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

PubMed

Salmon, J W

1975-01-01

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

Whole genome sequencing in support of wellness and health maintenance.

PubMed

Patel, Chirag J; Sivadas, Ambily; Tabassum, Rubina; Preeprem, Thanawadee; Zhao, Jing; Arafat, Dalia; Chen, Rong; Morgan, Alexander A; Martin, Gregory S; Brigham, Kenneth L; Butte, Atul J; Gibson, Greg

2013-01-01

Whole genome sequencing is poised to revolutionize personalized medicine, providing the capacity to classify individuals into risk categories for a wide range of diseases. Here we begin to explore how whole genome sequencing (WGS) might be incorporated alongside traditional clinical evaluation as a part of preventive medicine. The present study illustrates novel approaches for integrating genotypic and clinical information for assessment of generalized health risks and to assist individuals in the promotion of wellness and maintenance of good health. Whole genome sequences and longitudinal clinical profiles are described for eight middle-aged Caucasian participants (four men and four women) from the Center for Health Discovery and Well Being (CHDWB) at Emory University in Atlanta. We report multivariate genotypic risk assessments derived from common variants reported by genome-wide association studies (GWAS), as well as clinical measures in the domains of immune, metabolic, cardiovascular, musculoskeletal, respiratory, and mental health. Polygenic risk is assessed for each participant for over 100 diseases and reported relative to baseline population prevalence. Two approaches for combining clinical and genetic profiles for the purposes of health assessment are then presented. First we propose conditioning individual disease risk assessments on observed clinical status for type 2 diabetes, coronary artery disease, hypertriglyceridemia and hypertension, and obesity. An approximate 2:1 ratio of concordance between genetic prediction and observed sub-clinical disease is observed. Subsequently, we show how more holistic combination of genetic, clinical and family history data can be achieved by visualizing risk in eight sub-classes of disease. Having identified where their profiles are broadly concordant or discordant, an individual can focus on individual clinical results or genotypes as they develop personalized health action plans in consultation with a health

Whole genome sequencing in support of wellness and health maintenance

PubMed Central

2013-01-01

Background Whole genome sequencing is poised to revolutionize personalized medicine, providing the capacity to classify individuals into risk categories for a wide range of diseases. Here we begin to explore how whole genome sequencing (WGS) might be incorporated alongside traditional clinical evaluation as a part of preventive medicine. The present study illustrates novel approaches for integrating genotypic and clinical information for assessment of generalized health risks and to assist individuals in the promotion of wellness and maintenance of good health. Methods Whole genome sequences and longitudinal clinical profiles are described for eight middle-aged Caucasian participants (four men and four women) from the Center for Health Discovery and Well Being (CHDWB) at Emory University in Atlanta. We report multivariate genotypic risk assessments derived from common variants reported by genome-wide association studies (GWAS), as well as clinical measures in the domains of immune, metabolic, cardiovascular, musculoskeletal, respiratory, and mental health. Results Polygenic risk is assessed for each participant for over 100 diseases and reported relative to baseline population prevalence. Two approaches for combining clinical and genetic profiles for the purposes of health assessment are then presented. First we propose conditioning individual disease risk assessments on observed clinical status for type 2 diabetes, coronary artery disease, hypertriglyceridemia and hypertension, and obesity. An approximate 2:1 ratio of concordance between genetic prediction and observed sub-clinical disease is observed. Subsequently, we show how more holistic combination of genetic, clinical and family history data can be achieved by visualizing risk in eight sub-classes of disease. Having identified where their profiles are broadly concordant or discordant, an individual can focus on individual clinical results or genotypes as they develop personalized health action plans in

40 CFR 761.193 - Maintenance of monitoring records by persons who import, manufacture, process, distribute in...

Code of Federal Regulations, 2010 CFR

2010-07-01

... persons who import, manufacture, process, distribute in commerce, or use chemicals containing..., DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS General Records and Reports § 761.193 Maintenance of monitoring records by persons who import, manufacture, process, distribute in commerce, or use chemicals containing...

Applying Psychological Theories to Promote Long-Term Maintenance of Health Behaviors

PubMed Central

Joseph, Rodney P.; Daniel, Casey L.; Thind, Herpreet; Benitez, Tanya J.; Pekmezi, Dori

2014-01-01

Behavioral health theory provides a framework for researchers to design, implement, and evaluate the effects of health promotion programs. However, limited research has examined theories used in interventions to promote long-term maintenance of health behaviors. The purpose of this review was to evaluate the available literature and identify prominent behavioral health theories used in intervention research to promote maintenance of health behaviors. We reviewed theories used in intervention research assessing long-term maintenance (≥ 6 months post-intervention) of physical activity, weight loss, and smoking cessation. Five prominent behavioral theories were referenced by the 34 studies included in the review: Self-Determination Theory, Theory of Planned Behavior, Social Cognitive Theory, Transtheoretical Model, and Social Ecological Model. Descriptions and examples of applications of these theories are provided. Implications for future research are discussed. PMID:28217036

Health maintenance organizations: organizational structure and services--HCFA. Correction notice.

PubMed

1993-09-03

This document corrects regulatory citations in the preamble of a notice of proposed rulemaking that we issued in the Federal Register on July 15, 1993 (56 FR 38170). The notice proposed to amend the HCFA regulations governing requirements for health maintenance organizations that are Federally qualified (FQHMOs) to incorporate changes made by the Health Maintenance Organization Amendments of 1988 pertaining to the definition of an FQHMO, requirements for providing physician services as basic health services, and requirements for fiscal soundness and insolvency protection.

Physician Incentives in Health Maintenance Organizations

ERIC Educational Resources Information Center

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

2004-01-01

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

The big five personality traits and individual job performance growth trajectories in maintenance and transitional job stages.

PubMed

Thoresen, Carl J; Bradley, Jill C; Bliese, Paul D; Thoresen, Joseph D

2004-10-01

This study extends the literature on personality and job performance through the use of random coefficient modeling to test the validity of the Big Five personality traits in predicting overall sales performance and sales performance trajectories--or systematic patterns of performance growth--in 2 samples of pharmaceutical sales representatives at maintenance and transitional job stages (K. R. Murphy, 1989). In the maintenance sample, conscientiousness and extraversion were positively associated with between-person differences in total sales, whereas only conscientiousness predicted performance growth. In the transitional sample, agreeableness and openness to experience predicted overall performance differences and performance trends. All effects remained significant with job tenure statistically controlled. Possible explanations for these findings are offered, and theoretical and practical implications of findings are discussed. (c) 2004 APA, all rights reserved

Social Health Maintenance Organizations: assessing their initial experience.

PubMed

Newcomer, R; Harrington, C; Friedlob, A

1990-08-01

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

Social Health Maintenance Organizations: assessing their initial experience.

PubMed Central

Newcomer, R; Harrington, C; Friedlob, A

1990-01-01

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

Health maintenance and management in childhood disability.

PubMed

Ayyangar, Rita

2002-11-01

Health and health-related needs of children with disabilities are very broad in scope, and it is impossible to adequately cover all aspects in a single article. This article has tried, however, to highlight the issues common to disability, and lay the groundwork for the development of health maintenance guidelines for this population. The prevalence of childhood disability is on the rise, yet life expectancies are improving, and it is not uncommon for children even with severe disabilities to live well into adulthood. The ICIDH2 paradigm shift to focus on health and function rather than impairment and disability fits well with the national initiative to promote health for all. There is a paucity of information on the impact of childhood interventions on health in adulthood, yet it would be prudent to surmise that early interventions will be effective. Directed attention to the basic health needs and preventive measures for the management of children with disabilities is required. This can be difficult because the management of a child with disability is dynamic and challenging, and health care providers may find their time and energies consumed with just managing the more obvious and striking disability-related problems. The widespread ramifications of disability on both the individual and society, call for teamwork between family, health care providers, and the community. Although the specific needs of such a diverse group vary widely; as a group, children with disabilities have many common needs. These include the need for basic health maintenance and health promotion measures such as nutrition, immunizations and physical fitness, as well as coordination of services, psychologic and family support, technical assistance, funding resources, communication between health and education fields, and access to a "medical home," the site for primary care of the child. As a tree is bent, so it will grow. Efforts to promote growth and maximize opportunities for development

Personal health and consumer informatics. The impact of health oriented social media applications on health outcomes.

PubMed

Gibbons, M C

2013-01-01

The rapid evolution in the world-wide use of Social Media tools suggests the emergence of a global phenomenon that may have implications in the Personal Health and Consumer Health Informatics domains. However the impact of these tools on health outcomes is not known. The goal of this research was to review the randomized controlled trial (RCT) evidence of the impact of health oriented Social Media informatics tools on health outcomes. Evaluations of Social Media consumer health tools were systematically reviewed. Research was limited to studies published in the English language, published in Medline, published in the calendar year 2012 and limited to studies that utilized a RCT methodological design. Two high quality Randomized Controlled Trials among over 600 articles published in Medline were identified. These studies indicate that Social Media interventions may be able to significantly improve pain control among patients with chronic pain and enhance weight loss maintenance among individuals attempting to lose weight. Significantly more research needs to be done to confirm these early findings, evaluate additional health outcomes and further evaluate emerging health oriented Social Media interventions. Chronic pain and weight control have both socially oriented determinants. These studies suggest that understanding the social component of a disease may ultimately provide novel therapeutic targets and socio-clinical interventional strategies.

Personalization in the health care system: do personal health budgets have an impact on outcomes and cost?

PubMed

Jones, Karen; Forder, Julien; Caiels, James; Welch, Elizabeth; Glendinning, Caroline; Windle, Karen

2013-10-01

In England's National Health Service, personal health budgets are part of a growing trend to give patients more choice and control over how health care services are managed and delivered. The personal health budget programme was launched by the Department of Health in 2009, and a three-year independent evaluation was commissioned with the aim of identifying whether the initiative ensured better health- and care-related outcomes and at what cost when compared to conventional service delivery. The evaluation used a pragmatic controlled trial design to compare the outcomes and costs of patients selected to receive a personal health budget with those continuing with conventional support arrangements (control group). Just over 1000 individuals were recruited into the personal health budget group and 1000 into the control group in order to ensure sufficient statistical power, and followed for 12 months. The use of personal health budgets was associated with significant improvement in patients' care-related quality of life and psychological wellbeing at 12 months. Personal health budgets did not appear to have an impact on health status, mortality rates, health-related quality of life or costs over the same period. With net benefits measured in terms of care-related quality of life on the adult social care outcome toolkit measure, personal health budgets were cost-effective: that is, budget holders experienced greater benefits than people receiving conventional services, and the budgets were worth the cost. The evaluation provides support for the planned wider roll-out of personal health budgets in the English NHS after 2014 in so far as the localities in the pilot sample are representative of the whole country.

(White House Conference on Aging, 1981. Health Maintenance and Health Promotion. Report and Executive Summary of the Technical Committee.)

ERIC Educational Resources Information Center

Farber, Seymour M.; And Others

The introduction to this Technical Committee Report reviews the health status of the older population and examines major disease entities where health maintenance and promotion can play a role. Part One, "Health Maintenance and Health Promotion Services," discusses the physical and social environments, indicators of change in physical…

Maintenance of head and neck tumor on-chip: gateway to personalized treatment?

PubMed Central

Bower, Ruth; Green, Victoria L; Kuvshinova, Elena; Kuvshinov, Dmitriy; Karsai, Laszlo; Crank, Stephen T; Stafford, Nicholas D; Greenman, John

2017-01-01

Aim: Head and neck squamous cell carcinomas (HNSCC) are solid tumors with low overall survival (40–60%). In a move toward personalized medicine, maintenance of tumor biopsies in microfluidic tissue culture devices is being developed. Methodology/results: HNSCC (n = 15) was dissected (5–10 mg) and either analyzed immediately or cultured in a microfluidic device (37°C) for 48 h. No difference was observed in morphology between pre- and postculture specimens. Dissociated samples were analyzed using trypan blue exclusion (viability), propidium iodide flow cytometry (death) and MTS assay (proliferation) with no significant difference observed highlighting tissue maintenance. Computational fluid dynamics showed laminar flow within the system. Conclusion: The microfluidic culture system successfully maintained HNSCC for 48 h, the culture system will allow testing of different treatment modalities with response monitoring. PMID:28670466

14 CFR 91.407 - Operation after maintenance, preventive maintenance, rebuilding, or alteration.

Code of Federal Regulations, 2012 CFR

2012-01-01

... flies the aircraft, makes an operational check of the maintenance performed or alteration made, and logs... maintenance, preventive maintenance, rebuilding, or alteration. (a) No person may operate any aircraft that... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Operation after maintenance, preventive...

14 CFR 91.407 - Operation after maintenance, preventive maintenance, rebuilding, or alteration.

Code of Federal Regulations, 2013 CFR

2013-01-01

... flies the aircraft, makes an operational check of the maintenance performed or alteration made, and logs... maintenance, preventive maintenance, rebuilding, or alteration. (a) No person may operate any aircraft that... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Operation after maintenance, preventive...

14 CFR 91.407 - Operation after maintenance, preventive maintenance, rebuilding, or alteration.

Code of Federal Regulations, 2010 CFR

2010-01-01

... flies the aircraft, makes an operational check of the maintenance performed or alteration made, and logs... maintenance, preventive maintenance, rebuilding, or alteration. (a) No person may operate any aircraft that... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Operation after maintenance, preventive...

14 CFR 91.407 - Operation after maintenance, preventive maintenance, rebuilding, or alteration.

Code of Federal Regulations, 2011 CFR

2011-01-01

... flies the aircraft, makes an operational check of the maintenance performed or alteration made, and logs... maintenance, preventive maintenance, rebuilding, or alteration. (a) No person may operate any aircraft that... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Operation after maintenance, preventive...

14 CFR 91.407 - Operation after maintenance, preventive maintenance, rebuilding, or alteration.

Code of Federal Regulations, 2014 CFR

2014-01-01

... flies the aircraft, makes an operational check of the maintenance performed or alteration made, and logs... maintenance, preventive maintenance, rebuilding, or alteration. (a) No person may operate any aircraft that... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Operation after maintenance, preventive...

Enabling Patient Control of Personal Electronic Health Records Through Distributed Ledger Technology.

PubMed

Cunningham, James; Ainsworth, John

2017-01-01

The rise of distributed ledger technology, initiated and exemplified by the Bitcoin blockchain, is having an increasing impact on information technology environments in which there is an emphasis on trust and security. Management of electronic health records, where both conformation to legislative regulations and maintenance of public trust are paramount, is an area where the impact of these new technologies may be particularly beneficial. We present a system that enables fine-grained personalized control of third-party access to patients' electronic health records, allowing individuals to specify when and how their records are accessed for research purposes. The use of the smart contract based Ethereum blockchain technology to implement this system allows it to operate in a verifiably secure, trustless, and openly auditable environment, features crucial to health information systems moving forward.

Challenges and Opportunities with Empowering Baby Boomers for Personal Health Information Management Using Consumer Health Information Technologies: an Ecological Perspective

PubMed Central

LeRouge, Cynthia M.; Tao, Donghua; Ohs, Jennifer; Lach, Helen W.; Jupka, Keri; Wray, Ricardo

2014-01-01

“Baby Boomers” (adults born between the years of 1946 and 1964) make up the largest segment of the population in many countries, including the United States (about 78 million Americans) [1]. As Baby Boomers reach retirement age and beyond, many will have increasing medical needs and thus demand more health care resources that will challenge the healthcare system. Baby Boomers will likely accelerate the movement toward patient self-management and prevention efforts. Consumer Health Information Technologies (CHIT) hold promise for empowering health consumers to take an active role in health maintenance and disease management, and thus, have the potential to address Baby Boomers' health needs. Such innovations require changes in health care practice and processes that take into account Baby Boomers' personal health needs, preferences, health culture, and abilities to use these technologies. Without foundational knowledge of barriers and opportunities, Baby Boomers may not realize the potential of these innovations for improving self-management of health and health outcomes. However, research to date has not adequately explored the degree to which Baby Boomers are ready to embrace consumer health information technology and how their unique subcultures affect adoption and diffusion. This position paper describes an ecological conceptual framework for understanding and studying CHIT aimed at satisfying the personal health needs of Baby Boomers. We explore existing literature to provide a detailed depiction of our proposed conceptual framework, which focuses characteristics influencing Baby Boomers and their Personal Health Information Management (PHIM) and potential information problems. Using our ecological framework as a backdrop, we provide insight and implications for future research based on literature and underlying theories represented in our model. PMID:29546084

Challenges and Opportunities with Empowering Baby Boomers for Personal Health Information Management Using Consumer Health Information Technologies: an Ecological Perspective.

PubMed

LeRouge, Cynthia M; Tao, Donghua; Ohs, Jennifer; Lach, Helen W; Jupka, Keri; Wray, Ricardo

2014-01-01

"Baby Boomers" (adults born between the years of 1946 and 1964) make up the largest segment of the population in many countries, including the United States (about 78 million Americans) [1]. As Baby Boomers reach retirement age and beyond, many will have increasing medical needs and thus demand more health care resources that will challenge the healthcare system. Baby Boomers will likely accelerate the movement toward patient self-management and prevention efforts. Consumer Health Information Technologies (CHIT) hold promise for empowering health consumers to take an active role in health maintenance and disease management, and thus, have the potential to address Baby Boomers' health needs. Such innovations require changes in health care practice and processes that take into account Baby Boomers' personal health needs, preferences, health culture, and abilities to use these technologies. Without foundational knowledge of barriers and opportunities, Baby Boomers may not realize the potential of these innovations for improving self-management of health and health outcomes. However, research to date has not adequately explored the degree to which Baby Boomers are ready to embrace consumer health information technology and how their unique subcultures affect adoption and diffusion. This position paper describes an ecological conceptual framework for understanding and studying CHIT aimed at satisfying the personal health needs of Baby Boomers. We explore existing literature to provide a detailed depiction of our proposed conceptual framework, which focuses characteristics influencing Baby Boomers and their Personal Health Information Management (PHIM) and potential information problems. Using our ecological framework as a backdrop, we provide insight and implications for future research based on literature and underlying theories represented in our model.

Personalized health care: from theory to practice.

PubMed

Snyderman, Ralph

2012-08-01

The practice of medicine stands at the threshold of a transformation from its current focus on the treatment of disease events to an emphasis on enhancing health, preventing disease and personalizing care to meet each individual's specific health needs. Personalized health care is a new and strategic approach that is driven by personalized health planning empowered by personalized medicine tools, which are facilitated by advances in science and technology. These tools improve the capability to predict health risks, to determine and quantify the dynamics of disease development, and to target therapeutic approaches to the needs of the individual. Personalized health care can be implemented today using currently available technologies and know-how and thereby provide a market for the rational introduction of new personalized medicine tools. The need for early adoption of personalized health care stems from the necessity to reduce the egregious and wasteful burden of preventable chronic diseases, which is not effectively addressed by our current approach to care. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Health maintenance organizations--PHS. Final rule.

PubMed

1985-02-14

This rule amends the Public Health Service regulations on health maintenance organizations (HMOs) to elaborate on the 1981 amendments to the HMO statute regarding member protection in the event of insolvency, community rating by class, and primary care within the service area of a non-metropolitan HMO. In addition, the rule removes regulatory provisions that are considered unnecessary or burdensome, such as the specification of contractual provisions, and increases one of the regulatory limits on copayments to permit HMOs to become more competitive. These amendments are made after consideration of public comments on the notice of proposed rulemaking (NPRM) published on March 22, 1983.

Health maintenance organizations: are they for the inner cities?

PubMed

Roman, S A

1975-01-01

Health Maintenance Organizations present some major limitations as a means to address the health care needs in our nation's inner cities. The HMO as it has been affected by HMO legislation is discussed and an identification made of those areas that may adversely affect the delivery of health services to inner-city residents where costs may be greatest for those who can least afford it.

Navy Occupational Health Information Management System (NOHIMS). Medical Exam Scheduling Module. Program Maintenance Manual

DTIC Science & Technology

1987-06-01

NAVY OCCUPATIONAL HEALTH INFORMATION MANAGEMENT SYSTEM NOH I MS MEDICAL EXAM SCHEDULING MODULE PROGRAM MAINTENANCE MANUAL S JUNE 1987 DT11C 00... Information Management System (NOHIMS) ~ Medical Examination Scheduling (MES) Program Maintenance Manual 7. Author(s) 8. Performing Organization Rapt. No...the Navy Occupational Health Information Management System (NOHIMS). NOHIMS, whose initial version was developed at the Naval Health Research Center

Increment 23/24 Critical Readiness Review Health Maintenance System

NASA Technical Reports Server (NTRS)

Nieschwitz, Linda

2010-01-01

This slide presentation reviews the Health Maintenance System. It includes information on the carbon dioxide (CO2) and moisture removal system (CMRS), the variable oxygen system,rendevous station panels, and the crew contamination protection kit (CCPK).

[Personal health records: the case of the Personal Health Folder of Catalonia (Spain)].

PubMed

Saigí, Francesc; Cerdá Calafat, Ismael; Guanyabens Calvet, Joan; Carrau Vidal, Elisenda

2012-01-01

The aims of this study were to explore the possibilities of the Personal Health Folder and to identify the gap between the potential applications of this tool and what it offers through the Internet. The Personal Health Folder is presented, a project linked to the Shared Medical Record of Catalonia (Spain), which provides citizens with an access point to information about their health insurance, customized and supported by information and communication technologies. The project was carried out by the Ministry of Health of the Government of Catalonia (Generalitat de Catalunya) and data were gathered through an anonymous survey. The results were critical to obtain information on the suitability of the published data and on the expectations of a tool aimed at the general population. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

Psychological health maintenance on Space Station Freedom

NASA Technical Reports Server (NTRS)

Santy, Patricia A.

1990-01-01

The scheduling of crew rotations at intervals of as much as 180 days on NASA's Space Station Freedom entails that the cumulative effects of psychological, emotional, and social stressors on astronauts be monitored. The Space Station's Health Maintenance Facility (HMF) will furnish preventive, diagnostic, and therapeutic assistance for significant psychiatric and interpersonal problems. Mental health professionals must be part of the team of medical personnel charged with facilitating the physiological and phychological transition from earth to space and back. An account is presently given of the critical factors to be addressed by HMF personnel on extended-duration missions.

Dynamics of Implementation and Maintenance of Organizational Health Interventions.

PubMed

Jalali, Mohammad S; Rahmandad, Hazhir; Bullock, Sally Lawrence; Ammerman, Alice

2017-08-15

In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative obesity prevention case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes.

Behavioral Groups as Preventive Care in a Health Maintenance Organization.

ERIC Educational Resources Information Center

Shapiro, Joan; And Others

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

Psychiatric components of a Health Maintenance Facility (HMF) on Space Station

NASA Technical Reports Server (NTRS)

Santy, Patricia A.

