in the dark, and a little bright light during night work. We present a diagram of a sleep-and-light schedule to reduce circadian misalignment in permanent night work, or a rotation between evenings and nights, and give practical advice on how to implement this type of plan. PMID:23620685

  4. Innovative strategies to expand cadaveric donor pool for liver transplantation (SITF project): a network between Italian transplantation centers supported by the Ministry of Health.

    PubMed

    Santori, G; Andorno, E; Valente, R; Ghirelli, R; Pensalfini, F; Castiglione, A G; Valente, U

    2005-01-01

    In 2002, the Italian Ministry of Health (IMH) launched a formal call for health research programs within the Research and Development (R&D) Policy. In this context, the research program "Innovative Strategies to Expand Cadaveric Donor Pool for Liver Transplantation" (SITF Project) has been proposed. The SITF Project has been formally approved by IMH as a 2-year research program included in the R&D Policy. The main goals of the SITF Project are to improve matching criteria for split liver transplantation (SLT) in both pediatric and adult recipients, to promote an increase of the SLT/full- size liver transplantation ratio at the national level, and, especially, to establish shared criteria for SLT in 2 adult recipients. The original executive plan of the SITF Project prefigured the participation of both the Italian transplantation centers with more advanced experience in the field of SLT, and institutional partnership, such as Nord Italia Transplant (NITp) and Italian National Transplant Center. A first Web public area concerning the SITF Project has been activated, as well as a reserved Web area with the aim to share cadaveric donors and patients in the waiting lists between Operative Units involved in the research program. For this objective, the first version Oracle-based database able to perform an automatic matching between a single cadaveric donor and 2 potential adult recipients has been released at the beginning of 2005. The SITF Project represents a new approach in the management of SLT for 2 adult recipients in Italy and a model for a functional network between Italian transplantation centers. PMID:16182693

  5. Innovative Partnerships

    USGS Publications Warehouse

    Szemraj, John

    2001-01-01

    A major responsibility of the U.S. Geological Survey (USGS) is to ensure geospatial data availability. This includes the cooperative production of digital geospatial data through the National Mapping Program's Innovative Partnerships (IP) initiative, which began in October 1992.

  6. Surgical innovation: the ethical agenda

    PubMed Central

    Broekman, Marike L.; Carrière, Michelle E.; Bredenoord, Annelien L.

    2016-01-01

    Abstract The aim of the present article was to systematically review the ethics of surgical innovation and introduce the components of the learning health care system to guide future research and debate on surgical innovation. Although the call for evidence-based practice in surgery is increasingly high on the agenda, most surgeons feel that the format of the randomized controlled trial is not suitable for surgery. Innovation in surgery has aspects of, but should be distinguished from both research and clinical care and raises its own ethical challenges. To answer the question “What are the main ethical aspects of surgical innovation?”, we systematically searched PubMed and Embase. Papers expressing an opinion, point of view, or position were included, that is, normative ethical papers. We included 59 studies discussing ethical aspects of surgical innovation. These studies discussed 4 major themes: oversight, informed consent, learning curve, and vulnerable patient groups. Although all papers addressed the ethical challenges raised by surgical innovation, surgeons hold no uniform view of surgical innovation, and there is no agreement on the distinction between innovation and research. Even though most agree to some sort of oversight, they offer different alternatives ranging from the formation of new surgical innovation committees to establishing national registries. Most agree that informed consent is necessary for innovative procedures and that surgeons should be adequately trained to assure their competence to tackle the learning curve problem. All papers agree that in case of vulnerable patients, alternatives must be found for the informed consent procedure. We suggest that the concept of the learning health care system might provide guidance for thinking about surgical innovation. The underlying rationale of the learning health care system is to improve the quality of health care by embedding research within clinical care. Two aspects of a learning health

  7. provider venture capital funds: investing in innovation.

    PubMed

    Potter, Mary Jo; Wesslund, Rick

    2016-05-01

    As health systems continue to embrace disruptive innovation, they are increasingly likely to consider making a move into venture capital. Working in venture capital can benefit a health system in several ways, including: Allowing it to operate outside of bureaucracy and align projects with its core values. Encouraging innovation within the organization. Enabling it to respond quickly to changes in the market. PMID:27382708

  8. Government can't do it all. Over 250 million people in the developing world benefit from NGO support.

    PubMed

    1993-09-01

    Throughout the world, citizens are attempting to improve living conditions using direct participatory measures. Trade unions provide some of the clearest examples of citizens' groups which are challenging the power structure and encouraging democratization. In Chile, Korea, Zambia, Mali, and Poland, unions have been responsible for impressive governmental changes. People have also been working to improve living conditions through nongovernmental organizations (NGOs), which have expanded their beneficial influence from 100 million people in the early 1980s to 250 million today. Donors unhappy with official channels for aid have funneled funds between the North and the South in amounts which have increased from US $1 billion in 1970 to $5 billion 1990. NGOs help the poorest of the poor to achieve a measure of self-sufficiency (for example, an NGO provides small loans to landless people in Bangladesh). They also have the flexibility to respond to emergencies with an immediacy denied official channels (for example Oxfam chartered a boatload of food and supplies for Cambodia in 1979), and they remain to provide aid when officialdom has deserted the field (for example, the Red Cross, Save the Children, CARE, Concern, and Medicins Sans Frontieres have been a constant presence in Somalia). By helping marginalized groups claim their rights (for example, land rights for Indians in Ecuador), NGOs empower citizens to improve their lives in countless arenas. NGOs also provide advocacy for the powerless; Amnesty International contributed to the release of 1,296 political prisoners in 1990. Despite the important role of these groups, NGOs operate on a very small scale and can never assume the role of governments. In fact, one of the most important tasks ahead for NGOs may be to act as an intermediary between governments and their citizens. With more aid and partnership support, NGOs will be able to continue to expand their positive influence in the world. PMID:12345099

  9. Canadian cardiac surgeons' perspectives on biomedical innovation.

    PubMed

    Snyman, Gretchen; Tucker, Joseph E L; Cimini, Massimo; Narine, Kishan; Fedak, Paul W M

    2012-01-01

    Barriers to successful innovation can be identified and potentially addressed by exploring the perspectives of key stakeholders in the innovation process. Cardiac surgeons in Canada were surveyed for personal perspectives on biomedical innovation. Quantitative data was obtained by questionnaire and qualitative data via interviews with selected survey participants. Surgeons were asked to self-identify into 1 of 3 categories: "innovator," "early adopter," or "late adopter," and data were compared between groups. Most surgeons viewed innovation favourably and this effect was consistent irrespective of perceived level of innovativeness. Key barriers to the innovation pathway were identified: (1) support from colleagues and institutions; (2) Canada's health system; (3) sufficient investment capital; and (4) the culture of innovation within the local environment. Knowledge of the innovation process was perceived differently based on self-reported innovativeness. The majority of surgeons did not perceive themselves as having the necessary knowledge and skills to effectively translate innovative ideas to clinical practice. In general, responses indicate support for implementation of leadership and training programs focusing on the innovation process in an effort to prepare surgeons and enhance their ability to successfully innovate and translate new therapies. The perspectives of cardiac surgeons provide an intriguing portal into the challenges and opportunities for healthcare innovation in Canada. PMID:22902159

  10. Toward universal coverage in Afghanistan: A multi-stakeholder assessment of capacity investments in the community health worker system.

    PubMed

    Edward, Anbrasi; Branchini, Casey; Aitken, Iain; Roach, Melissa; Osei-Bonsu, Kojo; Arwal, Said Habib

    2015-11-01

    Global efforts to scale-up the community health workforce have accelerated as a result of the growing evidence of their effectiveness to enhance coverage and health outcomes. Reconstruction efforts in Afghanistan integrated capacity investments for community based service delivery, including the deployment of over 28,000 community health workers (CHWs) to ensure access to basic preventive and curative services. The study aimed to conduct capacity assessments of the CHW system and determine stakeholder perspectives of CHW performance. Structured interviews were conducted on a national sample from 33 provinces and included supervisors, facility providers, patients, and CHWs. Formative assessments were also conducted with national policymakers, community members and health councils in two provinces. Results indicate that more than 70% of the NGO's provide comprehensive training for CHWs, 95% CHWs reported regular supervision, and more than 60% of the health posts had adequate infrastructure and essential commodities. Innovative strategies of paired male and female CHWs, institution of a special cadre of community health supervisors, and community health councils were introduced as systems strengthening mechanisms. Reported barriers included unrealistic and expanding task expectations (14%), unsatisfactory compensation mechanisms (75%), inadequate transport (69%), and lack of commodities (40%). Formative assessments evidenced that CHWs were highly valued as they provided equitable, accessible and affordable 24-h care. Their loyalty, dedication and the ability for women to access care without male family escorts was appreciated by communities. With rising concerns of workforce deficits, insecurity and budget constraints, the health system must enhance the capacity of these frontline workers to improve the continuum of care. The study provides critical insight into the strengths and constraints of Afghanistan's CHW system, warranting further efforts to contextualize

  11. Innovation Networks

    NASA Astrophysics Data System (ADS)

    Pyka, Andreas; Scharnhorst, Andrea

    The idea for this book started when we organized a topical workshop entitled "Innovation Networks - New Approaches in Modeling and Analyzing" (held in Augsburg, Germany in October 2005), under the auspices of Exystence, a network of excellence funded in the European Union's Fifth Framework Program. Unlike other conferences on innovation and networks, however, this workshop brought together scientists from economics, sociology, communication science, science and technology studies, and physics. With this book we aim to build further on a bridge connecting the bodies of knowledge on networks in economics, the social sciences and, more recently, statistical physics.

  12. Accessing completeness of pregnancy, delivery, and death registration by Accredited Social Health Activists [ASHA] in an innovative mHealth project in the tribal areas of Gujarat: A cross-sectional study

    PubMed Central

    Modi, D; Patel, J; Desai, S; Shah, P

    2016-01-01

    Background: The Innovative Mobile-phone Technology for Community Health Operation (ImTeCHO) is a mobile-phone application that helps Accredited Social Health Activists (ASHAs) in complete registration through the strategies employed during implementation that is linking ASHAs’ incentives to digital records, regular feedback, onsite data entry, and demand generation among beneficiaries. Objective: To determine the proportion of pregnancies, deliveries, and infant deaths (events) being registered through the ImTeCHO application against actual number of events in a random sample of villages. Materials and Methods: Five representative villages were randomly selected from the ImTeCHO project area in the tribal areas of Gujarat, India to obtain the required sample of 98 recently delivered women. A household survey was done in the entire villages to enumerate each family and create a line-listing of events since January 2014; the line-listing was compared with list of women registered through the ImTeCHO application. The proportion of events being registered through the ImTeCHO application was compared against the actual number of events to find sensitivity of the ImTeCHO application. Result: A total of 844 families were found during household enumeration. Out of actual line-listing of pregnancies (N = 39), deliveries (N = 102), and infant deaths (N = 5) found during household enumeration, 38 (97.43%), 101 (99.01%), and 5 (100%) were registered by ASHAs through the ImTeCHO application. Conclusion: The use of mobile-phone technology and strategies applied during the ImTeCHO implementation should be upscaled to supplement efforts to improve the completeness of registration. PMID:27241808

  13. Dual-Wavelength Irradiation and Dox Delivery for -Cancer Cell Ablation with Photocatalytic Pr Doped TiO2 /NGO -Hybrid Nanocomposite.

    PubMed

    Jang, Hongje; Choi, Myung-Ho; Yim, Yeajee; Kim, Young-Kwan; Min, Dal-Hee

    2015-08-26

    Herein, hybrid nanocomposite of praseodymium doped TiO2 nanocrystals and graphene oxide nanosheets are prepared by facile hydrothermal treatment. As-synthesized Pr-TiO2 /NGO hybrid nanocomposite exhibits enhanced photocatalytic activity under visible light irradiation by the intact graphene oxide and doped lanthanide mediated band gap narrowing compared to TiO2 . Moreover, high payload and controlled release of doxorubicin by charge reversal of hybrid nanocomposite at endosomal pH and near-infrared irradiation mediated efficient photothermal conversion provide highly favorable features in therapeutic applications. Through the combination of these three distinctive therapeutic modalities, highly efficient trimodal cancer cell ablation is demonstrated. PMID:26085286

  14. Mathematical Innovation

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Through Small Business Innovation Research funds from the Stennis Space Center, MathSoft, Inc., developed a system that can provide the building blocks for signal analysis and rapid prototyping. The product is the result of work to help NASA develop a complete understanding propulsion test data by using time frequency displays, automatic estimation and denoising, and data analysis plots for wavelet decomposition.