1987-01-01

The operational psychiatric requirements for a comprehensive Health Maintenance Facility (HMF) on a permanently manned Space Station are examined. Consideration is given to the psychological health maintenance program designed for the diagnosis of mental distress in astronauts during flight and for prevention of mental breakdown. The types of mental disorders that can possibly affect the astronauts in flight are discussed, including various organic, psychotic, and affective mental disorders, as well as anxiety, adjustment, and somatoform/dissociative disorders. Special attention is given to therapeutic considerations for psychiatric operations on Space Station, such as restraints, psychopharmacology, psychotherapy, and psychosocial support.

Personal Health Records

MedlinePlus

... chart there, too. These charts are your medical records. They may be on paper or electronic. To ... good idea to keep your own personal health record. What kind of information would you put in ...

Associations between self-rated health and personality.

PubMed

Aiken-Morgan, Adrienne T; Bichsel, Jacqueline; Savla, Jyoti; Edwards, Christopher L; Whitfield, Keith E

2014-01-01

The goal of our study was to examine how Big Five personality factors predict variability in self-rated health in a sample of older African Americans from the Baltimore Study of Black Aging. Personality was measured by the NEO Personality Inventory-Revised, and self-rated health was assessed by the Health Problems Checklist. The study sample had 202 women and 87 men. Ages ranged from 49 to 90 years (M = 67.2 years, SD = 8.55), and average years of formal education was 10.8 (SD = 3.3). Multiple linear regressions showed that neuroticism and extraversion were significant regression predictors of self-rated health, after controlling for demographic factors. These findings suggest individual personality traits may influence health ratings, behaviors, and decision-making among older African Americans.

Navy Occupational Health Information Management System (NOHIMS). System-Wide Module. Program Maintenance Manual

DTIC Science & Technology

1987-06-01

NAVY OCCUPATIONAL HEALTH INFORMATION MANAGEMENT SYSTEM NOHIMS SYSTEM-WIDE MODULE PROGRAM MAINTENANCE MANUAL JUNE 1987 DTIC 00 SEP I 21988DJ 0) 4... INFORMATION MANAGEMENT SYSTEM (NOHIMS) N 1.98 SYSTEM-WIDE MODULE PROGRAM MAINTENANCE MANUAL 7. Author(s) a. Performing Organization Rapt. No. MITRE... Management System (NOHIMS). NORIMS, whose initial version was ,eveloped at the Naval Health Research Center (NHRC), is a composite of 4 -’o subsystems: an

Dynamics of Implementation and Maintenance of Organizational Health Interventions

PubMed Central

Rahmandad, Hazhir; Bullock, Sally Lawrence; Ammerman, Alice

2017-01-01

In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative obesity prevention case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes. PMID:28809807

Personalizing public health: your health avatar.

PubMed

Pereira, Chrystian; McNamara, Anusha; Sorge, Lindsay; Arya, Vibhuti

2013-01-01

To describe the creation of a health avatar, with the goals of providing patients with complete health information from various sources, establishing an interactive and customizable platform, empowering users to determine how the health information best fits or speaks to their personal needs, and providing perspective by comparing the health status of the individual with that of the individual's community. The Internet is rapidly becoming integrated into Americans' daily lives. According to the 2007 Health Information National Trends Study, 69% of U.S. adults had access to the Internet and 23% reported using a social networking site. The impact of social media has further grown, and an estimated 50% of adults in America have a profile on social media. The potential for using cyber communities to improve health messaging is great. Several health care organizations have implemented the use of social media in a variety of ways to varying degrees of success. We propose a platform that automatically gathers information and reflects the health status of an individual back to the user. An avatar, which is a representation of a user, could be created and assigned characteristics that allow users to appreciate their health status. The health avatar platform also would allow users to compare their personal status with that of their community. The overall goal is to engage and then motivate users to improve their overall health status. Medicine must acknowledge the evolving relationships that the next generation of patients will have with technology. The health avatar is a platform that incorporates a connection with the health system through electronic medical records and connects individuals to the greater community.

Personality Diagnosis for Personalized eHealth Services

NASA Astrophysics Data System (ADS)

Cortellese, Fabio; Nalin, Marco; Morandi, Angelica; Sanna, Alberto; Grasso, Floriana

In this paper we present two different approaches to personality diagnosis, for the provision of innovative personalized services, as used in a case study where diabetic patients were supported in the improvement of physical activity in their daily life. The first approach presented relies on a static clustering of the population, with a specific motivation strategy designed for each cluster. The second approach relies on a dynamic population clustering, making use of recommendation systems and algorithms, like Collaborative Filtering. We discuss pro and cons of each approach and a possible combination of the two, as the most promising solution for this and other personalization services in eHealth.

Health maintenance facility: Dental equipment requirements

NASA Technical Reports Server (NTRS)

Young, John; Gosbee, John; Billica, Roger

1991-01-01

The objectives were to test the effectiveness of the Health Maintenance Facility (HMF) dental suction/particle containment system, which controls fluids and debris generated during simulated dental treatment, in microgravity; to test the effectiveness of fiber optic intraoral lighting systems in microgravity, while simulating dental treatment; and to evaluate the operation and function of off-the-shelf dental handheld instruments, namely a portable dental hand drill and temporary filling material, in microgravity. A description of test procedures, including test set-up, flight equipment, and the data acquisition system, is given.

Personality Plus. (Your Guide to Better Health and Personal Development).

ERIC Educational Resources Information Center

de la Concha, Hector

This manual is designed to acquaint individuals with basic principles of personal health, grooming, and personality development. Addressed in the individual chapters of the guide are the following topics: self-evaluation and completion of a personal inventory; proper diet and principles of maintaining a sound body; relaxation techniques; key words…

Primary care quality: community health center and health maintenance organization.

PubMed

Shi, Leiyu; Starfield, Barbara; Xu, Jiahong; Politzer, Robert; Regan, Jerrilyn

2003-08-01

This study compares the primary health care quality of community health centers (CHCs) and health maintenance organizations (HMOs) in South Carolina to elucidate the quality of CHC performance relative to mainstream settings such as the HMO. Mail surveys were used to obtain data from 350 randomly selected HMO users. Surveys with follow-up interviews were conducted to obtain data from 540 randomly selected CHC users. A validated adult primary care assessment tool was used in both surveys. Multivariate analyses were performed to assess the association of health care setting (HMO versus CHC) with primary care quality while controlling for sociodemographic and health care characteristics. After controlling for sociodemographic and health care use measures, CHC patients demonstrated higher scores in several primary care domains (ongoing care, coordination of service, comprehensiveness, and community orientation) as well as total primary care performance. Users of CHC are more likely than HMO users to rate their primary health care provider as good, except in the area of ease of first contact. The positive rating of the CHC is particularly impressive after taking into account that many CHC users have characteristics associated with poorer ratings of care.

Relationship challenges and relationship maintenance activities following disclosure of transsexualism.

PubMed

Alegría, C Aramburu

2010-12-01

• Transsexual persons are increasing their visibility in society, and health care providers and others (such as social workers) will be called upon to help with issues that transsexual persons face. Challenges that face transsexual persons often include issues involving relationships. Psychiatric and mental health nurses and other caregivers can increase their therapeutic skills in working with couples that include transsexual persons by becoming aware of these challenges and subsequent activities that can help with them. • This research study looks at couple relationships in which one partner reveals male-to-female transsexual identity. These are relationships that were established as man-woman and now will transition into relationships that include a male-to-female person and a female partner. • Common challenges for these couples include issues related to: (1) sexual identity and relationship uncertainty; (2) male-to-female transition decision making; and (3) presenting in public. • Relationship maintenance activities that helped the couples in the study maintain and strengthen their relationships through these challenges include: (1) communication; (2) self-talk (for example, putting the situation in perspective); (3) social networks; (4) positive interactions; (5) impression management (for example, managing displays of affection in public); and (6) social activism. This qualitative study describes the relational dynamics that help sustain relationships of couples that include male-to-female transsexual persons (MTF) and their natal female partners (NF) following disclosure of transsexualism. Relationship challenges and relationship maintenance activities are identified. Each partner in 17 MTF-NF couples participated in individual surveys and interviews. The data were coded for themes related to relationship challenges and activities. MTF-NF couples experience challenges within the contexts of their relationships and of society. These challenges

14 CFR 125.247 - Inspection programs and maintenance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... CAPACITY OF 6,000 POUNDS OR MORE; AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Maintenance § 125.247 Inspection programs and maintenance. (a) No person may operate an airplane subject to this part unless (1... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Inspection programs and maintenance. 125...

14 CFR 125.247 - Inspection programs and maintenance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... CAPACITY OF 6,000 POUNDS OR MORE; AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Maintenance § 125.247 Inspection programs and maintenance. (a) No person may operate an airplane subject to this part unless (1... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Inspection programs and maintenance. 125...

14 CFR 125.247 - Inspection programs and maintenance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... CAPACITY OF 6,000 POUNDS OR MORE; AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Maintenance § 125.247 Inspection programs and maintenance. (a) No person may operate an airplane subject to this part unless (1... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Inspection programs and maintenance. 125...

14 CFR 125.247 - Inspection programs and maintenance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... CAPACITY OF 6,000 POUNDS OR MORE; AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Maintenance § 125.247 Inspection programs and maintenance. (a) No person may operate an airplane subject to this part unless (1... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Inspection programs and maintenance. 125...

14 CFR 125.247 - Inspection programs and maintenance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... CAPACITY OF 6,000 POUNDS OR MORE; AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Maintenance § 125.247 Inspection programs and maintenance. (a) No person may operate an airplane subject to this part unless (1... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Inspection programs and maintenance. 125...

Drivers and challenges of personal health systems in workplace health promotion.

PubMed

Ilvesmäki, Antti

2007-01-01

Novel technologies such as wearable sensors, electronic health diaries and personalized web services are thought to have the potential to improve population health in a cost- efficient manner. The use of personal health systems in workplace health promotion is of particular interest, since the workplace often provides an excellent setting and infrastructure to support health- related interventions. Compared to the elderly or those already debilitated by disease, working people are also generally more capable of taking advantage of information technology. Extant research on the use of ICT in health promotion has recognized several functional and technological requirements, but relatively little is known about other factors that affect the commercialization and adoption of such systems. This paper attempts to identify some economic and structural drivers and challenges that may be relevant to the success of personal health systems in workplace health promotion.

Associate Degree Nursing Students in Family Health Maintenance: A Pilot Project.

ERIC Educational Resources Information Center

Conatser, Cheryl

The report describes the implementation and continuation of a family health maintenance program for associate degree nursing students at a community college. Four specific objectives are stated supporting the overall purpose of increasing student awareness of the total health care situation of the family. Implementation of the project, which…

Manned Mars mission health maintenance facility

NASA Technical Reports Server (NTRS)

Degioanni, Joseph C.

1986-01-01

The Health Maintenance Facility (HMF) requirements which enable/enhance manned Mars missions (MMMs) are addressed. It does not attempt to resolve any issues that may affect the feasibility of any given element in the HMF. Reference is made to current work being conducted in the design of the space station HMF. The HMF requirements are discussed within the context of two distinctly different scenarios: HMF as part of the Mars surface infrastructure, and HMF as part of the nine months translation from low Earth orbit to Mars orbit. Requirements for an HMF are provided, and a concept of HMF is shown.

Personal responsibility in oral health: ethical considerations.

PubMed

Albertsen, Andreas

2012-11-30

Personal responsibility is a powerful idea supported by many values central to West European thought. On the conceptual level personal responsibility is a complex notion. It is important to separate the concept of being responsible for a given state of affairs from the concept of holding people responsible by introducing measures that decrease their share of available resources. Introducing personal responsibility in oral health also has limitations of a more practical nature. Knowledge, social status and other diseases affect the degree to which people can be said to be responsible for their poor oral health. These factors affect people's oral health and their ability to take care of it. Both the conceptual and practical issues at stake are not reasons to abandon the idea of personal responsibility in oral health, but they do affect what the notion means and when it is reasonable to hold people responsible. They also commit people who support the idea of personal responsibility in oral health to supporting the idea of societal responsibility for mitigating the effects of factors that diminish people's responsibility and increase the available information and knowledge in the population.

Personal Health Records - Multiple Languages

MedlinePlus

... Seattle and King County Spanish (español) Expand Section Personal Health Records: MedlinePlus Health Topic - English ... Subscribe to RSS Follow us Disclaimers Copyright Privacy Accessibility Quality Guidelines Viewers & Players MedlinePlus Connect for ...

Relationship between person-organization fit and objective and subjective health status (person-organization fit and health).

PubMed

Merecz, Dorota; Andysz, Aleksandra

2012-06-01

[corrected] Person-Environment fit (P-E fit) paradigm, seems to be especially useful in explaining phenomena related to work attitudes and occupational health. The study explores the relationship between a specific facet of P-E fit as Person-Organization fit (P-O fit) and health. Research was conducted on the random sample of 600 employees. Person-Organization Fit Questionnaire was used to asses the level of Person-Organization fit; mental health status was measured by General Health Questionnaire (GHQ-28); and items from Work Ability Index allowed for evaluation of somatic health. Data was analyzed using non parametric statistical tests. The predictive value of P-O fit for various aspects of health was checked by means of linear regression models. A comparison between the groups distinguished on the basis of their somatic and mental health indicators showed significant differences in the level of overall P-O fit (χ(2) = 23.178; p < 0.001) and its subdimensions: for complementary fit (χ(2) = 29.272; p < 0.001), supplementary fit (χ(2) = 23.059; p < 0.001), and identification with organization (χ(2) = 8.688; p = 0.034). From the perspective of mental health, supplementary P-O fit seems to be important for men's well-being and explains almost 9% of variance in GHQ-28 scores, while in women, complementary fit (5% explained variance in women's GHQ score) and identification with organization (1% explained variance in GHQ score) are significant predictors of mental well-being. Interestingly, better supplementary and complementary fit are related to better mental health, but stronger identification with organization in women produces adverse effect on their mental health. The results show that obtaining the optimal level of P-O fit can be beneficial not only for the organization (e.g. lower turnover, better work effectiveness and commitment), but also for the employees themselves. Optimal level of P-O fit can be considered as a factor maintaining workers' health

14 CFR 43.3 - Persons authorized to perform maintenance, preventive maintenance, rebuilding, and alterations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... maintenance are a result of a known or suspected mechanical difficulty or malfunction that occurred en route... is authorized in writing by the certificate holder for each item of preventive maintenance that the... satisfactorily completed an approved training program and is authorized in writing by the certificate holder to...

Personality Accounts for the Connection Between Volunteering and Health

PubMed Central

Jackson, Joshua J.; Morrow-Howell, Nancy; Oltmanns, Thomas F.

2015-01-01

Objectives. Existing literature has shown that volunteering is related to better physical and mental health outcomes. The purpose of this study is to examine whether personality traits and volunteering are independent predictors of physical and mental health. Methods. The current study utilizes data from the St. Louis Personality and Aging Network (SPAN), a representative sample of community-based adults between the ages of 55 and 64. Using hierarchical linear regressions, we test whether volunteering is a significant predictor of both physical and mental health while controlling for personality traits. Results. We find that volunteering is not significantly related to either physical or mental health while controlling for personality traits. We also find that lower neuroticism is related to better physical functioning and mental health, whereas higher extraversion is related to better mental health. Discussion. These results indicate that volunteering may be related to health outcomes because of the personality characteristics of volunteers, not the volunteering experience in and of itself. Future longitudinal studies are needed to further explore the relationship between personality, volunteering, and health. PMID:24704620

A Medical Decision Support System for the Space Station Health Maintenance Facility

PubMed Central

Ostler, David V.; Gardner, Reed M.; Logan, James S.

1988-01-01

NASA is developing a Health Maintenance Facility (HMF) to provide the equipment and supplies necessary to deliver medical care in the Space Station. An essential part of the Health Maintenance Facility is a computerized Medical Decision Support System (MDSS) that will enhance the ability of the medical officer (“paramedic” or “physician”) to maintain the crew's health, and to provide emergency medical care. The computer system has four major functions: 1) collect and integrate medical information into an electronic medical record from Space Station medical officers, HMF instrumentation, and exercise equipment; 2) provide an integrated medical record and medical reference information management system; 3) manage inventory for logistical support of supplies and secure pharmaceuticals; 4) supply audio and electronic mail communications between the medical officer and ground based flight surgeons. ImagesFigure 1

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

PubMed

Baranes, Edmond; Bardey, David

2015-12-01

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

The personal health record: consumers banking on their health.

PubMed

Ball, Marion J; Costin, Melinda Y; Lehmann, Christoph

2008-01-01

With personal health records (PHRs) acting much like ATM cards, increasingly wired consumers can "bank on health", accessing their own personal health information and a wide array of services. Consumer-owned, the PHR is dependent upon the existence of the legal electronic medical record (EMR) and interoperability. Working PHRs are in place in Veterans Health Administration, private health care institutions, and in the commercial sector. By allowing consumers to become involved in their own care, the PHR creates new roles and relationships. New tools change the clinician's workflow and thought flow, and pose new challenges for consumers. Key components of the PHR include the EMR and regional health information organizations (RHIOs); key strategies focus on human factors in successful project management. Online resources provided by the National Library of Medicine and Health On the Net help address consumer needs for information that is reliable and understandable. The growth of self-management tools adds to the challenge and the promise of PHRs for clinicians and consumers alike.

[Personal satisfaction of adolescent drug addicts in the family environment during treatment at a mental health institute].

PubMed

Velásquez Carranza, Doris Violeta; Pedrão, Luiz Jorge

2005-01-01

This study aimed at analyzing the level of personal satisfaction of adolescents addicted to drugs in family environment during the treatment stage at a mental health institute. Authors used the Family Satisfaction Scale with Adjectives adapted, validated and applied to a sample of 34 patients selected according to established inclusion and exclusion criteria. A significant relationship between the level of satisfaction and parents' good relationship in their marriage was found. 61% of adolescents presented an average personal satisfaction level and 41.18% of them were from families whose maintenance is provided by both parents. There are no similar studies, thus, this research aims at contributing to improve rehabilitation programs based on the nursing perspective and facilitating the relationship between the family and the addicted in treatment.

Sexual function in F-111 maintenance workers: the study of health outcomes in aircraft maintenance personnel.

PubMed

Brown, Anthony; Gibson, Richard; Tavener, Meredith; Guest, Maya; D'Este, Catherine; Byles, Julie; Attia, John; Horsley, Keith; Harrex, Warren; Ross, James

2009-06-01

In Australia, four formal F-111 fuel tank deseal/reseal (DSRS) repair programs were implemented over more than two decades, each involving different processes and using a range of hazardous substances. However, health concerns were raised by a number of workers. The "Study of Health Outcomes in Aircraft Maintenance Personnel" was commissioned by the Australian Department of Defence to investigate potential adverse health outcomes as a result of being involved in the deseal/reseal processes. To compare measures of sexual function in F-111 aircraft fuel tank DSRS maintenance workers, against two appropriate comparison groups. Exposed and comparison participants completed a postal questionnaire which included general questions of health and health behavior, and two specific questions on sexual functioning. They also completed the International Index of Erectile Function (IIEF) questionnaire. Logistic regression was used to explore exposure status and outcome while adjusting for potential confounders. The three outcomes of interest for this study were the proportion of participants with erectile dysfunction (ED) according to the IIEF, the proportion with self-reported loss of interest in sex, and the proportion with self-reported problems with sexual functioning. Compared with each of the comparison groups, a larger proportion of the exposed group reported sexual problems and were classified as having ED according to the IIEF. In logistic regression, the odds of all three outcomes were higher for exposed participants relative to each comparison group and after adjustment for potentially confounding variables including anxiety and depression. There was a consistent problem with sexual functioning in the exposed group that is not explained by anxiety and depression, and it appears related to DSRS activities.

Does personality predict health and well-being? A metasynthesis.

PubMed

Strickhouser, Jason E; Zell, Ethan; Krizan, Zlatan

2017-08-01

To derive a robust and comprehensive estimate of the overall relation between Big Five personality traits and health variables using metasynthesis (i.e., second-order meta-analysis). Thirty-six meta-analyses, which collectively provided 150 meta-analytic effects from over 500,000 participants, met criteria for inclusion in the metasynthesis. Information on methodological quality as well as the type of health outcome, unreliability adjustment, population sampled, health outcome source, personality source, and research design was extracted from each meta-analysis. An unweighted model was used to aggregate data across meta-analyses. When entered simultaneously, the Big Five traits were moderately associated with overall health (multiple R = .35). Personality-health relations were larger when examining mental health outcomes than physical health outcomes or health-related behaviors and when researchers adjusted for measurement unreliability, used self-report as opposed to other-report Big Five scales, or focused on clinical as opposed to nonclinical samples. Further, effects were larger among agreeableness, conscientiousness, and neuroticism than extraversion or openness to experience. This metasynthesis provides among the most compelling evidence to date that personality predicts overall health and well-being. In addition, it may inform research on the mechanisms by which personality impacts health as well as research on the structure of personality. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Perceived job insecurity, job predictability, personality, and health.

PubMed

Lau, Bjørn; Knardahl, Stein

2008-02-01

The present study sought to determine whether job insecurity is associated with personality traits and beliefs. In addition, it was tested whether aspects of personality confounded the relationships between job insecurity and health, or moderated this association. At the first data collection, 5163 persons participated, and at the second data collection, 1946 persons of a random sample participated. Data were obtained from Oslo Health Study. The job insecurity aspect concerning confidence in having a good job in 2 years was more strongly related to the health variables, and particularly with mental distress, compared with other aspects of job insecurity. Type-A behavior predicted an increase in upper back pain (beta 0.07), while optimism predicted a change in lower back pain (beta -0.07). Job insecurity is associated with health; this association is strongest for mental distress and self-reported health, and weaker for back-pain.

Personality Accounts for the Connection Between Volunteering and Health.

PubMed

King, Hannah R; Jackson, Joshua J; Morrow-Howell, Nancy; Oltmanns, Thomas F

2015-09-01

Existing literature has shown that volunteering is related to better physical and mental health outcomes. The purpose of this study is to examine whether personality traits and volunteering are independent predictors of physical and mental health. The current study utilizes data from the St. Louis Personality and Aging Network (SPAN), a representative sample of community-based adults between the ages of 55 and 64. Using hierarchical linear regressions, we test whether volunteering is a significant predictor of both physical and mental health while controlling for personality traits. We find that volunteering is not significantly related to either physical or mental health while controlling for personality traits. We also find that lower neuroticism is related to better physical functioning and mental health, whereas higher extraversion is related to better mental health. These results indicate that volunteering may be related to health outcomes because of the personality characteristics of volunteers, not the volunteering experience in and of itself. Future longitudinal studies are needed to further explore the relationship between personality, volunteering, and health. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Analysis model for personal eHealth solutions and services.