  15. Accelerating Innovation

    ERIC Educational Resources Information Center

    Education Week, 2012

    2012-01-01

    The word "innovation" seems to be in everyone's lexicon these days; it's even turning up as part of new education job titles in school districts and states. The ideas that undergird it are animating a growing movement that's spurring new policies, programs, and products that carry with them the potential to transform how students learn and how…

  16. Discursive Enactments of the World Health Organization's Policies: Competing Cultural Models in Tanzanian HIV/AIDS Prevention

    ERIC Educational Resources Information Center

    Higgins, Christina

    2010-01-01

    In the healthcare arena, language policy-related research has thus far been limited to questions about "language access," i.e., whether individuals are supplied with health information in their languages, and whether interpreters for doctor-patient consultations are provided (Martinez 2008; Ngo-Metzger et al. 2003; Partida 2007; Vahabi 2007). This…

  17. Accelerating Innovation: How Nuclear Physics Benefits Us All

    DOE R&D Accomplishments Database

    2011-01-01

    Innovation has been accelerated by nuclear physics in the areas of improving our health; making the world safer; electricity, environment, archaeology; better computers; contributions to industry; and training the next generation of innovators.

  18. Innovating Firms and Aggregate Innovation.

    ERIC Educational Resources Information Center

    Klette, Tor Jakob; Kortum, Samuel

    2004-01-01

    We develop a parsimonious model of innovation to confront firm-level evidence. It captures the dynamics of individual heterogeneous firms, describes the behavior of an industry with firm entry and exit, and delivers a general equilibrium model of technological change. While unifying the theoretical analysis of firms, industries, and the aggregate…

  19. Deletion of One Nucleotide within the Homonucleotide Tract Present in the hsdS Gene Alters the DNA Sequence Specificity of Type I Restriction-Modification System NgoAV▿†

    PubMed Central

    Adamczyk-Poplawska, Monika; Lower, Michal; Piekarowicz, Andrzej

    2011-01-01

    As a result of a frameshift mutation, the hsdS locus of the NgoAV type IC restriction and modification (RM) system comprises two genes, hsdSNgoAV1 and hsdSNgoAV2. The specificity subunit, HsdSNgoAV, the product of the hsdSNgoAV1 gene, is a naturally truncated form of an archetypal specificity subunit (208 N-terminal amino acids instead of 410). The presence of a homonucleotide tract of seven guanines (poly[G]) at the 3′ end of the hsdSNgoAV1 gene makes the NgoAV system a strong candidate for phase variation, i.e., stochastic addition or reduction in the guanine number. We have constructed mutants with 6 guanines instead of 7 and demonstrated that the deletion of a single nucleotide within the 3′ end of the hsdSNgoAV1 gene restored the fusion between the hsdSNgoAV1 and hsdSNgoAV2 genes. We have demonstrated that such a contraction of the homonucleotide tract may occur in vivo: in a Neisseria gonorrhoeae population, a minor subpopulation of cells appeared to have only 6 guanines at the 3′ end of the hsdSNgoAV1 gene. Escherichia coli cells carrying the fused gene and expressing the NgoAVΔ RM system were able to restrict λ phage at a level comparable to that for the wild-type NgoAV system. NgoAV recognizes the quasipalindromic interrupted sequence 5′-GCA(N8)TGC-3′ and methylates both strands. NgoAVΔ recognizes DNA sequences 5′-GCA(N7)GTCA-3′ and 5′-GCA(N7)CTCA-3′, although the latter sequence is methylated only on the complementary strand within the 5′-CTCA-3′ region of the second recognition target sequence. PMID:21984785

  20. Professional strategies of medical officers of health in the post-war period--1: 'innovative traditionalism': the case of Dr Ian MacQueen, MOH for Aberdeen 1952-1974, a 'bull-dog' with the 'hide of a rhinoceros'.

    PubMed

    Diack, Lesley; Smith, David F

    2002-06-01

    Recent policies concerning the enhancement of preventive medicine and health improvement have raised important questions about leadership in public health and have emphasized the roles that can be played by local authorities. In this light, it is worth exploring the activities undertaken by local authority Medical Officers of Health (MOsH), until their posts were abolished in 1974. The process leading to 1974 has often been blamed, at least partly, on the complacency, lack of imagination and demoralization of MOsH. However, when John Welshman asked the question 'watchdog or lapdog?' of the MOH, in a paper published in 1997, he concluded there was little justification for the latter label. This paper considers the career of Ian MacQueen, Aberdeen's last MOH, who is well known for the criticisms of his handling of the Aberdeen typhoid outbreak in 1964, which appeared in the report of an official enquiry. He was deemed to have made excessive use of the media and to have turned the outbreak into an event approaching a national crisis. However, in the context of MacQueen's 32 year career in Aberdeen, his use of the media during the typhoid outbreak was no aberration. Rather, it was characteristic of his determination to maintain an important role for the MOH within the NHS-era health services. There is therefore continuity between MacQueen's strategy and the ambitions of many MOsH before the NHS, who hoped for a unified health service with themselves occupying a leading role. MacQueen's actions during the typhoid outbreak also reflected his innovative activities in the field of health education, and his interest in the media for that purpose. In conclusion, MacQueen provides an example of an MOH who cannot be charged with complacency and resignation to a declining role: rather, his strategy of 'innovative traditionalism' sought to protect and extend his department's services. PMID:12141581

  1. Improving government health services through contract management: a case from Cambodia.

    PubMed

    Soeters, Robert; Griffiths, Fred

    2003-03-01

    Most government health facilities in Cambodia perform poorly, due to lack of funds, inadequate management and inefficient use of resources, but mostly due to poor motivation of staff. This paper describes contracting as a possible tool for Ministries of Health to improve health service delivery more rapidly than the more traditional reform approaches. In Cambodia, the Ministry of Health started an experiment with contracting in eight districts, covering 1 million people. Health care management in five districts was sub-contracted to private sector operators, and their results were compared with three control districts. Both internal and external reviews showed that after 3 years of implementation, the utilization of health services in the contracted districts improved significantly, in comparison with the control districts. There was adequate competition in awarding the contracts. A Ministry of Health Project Co-ordinating Unit measured the performance of the contractors, and contributed pro-actively. There was no evidence of rent-seeking practices by either the contracting agency or the contractors. This paper describes in more detail the successes and failures in one of the contracted districts, where HealthNet International applied the contracting approach. Despite significantly increased official user fees, constituting 16% of recurrent costs, the utilization of services was equally increased. Patients thought the fees were reasonable because they were still lower than the fees demanded if government health workers charged informally. They also thought that the services were of better quality than in the unregulated private sector. Another important result was that combining strict monitoring with performance-based incentives demonstrates a decrease in total family health expenditure of some 40% from US dollars 18 to US dollars 11 per capita per year. Innovative and decisive management proved to be essential, which is more likely to be achieved by a contracted

  2. Creating innovative departments.

    PubMed

    von Segesser, Ludwig K

    2004-12-01

    'Creating an innovative department' as an objective implies further improvements in organization, function, and progression of a surgical unit active in patient care, research, and education. It is of prime importance to stress here the mutual benefits of patient care, research (the basis for future patient care) and education (the channel for training health care professionals in future patient care). Neither innovation (from latin innovare: to renew, revive) nor creation (from latin creare: to make, produce) is something that will fall from heaven without effort any time soon. Hence, a pro-active attitude towards progress is indicated. This requires searching for new ideas, allocation of resources, finding allies, getting focussed, and being persistent. One word says it all: WORK! PMID:15776856

  3. Promoting innovative thinking.

    PubMed

    Ness, Roberta B

    2015-03-01

    Innovation is the engine of scientific progress, yet we do not train public health students to think creatively. I present the key concepts within an evidence-based method currently taught at the University of Texas. Habitual thought patterns involve deeply held framed expectations. Finding alternatives generates originality. Because frame breaking is difficult, a series of innovation heuristics and tools are offered including enhancing observation, using analogies, changing point of view, juggling opposites, broadening perspective, reversal, reorganization and combination, and getting the most from groups. Gaining cognitive attributes such as nonjudgment, willingness to question, mindfulness, and plasticity is also emphasized. Students completing the class demonstrate substantial increases on a standardized test of idea fluency and originality, more joyful attitudes toward science, and more pluralistic approaches. PMID:25706005

  4. Qualitative assessment of innovations in healthcare provision

    PubMed Central

    Porzsolt, Franz; Ghosh, Amit K; Kaplan, Robert M

    2009-01-01

    Background The triad of quality, innovation and economic restraint is as important in health care as it is in the business world. There are many proposals for the assessment of quality and of economic restraints in health care but only a few address assessment of innovations. We propose a strategy and new structures to standardize the description of health care innovations and to quantify them. Discussion Strategy and structure are based on the assumption that in the early phase of an innovation only data on the feasibility and possibly on the efficacy or effectiveness of an innovation can be expected. From the patient's perspective, benefit resulting from an innovation can be confirmed only in a later phase of development. Early indicators of patient's benefit will be surrogate parameters which correlate only weakly with the desired endpoints. After the innovation has been in use, there will be more evidence on correlations between surrogate parameters and the desired endpoints to provide evidence of the patient benefit. From an administrative perspective, this evidence can be considered in decisions about public financing. Different criteria are proposed for the assessment of innovations in prevention, diagnosis and therapy. For decisions on public financing a public fund for innovations may be helpful. Depending on the phase of innovation risk sharing models are proposed between manufacturers, private insurers and public funding. Summary Potential for patient benefit is always uncertain during early stages of innovations. This uncertainty decreases with increasing information on the effects of the innovation. Information about an innovation can be quantified, categorized and integrated into rational economic decisions. PMID:19298658

  5. The role of international NGOs in health systems strengthening: the case of Timor-Leste.

    PubMed

    Mercer, Mary Anne; Thompson, Susan M; de Araujo, Rui Maria

    2014-01-01

    Achieving the United Nations Millennium Development Goals for health will require that programs supporting health in developing countries focus on strengthening national health care systems. However, the dominant neoliberal model of development mandates reduced public spending on health and other social services, often resulting in increased funding for nongovernmental organizations (NGOs) at the expense of support for government systems. East Timor, later Timor-Leste, is an example of a post-crisis country where international NGO efforts were initially critical to providing relief efforts to a traumatized population. Those groups were not prepared to help develop and support a standardized Timorese national health plan, however, and the cost of their support was unsustainable in the long term. In response, local authorities designed and implemented a post-crisis NGO phase-over plan that addressed risks to service disruption and monitored the process. Since then, some NGOs have worked collaboratively with the Ministry of Health to support specific efforts and initiatives under a framework provided by the ministry. Timor-Leste has shown that ministries of health can facilitate an effective transition of NGO support from crisis to development if they are allowed to plan and manage the process. PMID:24919307

  6. Innovative Models for School Consultation.

    ERIC Educational Resources Information Center

    Schlozman, Steven C.

    2003-01-01

    Describes common characteristics of two innovative models of student mental-health consultation programs: One, organized by two Harvard Medical School psychiatrists, operates in two Boston-area inner-city charter schools; the other, Responsive Advocacy for Life and Learning (RALLY), launched by a Harvard Medical School developmental psychologist,…

  7. Differentiating innovation priorities among stakeholder in hospital care

    PubMed Central

    2013-01-01

    Background Decisions to adopt a particular innovation may vary between stakeholders because individual stakeholders may disagree on the costs and benefits involved. This may translate to disagreement between stakeholders on priorities in the implementation process, possibly explaining the slow diffusion of innovations in health care. In this study, we explore the differences in stakeholder preferences for innovations, and quantify the difference in stakeholder priorities regarding costs and benefits. Methods The decision support technique called the analytic hierarchy process was used to quantify the preferences of stakeholders for nine information technology (IT) innovations in hospital care. The selection of the innovations was based on a literature review and expert judgments. Decision criteria related to the costs and benefits of the innovations were defined. These criteria were improvement in efficiency, health gains, satisfaction with care process, and investments required. Stakeholders judged the importance of the decision criteria and subsequently prioritized the selected IT innovations according to their expectations of how well the innovations would perform for these decision criteria. Results The stakeholder groups (patients, nurses, physicians, managers, health care insurers, and policy makers) had different preference structures for the innovations selected. For instance, self-tests were one of the innovations most preferred by health care insurers and managers, owing to their expected positive impacts on efficiency and health gains. However, physicians, nurses and patients strongly doubted the health gains of self-tests, and accordingly ranked self-tests as the least-preferred innovation. Conclusions The various stakeholder groups had different expectations of the value of the nine IT innovations. The differences are likely due to perceived stakeholder benefits of each innovation, and less to the costs to individual stakeholder groups. This study

  8. After Mexico: NGOs and the Follow-Up to the International Conference on Population. Summary Report of the Annual NGO/UNFPA Consultation on Population in New York (4th, Church Centre, New York, March 6, 1985).

    ERIC Educational Resources Information Center

    Cassidy, Kevin, Ed.

    This document consists of three parts. Part I is a summary report of the Fourth Annual Non-Governmental Organizations/United Nations Fund for Population Activities (NGO/UNFPA) Consultation on Population. It includes: an opening statement by David Poindexter; presentations by Bradman Weerakoon ("Opportunities for Action") and Sheldon Segal ("Global…

  9. Innovation: It's Academic.

    ERIC Educational Resources Information Center

    Long, Carl

    1988-01-01

    Discusses the development of innovation and business incubators, including the stages of innovation typically addressed by such programs. Describes the efforts of the Thayer School, a graduate professional school at Dartmouth College, in establishing an innovation incubator. (TW)

  10. The Challenge of Self-Renewal in the Innovative College.

    ERIC Educational Resources Information Center

    Johnstone, Douglas B.