PubMed

Mykkänen, Juha; Tuomainen, Mika; Luukkonen, Irmeli; Itälä, Timo

2010-01-01

In this paper, we present a framework for analysing and assessing various features of personal wellbeing information management services and solutions such as personal health records and citizen-oriented eHealth services. The model is based on general functional and interoperability standards for personal health management applications and generic frameworks for different aspects of analysis. It has been developed and used in the MyWellbeing project in Finland to provide baseline for the research, development and comparison of many different personal wellbeing and health management solutions and to support the development of unified "Coper" concept for citizen empowerment.

Personality as a predictor of weight loss maintenance after surgery for morbid obesity.

PubMed

Larsen, Junilla K; Geenen, Rinie; Maas, Cora; de Wit, Pieter; van Antwerpen, Tiny; Brand, Nico; van Ramshorst, Bert

2004-11-01

Personality characteristics are assumed to underlie health behaviors and, thus, a variety of health outcomes. Our aim was to examine prospectively whether personality traits predict short- and long-term weight loss after laparoscopic adjustable gastric banding. Of patients undergoing laparoscopic adjustable gastric banding, 168 (143 women, 25 men, 18 to 58 years old, mean 37 years, preoperative BMI 45.9 +/- 5.6 kg/m(2)) completed the Dutch Personality Questionnaire on average 1.5 years before the operation. The relationship between preoperative personality and short- and long-term postoperative weight loss was determined using multilevel regression analysis. The average weight loss of patients progressively increased to 10 BMI points until 18 months after surgery and stabilized thereafter. A lower baseline BMI, being a man, and a higher educational level were associated with a lower weight loss. None of the personality variables was associated with weight outcome at short-term follow-up. Six of seven personality variables did not predict long-term weight outcome. Egoism was associated with less weight loss in the long-term postoperative period. The effect sizes of the significant predictions were small. None of the personality variables predicted short-term weight outcome, and only one variable showed a small and unexpected association with long-term weight outcome that needs confirmation. This suggests that personality assessment as intake psychological screening is of little use for the prediction of a poor or successful weight outcome after bariatric surgery.

Personal hygiene among primary school children living in a slum of Kolkata, India.

PubMed

Sarkar, M

2013-09-01

For children, maintenance of personal hygiene helps to improve the quality of life and longevity. This is of particular importance in a slum community with compromised living situation. This study was undertaken to find out the knowledge and practice of personal hygiene among the primary school children living in a slum area, to identify any misconception among them regarding the maintenance of personal hygiene, to find out their morbidity pattern, and also to elicit the relationship between practice of personal hygiene among the children and the literacy status of their mother. A cross-sectional observational study was conducted among 104 primary school children of a primary school situated in the slum area of Chetla, Kolkata, India with the help of a predesigned, pre-tested and structured questionnaire. Data were analyzed statistically by simple proportions and tests of significance. It was found that the female students were more knowledgeable than the male students regarding the maintenance of personal hygiene. There was a wide gap between practice and knowledge of personal hygiene among the primary school children living in the slum area. Even, misconceptions do exist on certain indicators of personal hygiene among the students. Statistically significant association was observed between practices of personal hygiene among the primary school children and the literacy status of their mother. Future of a society depends considerably on the health of its children. The parents and the school teachers, as constructive shapers of children's health behaviors, should play a responsible role in early education of children on personal hygiene.

Personal health technologies, micropolitics and resistance: A new materialist analysis.

PubMed

Fox, Nick J

2017-03-01

Personal health technologies are near-body devices or applications designed for use by a single individual, principally outside healthcare facilities. They enable users to monitor physiological processes or body activity, are frequently communication-enabled and sometimes also intervene therapeutically. This article explores a range of personal health technologies, from blood pressure or blood glucose monitors purchased in pharmacies and fitness monitors such as Fitbit and Nike+ Fuelband to drug pumps and implantable medical devices. It applies a new materialist analysis, first reverse engineering a range of personal health technologies to explore their micropolitics and then forward engineering personal health technologies to meet, variously, public health, corporate, patient and resisting-citizen agendas. This article concludes with a critical discussion of personal health technologies and the possibilities of designing devices and apps that might foster subversive micropolitics and encourage collective and resisting 'citizen health'.

What Predicts Exercise Maintenance and Well-Being? Examining The Influence of Health-Related Psychographic Factors and Social Media Communication.

PubMed

Zhou, Xin; Krishnan, Archana

2018-01-26

Habitual exercising is an important precursor to both physical and psychological well-being. There is, thus, a strong interest in identifying key factors that can best motivate individuals to sustain regular exercise regimen. In addition to the importance of psychographic factors, social media use may act as external motivator by allowing users to interact and communicate about exercise. In this study, we examined the influence of health consciousness, health-oriented beliefs, intrinsic motivation, as willingness to communicate about health on social media, social media activity on exercise, and online social support on exercise maintenance and well-being on a sample of 532 American adults. Employing structural equation modeling, we found that health-oriented beliefs mediated the effect of health consciousness on intrinsic motivation which in turn was a significant predictor of exercise maintenance. Exercise maintenance significantly predicted both physical and psychological well-being. Extrinsic motivators, as measured by willingness to communicate about health on social media, social media activity on exercise, and online social support did not however significantly influence exercise maintenance. These findings have implications for the design and implementation of exercise-promoting interventions by identifying underlying factors that influence exercise maintenance.

The SADI Personal Health Lens: A Web Browser-Based System for Identifying Personally Relevant Drug Interactions.

PubMed

Vandervalk, Ben; McCarthy, E Luke; Cruz-Toledo, José; Klein, Artjom; Baker, Christopher J O; Dumontier, Michel; Wilkinson, Mark D

2013-04-05

The Web provides widespread access to vast quantities of health-related information that can improve quality-of-life through better understanding of personal symptoms, medical conditions, and available treatments. Unfortunately, identifying a credible and personally relevant subset of information can be a time-consuming and challenging task for users without a medical background. The objective of the Personal Health Lens system is to aid users when reading health-related webpages by providing warnings about personally relevant drug interactions. More broadly, we wish to present a prototype for a novel, generalizable approach to facilitating interactions between a patient, their practitioner(s), and the Web. We utilized a distributed, Semantic Web-based architecture for recognizing personally dangerous drugs consisting of: (1) a private, local triple store of personal health information, (2) Semantic Web services, following the Semantic Automated Discovery and Integration (SADI) design pattern, for text mining and identifying substance interactions, (3) a bookmarklet to trigger analysis of a webpage and annotate it with personalized warnings, and (4) a semantic query that acts as an abstract template of the analytical workflow to be enacted by the system. A prototype implementation of the system is provided in the form of a Java standalone executable JAR file. The JAR file bundles all components of the system: the personal health database, locally-running versions of the SADI services, and a javascript bookmarklet that triggers analysis of a webpage. In addition, the demonstration includes a hypothetical personal health profile, allowing the system to be used immediately without configuration. Usage instructions are provided. The main strength of the Personal Health Lens system is its ability to organize medical information and to present it to the user in a personalized and contextually relevant manner. While this prototype was limited to a single knowledge domain

The SADI Personal Health Lens: A Web Browser-Based System for Identifying Personally Relevant Drug Interactions

PubMed Central

Vandervalk, Ben; McCarthy, E Luke; Cruz-Toledo, José; Klein, Artjom; Baker, Christopher J O; Dumontier, Michel

2013-01-01

Background The Web provides widespread access to vast quantities of health-related information that can improve quality-of-life through better understanding of personal symptoms, medical conditions, and available treatments. Unfortunately, identifying a credible and personally relevant subset of information can be a time-consuming and challenging task for users without a medical background. Objective The objective of the Personal Health Lens system is to aid users when reading health-related webpages by providing warnings about personally relevant drug interactions. More broadly, we wish to present a prototype for a novel, generalizable approach to facilitating interactions between a patient, their practitioner(s), and the Web. Methods We utilized a distributed, Semantic Web-based architecture for recognizing personally dangerous drugs consisting of: (1) a private, local triple store of personal health information, (2) Semantic Web services, following the Semantic Automated Discovery and Integration (SADI) design pattern, for text mining and identifying substance interactions, (3) a bookmarklet to trigger analysis of a webpage and annotate it with personalized warnings, and (4) a semantic query that acts as an abstract template of the analytical workflow to be enacted by the system. Results A prototype implementation of the system is provided in the form of a Java standalone executable JAR file. The JAR file bundles all components of the system: the personal health database, locally-running versions of the SADI services, and a javascript bookmarklet that triggers analysis of a webpage. In addition, the demonstration includes a hypothetical personal health profile, allowing the system to be used immediately without configuration. Usage instructions are provided. Conclusions The main strength of the Personal Health Lens system is its ability to organize medical information and to present it to the user in a personalized and contextually relevant manner. While this

Assessment of primary care services and perceived barriers to care in persons with disabilities.

PubMed

Harrington, Amanda L; Hirsch, Mark A; Hammond, Flora M; Norton, H James; Bockenek, William L

2009-10-01

To determine what percentage of persons with disabilities have a primary care provider, participate in routine screening and health maintenance examinations, and identify perceived physical or physician barriers to receiving care. A total of 344 surveys, consisting of 66 questions, were collected from adults with disabilities receiving care at an outpatient rehabilitation clinic. A total of 89.5% (95% CI 86.3%-92.8%) of participants reported having a primary care physician. Younger persons (P < 0.0001), men (P < 0.02), persons with brain injury (P < 0.05), or persons with amputations (P < 0.05) were less likely to have a primary care physician. Participant report of screening for alcohol, nonprescription drug use, and safety with relationships at home ranged from 26.6% to 37.5% compared with screening for depression, diet, exercise, and smoking (64.5%-70%). Completion rates of age- and gender-appropriate health maintenance examinations ranged from 42.4% to 90%. A total of 2.67% of participants reported problems with physical access at their physician's office, and 36.4% (95% CI 30.8%-42.1%) of participants reported having to teach their primary care physician about their disability. Most persons with disabilities have a primary care physician. In general, completion rates for routine screening and health maintenance examinations were high. Perceived deficits in primary care physicians' knowledge of disability issues seem more prevalent than physical barriers to care.

75 FR 62684 - Health Insurance Reform; Announcement of Maintenance Changes to Electronic Data Transaction...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-13

... 0938-AM50 Health Insurance Reform; Announcement of Maintenance Changes to Electronic Data Transaction Standards Adopted Under the Health Insurance Portability and Accountability Act of 1996 AGENCY: Office of... of the Health Insurance Portability and Accountability Act of 1996 standards made by the Designated...

Building the national health information infrastructure for personal health, health care services, public health, and research

PubMed Central

Detmer, Don E

2003-01-01

Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII) offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries). The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security) framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin PMID:12525262

Auditory and Visual Cues for Topic Maintenance with Persons Who Exhibit Dementia of Alzheimer's Type.

PubMed

Teten, Amy F; Dagenais, Paul A; Friehe, Mary J

2015-01-01

This study compared the effectiveness of auditory and visual redirections in facilitating topic coherence for persons with Dementia of Alzheimer's Type (DAT). Five persons with moderate stage DAT engaged in conversation with the first author. Three topics related to activities of daily living, recreational activities, food, and grooming, were broached. Each topic was presented three times to each participant: once as a baseline condition, once with auditory redirection to topic, and once with visual redirection to topic. Transcripts of the interactions were scored for overall coherence. Condition was a significant factor in that the DAT participants exhibited better topic maintenance under visual and auditory conditions as opposed to baseline. In general, the performance of the participants was not affected by the topic, except for significantly higher overall coherence ratings for the visually redirected interactions dealing with the topic of food.

Auditory and Visual Cues for Topic Maintenance with Persons Who Exhibit Dementia of Alzheimer's Type

PubMed Central

Teten, Amy F.; Dagenais, Paul A.; Friehe, Mary J.

2015-01-01

This study compared the effectiveness of auditory and visual redirections in facilitating topic coherence for persons with Dementia of Alzheimer's Type (DAT). Five persons with moderate stage DAT engaged in conversation with the first author. Three topics related to activities of daily living, recreational activities, food, and grooming, were broached. Each topic was presented three times to each participant: once as a baseline condition, once with auditory redirection to topic, and once with visual redirection to topic. Transcripts of the interactions were scored for overall coherence. Condition was a significant factor in that the DAT participants exhibited better topic maintenance under visual and auditory conditions as opposed to baseline. In general, the performance of the participants was not affected by the topic, except for significantly higher overall coherence ratings for the visually redirected interactions dealing with the topic of food. PMID:26171273

Integrated Systems Health Management as an Enabler for Condition Based Maintenance and Autonomic Logistics

DTIC Science & Technology

2015-09-17

turbines , SHM tools, maintenance scheduling, and performance of the SHM system determine the added value of the system of systems (A. Van Horenbeek...J. R., & Pintelon, L. (2013). Quantifying the added value of an imperfectly performing condition monitoring system— Application to a wind turbine ...INTEGRATED SYSTEMS HEALTH MANAGEMENT AS AN ENABLER FOR CONDITION BASED MAINTENANCE AND AUTONOMIC

Associations of health literacy with dialysis adherence and health resource utilization in patients receiving maintenance hemodialysis.

PubMed

Green, Jamie A; Mor, Maria K; Shields, Anne Marie; Sevick, Mary Ann; Arnold, Robert M; Palevsky, Paul M; Fine, Michael J; Weisbord, Steven D

2013-07-01

Although limited health literacy is common in hemodialysis patients, its effects on clinical outcomes are not well understood. Observational study. 260 maintenance hemodialysis patients enrolled in a randomized clinical trial of symptom management strategies from January 2009 through April 2011. Limited health literacy. Dialysis adherence (missed and abbreviated treatments) and health resource utilization (emergency department visits and end-stage renal disease [ESRD]-related hospitalizations). We assessed health literacy using the Rapid Estimate of Adult Literacy in Medicine (REALM) and used negative binomial regression to analyze the independent associations of limited health literacy with dialysis adherence and health resource utilization over 12-24 months. 41 of 260 (16%) patients showed limited health literacy (REALM score, ≤60). There were 1,152 missed treatments, 5,127 abbreviated treatments, 552 emergency department visits, and 463 ESRD-related hospitalizations. Limited health literacy was associated independently with an increased incidence of missed dialysis treatments (missed, 0.6% vs 0.3%; adjusted incidence rate ratio [IRR], 2.14; 95% CI, 1.10-4.17), emergency department visits (annual visits, 1.7 vs 1.0; adjusted IRR, 1.37; 95% CI, 1.01-1.86), and hospitalizations related to ESRD (annual hospitalizations, 0.9 vs 0.5; adjusted IRR, 1.55; 95% CI, 1.03-2.34). Generalizability and potential for residual confounding. Patients receiving maintenance hemodialysis who have limited health literacy are more likely to miss dialysis treatments, use emergency care, and be hospitalized related to their kidney disease. These findings have important clinical practice and cost implications. Copyright © 2013 National Kidney Foundation, Inc. All rights reserved.

[Clinical and health economic challenges of personalized medicine].

PubMed

Brüggenjürgen, B; Kornbluth, L; Ferrara, J V; Willich, S N

2012-05-01

Healthcare systems across the globe are currently challenged by aging populations, increases in chronic diseases and the difficult task of managing a healthcare budget. In this health economic climate, personalized medicine promises not only an improvement in healthcare delivery but also the possibility of more cost-effective therapies. It is important to remember, however, that personalized medicine has the potential to both increase and decrease costs. Each targeted therapy must be evaluated individually. However, standard clinical trial design is not suitable for personalized therapies. Therefore, both scientists and regulatory authorities will need to accept innovative study designs in order to validate personalized therapies. Hence correct economic evaluations are difficult to carry out due to lack of clear clinical evidence, longitudinal accounting and experience with patient/clinician behavior in the context of personalized medicine. In terms of reimbursement, payers, pharmaceutical companies and companion diagnostic manufacturers will also need to explore creative risk-sharing concepts. Germany is no exception to the challenges that face personalized medicine and for personalized medicine to really become the future of medicine many health economic challenges first need to be overcome. The health economic implications of personalized medicine remain unclear but it is certain that the expansion of targeted therapies in current healthcare systems will create a host of challenges.

Summary of Existing Legislation Affecting Persons with Disabilities.

ERIC Educational Resources Information Center

Office of Special Education and Rehabilitation Services (ED), Washington, DC. Clearinghouse on the Handicapped.

Summaries are presented of more than 60 key federal laws pertaining to the legal rights and benefits available to persons with disabilities. The laws are organized into general subject areas, including: education, employment, health, housing, income maintenance, nutrition, rights, social services, transportation, and vocational rehabilitation. The…

Michigan Health Care Costs Review. Personal Health Care Expenditures, 1966-1981. Number 1.

ERIC Educational Resources Information Center

Michigan State Office of Health and Medical Affairs, Lansing.

Data are presented describing expenditures for personal health services in Michigan from 1977 to 1981. The rapid growth in expenditures is illustrated, as well as the rates of growth in expenditures, for major categories of health services. Personal health expenditures are defined as payments for care directly provided to patients: specifically,…

What explains health in persons with visual impairment?

PubMed Central

2014-01-01

Background Visual impairment is associated with important limitations in functioning. The International Classification of Functioning, Disability and Health (ICF) adopted by the World Health Organisation (WHO) relies on a globally accepted framework for classifying problems in functioning and the influence of contextual factors. Its comprehensive perspective, including biological, individual and social aspects of health, enables the ICF to describe the whole health experience of persons with visual impairment. The objectives of this study are (1) to analyze whether the ICF can be used to comprehensively describe the problems in functioning of persons with visual impairment and the environmental factors that influence their lives and (2) to select the ICF categories that best capture self-perceived health of persons with visual impairment. Methods Data from 105 persons with visual impairment were collected, including socio-demographic data, vision-related data, the Extended ICF Checklist and the visual analogue scale of the EuroQoL-5D, to assess self-perceived health. Descriptive statistics and a Group Lasso regression were performed. The main outcome measures were functioning defined as impairments in Body functions and Body structures, limitations in Activities and restrictions in Participation, influencing Environmental factors and self-perceived health. Results In total, 120 ICF categories covering a broad range of Body functions, Body structures, aspects of Activities and Participation and Environmental factors were identified. Thirteen ICF categories that best capture self-perceived health were selected based on the Group Lasso regression. While Activities-and-Participation categories were selected most frequently, the greatest impact on self-perceived health was found in Body-functions categories. The ICF can be used as a framework to comprehensively describe the problems of persons with visual impairment and the Environmental factors which influence their

Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine

PubMed Central

Chapman, Benjamin P.; Roberts, Brent; Duberstein, Paul

2011-01-01

We review evidence for links between personality traits and longevity. We provide an overview of personality for health scientists, using the primary organizing framework used in the study of personality and longevity. We then review data on various aspects of personality linked to longevity. In general, there is good evidence that higher level of conscientiousness and lower levels of hostility and Type D or “distressed” personality are associated with greater longevity. Limited evidence suggests that extraversion, openness, perceived control, and low levels of emotional suppression may be associated with longer lifespan. Findings regarding neuroticism are mixed, supporting the notion that many component(s) of neuroticism detract from life expectancy, but some components at some levels may be healthy or protective. Overall, evidence suggests various personality traits are significant predictors of longevity and points to several promising directions for further study. We conclude by discussing the implications of these links for epidemiologic research and personalized medicine and lay out a translational research agenda for integrating the psychology of individual differences into public health and medicine. PMID:21766032

Determining the state-of-health of maintenance-free aircraft batteries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vutetakis, D.G.; Viswanathan, V.V.

1995-07-01

This paper presents an overview of methods to determine the state-of-health of maintenance-free aircraft batteries. The various failure modes of aircraft batteries are discussed, along with methods of detecting failed batteries. Specific examples of detection methods are presented for the F-16, F-18, AV-8B, B-1B, and B-52 aircraft batteries.

Exploring the Role of In-Person Components for Online Health Behavior Change Interventions: Can a Digital Person-to-Person Component Suffice?

PubMed Central

Kane, Deborah; Senn, Charlene Y; Woodruff, Sarah J

2018-01-01

The growth of the digital environment provides tremendous opportunities to revolutionize health behavior change efforts. This paper explores the use of Web-based, mobile, and social media health behavior change interventions and determines whether there is a need for a face-to-face or an in-person component. It is further argued that that although in-person components can be beneficial for online interventions, a digital person-to-person component can foster similar results while dealing with challenges faced by traditional intervention approaches. Using a digital person-to-person component is rooted in social and behavioral theories such as the theory of reasoned action, and the social cognitive theory, and further justified by the human support constructs of the model of supportive accountability. Overall, face-to-face and online behavior change interventions have their respective advantages and disadvantages and functions, yet both serve important roles. It appears that it is in fact human support that is the most important component in the effectiveness and adherence of both face-to-face and online behavior change interventions, and thoughtfully introducing a digital person-to-person component, to replace face-to-face interactions, can provide the needed human support while diminishing the barriers of in-person meetings. The digital person-to-person component must create accountability, generate opportunities for tailored feedback, and create social support to successfully create health behavior change. As the popularity of the online world grows, and the interest in using the digital environment for health behavior change interventions continues to be embraced, further research into not only the use of online interventions, but the use of a digital person-to-person component, must be explored. PMID:29643048

Personality traits predict perceived health-related quality of life in persons with multiple sclerosis.

PubMed

Zarbo, Ignazio Roberto; Minacapelli, Eleonora; Falautano, Monica; Demontis, Silvia; Carpentras, Giovanni; Pugliatti, Maura

2016-04-01

Personality traits can affect health-related quality of life (HRQoL) in different disorders. In multiple sclerosis (MS), personality traits can determine patients' willingness to take on more risky treatment options, predispose to neuropsychiatric symptoms and affect coping strategies. We investigated the role of personality traits as possible predictors of HRQoL in a large cohort of persons with MS (PwMS). In total, 253 consecutively recruited PwMS were screened for intellectual deficits with Raven Colour Progressive Matrices (RCPM), state anxiety with STAI-X1 and major depression on a clinical basis. PwMS' self-perceived mental and physical health status was measured with the 36-Item Short Form Health Survey (SF-36), and the personality profile with the Eysenck Personality Questionnaire (EPQ-R). The correlation between HRQoL and personality traits was investigated by means of analysis of variance, adjusting for possible confounders. Of the 253 MS patients, 195 (F:M=2.75), aged 41.7±10.2 years were included in the analysis. The variance of SF-36 mental and physical composite score was largely explained by extraversion and neuroticism. Our data confirm that PwMS' HRQoL is largely influenced by personality traits, which may therefore act as predictors of perceived quality of life and should be included in clinical and experimental settings focusing on HRQoL. © The Author(s), 2015.

Health maintenance organizations; amendments of 1981--Health Resources and Services Administration. Notice of proposed rulemaking.