    1990-01-01

    Any successful innovation creates a body of practice, policy, lore, and belief that becomes harder to change the longer it survives. Using case studies to illustrate, the essay outlines a conceptual model for institutional self-assessment of its innovative health and recommends strategies for keeping the innovative spirit alive. (Author/MLW)

  11. Innovation Roles: From Souls of Fire to Devil's Advocates.

    ERIC Educational Resources Information Center

    Meyer, Marcy

    2000-01-01

    Examines self-report data from organizational members of a federal government health information and education network piloting innovative intervention strategies to disseminate cancer information to the public. Suggests the existence of a new innovation role: the Devil's advocate. Explores the nature of resisting innovation, existing innovation…

  12. Anticipating change, sparking innovation: framing the future.

    PubMed

    Petersen, Donna J; Finnegan, John R; Spencer, Harrison C

    2015-03-01

    As the 100th anniversary of the 1915 Welch-Rose report approaches, the Association of Schools and Programs of Public Health (ASPPH) has been pursuing two initiatives to spark innovation in academic partnerships for enhancing population health: (1) Framing the Future: The Second 100 Years of Education for Public Health and (2) Reconnecting Public Health and Care Delivery to Improve the Health of Populations. We describe how ASPPH-member schools and programs accredited by the Council on Education for Public Health, along with their extraordinarily diverse array of partners, are working to improve education that better prepares health professionals to meet 21st-century population health needs. PMID:25706017

  13. [Creativity and innovation: competences on nursing management].

    PubMed

    Feldman, Liliane Bauer; Ruthes, Rosa Maria; Cunha, Isabel Cristina Kowal Olm

    2008-01-01

    This article presents the importance of the creativity and innovation on health services, distinguishing those concepts. Creative behavior is the improvement of an element or known actions: whereas innovation means finding new alternatives. Considering competences like knowledge, skill and attitude--KSA, it is understood that by stimulating creativity and innovation, the performance of the health professional will be optimized. Therefore, creativity and innovation are key elements for improvement and organization, and, more specifically, for Nursing to find alternatives for solving problems related to the occupation as a whole. In this way, this approach brings a strategic tool on the process of management and a differential for the nurse, which by innovating and creating will amaze herself with her potential. PMID:18572846

  14. The "Pesticides and Farmworker Health Toolkit" : An Innovative Model for Developing an Evidence-Informed Program for a Low-Literacy, Latino Immigrant Audience

    ERIC Educational Resources Information Center

    LePrevost, Catherine E.; Storm, Julia F.; Asuaje, Cesar R.; Cope, W. Gregory

    2014-01-01

    Migrant and seasonal farmworkers are typically Spanish-speaking, Latino immigrants with limited formal education and low literacy skills and, as such, are a vulnerable population. We describe the development of the "Pesticides and Farmworker Health Toolkit", a pesticide safety and health curriculum designed to communicate to farmworkers…

  15. A new prize system for drug innovation.

    PubMed

    Gandjour, Afschin; Chernyak, Nadja

    2011-10-01

    We propose a new prize (reward) system for drug innovation which pays a price based on the value of health benefits accrued over time. Willingness to pay for a unit of health benefit is determined based on the cost-effectiveness ratio of palliative/nursing care. We solve the problem of limited information on the value of health benefits by mathematically relating reward size to the uncertainty of information including information on potential drug overuse. The proposed prize system offers optimal incentives to invest in research and development because it rewards the innovator for the social value of drug innovation. The proposal is envisaged as a non-voluntary alternative to the current patent system and reduces excessive marketing of innovators and generic drug producers. PMID:21724290

  16. Reorienting primary health care for addressing chronic conditions in remote Australia and the South Pacific: review of evidence and lessons from an innovative quality improvement process.

    PubMed

    Gardner, Karen; Bailie, Ross; Si, Damin; O'Donoghue, Lynette; Kennedy, Cath; Liddle, Helen; Cox, Rhonda; Kwedza, Ru; Fittock, Marea; Hains, Jenny; Dowden, Michelle; Connors, Christine; Burke, Hugh; Beaver, Carol

    2011-06-01

    This paper reviews what is known about the challenges of implementing quality improvement programs and draws on data from a systematic continuous quality improvement (CQI) project in remote communities in Australia and Fiji, known as Audit and Best practice for Chronic Disease, to synthesise lessons and discuss the potential for broader application in low and middle income countries, including Pacific Island countries and territories. Although a number of systematic reviews have indicated that quality improvement programs can be effective in changing professional practice and improving the quality of care and patient outcomes, little is known about the key ingredients for change or how services use and implement different strategies to achieve improvements. We identify key features of an innovative CQI model and factors related to implementation that support improvement in diabetes service delivery and intermediate outcomes. Requirements for supporting CQI are identified and the potential for wider application discussed. It is argued that the participatory action research approach supports innovation and broad-based change and the evidence it has produced extends the current knowledge base and facilitates the translation of knowledge into action, for both policy and practice. PMID:21605223

  17. Lesson's-learned from a 2003-2006 USA-Honduras NGO and University Geosciences Education Partnership in Land use Land / Land Cover Change Analysis using Remote Sensing and GPS

    NASA Astrophysics Data System (ADS)

    Ford, R. E.

    2006-12-01

    Between 2004 and 2006 the Loma Linda University ESSE21 Mesoamerican Project (Earth System Science Education for the 21st Century) collaborated with a series of academic, NGO (nongovernmental) and government agencies, including a USAID (United States Agency for International Development) integrated environmental resource management project to: a) build the human and technical capacity of local partners in the use of geospatial technologies, e.g. GIS, GPS, Remote Sensing, b) improve their capacity to apply these tools to biodiversity, health, sustainability, protected-area management, and other NRM (Natural Resource Management) decision-making needs and problems, and c) establish long term institutional relationships for teacher/student exchange, including development of joint curricula and research projects focused on health geoinformatics as well as sustainable development. Much of this has contributed toward a new "geotourism" effort adopted by Honduras called the SAVE Honduras strategy (Scientific, Academic, Volunteer, Educational). A central element of this initiative is to increase joint collaborative research and learning together by students and faculty at US universities working with Honduran institutions (private and public). See SAVE Strategy page = http://www.fundacionsave.com/home_eng.html In the presentation we describe our experience over the last three years collaborating with key partners such as the Central American Observatory of Suyapa based at the UNAH (Universidad Nacional Autónoma de Honduras) which has opened a new GIS/Remote Sensing Laboratory. We also collaborated closely with CURLA (Centro Universitario Regional del Litoral Atlántico) located near La Ceiba--a land grant-type institution- -to support outreach and extension activities by students and staff to local-level NGOs and community groups dealing with conservation, hazards mitigation, biodiversity, fisheries and related problems. We have also participated in joint "informal

  18. The EPA/NIEHS Children’s Environmental Health And Disease Prevention Research Centers: More Than 15 Years of Innovative Research on Important Challenges in Children’s Environmental Health

    EPA Science Inventory

    Background: The U.S. Environmental Protection Agency (EPA) and the National Institute of Environmental Health Sciences (NIEHS) have jointly supported the Children's Environmental Health and Disease Prevention Research Centers (“Children’s Centers”) program since...

  19. Infrastructure to support learning health systems: are we there yet? Innovative solutions and lessons learned from American Recovery and Reinvestment Act CER investments.

    PubMed

    Holve, Erin; Segal, Courtney

    2014-11-01

    The 11 big health data networks participating in the AcademyHealth Electronic Data Methods Forum represent cutting-edge efforts to harness the power of big health data for research and quality improvement. This paper is a comparative case study based on site visits conducted with a subset of these large infrastructure grants funded through the Recovery Act, in which four key issues emerge that can inform the evolution of learning health systems, including the importance of acknowledging the challenges of scaling specialized expertise needed to manage and run CER networks; the delicate balance between privacy protections and the utility of distributed networks; emerging community engagement strategies; and the complexities of developing a robust business model for multi-use networks. PMID:25494570

  20. A Delivery Model for Home Fortification of Complementary Foods with Micronutrient Powders: Innovation in the Context of Vietnamese Health System Strengthening.

    PubMed

    Nguyen, Marie; Poonawala, Alia; Leyvraz, Magali; Berger, Jacques; Schofield, Dominic; Nga, Tran Thuy; Van, Tran Khan; Hoa, Do Thi Bao; Wieringa, Frank Tammo

    2016-01-01

    Adding micronutrient powders (MNP) to complementary foods at the point of preparation (home fortification) can improve micronutrient status of young children. Ensuring sustained access to MNPs at scale, however, remains challenging in many countries. The Global Alliance for Improved Nutrition (GAIN) partnered with the National Institute of Nutrition (NIN) in Vietnam to pioneer the distribution of a locally-produced MNP, provided for sale through the public health system with counseling on optimal infant and young child feeding practices by trained health workers. Different packaging options were available to adapt to caregivers' disposable income. During the six-month pilot, 1.5 million sachets were sold through 337 health centers across four provinces, targeting children 6-59 months of age. Sales were routinely monitored, and a cross-sectional survey in 32 communes for caregivers (n = 962) and health staff (n = 120) assessed MNP coverage and compliance, five months after the start of distribution. A total of 404 caregivers among the 962 caregivers surveyed (i.e., 42%) had visited the health center in the past year. Among them, 290 caregivers had heard about the product and a total of 217caregivers had given the MNP to their child at least once, representing a conversion rate from product awareness to product trial of 74.8%. The effective coverage (i.e., consumption of ≥3 sachets/child/week) was 11.5% among the total surveyed caregivers and reached 27.3% amongst caregivers who visited health centers in the previous month. The MNP purchase trends showed that the number of sachets bought by caregivers was positively correlated with the wealth index. The pilot showed that providing MNPs for sale in packs of various quantities, combined with infant and young child feeding (IYCF) counseling at the health center, is effective for groups accessing the health system. PMID:27136585

  1. A Delivery Model for Home Fortification of Complementary Foods with Micronutrient Powders: Innovation in the Context of Vietnamese Health System Strengthening

    PubMed Central

    Nguyen, Marie; Poonawala, Alia; Leyvraz, Magali; Berger, Jacques; Schofield, Dominic; Nga, Tran Thuy; Van, Tran Khan; Hoa, Do Thi Bao; Wieringa, Frank Tammo

    2016-01-01

    Adding micronutrient powders (MNP) to complementary foods at the point of preparation (home fortification) can improve micronutrient status of young children. Ensuring sustained access to MNPs at scale, however, remains challenging in many countries. The Global Alliance for Improved Nutrition (GAIN) partnered with the National Institute of Nutrition (NIN) in Vietnam to pioneer the distribution of a locally-produced MNP, provided for sale through the public health system with counseling on optimal infant and young child feeding practices by trained health workers. Different packaging options were available to adapt to caregivers’ disposable income. During the six-month pilot, 1.5 million sachets were sold through 337 health centers across four provinces, targeting children 6–59 months of age. Sales were routinely monitored, and a cross-sectional survey in 32 communes for caregivers (n = 962) and health staff (n = 120) assessed MNP coverage and compliance, five months after the start of distribution. A total of 404 caregivers among the 962 caregivers surveyed (i.e., 42%) had visited the health center in the past year. Among them, 290 caregivers had heard about the product and a total of 217caregivers had given the MNP to their child at least once, representing a conversion rate from product awareness to product trial of 74.8%. The effective coverage (i.e., consumption of ≥3 sachets/child/week) was 11.5% among the total surveyed caregivers and reached 27.3% amongst caregivers who visited health centers in the previous month. The MNP purchase trends showed that the number of sachets bought by caregivers was positively correlated with the wealth index. The pilot showed that providing MNPs for sale in packs of various quantities, combined with infant and young child feeding (IYCF) counseling at the health center, is effective for groups accessing the health system. PMID:27136585

  2. The Global Programme on Health Promotion Effectiveness (GPHPE): a bold concept with few resources.

    PubMed

    McQueen, David V

    2012-05-01

    This paper describes the past ten years of the International Union for Health Promotion and Education's (IUHPE) flagship programme on health promotion effectiveness. It examines the context in which the programme developed and the organization of the programme to carry out its goals. The paper takes a critical look at the strengths, weaknesses, opportunities and difficulties of conducting such a broad programme within a global membership-based non-governmental organization (NGO). It also discusses how the field of evidence gathering has developed in relationship to the project and what changes have emerged since the early years. Lack of resources, both in terms of contributors and financial support, is identified as the key problem in sustaining an NGO effort to examine effectiveness. PMID:22700575

  3. An Innovative Approach to Developing a Cultural Competency Curriculum; Efforts at the John A. Burns School of Medicine, Department of Native Hawaiian Health