PubMed

1983-03-22

This notice proposes to amend the Public Health Service rules on health maintenance organizations (HMOs) to conform with the 1981 amendments to the HMO statute regarding member protection in the event of insolvency, community rating by class, and primary care within the service area of a non-metropolitan HMO. In addition, this notice proposes: (a) to remove provisions of the rules that are considered unnecessary or burdensome, such as the regulatory specification of contractual provisions, and (b) to increase one of the regulatory limits on copayments to permit HMOs to become more competitive with alternative forms of health insurance.

A natural product telomerase activator as part of a health maintenance program: metabolic and cardiovascular response.

PubMed

Harley, Calvin B; Liu, Weimin; Flom, Peter L; Raffaele, Joseph M

2013-10-01

A short average telomere length is associated with low telomerase activity and certain degenerative diseases. Studies in animals and with human cells confirm a causal mechanism for cell or tissue dysfunction triggered by critically short telomeres, suggesting that telomerase activation may be an approach to health maintenance. Previously, we reported on positive immune remodeling in humans taking a commercial health maintenance program, PattonProtocol-1, composed of TA-65® (a natural product-derived telomerase activator) and other dietary supplements. In over a 5-year period and an estimated 7000 person-years of use, no adverse events or effects have been attributed to TA-65 by physicians licensed to sell the product. Here we report on changes in metabolic markers measured at baseline (n=97-107 subjects) and every 3-6 months (n=27-59 subjects) during the first 12 months of study. Rates of change per year from baseline determined by a multi-level model were -3.72 mg/dL for fasting glucose (p=0.02), -1.32 mIU/mL for insulin (p=0.01), -13.2 and -11.8 mg/dL for total cholesterol and low-density lipoprotein cholesterol (LDL-C) (p=0.002, p=0.002, respectively), -17.3 and -4.2 mmHg for systolic and diastolic blood pressure (p=0.007 and 0.001, respectively), and -3.6 μmole/L homocysteine (p=0.001). In a subset of individuals with bone mineral density (BMD) measured at baseline and 12 months, density increased 2.0% in the spine (p=0.003). We conclude that in addition to apparent positive immune remodeling, PattonProtocol-1 may improve markers of metabolic, bone, and cardiovascular health.

A Scalable Framework to Detect Personal Health Mentions on Twitter.

PubMed

Yin, Zhijun; Fabbri, Daniel; Rosenbloom, S Trent; Malin, Bradley

2015-06-05

Biomedical research has traditionally been conducted via surveys and the analysis of medical records. However, these resources are limited in their content, such that non-traditional domains (eg, online forums and social media) have an opportunity to supplement the view of an individual's health. The objective of this study was to develop a scalable framework to detect personal health status mentions on Twitter and assess the extent to which such information is disclosed. We collected more than 250 million tweets via the Twitter streaming API over a 2-month period in 2014. The corpus was filtered down to approximately 250,000 tweets, stratified across 34 high-impact health issues, based on guidance from the Medical Expenditure Panel Survey. We created a labeled corpus of several thousand tweets via a survey, administered over Amazon Mechanical Turk, that documents when terms correspond to mentions of personal health issues or an alternative (eg, a metaphor). We engineered a scalable classifier for personal health mentions via feature selection and assessed its potential over the health issues. We further investigated the utility of the tweets by determining the extent to which Twitter users disclose personal health status. Our investigation yielded several notable findings. First, we find that tweets from a small subset of the health issues can train a scalable classifier to detect health mentions. Specifically, training on 2000 tweets from four health issues (cancer, depression, hypertension, and leukemia) yielded a classifier with precision of 0.77 on all 34 health issues. Second, Twitter users disclosed personal health status for all health issues. Notably, personal health status was disclosed over 50% of the time for 11 out of 34 (33%) investigated health issues. Third, the disclosure rate was dependent on the health issue in a statistically significant manner (P<.001). For instance, more than 80% of the tweets about migraines (83/100) and allergies (85

Choosing health: qualitative evidence from the experiences of personal health budget holders.

PubMed

Davidson, Jacqueline; Baxter, Kate; Glendinning, Caroline; Irvine, Annie

2013-10-01

Personal health budgets were piloted in the English National Health Service between 2009 and 2012. Semi-structured interviews with a sub-sample of early budget holders aimed to explore their experiences of receiving and using a budget. Over 2000 people from 20 pilot sites were recruited to a multi-method evaluation of the personal health budget pilots. A sub-sample of 58 people was selected for qualitative interviews three months after the offer of a budget; 52 were re-interviewed six months later. The purposively selected sample reflected a range of health conditions, locality, age and gender. Personal health budgets were reported to have positive impacts on health, health care and relatives/family. Benefits often extended beyond the condition for which the budget had been awarded. However, interviewees rarely knew the level of their budget; some reported difficulty in agreeing acceptable uses for their budget; and delays could occur in procuring chosen services or equipment. Patients' experiences offer valuable insights for the roll-out of personal health budgets beyond the pilot phase. Flexibility in how budgets are used may allow maximum benefits to be derived. Clear information about what budgets can and cannot be used for, with suggestions offered, will be useful. People with newly diagnosed or recent sudden onset conditions may need more help to plan their support, but all budget holders are likely to benefit from regular contact with staff for reassurance and continued motivation.

Social health maintenance organizations' service use and costs, 1985-89

PubMed Central

Harrington, Charlene; Newcomer, Robert J.

1991-01-01

Presented in this article are aggregate utilization and financial data from the four social health maintenance organization (SIHMO) demonstrations that were collected and analyzed as a part of the national evaluation of the SIHMO demonstration project conducted for the Health Care Financing Administration. The S/HMOs, in offering a $6,500 to $12,000 chronic care benefit in addition to the basic HMO benefit package, had higher startup costs and financial losses over the first 5 years than expected, and controlling costs continues to be a challenge to the sites and their sponsors. PMID:10113612

A Novel Conceptual Architecture for Person-Centered Health Records.

PubMed

Schleyer, Titus; King, Zachary; Miled, Zina Ben

2016-01-01

Personal health records available to patients today suffer from multiple limitations, such as information fragmentation, a one-size-fits-all approach and a focus on data gathered over time and by institution rather than health conditions. This makes it difficult for patients to effectively manage their health, for these data to be enriched with relevant information from external sources and for clinicians to support them in that endeavor. We propose a novel conceptual architecture for person-centered health record information systems that transcends many of these limitations and capitalizes on the emerging trend of socially-driven information systems. Our proposed personal health record system is personalized on demand to the conditions of each individual patient; organized to facilitate the tracking and review of the patient's conditions; and able to support patient-community interactions, thereby promoting community engagement in scientific studies, facilitating preventive medicine, and accelerating the translation of research findings.

Debating personal health budgets

PubMed Central

Alakeson, Vidhya; Boardman, Jed; Boland, Billy; Crimlisk, Helen; Harrison, Charlotte; Iliffe, Steve; Khan, Masood; O'Shea, Rory; Patterson, Janet

2016-01-01

Personal health budgets (PHBs) were piloted in the National Health Service (NHS) in England between 2009 and 2012 and were found to have greater positive effects on quality of life and psychological well-being for those with mental health problems than commissioned service, as well as reducing their use of unplanned care. The government intends to extend PHBs in England for long-term conditions, including mental health, from April 2015. Given the importance of engaging clinicians in the next phase of PHB development, we provide an overview of the approach, synthesise the evidence from the national pilot and debate some of the opportunities and challenges. Balancing individual choice and recovery with concerns for risk, equity and the sustainability of existing community services is the central tension underpinning this innovation in mental health service delivery. PMID:26958358

Review of Extracting Information From the Social Web for Health Personalization

PubMed Central

Karlsen, Randi; Bonander, Jason

2011-01-01

In recent years the Web has come into its own as a social platform where health consumers are actively creating and consuming Web content. Moreover, as the Web matures, consumers are gaining access to personalized applications adapted to their health needs and interests. The creation of personalized Web applications relies on extracted information about the users and the content to personalize. The Social Web itself provides many sources of information that can be used to extract information for personalization apart from traditional Web forms and questionnaires. This paper provides a review of different approaches for extracting information from the Social Web for health personalization. We reviewed research literature across different fields addressing the disclosure of health information in the Social Web, techniques to extract that information, and examples of personalized health applications. In addition, the paper includes a discussion of technical and socioethical challenges related to the extraction of information for health personalization. PMID:21278049

Predictors affecting personal health information management skills.

PubMed

Kim, Sujin; Abner, Erin

2016-01-01

This study investigated major factors affecting personal health records (PHRs) management skills associated with survey respondents' health information management related activities. A self-report survey was used to assess individuals' personal characteristics, health knowledge, PHR skills, and activities. Factors underlying respondents' current PHR-related activities were derived using principal component analysis (PCA). Scale scores were calculated based on the results of the PCA, and hierarchical linear regression analyses were used to identify respondent characteristics associated with the scale scores. Internal consistency of the derived scale scores was assessed with Cronbach's α. Among personal health information activities surveyed (N = 578 respondents), the four extracted factors were subsequently grouped and labeled as: collecting skills (Cronbach's α = 0.906), searching skills (Cronbach's α = 0.837), sharing skills (Cronbach's α = 0.763), and implementing skills (Cronbach's α = 0.908). In the hierarchical regression analyses, education and computer knowledge significantly increased the explanatory power of the models. Health knowledge (β = 0.25, p < 0.001) emerged as a positive predictor of PHR collecting skills. This study confirmed that PHR training and learning should consider a full spectrum of information management skills including collection, utilization and distribution to support patients' care and prevention continua.

Exploring the Role of In-Person Components for Online Health Behavior Change Interventions: Can a Digital Person-to-Person Component Suffice?

PubMed

Santarossa, Sara; Kane, Deborah; Senn, Charlene Y; Woodruff, Sarah J

2018-04-11

The growth of the digital environment provides tremendous opportunities to revolutionize health behavior change efforts. This paper explores the use of Web-based, mobile, and social media health behavior change interventions and determines whether there is a need for a face-to-face or an in-person component. It is further argued that that although in-person components can be beneficial for online interventions, a digital person-to-person component can foster similar results while dealing with challenges faced by traditional intervention approaches. Using a digital person-to-person component is rooted in social and behavioral theories such as the theory of reasoned action, and the social cognitive theory, and further justified by the human support constructs of the model of supportive accountability. Overall, face-to-face and online behavior change interventions have their respective advantages and disadvantages and functions, yet both serve important roles. It appears that it is in fact human support that is the most important component in the effectiveness and adherence of both face-to-face and online behavior change interventions, and thoughtfully introducing a digital person-to-person component, to replace face-to-face interactions, can provide the needed human support while diminishing the barriers of in-person meetings. The digital person-to-person component must create accountability, generate opportunities for tailored feedback, and create social support to successfully create health behavior change. As the popularity of the online world grows, and the interest in using the digital environment for health behavior change interventions continues to be embraced, further research into not only the use of online interventions, but the use of a digital person-to-person component, must be explored. ©Sara Santarossa, Deborah Kane, Charlene Y Senn, Sarah J Woodruff. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 11.04.2018.

21 CFR 1250.35 - Health of persons handling food.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Health of persons handling food. 1250.35 Section 1250.35 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... SANITATION Food Service Sanitation on Land and Air Conveyances, and Vessels § 1250.35 Health of persons...

21 CFR 1250.35 - Health of persons handling food.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Health of persons handling food. 1250.35 Section 1250.35 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... SANITATION Food Service Sanitation on Land and Air Conveyances, and Vessels § 1250.35 Health of persons...

21 CFR 1250.35 - Health of persons handling food.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Health of persons handling food. 1250.35 Section 1250.35 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... SANITATION Food Service Sanitation on Land and Air Conveyances, and Vessels § 1250.35 Health of persons...

Electronic Personal Health Record Use Among Nurses in the Nursing Informatics Community.

PubMed

Gartrell, Kyungsook; Trinkoff, Alison M; Storr, Carla L; Wilson, Marisa L

2015-07-01

An electronic personal health record is a patient-centric tool that enables patients to securely access, manage, and share their health information with healthcare providers. It is presumed the nursing informatics community would be early adopters of electronic personal health record, yet no studies have been identified that examine the personal adoption of electronic personal health record's for their own healthcare. For this study, we sampled nurse members of the American Medical Informatics Association and the Healthcare Information and Management Systems Society with 183 responding. Multiple logistic regression analysis was used to identify those factors associated with electronic personal health record use. Overall, 72% were electronic personal health record users. Users tended to be older (aged >50 years), be more highly educated (72% master's or doctoral degrees), and hold positions as clinical informatics specialists or chief nursing informatics officers. Those whose healthcare providers used electronic health records were significantly more likely to use electronic personal health records (odds ratio, 5.99; 95% confidence interval, 1.40-25.61). Electronic personal health record users were significantly less concerned about privacy of health information online than nonusers (odds ratio, 0.32; 95% confidence interval, 0.14-0.70) adjusted for ethnicity, race, and practice region. Informatics nurses, with their patient-centered view of technology, are in prime position to influence development of electronic personal health records. Our findings can inform policy efforts to encourage informatics and other professional nursing groups to become leaders and users of electronic personal health record; such use could help them endorse and engage patients to use electronic personal health records. Having champions with expertise in and enthusiasm for the new technology can promote the adoptionof electronic personal health records among healthcare providers as well as

Personal health record systems and their security protection.

PubMed

Win, Khin Than; Susilo, Willy; Mu, Yi

2006-08-01

The objective of this study is to analyze the security protection of personal health record systems. To achieve this we have investigated different personal health record systems, their security functions, and security issues. We have noted that current security mechanisms are not adequate and we have proposed some security mechanisms to tackle these problems.

Requirements and Solutions for Personalized Health Systems.

PubMed

Blobel, Bernd; Ruotsalainen, Pekka; Lopez, Diego M; Oemig, Frank

2017-01-01

Organizational, methodological and technological paradigm changes enable a precise, personalized, predictive, preventive and participative approach to health and social services supported by multiple actors from different domains at diverse level of knowledge and skills. Interoperability has to advance beyond Information and Communication Technologies (ICT) concerns, including the real world business domains and their processes, but also the individual context of all actors involved. The paper introduces and compares personalized health definitions, summarizes requirements and principles for pHealth systems, and considers intelligent interoperability. It addresses knowledge representation and harmonization, decision intelligence, and usability as crucial issues in pHealth. On this basis, a system-theoretical, ontology-based, policy-driven reference architecture model for open and intelligent pHealth ecosystems and its transformation into an appropriate ICT design and implementation is proposed.

A guiding tool in Unani Tibb for maintenance and preservation of health: a review study.

PubMed

Jabin, Farkhunda

2011-01-01

Unani Tibb is a holistic traditional system of medicine. Ever since 1976, WHO has adopted its policy of promoting traditional medicine, Unani Medicine has enjoyed an upsurge of interest, especially in India, where it has been practiced as one of the Indian systems of medicine. Ali et al (2007) opined that "in Tibb, 'temperament' is a notion of primary importance, though a difficult theory as it indicates the properties of an atom, a molecule, a cell, a tissue, an organ and human body as a whole". Temperament of a person represents its physical constitution and tendencies. It is believed in Tibb that imbalance in temperament predisposes human body to various diseases by producing a biotic imbalance with in body. Causes of initial imbalance in temperament lies in more subtle elements of life like air, water, food, rest, activity, work, evacuation of wastes, sleep etc. To quote Bhika (2006a) "health can be preserved and maintained as long as overall quality of humours is in harmony with overall quality of the temperament of the individual and humoural balance is influenced by lifestyle factors." Hence temperament acts as a guiding force for maintenance and preservation of individuals' health.

A Personalized Health Information Retrieval System

PubMed Central

Wang, Yunli; Liu, Zhenkai

2005-01-01

Consumers face barriers when seeking health information on the Internet. A Personalized Health Information Retrieval System (PHIRS) is proposed to recommend health information for consumers. The system consists of four modules: (1) User modeling module captures user’s preference and health interests; (2) Automatic quality filtering module identifies high quality health information; (3) Automatic text difficulty rating module classifies health information into professional or patient educational materials; and (4) User profile matching module tailors health information for individuals. The initial results show that PHIRS could assist consumers with simple search strategies. PMID:16779435

Personality is of central concern to understand health: towards a theoretical model for health psychology

PubMed Central

Ferguson, Eamonn

2013-01-01

This paper sets out the case that personality traits are central to health psychology. To achieve this, three aims need to be addressed. First, it is necessary to show that personality influences a broad range of health outcomes and mechanisms. Second, the simple descriptive account of Aim 1 is not sufficient, and a theoretical specification needs to be developed to explain the personality-health link and allow for future hypothesis generation. Third, once Aims 1 and 2 are met, it is necessary to demonstrate the clinical utility of personality. In this review I make the case that all three Aims are met. I develop a theoretical framework to understand the links between personality and health drawing on current theorising in the biology, evolution, and neuroscience of personality. I identify traits (i.e., alexithymia, Type D, hypochondriasis, and empathy) that are of particular concern to health psychology and set these within evolutionary cost-benefit analysis. The literature is reviewed within a three-level hierarchical model (individual, group, and organisational) and it is argued that health psychology needs to move from its traditional focus on the individual level to engage group and organisational levels. PMID:23772230

Person-centered osteopathic practice: patients' personality (body, mind, and soul) and health (ill-being and well-being).

PubMed

Fahlgren, Elin; Nima, Ali A; Archer, Trevor; Garcia, Danilo

2015-01-01

Background. Osteopathic philosophy and practice are congruent with the biopsychosocial model, a patient-centered approach when treating disease, and the view of the person as a unity (i.e., body, mind, and soul). Nevertheless, a unity of being should involve a systematic person-centered understanding of the patient's personality as a biopsychosociospiritual construct that influences health (i.e., well-being and ill-being). We suggest Cloninger's personality model, comprising temperament (i.e., body) and character (i.e., mind and soul), as a genuine paradigm for implementation in osteopathic practice. As a first step, we investigated (1) the relationships between personality and health among osteopathic patients, (2) differences in personality between patients and a control group, and (3) differences in health within patients depending on the presenting problem and gender. Method. 524 osteopathic patients in Sweden (age mean = 46.17, SD = 12.54, 388 females and 136 males) responded to an online survey comprising the Temperament and Character Inventory and measures of health (well-being: life satisfaction, positive affect, harmony in life, energy, and resilience; ill-being: negative affect, anxiety, depression, stress, and dysfunction and suffering associated to the presenting problem). We conducted two structural equation models to investigate the association personality-health; graphically compared the patients' personality T-scores to those of the control group and compared the mean raw scores using t-tests; and conducted two multivariate analyses of variance, using age as covariate, to compare patients' health in relation to their presenting problem and gender. Results. The patients' personality explained the variance of all of the well-being (R (2) between .19 and .54) and four of the ill-being (R (2) between .05 and .43) measures. Importantly, self-transcendence, the spiritual aspect of personality, was associated to high levels of positive emotions and

Acceptability of financial incentives for maintenance of weight loss in mid-older adults: a mixed methods study.

PubMed

McGill, Bronwyn; O'Hara, Blythe J; Grunseit, Anne C; Bauman, Adrian; Osborne, Dale; Lawler, Luke; Phongsavan, Philayrath

2018-02-13

Health insurers worldwide implement financial incentive schemes to encourage health-related behaviours, including to facilitate weight loss. The maintenance of weight loss is a public health challenge, and as non-communicable diseases become more prevalent with increasing age, mid-older adults could benefit from programs which motivate weight loss maintenance. However, little is understood about their perceptions of using financial incentives to maintain weight loss. We used mixed methods to explore the attitudes and views of participants who had completed an Australian weight loss and lifestyle modification program offered to overweight and obese health insurance members with weight-related chronic diseases, about the acceptability and usefulness of different types of financial incentives to support weight loss maintenance. An online survey was completed by 130 respondents (mean age = 64 years); and a further 28 participants (mean age = 65 years) attended six focus groups. Both independent samples of participants supported a formalised maintenance program. Online survey respondents reported that non-cash (85.2%) and cash (77%) incentives would be potentially motivating; but only 40.5% reported that deposit contracts would motivate weight loss maintenance. Results of in-depth discussions found overall low support for any type of financial incentive, but particularly deposit contracts and lotteries. Some participants expressed that improved health was of more value than a monetary incentive and that they felt personally responsible for their own health, which was at odds with the idea of financial incentives. Others suggested ongoing program and peer support as potentially useful for weight loss maintenance. If financial incentives are considered for mid-older Australian adults in the health insurance setting, program planners will need to balance the discordance between participant beliefs about the individual responsibility for health and their desire

Laboratory equipment maintenance: a critical bottleneck for strengthening health systems in sub-Saharan Africa?

PubMed

Fonjungo, Peter N; Kebede, Yenew; Messele, Tsehaynesh; Ayana, Gonfa; Tibesso, Gudeta; Abebe, Almaz; Nkengasong, John N; Kenyon, Thomas

2012-02-01

Properly functioning laboratory equipment is a critical component for strengthening health systems in developing countries. The laboratory can be an entry point to improve population health and care of individuals for targeted diseases - prevention, care, and treatment of TB, HIV/AIDS, and malaria, plus maternal and neonatal health - as well as those lacking specific attention and funding. We review the benefits and persistent challenges associated with sustaining laboratory equipment maintenance. We propose equipment management policies as well as a comprehensive equipment maintenance strategy that would involve equipment manufacturers and strengthen local capacity through pre-service training of biomedical engineers. Strong country leadership and commitment are needed to assure development and sustained implementation of policies and strategies for standardization of equipment, and regulation of its procurement, donation, disposal, and replacement.

'Your experiences were your tools'. How personal experience of mental health problems informs mental health nursing practice.

PubMed

Oates, J; Drey, N; Jones, J

2017-09-01

WHAT IS KNOWN ON THE SUBJECT?: 'Expertise by experience' has become an increasingly valued element of service design and delivery by mental health service providers. The extent and influence of mental health professionals' personal experience of mental ill health on clinical practice has seldom been interrogated in depth. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: We investigate how mental health nurses' own personal experience of mental ill health informs their mental health nursing practice with particular reference to direct work with service users. Participants said that personal experience could impact on work in three positive ways: to develop their relationship with service users, to enhance their understanding of service users and as a motivation for potential mental health nurses to join the profession. This study moves the discussion of the state of mental health nurses' mental health further towards the recovery and well-being focus of contemporary mental health care, where 'expertise by experience' is highly valued. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: We must address the taboo of disclosure within clinical nursing practice and debate the extent to which personal and professional boundaries are negotiated during clinical encounters. Introduction 'Expertise by experience' is a highly valued element of service delivery in recovery-oriented mental health care, but is unacknowledged within the mental health nursing literature. Aim To explore the extent and influence of mental health professionals' personal experience of mental ill health on clinical practice. Method Twenty-seven mental health nurses with their own personal experience of mental ill health were interviewed about how their personal experience informed their mental health nursing practice, as part of a sequential mixed methods study. Results The influence of personal experience in nursing work was threefold: first, through overt disclosure; second, through the 'use of the self as a tool

PERSONAL HEALTH BUDGETS IN ENGLAND: MOOD MUSIC OR DEATH KNELL FOR THE NATIONAL HEALTH SERVICE?