    PubMed Central

    Kamaka, Martina L; Kaulukukui, C Malina

    2011-01-01

    Introduction Initial efforts to teach cultural competency at the University of Hawai‘i John A. Burns School of Medicine began in the late 1990s through the Native Hawaiian Center of Excellence. With the formation of the Department of Native Hawaiian Health in 2003, cultural competency training was added as a key area of focus for the department. A multidisciplinary team was formed to do the ground work. Physicians (Family Medicine and Internal Medicine) and an administrator (MBA now at Queens Medical Center) from the Department of Native Hawaiian Health were joined by a cultural anthropologist (Department of Family Medicine and Community Health), a social worker (UH Myron B. Thompson School of Social Work), and a retired DrPH/Registered Dietician from the State Department of Health to form the cultural competency curriculum team. All but one of the team members is Native Hawaiian. Discussion As cultural competency training is a relatively new, rapidly developing field, there is no consensus on how to teach it. The department decided early on to focus on a variety of methodologies using Native Hawaiian health as the curriculum's foundation. Many different paths were taken toward the development of the present curriculum which utilized different components within the medical school's curriculum. This paper describes the process and development of a cultural competency training curriculum at the University of Hawai‘i medical school. Recent literature recommendations by experts in the field reinforce the current curricular content that resulted from this developmental process. PMID:22235152

  4. A Pilot Study of the NGO-Based Relational Intervention Model for HIV Prevention among Drug Users in China

    ERIC Educational Resources Information Center

    Chen, Huey-Tsyh; Liao, Quilan

    2005-01-01

    The rapid growth of the HIV epidemic in China has raised a number of concerns among health care providers, governmental agencies, and nongovernmental organizations (NGOs). This article (a) briefly discusses the HIV epidemic in China, (b) explains why Chinese NGOs need to join the fight against the epidemic, (c) describes the development of an…

  5. Medical innovation laws: an unnecessary innovation.

    PubMed

    Richards, Bernadette

    2016-06-01

    Objective This paper aims to demonstrate that any suggestion that there is a need for specific innovation laws is flawed. Innovation is central to good medical practice and is adequately supported by current law. Methods The paper reviews the nature of medical innovation and outlines recent attempts in the UK to introduce specific laws aimed at 'encouraging' and 'supporting' innovation. The current legal framework is outlined and the role of the law in relation to medical innovation explored. Results The analysis demonstrates the cyclic relationship between medical advancement and the law and concludes that there is no requirement for specific innovation laws. Conclusions The law not only supports innovation and development in medical treatment but encourages it as central to a functioning medical system. There is no need to introduce specific laws aimed at medical innovation; to do so represents an unnecessary legal innovation and serves to complicate matters. What is known about the topic? Over recent months, there has been a great deal of discussion surrounding the law in the context of medical innovation. This was driven by the attempts in the UK to introduce specific laws in the Medical Innovation Bill. The general subject matter - negligence and the expected standard of care in the provision of treatment - is very well understood, but not in cases where the treatment can be described as innovative. The general rhetoric in both the UK and Australia around the Medical Innovation Bill demonstrates a lack of understanding of the position of the law with regards to innovative treatment. What does this paper add? This paper adds clarity to the debate. It presents the law and explains the manner in which the law can operate around innovative treatment. The paper asserts that medical innovation is both supported and encouraged by existing legal principles. What are the implications for practitioners? The paper presents an argument that can guide the policy position

  6. Public Health Works: Blood Donation in Urban China

    PubMed Central

    Adams, Vincanne; Erwin, Kathleen; Le, Phuoc V

    2009-01-01

    Recent shifts in the global health infrastructure warrant consideration of the value and effectiveness of national public health campaigns. These shifts include the globalization of pharmaceutical research, the rise of NGO-funded health interventions, and the rise of biosecurity models of international health. We argue that although these trends have arisen as worthwhile responses to actual health needs, it is important to remember the key role that public health campaigns can play in the promotion of national health, especially in developing nations. Focusing on an example set by China in response to a public health crisis surrounding the national need for a clean and adequate blood supply and the inadvertent spread of HIV by way of blood donation in the early 19902, we argue that there is an important role for strong national public health programs. We also identify the key factors that enabled China’s response to this bourgeoning epidemic to be, in the end, largely successful. PMID:19058887

  7. Innovation Practice Using Pervasive Mobile Technology Solutions to Improve Population Health Management: A Pilot Study of Gestational Diabetes Patient Care in Australia.

    PubMed

    Wickramasinghe, Nilmini; Gururajan, Raj

    2016-01-01

    Healthcare service delivery is moving forward from individual care to population health management, because of the fast growth of health records. However, to improve population health performance, it is necessary to leverage relevant data and information using new technology solutions, such as pervasive diabetes mobile technology solution of Inet International Inc., which offers the potential to facilitate patient empowerment with gestational diabetic care. Hence, this article examines the pilot study outcomes of a small clinical trial focusing on pregnant patients affected by gestational diabetes mellitus, in an Australian not for profit healthcare context. The aims include establishing proof of concept and also assessing the usability, acceptability, and functionality of this mobile solution and thereby generate hypotheses to be tested in a large-scale confirmatory clinical trial. PMID:26918811

  8. Innovative Programs in Education for the Professions.

    ERIC Educational Resources Information Center

    Leslie, Larry L.

    This document describes innovative programs in education for various professions including law, health services, social work, teaching, agriculture-related professions, architecture, business, and engineering. Programs of health services are further divided into those for physicians, physician assistants, nurses, and dentists. Information is…

  9. The role of telemedicine in fostering health-care innovations to address problems of access, specialty shortages and changing patient care needs.

    PubMed

    Rheuban, Karen S

    2006-01-01

    The integration of advanced technologies into health-care services promises to aid society in its transition to a coordinated, systems approach which is focused on disease prevention, enhanced wellness, chronic disease management, decision support, quality and patient safety. By incorporating such technologies, clinicians will be able to manage the growing volumes of medical information, research and decision support analytical tools. The deployment of advanced technologies will minimize the barriers of distance and geography to enhance access and facilitate the delivery of integrated health care. This will support and enhance the goals of the US federal Healthy People 2010 initiative. PMID:16989674

  10. An Innovative Model for the Provision of Practice Learning Opportunities in Family and Child Care: Newry Student Unit, Southern Health and Social Care Trust

    ERIC Educational Resources Information Center

    Canavan, Marion; Hayes, David

    2009-01-01

    This article describes the work of Newry Student Unit, which operates in the Southern Health and Social Care Trust. The background to the unit is outlined and its development is discussed in the context of practice learning provision in Northern Ireland. The operation of the unit in providing Family and Child Care practice learning opportunities…

  11. Clinical Decision-Making in Community Children's Mental Health: Using Innovative Methods to Compare Clinicians with and without Training in Evidence-Based Treatment

    ERIC Educational Resources Information Center

    Baker-Ericzén, Mary J.; Jenkins, Melissa M.; Park, Soojin; Garland, Ann F.