PubMed

Scott-Samuel, Alex

2015-01-01

Personal health budgets in England are National Health Service (NHS) funds that can be allocated to certain groups of patients to allow them, together with their NHS support staff, to purchase services or equipment that they believe will enhance their health and well-being. Some see this as a welcome personalization of health care that increases people's control over their health. However, personal health budgets are being introduced at a time when rapid privatization of the English NHS is taking place and when restrictions are being placed on people's access to health care. As a result, many view their introduction as a diversionary gimmick designed to help pave the way for the conversion of the NHS into the insurance-based system, which many believe is the intention of the U.K. government. This article describes the research and policy context in which this controversial intervention is being introduced and presents recent expert debate between proponents and opponents of personal health budgets, from e-mail discussion lists.

Health risk perception, optimistic bias, and personal satisfaction.

PubMed

Bränström, Richard; Brandberg, Yvonne

2010-01-01

To examine change in risk perception and optimistic bias concerning behavior-linked health threats and environmental health threats between adolescence and young adulthood and how these factors related to personal satisfaction. In 1996 and 2002, 1624 adolescents responded to a mailed questionnaire. Adolescents showed strong positive optimistic bias concerning behaviorlinked risks, and this optimistic bias increased with age. Increase in optimistic bias over time predicted increase in personal satisfaction. The capacity to process and perceive potential threats in a positive manner might be a valuable human ability positively influencing personal satisfaction and well-being.

Big Five personality and health in adults with and without cancer.

PubMed

Rochefort, Catherine; Hoerger, Michael; Turiano, Nicholas A; Duberstein, Paul

2018-01-01

Personality is associated with health, but examinations in patients with illnesses are lacking. We aimed to determine whether personality-physical health associations differed between community and cancer samples. This cross-sectional study involved 168 participants without cancer, 212 men with prostate cancer, and 55 women with breast cancer. We examined whether the Big Five personality dimensions were associated with health behaviors and multiple health indicators. Higher conscientiousness and lower neuroticism were associated with better health behaviors and health ( r max  = .31), with few differences between community and cancer samples. Findings call for research on the implications of personality in patients with serious illnesses.

Life resources and personal goals in old age.

PubMed

Saajanaho, Milla; Rantakokko, Merja; Portegijs, Erja; Törmäkangas, Timo; Eronen, Johanna; Tsai, Li-Tang; Jylhä, Marja; Rantanen, Taina

2016-09-01

It has been theorized that life resources influence goal engagement. The aim of the present study was to examine whether personal characteristics, and socio-economic, social and health resources are associated with personal goal content in old age. The participants were 824 community-dwelling people aged 75-90 from the Life-Space Mobility in Old Age project. Personal goals were elicited using a revised version of the Personal Project Analysis in a structured interview. Cross-sectional bi- and multivariate analyses using logistic regression modelling were conducted. The results showed that the most commonly reported goals were health maintenance related. People with better health resources were more likely to report goals related to leisure-time, social and physical activities and less likely to report goals related to recovery of health. Those with poor social resources were at risk for having no personal goals in their lives. The results are in line with theorizing on the influence of life resources on goal setting in old age. Further longitudinal studies are needed on whether resource loss precedes goal modification, and how goal setting strategies influence both mental and physical well-being in old age.

Personality traits and career satisfaction of health care professionals.

PubMed

Richardson, John D; Lounsbury, John W; Bhaskar, Tripti; Gibson, Lucy W; Drost, Adam W

2009-01-01

Based on Holland's theorizing that vocational satisfaction arises from a good match between one's personality and career choice, one purpose of the study was to examine broad and narrow personality traits that characterize health care workers in comparison with professionals from other occupations. Also investigated were ways in which characteristic traits of health care workers were related to career satisfaction. Professionals utilizing the services of eCareerfit.com responded to online surveys that have been demonstrated to produce reliable and valid measures of broad and narrow personality traits and levels of career satisfaction. An independent sample t test was used to compare means of health care workers with those from other occupations. Pearson product-moment correlations were then computed to assess relationships between the traits and career satisfaction of health care professionals. Two traits that were particularly strong among health care workers were also significantly correlated with career satisfaction: work drive and conscientiousness. Other traits were found to be significantly related to career satisfaction in health care but were not uniquely high in the sample of health care professionals. To increase career satisfaction of health care professionals and thus to improve retention rates, administrators should consider focusing on recruiting and selecting individuals with higher levels of key personality traits.

Person-centered osteopathic practice: patients’ personality (body, mind, and soul) and health (ill-being and well-being)

PubMed Central

Nima, Ali A.; Archer, Trevor

2015-01-01

Background. Osteopathic philosophy and practice are congruent with the biopsychosocial model, a patient-centered approach when treating disease, and the view of the person as a unity (i.e., body, mind, and soul). Nevertheless, a unity of being should involve a systematic person-centered understanding of the patient’s personality as a biopsychosociospiritual construct that influences health (i.e., well-being and ill-being). We suggest Cloninger’s personality model, comprising temperament (i.e., body) and character (i.e., mind and soul), as a genuine paradigm for implementation in osteopathic practice. As a first step, we investigated (1) the relationships between personality and health among osteopathic patients, (2) differences in personality between patients and a control group, and (3) differences in health within patients depending on the presenting problem and gender. Method. 524 osteopathic patients in Sweden (age mean = 46.17, SD = 12.54, 388 females and 136 males) responded to an online survey comprising the Temperament and Character Inventory and measures of health (well-being: life satisfaction, positive affect, harmony in life, energy, and resilience; ill-being: negative affect, anxiety, depression, stress, and dysfunction and suffering associated to the presenting problem). We conducted two structural equation models to investigate the association personality-health; graphically compared the patients’ personality T-scores to those of the control group and compared the mean raw scores using t-tests; and conducted two multivariate analyses of variance, using age as covariate, to compare patients’ health in relation to their presenting problem and gender. Results. The patients’ personality explained the variance of all of the well-being (R2 between .19 and .54) and four of the ill-being (R2 between .05 and .43) measures. Importantly, self-transcendence, the spiritual aspect of personality, was associated to high levels of positive emotions and

[Empowerment of children and adolescents--the role of personal and social resources and personal autonomy for subjective health].

PubMed

Erhart, M; Wille, N; Ravens-Sieberer, U

2008-12-01

Scientific research on empowerment so far is nearly exclusively focused on the adult population. Nevertheless, it is possible to show a link between empowerment and a) the developmental psychology concepts of resilience, b) autogenetic concepts and c) concepts of risks and resources. This paper aims to study the role of personal, familial and other social resources as well as personal autonomy for subjective health-ratings. A secondary analysis of the health data of 7,000 children and adolescents aged 10-17 years of the German health behaviour in school-aged children (HBSC) study as well as 1,700 children aged 11-17 years of the mental health module (BELLA Study) within the German health interview and examination survey for children and adolescents (KiGGS) was performed. Statistical analyses encompassed analyses of variance and linear regression. Analyses of the HBSC study showed a protective effect for school-class climate as well as parental support, whereby school was associated with fewer self-reported health complaints. Analyses of the BELLA/KiGGS study showed personal, familial and other social resources as well as personal autonomy as unique predictors for a better health-related quality of life (KINDL-R). This was true even if psychological problems were observed. The results confirm the importance of strengthening personal, familial and other social resources as well as the principal importance of personal autonomy for coping with health risks and health impairments. Future research explicitly focussed on empowerment could relate to the role of personal resources within children's and adolescents' contact with the medical and health care system. It can be expected that strengthening personal resources benefits and improves the communication and active participation of children and adolescents within treatment-decision and -evaluation.

Financial performance in the social health maintenance organization, 1985-88

PubMed Central

Leutz, Walter; Malone, Joelyn; Kistner, Marlin; O'Bar, Tim; Ripley, Jeanne M.; Sandhaus, Martin

1990-01-01

Since early 1985, four social health maintenance organizations have delivered integrated health and long-term care services to Medicare beneficiaries under congressionally mandated waivers that included shared public-program risk for losses. Three of four sites had substantial losses in the first 3 years, primarily because of slow enrollment and resultant high marketing and administrative costs. After assuming full risk, two of the three showed surpluses in 1988. Service and management costs for expanded long-term care were similar across sites and were affordable within the framework of Medicare and Medicaid reimbursement and private premiums. PMID:10113466

What Is a Personal Health Record (PHR)?

MedlinePlus

... and critical step in the evolution of health information management ( HIM ). The book “ The Personal Health Record ” assists ... potential health conditions, treatment options, costs of treatment, management of chronic conditions, healthy lifestyle choices, preventive actions, and monitoring the ... Does a PHR Work? How Does a ...

Personality, Aging Self-Perceptions, and Subjective Health: A Mediation Model

ERIC Educational Resources Information Center

Moor, Caroline; Zimprich, Daniel; Schmitt, Marina; Kliegel, Matthias

2006-01-01

Since the global item of subjective health has emerged as a strong predictor of important health outcomes such as mortality, there have been many attempts to uncover its correlates. In this study, we tested whether personality as assessed via the five-factor model of personality predicted subjective health when physician-rated health and…

Structural health monitoring methodology for aircraft condition-based maintenance

NASA Astrophysics Data System (ADS)

Saniger, Jordi; Reithler, Livier; Guedra-Degeorges, Didier; Takeda, Nobuo; Dupuis, Jean Pierre

2001-06-01

Reducing maintenance costs while keeping a constant level of safety is a major issue for Air Forces and airlines. The long term perspective is to implement condition based maintenance to guarantee a constant safety level while decreasing maintenance costs. On this purpose, the development of a generalized Structural Health Monitoring System (SHMS) is needed. The objective of such a system is to localize the damages and to assess their severity, with enough accuracy to allow low cost corrective actions. The present paper describes a SHMS based on acoustic emission technology. This choice was driven by its reliability and wide use in the aerospace industry. The described SHMS uses a new learning methodology which relies on the generation of artificial acoustic emission events on the structure and an acoustic emission sensor network. The calibrated acoustic emission events picked up by the sensors constitute the knowledge set that the system relies on. With this methodology, the anisotropy of composite structures is taken into account, thus avoiding the major cause of errors of classical localization methods. Moreover, it is adaptive to different structures as it does not rely on any particular model but on measured data. The acquired data is processed and the event's location and corrected amplitude are computed. The methodology has been demonstrated and experimental tests on elementary samples presented a degree of accuracy of 1cm.

Personal exposures to asbestos fibers during brake maintenance of passenger vehicles.

PubMed

Cely-García, María Fernanda; Sánchez, Mauricio; Breysse, Patrick N; Ramos-Bonilla, Juan P

2012-11-01

Brake linings and brake pads are among the asbestos-containing products that are readily available in Colombia. When sold separated from their support, brake linings require extensive manipulation involving several steps that include drilling, countersinking, riveting, bonding, cutting, beveling, and grinding. Without this manipulation, brake linings cannot be installed in a vehicle. The manipulation process may release asbestos fibers, which may expose brake mechanics to the fibers. Three brake repair shops located in Bogotá (Colombia) were sampled for 3 or 4 consecutive days using US National Institute for Occupational Safety and Health (NIOSH) methods 7400 and 7402. Standard procedures for quality control were followed during the sampling process, and asbestos samples were analyzed by an American Industrial Hygiene Association accredited laboratory. Personal samples were collected to assess full-shift and short-term exposures. Area samples were also collected close to the brake-lining manipulation equipment and within office facilities. Activities were documented during the sampling process. Using Phase Contrast Microscopy Equivalent counts to estimate air asbestos concentrations, all personal samples [i.e. 8-h time-weighted averages (TWAs) and 30-min personal samples] were in compliance with the US Occupational Safety and Health Administration standards. Personal asbestos concentrations based on transmission electron microscopy counts were extremely high, ranging from 0.006 to 3.493 f cm(-3) for 8-h TWA and from 0.015 to 8.835 f cm(-3) for 30-min samples. All asbestos fibers detected were chrysotile. Cleaning facilities and grinding linings resulted in the highest asbestos exposures based on transmission electron microscopy counts. There were also some samples that did not comply with the NIOSH's recommended exposure limits. The results indicate that the brake mechanics sampled are exposed to extremely high asbestos concentrations (i.e. based on transmission

Methadone maintenance treatment (MMT): a review of historical and clinical issues.

PubMed

Joseph, H; Stancliff, S; Langrod, J

2000-01-01

Methadone maintenance has been evaluated since its development in 1964 as a medical response to the post-World War II heroin epidemic in New York City. The findings of major early studies have been consistent. Methadone maintenance reduces and/or eliminates the use of heroin, reduces the death rates and criminality associated with heroin use, and allows patients to improve their health and social productivity. In addition, enrollment in methadone maintenance has the potential toreduce the transmission of infectious diseases associated with heroin injection, such as hepatitis and HIV. The principal effects of methadone maintenance are to relieve narcotic craving, suppress the abstinence syndrome, and block the euphoric effects associated with heroin. A majority of patients require 80-120 mg/d of methadone, or more, to achieve these effects and require treatment for an indefinite period of time, since methadone maintenance is a corrective but not a curative treatment for heroin addiction. Lower doses may not be as effective or provide the blockade effect. Methadone maintenance has been found to be medically safe and nonsedating. It is also indicated for pregnant women addicted to heroin. Reviews issued by the Institute of Medicine and the National Institutes of Health have defined narcotic addiction as a chronic medical disorder and have claimed that methadone maintenance coupled with social services is the most effective treatment for this condition. These agencies recommend reducing governmental regulation to facilitate patients access to treatment. In addition, they recommend that the number of programs be expanded, and that new models of treatment be implemented,if the nationwide problem of addiction is to be brought under control. The National Institutes of Health also recommend that methadone maintenance be available to persons under legal supervision, such as probationers, parolees and the incarcerated. However, stigma and bias directed at the programs and the

Trafficking in persons and victim health in Australia.

PubMed

Schloenhardt, Andreas; Klug, Benjamin

2011-12-01

This article explores the health problems experienced by victims of trafficking in persons in Australia and analyses the domestic support schemes established to assist these victims. It focuses specifically on the health of adult, female victims who constitute the majority of identified victims, and who are the principal recipients of government support services. Domestic experiences and support schemes are reviewed in the light of international law and best practice guidelines. Recommendations are made to improve the health services available to victims of trafficking in persons in Australia.

Does the Health Maintenance Facility Provide Speciality Capabilities?

NASA Technical Reports Server (NTRS)

Boyce, Joey; Wurgler, James; Broadwell, Kim; Martin, William; Stiernberg, Charles M.; Bove, Alfred; Fromm, Rob; O'Neill, Daniel

1991-01-01

The Health Maintenance Facility (HMF) is capable of handling all minor illnesses, most moderate illnesses, and some major illnesses on board a space station. Its primary purpose should be to treat problems that are mission threatening, not life threatening. The HMF will have greater medical capabilities than those currently on Navy submarines. Much of the discussion in this document focuses on the possibilities of treating specific medical conditions on board a space station. The HMF will be limited to caring for critically ill patients for a few days, so a crew return vehicle will be important.

Addressing the Antinomy between Health Education and Health Literacy in Advancing Personal Health and Public Health Outcomes

ERIC Educational Resources Information Center

Belcastro, Philip A.; Ramsaroop-Hansen, Hardaye

2017-01-01

Background: Health literacy evolved from a standard of English language proficiency designed to promote patient compliance into an inferential for promoting positive health decision-making and health outcomes. In turn, the United States relegated health literacy as a national strategy to improve personal health and health care outcomes as well as…

Application of ubiquitous computing in personal health monitoring systems.

PubMed

Kunze, C; Grossmann, U; Stork, W; Müller-Glaser, K D

2002-01-01

A possibility to significantly reduce the costs of public health systems is to increasingly use information technology. The Laboratory for Information Processing Technology (ITIV) at the University of Karlsruhe is developing a personal health monitoring system, which should improve health care and at the same time reduce costs by combining micro-technological smart sensors with personalized, mobile computing systems. In this paper we present how ubiquitous computing theory can be applied in the health-care domain.

PHIT for Duty, a Personal Health Intervention Tool for Psychological Health and Traumatic Brain Injury

DTIC Science & Technology

2015-04-01

Award Number: W81XWH-11-2-0129 TITLE: PHIT for Duty, a Personal Health Intervention Tool for Psychological Health and Traumatic Brain Injury...TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-11-2-0129 PHIT for Duty, a Personal Health Intervention Tool for Psychological Health and Traumatic...health problems. PHIT for Duty integrates self-report and physiological sensor instruments to assess health status via brief weekly screening

Health maintenance organization penetration and the practice location choices of new physicians: a study of large metropolitan areas in the United States.

PubMed

Escarce, J J; Polsky, D; Wozniak, G D; Pauly, M V; Kletke, P R

1998-11-01

The rapid growth of health maintenance organizations is reshaping the practice opportunities available to physicians. The practice location decisions of new physicians provide a sensitive bellwether of these changes. This study assessed the effect of health maintenance organization penetration on practice location for physicians completing graduate medical education (GME). Conditional logit regression analysis was used to determine the effect of health maintenance organization penetration on practice location, controlling for other market characteristics. Subjects were physicians who finished GME between 1989 and 1994 and who located in one of the 98 US metropolitan areas with more than 500,000 population. The outcome measure was the particular metropolitan area chosen by each new physician. Early in the study period, new generalists were significantly more likely to locate in metropolitan areas with high health maintenance organization penetration than in low penetration areas, whereas new specialists' practice location choices were not associated with health maintenance organization penetration. The likelihood of choosing a high penetration relative to a low penetration area declined with time, however, for both generalists and specialists. Consequently, by the end of the study period, health maintenance organization penetration had a weak but significant negative effect on practice location for generalists and a strong negative influence on practice location for specialists. New generalists who completed graduate medical education between 1989 and 1994 were more likely than new specialists to locate in market areas with high health maintenance organization penetration; however, the proportions of both generalists and specialists who chose high penetration areas decreased during the study period. This finding may reflect reduced practice opportunities in high penetration areas relative to low penetration areas as health maintenance organizations' systems for

Personal Health Care Expenditures by State, Selected Years 1966-1978

PubMed Central

Levit, Katharine R.

1982-01-01

In 1966, spending for personal health care in the U.S. was $39 billion. By 1978, these expenditures had grown to $166 billion. Among regions and states, different patterns and levels of spending emerged, along with different rates of growth. Some of the highlights from the accompanying report which pinpoint personal health care spending differences among regions and states are listed below. In 1978, $745 per person was spent for personal health care services within the U.S. Massachusetts led the nation in spending with $935 per person. The lowest spending for personal health—$521 per capita—occurred in South Carolina.Expenditures for hospital care ranged from a high of $490 per capita in Massachusetts to a low of $197 per capita in Idaho, with the U.S. expenditure level at $337 per person.Spending for physician services in 1978 was $161 per person nationwide. The highest level of spending—$238—was in California, and the lowest—$90—was in Vermont. Florida, with the largest proportion of aged residents in the U.S., registered expenditure levels of $208 per person for physician services. Despite a 29.5 percent increase nationwide in the number of physicians from 1969 to 1978, little change has occurred in the rank of states and regions in their physician-to-population concentrations.Minnesota led the nation in nursing home care expenditures, spending $126 per person for this service in 1978. Minnesota's high per capita spending for nursing home care correlates with its large number of nursing home beds per 65 years of age and over population. In 1978, the 96 beds per 1000 elderly residents which were maintained in Minnesota contrasted sharply with the 56 beds maintained per 1000 elderly residents nationwide.Personal health care expenditures per capita grew an average of 11.6 percent per year between 1966 and 1978. Growth was most dramatic in the Southeast, where expenditures per capita more than quadrupled, growing 12.6 percent per year. Mississippi

Security and privacy issues of personal health.

PubMed

Blobel, Bernd; Pharow, Peter

2007-01-01

While health systems in developed countries and increasingly also in developing countries are moving from organisation-centred to person-centred health service delivery, the supporting communication and information technology is faced with new risks regarding security and privacy of stakeholders involved. The comprehensively distributed environment puts special burden on guaranteeing communication security services, but even more on guaranteeing application security services dealing with privilege management, access control and audit regarding social implication and connected sensitivity of personal information recorded, processed, communicated and stored in an even internationally distributed environment.

Adherence with Universal Precautions after Immediate, Personalized Performance Feedback

ERIC Educational Resources Information Center

Luke, Molli M.; Alavosius, Mark

2011-01-01

We evaluated the effects of immediate, personalized performance feedback on adherence with hand hygiene by health-care staff in the context of a multiple baseline design across participants. Target behaviors reached mastery levels and were maintained near 100% throughout 2 months of maintenance probes. (Contains 1 table and 1 figure.)

Trafficking in persons: a health concern?

PubMed

Zimmerman, Cathy; Kiss, Ligia; Houssain, Mazeda; Watts, Charlotte

2009-01-01

Human trafficking is a phenomenon that has now been documented in most regions in the world. Although trafficking of women and girls for sexual exploitation is the most commonly recognised form of trafficking, it is widely acknowledged that human trafficking also involves men, women and children who are trafficked for various forms of labour exploitation and into other abusive circumstances. Despite the violence and harm inherent in most trafficking situations, there remains extremely little evidence on the individual and public health implications of any form of human trafficking. The Brazilian government has recently launched a national plan to combat human trafficking. However, because the health risks associated with human trafficking have not been well-recognised or documented, there is extremely limited reliable data on the health needs of trafficked persons to inform policy and practices.. Brazilian policy-makers and service providers should be encouraged to learn about the likely range of health impacts of trafficking, and incorporate this into anti-trafficking protection and response strategies. As well as prevention activities, the government, international and local organisations should work together with the public health research community to study the health needs of trafficked persons and explore opportunities to provide safe and appropriate services to victims in need of care.

Promoting child passenger safety in children served by a health maintenance organization.

PubMed

Chang, A; Hearey, C D; Gallagher, K D; English, P; Chang, P C

1989-06-01

A patient education program, based on the health belief model, promoting child passenger safety was developed and implemented at a health maintenance organization. The program included individual counseling by pediatricians, use of audiovisual materials and pamphlets, and (for newborn infants) a home visit by a child safety specialist. Based on parking lot observations, child safety device use increased to greater than 60% in both intervention and comparison-group children 1-4 years of age. During the child health supervision visit, pediatricians can play a leadership role in promoting child passenger safety.

The internet of things for personalized health.

PubMed

Schreier, Günter

2014-01-01

Advances in information and communications technologies (ICT) enable new personalized health care concepts which are often characterized by four "P" terms, i.e. personalized, predictive, preventive and participatory. However, real world implementations of the complete 4P spectrum hardly exist today. The Internet of Things (IoT) has been defined as an extension to the current Internet that enables pervasive communication between the physical and the virtual world. Smart devices and enabling elements like Near Field Communication (NFC) and Radio Frequency Identification (RFID) technology already exist and increasingly will be a mainstream element of our lives. This future vision paper attempts to assess if and how the Internet of Things for personalized health (IoT4pH) can help to facilitate the 4P healthcare paradigm and discusses related challenges and opportunities.

A Big Five approach to self-regulation: personality traits and health trajectories in the Hawaii longitudinal study of personality and health.

PubMed

Hampson, Sarah E; Edmonds, Grant W; Barckley, Maureen; Goldberg, Lewis R; Dubanoski, Joan P; Hillier, Teresa A

2016-01-01

Self-regulatory processes influencing health outcomes may have their origins in childhood personality traits. The Big Five approach to personality was used here to investigate the associations between childhood traits, trait-related regulatory processes and changes in health across middle age. Participants (N = 1176) were members of the Hawaii longitudinal study of personality and health. Teacher assessments of the participants' traits when they were in elementary school were related to trajectories of self-rated health measured on 6 occasions over 14 years in middle age. Five trajectories of self-rated health were identified by latent class growth analysis: Stable Excellent, Stable Very Good, Good, Decreasing and Poor. Childhood Conscientiousness was the only childhood trait to predict membership in the Decreasing class vs. the combined healthy classes (Stable Excellent, Stable Very Good and Good), even after controlling for adult Conscientiousness and the other adult Big Five traits. The Decreasing class had poorer objectively assessed clinical health measured on one occasion in middle age, was less well-educated, and had a history of more lifespan health-damaging behaviors compared to the combined healthy classes. These findings suggest that higher levels of childhood Conscientiousness (i.e. greater self-discipline and goal-directedness) may prevent subsequent health decline decades later through self-regulatory processes involving the acquisition of lifelong healthful behavior patterns and higher educational attainment.

Examining the Role of Anxiety and Apathy in Health Consumers' Intentions to Use Patient Health Portals for Personal Health Information Management

ERIC Educational Resources Information Center

Torres, Carlos A.

2011-01-01

This study investigated college students' attitudes toward and intentions to use personal health portals (PHPs) for managing their personal health information using a survey method. The study also aimed to examine the roles electronic Personal Health Information Management (PHIM) anxiety and apathy play in influencing students' attitudes toward…

Integrating Public Health and Personal Care in a Reformed US Health Care System

PubMed Central

Chernichovsky, Dov

2010-01-01

Compared with other developed countries, the United States has an inefficient and expensive health care system with poor outcomes and many citizens who are denied access. Inefficiency is increased by the lack of an integrated system that could promote an optimal mix of personal medical care and population health measures. We advocate a health trust system to provide core medical benefits to every American, while improving efficiency and reducing redundancy. The major innovation of this plan would be to incorporate existing private health insurance plans in a national system that rebalances health care spending between personal and population health services and directs spending to investments with the greatest long-run returns. PMID:20019310

Engine health monitoring systems: Tools for improved maintenance management in the 1980's

NASA Technical Reports Server (NTRS)

Kimball, J. C.

1981-01-01

The performance monitoring aspect of maintenance, characteristic of the engine health monitoring system are discussed. An overview of the system activities is presented and a summary of programs for improved monitoring in the 1980's are discussed.

Privacy by design in personal health monitoring.

PubMed

Nordgren, Anders

2015-06-01

The concept of privacy by design is becoming increasingly popular among regulators of information and communications technologies. This paper aims at analysing and discussing the ethical implications of this concept for personal health monitoring. I assume a privacy theory of restricted access and limited control. On the basis of this theory, I suggest a version of the concept of privacy by design that constitutes a middle road between what I call broad privacy by design and narrow privacy by design. The key feature of this approach is that it attempts to balance automated privacy protection and autonomously chosen privacy protection in a way that is context-sensitive. In personal health monitoring, this approach implies that in some contexts like medication assistance and monitoring of specific health parameters one single automatic option is legitimate, while in some other contexts, for example monitoring in which relatives are receivers of health-relevant information rather than health care professionals, a multi-choice approach stressing autonomy is warranted.

14 CFR 91.1433 - CAMP: Maintenance and preventive maintenance training program.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Fractional Ownership Operations Program Management § 91.1433 CAMP: Maintenance and preventive... each person (including inspection personnel) who determines the adequacy of work done is fully informed...

Personality and the perception of health and happiness.

PubMed

Cloninger, C Robert; Zohar, Ada H

2011-01-01

Health is a state of physical, mental, and social well-being. Personality traits measure individual differences in adaptive functioning and mental health, but little is known about how well personality accounts for health's affective aspects (i.e., "happiness") and its non-affective aspects (i.e., "wellness") in the general population. 1102 volunteer representatives of the Sharon area of Israel completed the Temperament and Character Inventory (TCI), the Positive and Negative Affect Scale (PANAS), the Satisfaction with Life Scale (SWLS), the Multidimensional Scale of Perceived Social Support (PSS), and the subjective health assessment of the General Health Questionnaire (GHQ). Multidimensional personality profiles were used to evaluate the linear and non-linear effects of interactions among dimensions on different aspects of well-being. Self-directedness was strongly associated with all aspects of well-being regardless of interactions with other dimensions. Cooperativeness was strongly associated with perceived social support, and weakly with other aspects of well-being, particularly when Self-directedness was low. Self-transcendence was strongly associated with positive emotions when the influence of the other character dimensions was taken into account. Personality explained nearly half the variance in happiness and more than one-third of the variance in wellness. Our data are cross-sectional and self-reported, so they are subject to personal perceptual bias. The emotional, social, and physical aspects of well-being are interdependent, but specific configurations of TCI Self-directedness, Cooperativeness, and Self-transcendence influence them differentially. Interactions among different combinations of character traits have strong effects on the perception of both wellness and happiness. Copyright © 2010 Elsevier B.V. All rights reserved.

A Scalable Framework to Detect Personal Health Mentions on Twitter

PubMed Central

Fabbri, Daniel; Rosenbloom, S Trent

2015-01-01

Background Biomedical research has traditionally been conducted via surveys and the analysis of medical records. However, these resources are limited in their content, such that non-traditional domains (eg, online forums and social media) have an opportunity to supplement the view of an individual’s health. Objective The objective of this study was to develop a scalable framework to detect personal health status mentions on Twitter and assess the extent to which such information is disclosed. Methods We collected more than 250 million tweets via the Twitter streaming API over a 2-month period in 2014. The corpus was filtered down to approximately 250,000 tweets, stratified across 34 high-impact health issues, based on guidance from the Medical Expenditure Panel Survey. We created a labeled corpus of several thousand tweets via a survey, administered over Amazon Mechanical Turk, that documents when terms correspond to mentions of personal health issues or an alternative (eg, a metaphor). We engineered a scalable classifier for personal health mentions via feature selection and assessed its potential over the health issues. We further investigated the utility of the tweets by determining the extent to which Twitter users disclose personal health status. Results Our investigation yielded several notable findings. First, we find that tweets from a small subset of the health issues can train a scalable classifier to detect health mentions. Specifically, training on 2000 tweets from four health issues (cancer, depression, hypertension, and leukemia) yielded a classifier with precision of 0.77 on all 34 health issues. Second, Twitter users disclosed personal health status for all health issues. Notably, personal health status was disclosed over 50% of the time for 11 out of 34 (33%) investigated health issues. Third, the disclosure rate was dependent on the health issue in a statistically significant manner (P<.001). For instance, more than 80% of the tweets about

Hospitals and Health Maintenance Organizations: An Analysis of the Minneapolis-St. Paul Experience

PubMed Central

Morrisey, Michael A.; Gibson, Geoffrey; Ashby, Cynthia S.

1983-01-01

Minneapolis-St. Paul is recognized as a prime example of health care competition. Policymakers and others have been asked to look to the Twin Cities as a model upon which to base new competitive initiatives in the health care sector. Yet little is known about the impact of Health Maintenance Organizations (HMOs) on other health care providers. This study examines the effects of the area's seven health maintenance organizations on the local hospital community. Three questions are addressed. First, is the situation in the Twin Cities unique? A comparison of case study findings and the available literature together with hospital data from similarly HMO-penetrated markets suggests that the Twin Cities' hospital market is indeed different. Second, what is the nature of hospital-HMO interaction? The flexibility of contracting apparently allows hospitals to affiliate successfully with an HMO under a variety of service and reimbursement agreements. Third, what effect has HMO activity had on community-wide utilization? While HMO enrollees clearly use fewer hospital days and the trend in the community is toward fewer days, attributing the change to HMOs is difficult. A large portion of the differences between HMO and community-wide utilization levels is attributable to differences in population. PMID:10309856

Providing Our Fellows in Training with Education on Inflammatory Bowel Disease Health Maintenance to Improve the Quality of Care in Our Health Care System.

PubMed

Lee, Ann Joo; Kraemer, Dale F; Smotherman, Carmen; Eid, Emely

2016-01-01

Inflammatory bowel disease (IBD) quality measures were established in an effort to standardize IBD health care. Despite effort to improve clinical performance, considerable variations in practice still exist. To further improve IBD health care, we propose incorporating an in-service educational session on IBD health maintenance to provide trainees with increasing awareness and knowledge on IBD management. Fifty electronic medical charts were randomly selected, and the level of quality documentation was assessed for 15 core IBD quality measures. Data were reported as the percentage of charts meeting audit criteria (compliance score). Fellows then attended an in-service educational session to review IBD quality measures and reinforce practice expectations. A second audit was then performed on an additional 50 patient charts to determine whether documentation practices improved after the educational session. We found a positive correlation between an in-service educational session and fellows' compliance with IBD health maintenance. Overall, the fellows' compliance score increased by 18% (before intervention, 65%; after intervention, 83%; P < 0.0001). The intervention was equally beneficial irrespective of training level. Although the magnitude of improvement was comparable, the mean compliance score was highest in year 2 at 81% (year 1: 72% [P = 0.019] and year 3: 70% [P = 0.002]). Fellows expressed a high degree of satisfaction with the educational intervention and emphasized the value in reviewing the conceptual bases for IBD health maintenance. Incorporating a standard curriculum on IBD health maintenance provides fellows in training with increased awareness and guidance on managing the unique preventive care needs of patients with IBD.

Does personality affect health-related quality of life? A systematic review

PubMed Central

Huang, I-Chan; Lee, Joy L.; Ketheeswaran, Pavinarmatha; Jones, Conor M.; Revicki, Dennis A.; Wu, Albert W.

2017-01-01

Background Health-related quality of life (HRQOL) is increasingly measured as an outcome for clinical and health services research. However, relatively little is known about how non-health factors affect HRQOL. Personality is a potentially important factor, yet evidence regarding the effects of personality on HRQOL measures is unclear. Methods This systematic review examined the relationships among aspects of personality and HRQOL. Eligible studies were identified from Medline and PsycINFO. The review included 76 English-language studies with HRQOL as a primary outcome and that assessed personality from the psychological perspective. Individuals with various health states, including ill (e.g., cancer, cardiovascular disorders), aging, and healthy, were included in this review study. Results Some personality characteristics were consistently related to psychosocial aspects more often than physical aspects of HRQOL. Personality characteristics, especially neuroticism, mastery, optimism, and sense of coherence were most likely to be associated with psychosocial HRQOL. Personality explained varying proportions of variance in different domains of HRQOL. The range of variance explained in psychosocial HRQOL was 0 to 45% and the range of explained variance in physical HRQOL was 0 to 39%. Conclusions Personality characteristics are related to HRQOL. Systematic collection and analysis of personality data alongside HRQOL measures may be helpful in medical research, clinical practice, and health policy evaluation. PMID:28355244

Cocaine users with comorbid Cluster B personality disorders show dysfunctional brain activation and connectivity in the emotional regulation networks during negative emotion maintenance and reappraisal.

PubMed

Albein-Urios, Natalia; Verdejo-Román, Juan; Soriano-Mas, Carles; Asensio, Samuel; Martínez-González, José Miguel; Verdejo-García, Antonio

2013-12-01

Cocaine dependence often co-occurs with Cluster B personality disorders. Since both disorders are characterized by emotion regulation deficits, we predicted that cocaine comorbid patients would exhibit dysfunctional patterns of brain activation and connectivity during reappraisal of negative emotions. We recruited 18 cocaine users with comorbid Cluster B personality disorders, 17 cocaine users without comorbidities and 21 controls to be scanned using functional magnetic resonance imaging (fMRI) during performance on a reappraisal task in which they had to maintain or suppress the emotions induced by negative affective stimuli. We followed region of interest (ROI) and whole-brain approaches to investigate brain activations and connectivity associated with negative emotion experience and reappraisal. Results showed that cocaine users with comorbid personality disorders had reduced activation of the subgenual anterior cingulate cortex during negative emotion maintenance and increased activation of the lateral orbitofrontal cortex and the amygdala during reappraisal. Amygdala activation correlated with impulsivity and antisocial beliefs in the comorbid group. Connectivity analyses showed that in the cocaine comorbid group the subgenual cingulate was less efficiently connected with the amygdala and the fusiform gyri and more efficiently connected with the anterior insula during maintenance, whereas during reappraisal the left orbitofrontal cortex was more efficiently connected with the amygdala and the right orbitofrontal cortex was less efficiently connected with the dorsal striatum. We conclude that cocaine users with comorbid Cluster B personality disorders have distinctive patterns of brain activation and connectivity during maintenance and reappraisal of negative emotions, which correlate with impulsivity and dysfunctional beliefs. Copyright © 2013 Elsevier B.V. and ECNP. All rights reserved.

Effect of Mergers on Health Maintenance Organization Premiums

PubMed Central

Feldman, Roger; Wholey, Douglas; Christianson, Jon

1996-01-01

This study estimated the effect of mergers on health maintenance organization (HMO) premiums, using data on all operational non-Medicaid HMOs in the United States from 1985 to 1993. Two critical issues were examined: whether HMO mergers increase or decrease premiums; and whether the effects of mergers differ according to the degree of competition among HMOs in local markets. The only significant merger effect was found in the most competitive markets, where premiums increased, but only for 1 year after the merger. Our research does not support the argument that consolidation of HMOs in local markets will benefit consumers through lower premiums. PMID:10158729

Health Information Sources, Perceived Vaccination Benefits, and Maintenance of Childhood Vaccination Schedules.

PubMed

Hwang, Juwon; Shah, Dhavan V

2018-06-05

Parental concerns over the safety or necessity of childhood vaccination have increased over the past decades. At the same time, there has been a proliferation of vaccine-related information available through a range of health information sources. This study investigates the associations between evaluations of health information sources, parental perceptions of childhood vaccination benefits, and the maintenance of vaccination schedules for their children. Specifically, this study aims to (a) incorporate social media into the battery of health information sources and (b) differentiate households with a childhood autism diagnosis and those without, given unsubstantiated but persistent concerns about vaccine safety and autism. Analyzing a sample of U.S. households, a total of 4,174 parents who have at least one child under the age of 18 were analyzed, including 138 of parents of households with a childhood autism diagnosis. Results show that the more the parents value interpersonal communication and magazines as sources of health information, the more they perceive vaccination benefits, and the more the value they put on television, the better they keep vaccination schedules up-to-date for their children. On the other hand, social media are negatively associated with their perceptions of vaccination benefits. Although parents of children diagnosed with autism are less likely to perceive vaccination benefits, no interaction effects with evaluations of health information sources are found on parental perceptions of vaccination benefits or maintenance of schedules.

Do nurses' personal health behaviours impact on their health promotion practice? A systematic review.

PubMed

Kelly, Muireann; Wills, Jane; Sykes, Susie

2017-11-01

There is a growing expectation in national and international policy and from professional bodies that nurses be role models for healthy behaviours, the rationale being that there is a relationship between nurses' personal health and the adoption of healthier behaviours by patients. This may be from patients being motivated by, and modelling, the visible healthy lifestyle of the nurse or that nurses are more willing to promote the health of their patients by offering public health or health promotion advice and referring the patient to support services. An integrated systematic review was conducted to determine if nurses' personal health behaviour impacted on (1) their health promotion practices, and (2) patient responses to a health promotion message. Medline, CINAHL, SCOPUS, and PsycINFO databases were searched. A narrative synthesis was conducted. 31 studies were included in the review. No consistent associations were noted between nurses' weight, alcohol use, or physical activity level and their health promotion practice, although smoking appeared to negatively impact on the likelihood of discussing and engaging in cessation counselling. Nurses who reported confidence and skills around health promotion practice were more likely to raise lifestyle issues with patients, irrespective of their own personal health behaviours. The two studies included in the review that examined patient responses noted that the perceived credibility of a public health message was not enhanced by being delivered by a nurse who reported adopting healthy behaviours. Although it is assumed that nurses' personal health behaviour influences their health promotion practice, there is little evidence to support this. The assertion in health care policy that nurses should be role models for healthy behaviours assumes a causal relationship between their health behaviours and the patient response and adoption of public health messages that is not borne out by the research evidence. Copyright �

Advancing a conceptual model to improve maternal health quality: The Person-Centered Care Framework for Reproductive Health Equity.

PubMed

Sudhinaraset, May; Afulani, Patience; Diamond-Smith, Nadia; Bhattacharyya, Sanghita; Donnay, France; Montagu, Dominic

2017-11-06

Background: Globally, substantial health inequities exist with regard to maternal, newborn and reproductive health. Lack of access to good quality care-across its many dimensions-is a key factor driving these inequities. Significant global efforts have been made towards improving the quality of care within facilities for maternal and reproductive health. However, one critically overlooked aspect of quality improvement activities is person-centered care. Main body: The objective of this paper is to review existing literature and theories related to person-centered reproductive health care to develop a framework for improving the quality of reproductive health, particularly in low and middle-income countries. This paper proposes the Person-Centered Care Framework for Reproductive Health Equity, which describes three levels of interdependent contexts for women's reproductive health: societal and community determinants of health equity, women's health-seeking behaviors, and the quality of care within the walls of the facility. It lays out eight domains of person-centered care for maternal and reproductive health. Conclusions: Person-centered care has been shown to improve outcomes; yet, there is no consensus on definitions and measures in the area of women's reproductive health care. The proposed Framework reviews essential aspects of person-centered reproductive health care.

How do people respond to health news? The role of personality traits.

PubMed

Weston, Sara J; Jackson, Joshua J

2016-06-01

When a patient receives a health diagnosis, their response (e.g. changes in behaviour, seeking support) can have significant consequences for long-term health and well-being. Characteristics of health news are known to influence these responses, but personality traits have been omitted from this line of research. The current study examines the role of personality traits in predicting response to health news. Participants (N = 298) read scenarios in which they received health news that was manipulated to vary in severity, controllability and likelihood of outcomes. Participants then rated how likely they were to engage in a number of response behaviours. We examined the main effects and interaction of situational manipulations and personality traits on ratings of these behaviours. Both situations and personality traits influenced behavioural responses to health events. In particular, conscientiousness predicted taking action and seeking social support. Neuroticism predicted both maladaptive and adaptive behavioural responses, providing support for the 'healthy neurotic' hypothesis. Moreover, personality traits predicted best in weak (unlikely, controllable) situations. Both personality traits and situational characteristics contribute to behavioural responses to health news.

Exploring Healthcare Consumer Acceptance of Personal Health Information Management Technology through Personal Health Record Systems

ERIC Educational Resources Information Center

Wu, Huijuan

2013-01-01

Healthcare technologies are evolving from a practitioner-centric model to a patient-centric model due to the increasing need for technology that directly serves healthcare consumers, including healthy people and patients. Personal health information management (PHIM) technology is one of the technologies designed to enhance an individual's ability…

29 CFR 825.211 - Maintenance of benefits under multi-employer health plans.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., DEPARTMENT OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.211 Maintenance of benefits under multi-employer health plans. (a) A... contributions on behalf of an employee using FMLA leave as though the employee had been continuously employed...

29 CFR 825.211 - Maintenance of benefits under multi-employer health plans.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., DEPARTMENT OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.211 Maintenance of benefits under multi-employer health plans. (a) A... contributions on behalf of an employee using FMLA leave as though the employee had been continuously employed...

29 CFR 825.211 - Maintenance of benefits under multi-employer health plans.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., DEPARTMENT OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.211 Maintenance of benefits under multi-employer health plans. (a) A... contributions on behalf of an employee using FMLA leave as though the employee had been continuously employed...

29 CFR 825.211 - Maintenance of benefits under multi-employer health plans.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., DEPARTMENT OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.211 Maintenance of benefits under multi-employer health plans. (a) A... contributions on behalf of an employee using FMLA leave as though the employee had been continuously employed...

Motivational indictors predicting the engagement, frequency and adequacy of rainwater tank maintenance

NASA Astrophysics Data System (ADS)

Mankad, Aditi; Greenhill, Murni

2014-01-01

Rainwater tank maintenance is a key social behavior in our changing environment, as tanks are being adopted worldwide to augment household water supplies and reduce urban water stress. The maintenance of rainwater tanks in urban areas is an important pro-environmental behavior that prevents public health issues arising from unhygienic tank use. This study examined motivational differences in maintenance behavior between householders with retrofitted and mandated (compulsory) rainwater tanks on their property (N = 1988). Results showed that retrofitted tank owners were more self-determined in their motivation than mandated owners. Amotivation and integrated regulation were both dominant predictors of engagement in tank maintenance, frequency and adequacy of tank maintenance activities. Those involved in more maintenance activity were likely driven to do so because of feelings of adherence to personal goals and values (e.g., as "sustainable" citizens), whereas individuals who experienced a lack of control and alienation from the activity were likely to view maintenance as meaningless. Thus, people with higher integrated regulation engaged in more tank maintenance activities, whereas more amotivated individuals engaged in less maintenance. As cities begin relying more on citizen self-sufficiency with respect to water and energy resources, issues relating to infrastructure maintenance and operation become paramount. Results show that motivation is important in the impetus to engage in a pro-environmental behavior as well as the frequency and accuracy with which that behavior is undertaken. Policy implications are further discussed.

A personal health information toolkit for health intervention research.

PubMed

Kizakevich, Paul N; Eckhoff, Randall; Weger, Stacey; Weeks, Adam; Brown, Janice; Bryant, Stephanie; Bakalov, Vesselina; Zhang, Yuying; Lyden, Jennifer; Spira, James

2014-01-01

With the emergence of mobile health (mHealth) apps, there is a growing demand for better tools for developing and evaluating mobile health interventions. Recently we developed the Personal Health Intervention Toolkit (PHIT), a software framework which eases app implementation and facilitates scientific evaluation. PHIT integrates self-report and physiological sensor instruments, evidence-based advisor logic, and self-help interventions such as meditation, health education, and cognitive behavior change. PHIT can be used to facilitate research, interventions for chronic diseases, risky behaviors, sleep, medication adherence, environmental monitoring, momentary data collection health screening, and clinical decision support. In a series of usability evaluations, participants reported an overall usability score of 4.5 on a 1-5 Likert scale and an 85 score on the System Usability Scale, indicating a high percentile rank of 95%.