    2015-01-01

    Background: Mental health professionals' decision-making practice is an area of increasing interest and importance, especially in the pediatric research and clinical communities. Objective: The present study explored the role of prior training in evidence-based treatments (EBTs) on clinicians' assessment and treatment formulations using…

  12. Social network recruitment for Yo Puedo: an innovative sexual health intervention in an underserved urban neighborhood—sample and design implications.

    PubMed

    Minnis, Alexandra M; vanDommelen-Gonzalez, Evan; Luecke, Ellen; Cheng, Helen; Dow, William; Bautista-Arredondo, Sergio; Padian, Nancy S

    2015-02-01

    Most existing evidence-based sexual health interventions focus on individual-level behavior, even though there is substantial evidence that highlights the influential role of social environments in shaping adolescents' behaviors and reproductive health outcomes. We developed Yo Puedo, a combined conditional cash transfer and life skills intervention for youth to promote educational attainment, job training, and reproductive health wellness that we then evaluated for feasibility among 162 youth aged 16-21 years in a predominantly Latino community in San Francisco, CA. The intervention targeted youth's social networks and involved recruitment and randomization of small social network clusters. In this paper we describe the design of the feasibility study and report participants' baseline characteristics. Furthermore, we examined the sample and design implications of recruiting social network clusters as the unit of randomization. Baseline data provide evidence that we successfully enrolled high risk youth using a social network recruitment approach in community and school-based settings. Nearly all participants (95%) were high risk for adverse educational and reproductive health outcomes based on multiple measures of low socioeconomic status (81%) and/or reported high risk behaviors (e.g., gang affiliation, past pregnancy, recent unprotected sex, frequent substance use; 62%). We achieved variability in the study sample through heterogeneity in recruitment of the index participants, whereas the individuals within the small social networks of close friends demonstrated substantial homogeneity across sociodemographic and risk profile characteristics. Social networks recruitment was feasible and yielded a sample of high risk youth willing to enroll in a randomized study to evaluate a novel sexual health intervention. PMID:25358834

  13. Empowering women: participatory approaches in women's health and development projects.

    PubMed

    Manderson, L; Mark, T

    1997-01-01

    The authors describe the experience of NGOs (nongovernmental organizations) and community-based organizations in implementing projects aimed at improving women's health. The study included 16 projects, reflecting Australian NGO experiences in Africa, China, Southeast Asia, the Pacific, and South America. They illustrate the value of participatory approaches in determining needs and priorities, and the value of the continued involvement of women in implementation, monitoring, and evaluation. Approaches that succeeded in increasing women's access to and use of health services addressed gender issues, set realistic and achievable objectives, and recognized and enhanced the roles and status of women. PMID:9119780

  14. A theoretical and empirical investigation into the willingness-to-pay function for new innovative drugs by Germany's health technology assessment agency (IQWiG).

    PubMed

    Gandjour, Afschin

    2013-11-01

    Under the recently enacted pharmaceutical price and reimbursement regulation in Germany, new drugs are subject to a rapid assessment to determine whether there is sufficient evidence of added clinical benefits compared with the existing standard of treatment. If such added benefits are confirmed, manufacturers and representatives of the Statutory Health Insurance (SHI) are expected to negotiate an appropriate reimbursement price. If parties fail to reach an agreement, a final decision on the reimbursement price will be made by an arbitration body. If one of the parties involved wishes so, then the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG) will be commissioned with a formal evaluation of costs and benefits of the product in question. IQWiG will make a recommendation for a reimbursement price based on the 'efficiency frontier' in a therapeutic area. The purpose of the assessments is to provide support for decision-making bodies that act on behalf of the SHI insurants. To determine the willingness to pay for new drugs, IQWiG uses the following decision rule: the incremental cost-effectiveness ratio of a new drug compared with the next effective intervention should not be higher than that of the next effective intervention compared with its comparator. The purpose of this paper was to investigate the theoretical and empirical relationship between the willingness to pay for drugs and their health benefits. The analysis shows that across disease areas IQWiG has a curvilinear relationship between willingness to pay and health benefits. Future research may address the validity of the willingness-to-pay function from the viewpoint of the individual SHI insurants. PMID:25595007

  15. Innovative Technology in Hearing Instruments

    PubMed Central

    2011-01-01

    Hearing instrument technology research is almost entirely focused on the projected needs of the consumer market in the developed world. However, two thirds of the world’s population with hearing impairment live in developing countries and this proportion will increase in future, given present demographic trends. In developing regions, amplification and other hearing health needs may differ from those in industrialized nations, for cultural, health, or economic reasons. World Health Organization estimates indicate that at present only a small percentage of individuals in developing countries who are in need of amplification have access to hearing aid provision. New technologies, such as trainable hearing aids, advanced noise reduction algorithms, feedback reduction circuitry, nano coatings for hearing aid components, and innovative power options, may offer considerable potential benefits, both for individuals with hearing impairment in developing countries and for those who provide hearing health care services in these regions. This article considers the possible supporting role of innovative hearing instrument technologies in the provision of affordable hearing health care services in developing countries and highlights the need for research that considers the requirements of the majority of the world population in need of hearing instrument provision. PMID:22068223

  16. Office of Disease Prevention and Health Promotion

    MedlinePlus

    ... Media About ODPHP Dietary Guidelines Physical Activity Guidelines Health Literacy and Communication Health Care Quality and Patient Safety ... learn innovative ways to get the Nation moving. Health Literacy and Communication Explore health literacy and communication tools, ...

  17. Innovating a way out

    NASA Astrophysics Data System (ADS)

    2015-09-01

    The ongoing European Union fiscal crisis has taken its toll on research and innovation across several member states. A number of initiatives aim to boost technological innovation as a tool for increasing wealth.

  18. Innovation and STEM Schools

    ERIC Educational Resources Information Center

    Roberts, Julia Link

    2015-01-01

    How do schools with a focus on science, technology, engineering, and mathematics (STEM) fit in with state goals to increase innovation and to boost the economy? This article briefly discusses how educators can encourage creativity and innovation.

  19. The Impact of Innovation

    ERIC Educational Resources Information Center

    O'Banion, Terry; Weidner, Laura; Wilson, Cynthia

    2012-01-01

    With funding from MetLife Foundation, the League for Innovation in the Community College engaged in a yearlong study in 2009 of the nature of innovation in the community college. Using recipients of the League's Innovation of the Year Award at 19 community colleges during the period from 1999 through 2008 as a data set, the authors used document…

  20. China's Innovation Paradox

    ERIC Educational Resources Information Center

    Chan, Jeremy

    2015-01-01

    China aims to become an innovation-led nation by 2020, but its leadership is generally sceptical--and oftentimes hostile--to the market forces, open exchange of ideas, and creative destruction that have unlocked innovation in other countries. Instead, Beijing hopes to promote innovation in China through a massive expansion in higher education,…