Health and wellness characteristics of persons with traumatic brain injury.

PubMed

Braden, Cynthia A; Cuthbert, Jeffrey P; Brenner, Lisa; Hawley, Lenore; Morey, Clare; Newman, Jody; Staniszewski, Kristi; Harrison-Felix, Cynthia

2012-01-01

To describe health and wellness characteristics of persons with TBI living in the community, compare to other disability populations and evaluate the associations between health-related constructs. Observational. Outpatient rehabilitation hospital and a Veterans Affairs Medical Centre. Seventy-four community-dwelling adults with moderate-to-severe TBI. None. Health Promoting Lifestyle Profile II (HPLP-II), Self Rated Abilities Health Practices Scale (SRAHP), Barriers to Health Promoting Activities for Disabled Scale (BHPAD), Medical Outcomes Study 12-Item Health Status Survey Short Form (SF-12), Personal Resource Questionnaire-adapted (PRQ-a), Perceived Wellness Survey (PWS), Diener Satisfaction with Life Scale (SWLS) and Participation Assessment with Recombined Tools-Objective (PART-O). Health-promoting behaviours, self-efficacy and barriers to health were comparable to other disability populations. Perceived health status, participation and life satisfaction were decreased. Measures of health promotion and self-efficacy were positively associated with perceived mental health status, life satisfaction and participation. Barriers to healthy activities were negatively associated with health promotion, self-efficacy and perceived mental health status. Health and wellness status was below desired levels for the study cohort, and comparable to other disability populations. Better understanding of associations among health-related constructs is needed. Continued research on conceptually-based health and wellness interventions for persons with TBI is recommended.

Are personal health records safe? A review of free web-accessible personal health record privacy policies.

PubMed

Carrión Señor, Inmaculada; Fernández-Alemán, José Luis; Toval, Ambrosio

2012-08-23

Several obstacles prevent the adoption and use of personal health record (PHR) systems, including users' concerns regarding the privacy and security of their personal health information. To analyze the privacy and security characteristics of PHR privacy policies. It is hoped that identification of the strengths and weaknesses of the PHR systems will be useful for PHR users, health care professionals, decision makers, and designers. We conducted a systematic review using the principal databases related to health and computer science to discover the Web-based and free PHR systems mentioned in published articles. The privacy policy of each PHR system selected was reviewed to extract its main privacy and security characteristics. The search of databases and the myPHR website provided a total of 52 PHR systems, of which 24 met our inclusion criteria. Of these, 17 (71%) allowed users to manage their data and to control access to their health care information. Only 9 (38%) PHR systems permitted users to check who had accessed their data. The majority of PHR systems used information related to the users' accesses to monitor and analyze system use, 12 (50%) of them aggregated user information to publish trends, and 20 (83%) used diverse types of security measures. Finally, 15 (63%) PHR systems were based on regulations or principles such as the US Health Insurance Portability and Accountability Act (HIPAA) and the Health on the Net Foundation Code of Conduct (HONcode). Most privacy policies of PHR systems do not provide an in-depth description of the security measures that they use. Moreover, compliance with standards and regulations in PHR systems is still low.

Are Personal Health Records Safe? A Review of Free Web-Accessible Personal Health Record Privacy Policies

PubMed Central

Fernández-Alemán, José Luis; Toval, Ambrosio

2012-01-01

Background Several obstacles prevent the adoption and use of personal health record (PHR) systems, including users’ concerns regarding the privacy and security of their personal health information. Objective To analyze the privacy and security characteristics of PHR privacy policies. It is hoped that identification of the strengths and weaknesses of the PHR systems will be useful for PHR users, health care professionals, decision makers, and designers. Methods We conducted a systematic review using the principal databases related to health and computer science to discover the Web-based and free PHR systems mentioned in published articles. The privacy policy of each PHR system selected was reviewed to extract its main privacy and security characteristics. Results The search of databases and the myPHR website provided a total of 52 PHR systems, of which 24 met our inclusion criteria. Of these, 17 (71%) allowed users to manage their data and to control access to their health care information. Only 9 (38%) PHR systems permitted users to check who had accessed their data. The majority of PHR systems used information related to the users’ accesses to monitor and analyze system use, 12 (50%) of them aggregated user information to publish trends, and 20 (83%) used diverse types of security measures. Finally, 15 (63%) PHR systems were based on regulations or principles such as the US Health Insurance Portability and Accountability Act (HIPAA) and the Health on the Net Foundation Code of Conduct (HONcode). Conclusions Most privacy policies of PHR systems do not provide an in-depth description of the security measures that they use. Moreover, compliance with standards and regulations in PHR systems is still low. PMID:22917868

Health Care Finance Executive Personalities Revisited: A 10-Year Follow-up Study.

PubMed

Lieneck, Cristian; Nowicki, Michael

2015-01-01

A dynamic health care industry continues to call upon health care leaders to possess not one but multiple competencies. Inherent personality characteristics of leaders often play a major role in personal as well as organizational success to include those in health care finance positions of responsibility. A replication study was conducted to determine the Myers-Briggs personality-type differences between practicing health care finance professionals in 2014, as compared with a previous 2003 study. Results indicate a significant shift between both independent samples of health care finance professionals over the 10-year period from original high levels of introversion to that of extraversion, as well as higher sensing personality preferences, as compared with the original sample's high level of intuition preferences. Further investigation into the evolving role of the health care finance manager is suggested, while continued alignment of inherent, personal characteristics is suggested to meet ongoing changes in the industry.

14 CFR 171.161 - Maintenance and operations requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... meet at a minimum the Federal Communications Commission's licensing requirements and show that he has the special knowledge and skills needed to maintain the facility, including proficiency in maintenance... facility. (2) Maintenance and operations by authorized persons only. (3) Federal Communications Commission...

14 CFR 171.161 - Maintenance and operations requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... meet at a minimum the Federal Communications Commission's licensing requirements and show that he has the special knowledge and skills needed to maintain the facility, including proficiency in maintenance... facility. (2) Maintenance and operations by authorized persons only. (3) Federal Communications Commission...

14 CFR 171.161 - Maintenance and operations requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... meet at a minimum the Federal Communications Commission's licensing requirements and show that he has the special knowledge and skills needed to maintain the facility, including proficiency in maintenance... facility. (2) Maintenance and operations by authorized persons only. (3) Federal Communications Commission...

14 CFR 171.161 - Maintenance and operations requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... meet at a minimum the Federal Communications Commission's licensing requirements and show that he has the special knowledge and skills needed to maintain the facility, including proficiency in maintenance... facility. (2) Maintenance and operations by authorized persons only. (3) Federal Communications Commission...

Tobacco-related mortality among persons with mental health and substance abuse problems.

PubMed

Bandiera, Frank C; Anteneh, Berhanu; Le, Thao; Delucchi, Kevin; Guydish, Joseph

2015-01-01

The rate of cigarette smoking is greater among persons with mental health and/or substance abuse problems. There are few population-based datasets with which to study tobacco mortality in these vulnerable groups. The Oregon Health Authority identified persons who received publicly-funded mental health or substance abuse services from January 1996 through December 2005. These cases were then matched to Oregon Vital Statistics records for all deaths (N= 148,761) in the period 1999-2005. The rate of tobacco-related death rates was higher among persons with substance abuse problems only (53.6%) and those with both substance abuse and mental health problems (46.8%), as compared to the general population (30.7%). The rate of tobacco-related deaths among persons with mental health problems (30%) was similar to that in the general population. Persons receiving substance abuse treatment alone, or receiving both substance abuse and mental health treatment, were more likely to die and more likely to die prematurely of tobacco-related causes as compared to the general population. Persons receiving mental health services alone were not more likely to die of tobacco-related causes, but tobacco-related deaths occurred earlier in this population.

Seamless personal health information system in cloud computing.

PubMed

Chung, Wan-Young; Fong, Ee May

2014-01-01

Noncontact ECG measurement has gained popularity these days due to its noninvasive and conveniences to be applied on daily life. This approach does not require any direct contact between patient's skin and sensor for physiological signal measurement. The noncontact ECG measurement is integrated with mobile healthcare system for health status monitoring. Mobile phone acts as the personal health information system displaying health status and body mass index (BMI) tracking. Besides that, it plays an important role being the medical guidance providing medical knowledge database including symptom checker and health fitness guidance. At the same time, the system also features some unique medical functions that cater to the living demand of the patients or users, including regular medication reminders, alert alarm, medical guidance, appointment scheduling. Lastly, we demonstrate mobile healthcare system with web application for extended uses, thus health data are clouded into web server system and web database storage. This allows remote health status monitoring easily and so forth it promotes a cost effective personal healthcare system.

Provision of Personal Healthcare Services by Local Health Departments: 2008-2013.

PubMed

Luo, Huabin; Sotnikov, Sergey; Winterbauer, Nancy

2015-09-01

The scope of local health department (LHD) involvement in providing personal healthcare services versus population-based services has been debated for decades. A 2012 IOM report suggests that LHDs should gradually withdraw from providing personal healthcare services. The purpose of this study is to assess the level of LHD involvement in provision of personal healthcare services during 2008-2013 and examine the association between provision of personal healthcare services and per capita public health expenditures. Data are from the 2013 survey of LHDs and Area Health Resource Files. The number, ratio, and share of revenue from personal healthcare services were estimated. Both linear and panel fixed effects models were used to examine the association between provision of personal healthcare services and per capita public health expenditures. Data were analyzed in 2014. The mean number of personal healthcare services provided by LHDs did not change significantly in 2008-2013. Overall, personal services constituted 28% of total service items. The share of revenue from personal services increased from 16.8% in 2008 to 20.3% in 2013. Results from the fixed effect panel models show a positive association between personal healthcare services' share of revenue and per capita expenditures (b=0.57, p<0.001). A lower share of revenue from personal healthcare services is associated with lower per capita expenditures. LHDs, especially those serving <25,000 people, are highly dependent on personal healthcare revenue to sustain per capita expenditures. LHDs may need to consider strategies to replace lost revenue from discontinuing provision of personal healthcare services. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

Issues in Worksite Health Promotion: A Personal Viewpoint.

ERIC Educational Resources Information Center

Shephard, Roy J.

2002-01-01

Attempts to change employees' personal behavior to promote a healthy workplace raise ethical and professional questions. Needs for successful wellness programs must be balanced against individual rights to remain unhealthy. The paper discusses potential fiscal benefits of wellness programs, ethics of motivation, personal responsibility for health,…

14 CFR 125.407 - Maintenance log: Airplanes.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Maintenance log: Airplanes. 125.407 Section... OPERATIONS: AIRPLANES HAVING A SEATING CAPACITY OF 20 OR MORE PASSENGERS OR A MAXIMUM PAYLOAD CAPACITY OF 6... Maintenance log: Airplanes. (a) Each person who takes corrective action or defers action concerning a reported...

14 CFR 125.407 - Maintenance log: Airplanes.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Maintenance log: Airplanes. 125.407 Section... OPERATIONS: AIRPLANES HAVING A SEATING CAPACITY OF 20 OR MORE PASSENGERS OR A MAXIMUM PAYLOAD CAPACITY OF 6... Maintenance log: Airplanes. (a) Each person who takes corrective action or defers action concerning a reported...

14 CFR 125.407 - Maintenance log: Airplanes.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Maintenance log: Airplanes. 125.407 Section... OPERATIONS: AIRPLANES HAVING A SEATING CAPACITY OF 20 OR MORE PASSENGERS OR A MAXIMUM PAYLOAD CAPACITY OF 6... Maintenance log: Airplanes. (a) Each person who takes corrective action or defers action concerning a reported...

14 CFR 125.407 - Maintenance log: Airplanes.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Maintenance log: Airplanes. 125.407 Section... OPERATIONS: AIRPLANES HAVING A SEATING CAPACITY OF 20 OR MORE PASSENGERS OR A MAXIMUM PAYLOAD CAPACITY OF 6... Maintenance log: Airplanes. (a) Each person who takes corrective action or defers action concerning a reported...

14 CFR 125.407 - Maintenance log: Airplanes.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Maintenance log: Airplanes. 125.407 Section... OPERATIONS: AIRPLANES HAVING A SEATING CAPACITY OF 20 OR MORE PASSENGERS OR A MAXIMUM PAYLOAD CAPACITY OF 6... Maintenance log: Airplanes. (a) Each person who takes corrective action or defers action concerning a reported...

Enhancing the Mental Health Promotion Component of a Health and Personal Development Programme in Irish Schools

ERIC Educational Resources Information Center

Fitzpatrick, Carol; Conlon, Andrea; Cleary, Deirdre; Power, Mike; King, Frances; Guerin, Suzanne

2013-01-01

This study set out to examine the impact of a health and personal development programme (the Social, Personal and Health Education Programme) which had been "enhanced" by the addition of a mental health promotion component. Students aged 12-16 years attending 17 secondary schools were randomly allocated as clusters to participate in…

Studies in Ambulatory Care Quality Assessment in the Indian Health Service. Volume III: Comparison of Rural Private Practice, Health Maintenance Organizations, and the Indian Health Service.

ERIC Educational Resources Information Center

Nutting, Paul A.; And Others

Utilizing a quality assessment methodology for ambulatory patient care currently under development by the Indian Health Service's (IHS) Office of Research and Development, comparisons were made between results derived from a pilot test in IHS service units, 2 metropolitan Health Maintenance Organizations (HMO), and 3 rural private practices.…

Web-based versus in-person methods for training lay community health advisors to implement health promotion workshops: participant outcomes from a cluster-randomized trial.

PubMed

Holt, Cheryl L; Tagai, Erin K; Santos, Sherie Lou Zara; Scheirer, Mary Ann; Bowie, Janice; Haider, Muhiuddin; Slade, Jimmie

2018-06-28

Project HEAL (Health through Early Awareness and Learning) is an implementation trial that compared two methods of training lay peer community health advisors (CHAs)-in-person ("Traditional") versus web-based ("Technology")-to conduct a series of three evidence-based cancer educational workshops in African American churches. This analysis reports on participant outcomes from Project HEAL. Fifteen churches were randomized to the two CHA training methods and the intervention impact was examined over 24 months. This study was conducted in Prince George's County, MD, and enrolled 375 church members age 40-75. Participants reported on knowledge and screening behaviors for breast, prostate, and colorectal cancer. Overall, cancer knowledge in all areas increased during the study period (p < .001). There were significant increases in digital rectal exam (p < .05), fecal occult blood test (p < .001), and colonoscopy (p < .01) at 24 months; however, this did not differ by study group. Mammography maintenance (56% overall) was evidenced by women reporting multiple mammograms within the study period. Participants attending all three workshops were more likely to report a fecal occult blood test or colonoscopy at 24 months (p < .05) than those who attended only one. These findings suggest that lay individuals can receive web-based training to successfully implement an evidence-based health promotion intervention that results in participant-level outcomes comparable with (a) people trained using the traditional classroom method and (b) previous efficacy trials. Findings have implications for resources and use of technology to increase widespread dissemination of evidence-based health promotion interventions through training lay persons in community settings.

An Interactive Computer-Based Training Program for Beginner Personal Computer Maintenance.

ERIC Educational Resources Information Center

Summers, Valerie Brooke

A computer-assisted instructional program, which was developed for teaching beginning computer maintenance to employees of Unisys, covered external hardware maintenance, proper diskette care, making software backups, and electro-static discharge prevention. The procedure used in developing the program was based upon the Dick and Carey (1985) model…

[Mental health as a front-line service for bewildered persons].

PubMed

Mulder, C L; van Weeghel, J; Wierdsma, A; Zoeteman, J; Schene, A

'Bewildered persons' have often been in the news over the last few years. There has been much discussion about the meaning of the term 'bewildered persons', the number of people involved, the way the problem should be tackled and the role of the mental health services.
AIM: To look critically at the term 'bewildered persons' and to discuss the suspected increase in numbers and the role of mental health services.
METHOD: Review and discussion of the relevant literature relating to 'bewildered persons' which has been published in the last 25 years.
RESULTS: The term 'bewildered persons' is a general label given by the Dutch police to several groups of people. Suicide rates are rising and more and more people are being compulsorily admitted to psychiatric clinics and hospitals. These factors indicate that increasing numbers of people may now be a danger to themselves and to their fellow-citizens. It is not clear whether the increase in numbers is real or simply reflects the extra attention given by the police. These people may in fact be a new group consisting of persons already known to the mental health services. A national team that aims to improve the care of 'bewildered persons' has made several recommendations to stop the increase: prevention and better cooperation between municipalities and mental health facilities. In our view the mental health services should operate at the front-line of the public mental health service, providing low-threshold diagnostics, assertive outreach and treatment for patients who have mental disorders but are unwilling to accept care or treatment. Such a service requires adequate finance, good cooperative agreements and removal of the bureaucratic and financial barriers that prevent patients from seeking care.
CONCLUSION: 'Bewildered persons' is an umbrella term used to denote people who urgently require care and are a public nuisance and who display disturbing behavior. 'Bewildered persons', who now form a part

77 FR 10662 - Guidance for Industry: Questions and Answers Regarding Establishment and Maintenance of Records...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-23

... Records by Persons Who Manufacture, Process, Pack, Transport, Distribute, Receive, Hold, or Import Food... ``Questions and Answers Regarding Establishment and Maintenance of Records by Persons Who Manufacture, Process... updated information pertaining to the establishment and maintenance of records by persons who manufacture...

Personal and Professional Well-Being of Surgical Residents in New England.

PubMed

Yoo, Peter S; Tackett, John J; Maxfield, Mark W; Fisher, Rosemarie; Huot, Stephen J; Longo, Walter E

2017-06-01

Although there is increasing literature about burnout and attrition among surgeons, little is known about personal and professional well-being of surgical trainees. General surgery residents from the 6 New England states participated in a cross-sectional, qualitative, self-reported survey to assess the domains of personal health maintenance, personal finance, work environment, and fatigue management as they relate to surgical training. All surgical residency programs in the New England region were invited to participate. Of these 19 programs, 10 elected to participate in the study. Three hundred and sixty-three total trainees were contacted with requests to participate, and 166 completed responses to the survey, resulting in a response rate of 44.9%. Ninety percent of respondents identified their programs as "university or academic." Substantial cohorts reported that during training they lacked basic healthcare maintenance visits (54%) and had undesired weight gain (44%). Although most found their stipends adequate, three-quarters worried about their finances (75%) and reported substantial educational debt (45%). Most residents enjoyed coming to work; however, the vast majority reported that work-related stress is moderate to extreme (92%). Most also reported that work-related stress negatively affects their overall well-being (72%). The mean Epworth Sleepiness Scale score among respondents was 14, consistent with moderate excessive daytime sleepiness. Surgical trainee well-being is critical to optimal patient care, career development, and burnout reduction. Surgical residents attend to their own preventive health maintenance, finances, sleep, and stress reduction with variable success. Residency programs should make modest programmatic accommodations to allow trainees to tend to various aspects of their personal well-being. Copyright © 2017. Published by Elsevier Inc.

Health, Maintenance, and Recovery of Soft Tissues around Implants.

PubMed

Wang, Yulan; Zhang, Yufeng; Miron, Richard J

2016-06-01

The health of peri-implant soft tissues is one of the most important aspects of osseointegration necessary for the long-term survival of dental implants. To review the process of soft tissue healing around osseointegrated implants and discuss the maintenance requirements as well as the possible short-comings of peri-implant soft tissue integration. Literature search on the process involved in osseointegration, soft tissue healing and currently available treatment modalities was performed and a brief description of each process was provided. The peri-implant interface has been shown to be less effective than natural teeth in resisting bacterial invasion because gingival fiber alignment and reduced vascular supply make it more vulnerable to subsequent peri-implant disease and future bone loss around implants. And we summarized common procedures which have been shown to be effective in preventing peri-implantitis disease progression as well as clinical techniques utilized to regenerate soft tissues with bone loss in advanced cases of peri-implantitis. Due to the difference between peri-implant interface and natural teeth, clinicians and patients should pay more attention in the maintenance and recovery of soft tissues around implants. © 2015 Wiley Periodicals, Inc.

Personal, Electronic, Secure National Library of Medicine Hosts Health Records Conference

MedlinePlus

... Bar Home Current Issue Past Issues EHR Personal, Electronic, Secure: National Library of Medicine Hosts Health Records ... One suggestion for saving money is to implement electronic personal health records. With this in mind, the ...

Personal needs versus national needs: public attitudes regarding health care priorities at the personal and national levels.

PubMed

Kaplan, Giora; Baron-Epel, Orna

2015-01-01

Many stakeholders have little or no confidence in the ability of the public to express their opinions on health policy issues. The claim often arises that lay people prioritize according to their own personal experiences and may lack the broad perspective necessary to understand the needs of the population at large. In order to test this claim empirically, this study compares the public's priorities regarding personal insurance to their priorities regarding allocation of national health resources. Thus, the study should shed light on the extent to which the public's priorities at the national level are a reflection of their priorities at the personal level. A telephone survey was conducted with a representative sample of the Israeli adult population aged 18 and over (n = 1,225). The public's priorities were assessed by asking interviewees to assume that they were the Minister of Health and from this point of view allocate an additional budget among various health areas. Their priorities at the personal level were assessed by asking interviewees to choose preferred items for inclusion in their personal supplementary health insurance. Over half of the respondents (54%) expressed different personal and national priorities. In multivariable logistic analysis, "population group" was the only variable found to be statistically significant; Jews were 1.8 times more likely than Arabs to give a similar response to both questions. Income level was of borderline significance. At least half of the population was able to differentiate between their personal needs and national policy needs. We do not advocate a decision-making process based on polls or referendums. However, we believe that people should be allowed to express their priorities regarding national policy issues, and that decision-makers should consider these as one of the factors used to determine policy decisions.

Combining iGoogle and personal health records to create a prototype personal health application for diabetes self-management.

PubMed

Fonda, Stephanie J; Kedziora, Richard J; Vigersky, Robert A; Bursell, Sven-Erik

2010-05-01

The aim of this project is to create a prototype for a personal health application (PHA) for patients (i.e., consumers) with diabetes by employing a user-centered design process. This article describes the design process for and resulting architecture, workflow, and functionality of such a PHA. For the design process, we conducted focus groups with people who have diabetes (n = 21) to ascertain their needs for a PHA. We then developed a prototype in response to these needs, and through additional focus groups and step-by-step demonstrations for people with diabetes as well as healthcare providers, we obtained feedback about the prototype. The feedback led to changes in the PHA's presentation and function. Focus group participants said they wanted a tool that could give them timely, readily available information on how diabetes-related domains interact, how their behaviors affect them, and what to do next. Thus, the prototype PHA is Internet-based, retrieves data for diabetes self-management from a personal health record, displays those data using gadgets in the consumer's iGoogle page, and makes the data available to a decision-support component that provides lifestyle-oriented advice. Manipulation of the data enables consumers to anticipate the results of future actions and to see interrelationships. A user-centered design process resulted in a PHA that uses technology that is publicly available, employs a personal health record, and is Internet based. This PHA can provide the backbone for a decision support system that can bring together the cornerstones of diabetes self-management and integrate them into the life of the person with diabetes.

Relationship of personal health experiences with interest in health careers among youth from an underserved area.

PubMed

Brooks, Alyssa T; Washington, Shakira; Boekeloo, Bradley O; Gilchrist, Brian; Wang, Min Q

2013-01-01

Only 10% of health professionals are from racial/ethnic minority groups, and much research has been focused on encouraging minorities to enter a health career. The lack of health workforce diversity has many implications for the effective delivery of care to an increasingly diverse US population. The goal of this analysis is to examine the influence of personal health experiences on interest in a health career. "Personal Health Experiences" is a newly created scaled variable that assesses the influence of direct and indirect health experiences of respondents. In a sample of 134 predominantly minority 10th graders from underprivileged neighborhoods, the scale had adequate psychometric properties (range 1-7; mean 4.44, SD 1.46, median 4.60, Cronbach's alpha 0.72), and multivariate regression modeling revealed that it predicted increased "Interest in Health Careers" (B=0.46, SE 0.10, p<0.01). Future research is needed to determine the role that personal health experiences play in career choices and one's success in health career decisions. Such information could, for example, help to refine health profession recruitment strategies.

Access to health care for persons with disabilities in rural South Africa.

PubMed

Vergunst, R; Swartz, L; Hem, K-G; Eide, A H; Mannan, H; MacLachlan, M; Mji, G; Braathen, S H; Schneider, M

2017-11-17

Global research suggests that persons with disabilities face barriers when accessing health care services. Yet, information regarding the nature of these barriers, especially in low-income and middle-income countries is sparse. Rural contexts in these countries may present greater barriers than urban contexts, but little is known about access issues in such contexts. There is a paucity of research in South Africa looking at "triple vulnerability" - poverty, disability and rurality. This study explored issues of access to health care for persons with disabilities in an impoverished rural area in South Africa. The study includes a quantitative survey with interviews with 773 participants in 527 households. Comparisons in terms of access to health care between persons with disabilities and persons with no disabilities were explored. The approach to data analysis included quantitative data analysis using descriptive and inferential statistics. Frequency and cross tabulation, comparing and contrasting the frequency of different phenomena between persons with disabilities and persons with no disabilities, were used. Chi-square tests and Analysis of Variance tests were then incorporated into the analysis. Persons with disabilities have a higher rate of unmet health needs as compared to non-disabled. In rural Madwaleni in South Africa, persons with disabilities faced significantly more barriers to accessing health care compared to persons without disabilities. Barriers increased with disability severity and was reduced with increasing level of education, living in a household without disabled members and with age. This study has shown that access to health care in a rural area in South Africa for persons with disabilities is more of an issue than for persons without disabilities in that they face more barriers. Implications are that we need to look beyond the medical issues of disability and address social and inclusion issues as well.

Health maintenance facility system effectiveness testing

NASA Technical Reports Server (NTRS)

Lloyd, Charles W.; Gosbee, John; Bueker, Richard; Kupra, Debra; Ruta, Mary

1993-01-01

The Medical Simulations Working Group conducted a series of medical simulations to evaluate the proposed Health Maintenance Facility (HMF) Preliminary Design Review (PDR) configuration. The goal of these simulations was to test the system effectiveness of the HMF PDR configurations. The objectives of the medical simulations are to (1) ensure fulfillment of requirements with this HMF design, (2) demonstrate the conformance of the system to human engineering design criteria, and (3) determine whether undesirable design or procedural features were introduced into the design. The simulations consisted of performing 6 different medical scenarios with the HMF mockup in the KRUG laboratory. The scenarios included representative medical procedures and used a broad spectrum of HMF equipment and supplies. Scripts were written and simulations performed by medical simulations working group members under observation from others. Data were collected by means of questionnaires, debriefings, and videotapes. Results were extracted and listed in the individual reports. Specific issues and recommendations from each simulation were compiled into the individual reports. General issues regarding the PDR design of the HMF are outlined in the summary report.

The Emergence of Personalized Health Technology.

PubMed

Allen, Luke Nelson; Christie, Gillian Pepall

2016-05-10

Personalized health technology is a noisy new entrant to the health space, yet to make a significant impact on population health but seemingly teeming with potential. Devices including wearable fitness trackers and healthy-living apps are designed to help users quantify and improve their health behaviors. Although the ethical issues surrounding data privacy have received much attention, little is being said about the impact on socioeconomic health inequalities. Populations who stand to benefit the most from these technologies are unable to afford, access, or use them. This paper outlines the negative impact that these technologies will have on inequalities unless their user base can be radically extended to include vulnerable populations. Frugal innovation and public-private partnership are discussed as the major means for reaching this end.

Geometric Data Perturbation-Based Personal Health Record Transactions in Cloud Computing

PubMed Central

Balasubramaniam, S.; Kavitha, V.

2015-01-01

Cloud computing is a new delivery model for information technology services and it typically involves the provision of dynamically scalable and often virtualized resources over the Internet. However, cloud computing raises concerns on how cloud service providers, user organizations, and governments should handle such information and interactions. Personal health records represent an emerging patient-centric model for health information exchange, and they are outsourced for storage by third parties, such as cloud providers. With these records, it is necessary for each patient to encrypt their own personal health data before uploading them to cloud servers. Current techniques for encryption primarily rely on conventional cryptographic approaches. However, key management issues remain largely unsolved with these cryptographic-based encryption techniques. We propose that personal health record transactions be managed using geometric data perturbation in cloud computing. In our proposed scheme, the personal health record database is perturbed using geometric data perturbation and outsourced to the Amazon EC2 cloud. PMID:25767826

Geometric data perturbation-based personal health record transactions in cloud computing.

PubMed

Balasubramaniam, S; Kavitha, V

2015-01-01

Cloud computing is a new delivery model for information technology services and it typically involves the provision of dynamically scalable and often virtualized resources over the Internet. However, cloud computing raises concerns on how cloud service providers, user organizations, and governments should handle such information and interactions. Personal health records represent an emerging patient-centric model for health information exchange, and they are outsourced for storage by third parties, such as cloud providers. With these records, it is necessary for each patient to encrypt their own personal health data before uploading them to cloud servers. Current techniques for encryption primarily rely on conventional cryptographic approaches. However, key management issues remain largely unsolved with these cryptographic-based encryption techniques. We propose that personal health record transactions be managed using geometric data perturbation in cloud computing. In our proposed scheme, the personal health record database is perturbed using geometric data perturbation and outsourced to the Amazon EC2 cloud.

The incidence of duodenal and gastric ulcers in a large health maintenance organization.

PubMed

Kurata, J H; Honda, G D; Frankl, H

1985-06-01

We report the incidence of peptic ulcers (duodenal, pyloric canal, gastric, and combined) verified by radiologic, endoscopic, or surgical evidence in a large Health Maintenance Organization (HMO) in Los Angeles, California. For members age 15 and above, the peptic ulcer incidence rate was 0.86 per 1,000 person-years (p-y) (males 1.10, females 0.63). The male to female sex ratio was 1.7. Two hundred twenty-two duodenal, 17 pyloric canal, 89 gastric, and 21 combined first-time diagnosed ulcer cases were located. For duodenal and pyloric canal ulcer, the incidence rate for members age 15 and above was 0.58 per 1,000 p-y (males 0.76, females 0.40). For gastric ulcer, the incidence rate for members age 15 and above was 0.21 per 1,000 p-y (males 0.23, females 0.18). The combined ulcer rate was 0.05 per 1,000 p-y (males 0.07, females 0.02). Gastric ulcer rates were two times higher in 1980 than in 1977. Peptic ulcer age-specific incidence rates increased with age. Incidence rates were much lower than those reported in previous studies, but the gastric to duodenal ulcer ratio and the age and sex relation to ulcer incidence were similar to those previously reported.

Personal Health Technologies in Employee Health Promotion: Usage Activity, Usefulness, and Health-Related Outcomes in a 1-Year Randomized Controlled Trial

PubMed Central

Orsama, Anna-Leena; Ahtinen, Aino; Hopsu, Leila; Leino, Timo; Korhonen, Ilkka

2013-01-01

Background Common risk factors such as obesity, poor nutrition, physical inactivity, stress, and sleep deprivation threaten the wellness and work ability of employees. Personal health technologies may help improve engagement in health promotion programs and maintenance of their effect. Objective This study investigated personal health technologies in supporting employee health promotion targeting multiple behavioral health risks. We studied the relations of usage activity to demographic and physiological characteristics, health-related outcomes (weight, aerobic fitness, blood pressure and cholesterol), and the perceived usefulness of technologies in wellness management. Methods We conducted a subgroup analysis of the technology group (114 subjects, 33 males, average age 45 years, average BMI 27.1 kg/m2) of a 3-arm randomized controlled trial (N=352). The trial was organized to study the efficacy of a face-to-face group intervention supported by technologies, including Web services, mobile applications, and personal monitoring devices. Technology usage was investigated based on log files and questionnaires. The associations between sustained usage of Web and mobile technologies and demographic and physiological characteristics were analyzed by comparing the baseline data of sustained and non-sustained users. The associations between sustained usage and changes in health-related outcomes were studied by repeated analysis of variance, using data measured by baseline and end questionnaires, and anthropometric and laboratory measurements. The experienced usability, usefulness, motivation, and barriers to using technologies were investigated by 4 questionnaires and 2 interviews. Results 111 subjects (97.4%) used technologies at some point of the study, and 33 (29.9%) were classified as sustained users of Web or mobile technologies. Simple technologies, weight scales and pedometer, attracted the most users. The sustained users were slightly older 47 years (95% CI 44 to 49

Personal health technologies in employee health promotion: usage activity, usefulness, and health-related outcomes in a 1-year randomized controlled trial.

PubMed

Mattila, Elina; Orsama, Anna-Leena; Ahtinen, Aino; Hopsu, Leila; Leino, Timo; Korhonen, Ilkka

2013-07-29

Common risk factors such as obesity, poor nutrition, physical inactivity, stress, and sleep deprivation threaten the wellness and work ability of employees. Personal health technologies may help improve engagement in health promotion programs and maintenance of their effect. This study investigated personal health technologies in supporting employee health promotion targeting multiple behavioral health risks. We studied the relations of usage activity to demographic and physiological characteristics, health-related outcomes (weight, aerobic fitness, blood pressure and cholesterol), and the perceived usefulness of technologies in wellness management. We conducted a subgroup analysis of the technology group (114 subjects, 33 males, average age 45 years, average BMI 27.1 kg/m(2)) of a 3-arm randomized controlled trial (N=352). The trial was organized to study the efficacy of a face-to-face group intervention supported by technologies, including Web services, mobile applications, and personal monitoring devices. Technology usage was investigated based on log files and questionnaires. The associations between sustained usage of Web and mobile technologies and demographic and physiological characteristics were analyzed by comparing the baseline data of sustained and non-sustained users. The associations between sustained usage and changes in health-related outcomes were studied by repeated analysis of variance, using data measured by baseline and end questionnaires, and anthropometric and laboratory measurements. The experienced usability, usefulness, motivation, and barriers to using technologies were investigated by 4 questionnaires and 2 interviews. 111 subjects (97.4%) used technologies at some point of the study, and 33 (29.9%) were classified as sustained users of Web or mobile technologies. Simple technologies, weight scales and pedometer, attracted the most users. The sustained users were slightly older 47 years (95% CI 44 to 49) versus 44 years (95% CI 42 to 45

Issues in implementing a knowledge-based ECG analyzer for personal mobile health monitoring.

PubMed

Goh, K W; Kim, E; Lavanya, J; Kim, Y; Soh, C B

2006-01-01

Advances in sensor technology, personal mobile devices, and wireless broadband communications are enabling the development of an integrated personal mobile health monitoring system that can provide patients with a useful tool to assess their own health and manage their personal health information anytime and anywhere. Personal mobile devices, such as PDAs and mobile phones, are becoming more powerful integrated information management tools and play a major role in many people's lives. We focus on designing a health-monitoring system for people who suffer from cardiac arrhythmias. We have developed computer simulation models to evaluate the performance of appropriate electrocardiogram (ECG) analysis techniques that can be implemented on personal mobile devices. This paper describes an ECG analyzer to perform ECG beat and episode detection and classification. We have obtained promising preliminary results from our study. Also, we discuss several key considerations when implementing a mobile health monitoring solution. The mobile ECG analyzer would become a front-end patient health data acquisition module, which is connected to the Personal Health Information Management System (PHIMS) for data repository.

Using Focus Groups to Identify Factors Affecting Healthful Weight Maintenance in Latino Immigrants

ERIC Educational Resources Information Center

Greaney, Mary L.; Lees, Faith D.; Lynch, Breanna; Sebelia, Linda; Greene, Geoffrey W.

2012-01-01

Objective: To explore (1) how migration influenced physical activity and dietary behaviors among Latino immigrants and (2) participants' perception of concepts related to a Health at Every Size (HAES) approach to weight maintenance (mindful eating, taking care of oneself). Methods: Four focus groups (n = 35), homogenous by sex, were conducted in…

Masonry. Teacher's Guide. Building Maintenance Units of Instruction.

ERIC Educational Resources Information Center

Barnes, Bill

This teaching guide on masonry building maintenance, one in a series of six publications designed for building maintenance instructors in Texas, is designed to give students an understanding of masonry construction. Introductory material provides teachers with information on use of the units of instruction and personalization and localization of…

Case management of persons with acquired immunodeficiency syndrome in San Francisco

PubMed Central

Benjamin, A. E.; Lee, Philip R.; Solkowitz, Sharon N.

1988-01-01

The acquired immunodeficiency syndrome (AIDS) epidemic represents a growing challenge for the health care system and for case management models applied to persons with AIDS. The experience of San Francisco highlights some of the issues involved in developing a case management system appropriate to the needs of persons with AIDS, as well as providers, and payers. Dramatic growth in the size and complexity of the AIDS caseload and the involvement of public, health maintenance organization, and community providers has required the increasing formalization and centralization of case management roles. Persistent questions about the definition and goals of case management complicate development of these services. PMID:10312974

42 CFR 476.72 - Review of the quality of care of risk-basis health maintenance organizations and competitive...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Review of the quality of care of risk-basis health maintenance organizations and competitive medical plans. 476.72 Section 476.72 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT...

[A preliminary evaluation of mental status and an investigation of occupational health knowledge demand in operating and maintenance personnel in wind power plants].

PubMed

Hu, S Q; Zhang, Q; Zhu, X H; Sun, K; Chen, S Z; Liu, A G; Luo, G L; Huang, W

2016-10-20

Objective: To investigate the mental status, level of occupational health knowledge, health behaviors, and occupational health knowledge demand in operating and maintenance personnel in wind power plants, and to provide a basis for formulating protective measures of occupational health for operating and maintenance personnel in wind power plants. Methods: A cluster sampling was performed in regionally representative wind power plants in the wind power industry from May 2014 to June 2015, and the Symptom Checklist-90 (SCL-90) and a self-made evaluation questionnaire were used to investigate the general status, mental health, and occupational health knowledge demand in 160 operating and maintenance workers. Results: Of all respondents, 26.9% had mental health issues. The awareness rate of infectious disease knowledge and preventive measures was 11.9%. Of all workers, 96.5% wanted to know the occupational hazard factors in the workplace, and 96.3% wanted to get the knowledge of the prevention of related diseases. Conclusion: Mental health issues in operating and maintenance personnel in wind power plants cannot be neglected and there is a high demand for occupational health services and related knowledge. Comprehensive intervention measures for health promotion in the workplace should be adopted to improve working environment, enhance individual mental health education, increase the level of occupational health management, and protect the health of workers.

Blurring personal health and public priorities: an analysis of celebrity health narratives in the public sphere.

PubMed

Beck, Christina S; Aubuchon, Stellina M; McKenna, Timothy P; Ruhl, Stephanie; Simmons, Nathaniel

2014-01-01

This article explores the functions of personal celebrity health narratives in the public sphere. This study examines data about 157 celebrities, including athletes, actors, musicians, and politicians, who have shared private information regarding a personal health situation (or that of a loved one) with others in the public domain. Part of a larger project on celebrity health narratives, this article highlights three key functions that celebrity health narratives perform--education, inspiration, and activism--and discusses the implications for celebrities and for public conversations about health-related issues.

Vaccination and Health Maintenance Issues to Consider in Patients With Inflammatory Bowel Disease

PubMed Central

Wasan, Sharmeel K.; Farraye, Francis A.

2017-01-01

Patients with inflammatory bowel disease (IBD) do not receive routine preventive care at the same rate as the general population. IBD places patients at increased risk for developing vaccine-preventable illnesses. This risk is further exacerbated by immunosuppressive therapy. This article highlights the necessary vaccinations for IBD patients and the timing of vaccination for immunosuppressed patients, and discusses the health maintenance needs and preventive care issues related to heart disease, smoking, osteoporosis, mental health, cervical cancer, and skin cancer. PMID:29339947

Is Personality Associated with Health Care Use by Older Adults?

PubMed Central

Friedman, Bruce; Veazie, Peter J; Chapman, Benjamin P; Manning, Willard G; Duberstein, Paul R

2013-01-01

Context The patterns of health care utilization in the United States pose well-established challenges for public policy. Although economic and sociological research has resulted in considerable knowledge about what influences the use of health services, the psychological literature in this area is underdeveloped. Importantly, it is not known whether personality traits are associated with older adults’ use of acute and long-term care services. Methods Data were collected from 1,074 community-dwelling seniors participating in a Medicare demonstration. First they completed a self-report questionnaire measuring the “Big Five” personality traits: Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. During the next two years, the participants maintained daily journals of their use of health care services. We used regression models based on the Andersen behavioral model of health care utilization to test for associations. Findings Our hypothesis that higher Neuroticism would be associated with greater health care use was confirmed for three services—probability of any emergency department (ED) use, likelihood of any custodial nursing home use, and more skilled nursing facility (SNF) days for SNF users—but was disconfirmed for hospital days for those hospitalized. Higher Openness to Experience was associated with a greater likelihood of custodial home care use, and higher Agreeableness and lower Conscientiousness with a higher probability of custodial nursing home use. For users, lower Openness was associated with more ED visits and SNF days, and lower Conscientiousness with more ED visits. For many traits with significant associations, the predicted use was 16 to 30 percent greater for people high (low) versus low (high) in specific traits. Conclusions Personality traits are associated with Medicare beneficiaries’ use of many expensive health care services, findings that have implications for health services research and

The use of self-quantification systems for personal health information: big data management activities and prospects.

PubMed

Almalki, Manal; Gray, Kathleen; Sanchez, Fernando Martin

2015-01-01

Self-quantification is seen as an emerging paradigm for health care self-management. Self-quantification systems (SQS) can be used for tracking, monitoring, and quantifying health aspects including mental, emotional, physical, and social aspects in order to gain self-knowledge. However, there has been a lack of a systematic approach for conceptualising and mapping the essential activities that are undertaken by individuals who are using SQS in order to improve health outcomes. In this paper, we propose a new model of personal health information self-quantification systems (PHI-SQS). PHI-SQS model describes two types of activities that individuals go through during their journey of health self-managed practice, which are 'self-quantification' and 'self-activation'. In this paper, we aimed to examine thoroughly the first type of activity in PHI-SQS which is 'self-quantification'. Our objectives were to review the data management processes currently supported in a representative set of self-quantification tools and ancillary applications, and provide a systematic approach for conceptualising and mapping these processes with the individuals' activities. We reviewed and compared eleven self-quantification tools and applications (Zeo Sleep Manager, Fitbit, Actipressure, MoodPanda, iBGStar, Sensaris Senspod, 23andMe, uBiome, Digifit, BodyTrack, and Wikilife), that collect three key health data types (Environmental exposure, Physiological patterns, Genetic traits). We investigated the interaction taking place at different data flow stages between the individual user and the self-quantification technology used. We found that these eleven self-quantification tools and applications represent two major tool types (primary and secondary self-quantification systems). In each type, the individuals experience different processes and activities which are substantially influenced by the technologies' data management capabilities. Self-quantification in personal health maintenance

Personal responsibility within health policy: unethical and ineffective.

PubMed

Friesen, Phoebe

2018-01-01

This paper argues against incorporating assessments of individual responsibility into healthcare policies by expanding an existing argument and offering a rebuttal to an argument in favour of such policies. First, it is argued that what primarily underlies discussions surrounding personal responsibility and healthcare is not causal responsibility, moral responsibility or culpability, as one might expect, but biases towards particular highly stigmatised behaviours. A challenge is posed for proponents of taking personal responsibility into account within health policy to either expand the debate to also include socially accepted behaviours or to provide an alternative explanation of the narrowly focused discussion. Second, a critical response is offered to arguments that claim that policies based on personal responsibility would lead to several positive outcomes including healthy behaviour change, better health outcomes and decreases in healthcare spending. It is argued that using individual responsibility as a basis for resource allocation in healthcare is unlikely to motivate positive behaviour changes, and is likely to increase inequality which may lead to worse health outcomes overall. Finally, the case of West Virginia's Medicaid reform is examined, which raises a worry that policies focused on personal responsibility have the potential to lead to increases in medical spending overall. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

14 CFR 43.3 - Persons authorized to perform maintenance, preventive maintenance, rebuilding, and alterations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... certificate holder has written procedures available to the pilot to evaluate the accomplishment of the task... alterations as provided in part 121 or 135. (g) Except for holders of a sport pilot certificate, the holder of a pilot certificate issued under part 61 may perform preventive maintenance on any aircraft owned or...

Maintenance of stellite and tungsten carbide saw tips: respiratory health and exposure-response evaluations.

PubMed Central

Kennedy, S M; Chan-Yeung, M; Marion, S; Lea, J; Teschke, K

1995-01-01

OBJECTIVE--To study exposure to cobalt and chromium in saw maintenance rooms and test respiratory health among saw filers at lumber mills. Hard-metal lung disease is associated with cobalt in the manufacture of tungsten carbide tools; recently it has also been reported among tool maintenance workers. Lumber mills often use saws tipped with tungsten carbide or with a newer alloy, stellite (containing more cobalt, as well as chromium). METHODS--A cross sectional study of 118 saw filers at eight lumber mills was carried out that included a standardised questionnaire, spirometry, personal air sampling, and examination of tasks every 10 minutes (by observation). Comparison data were from a study of bus mechanics tested with similar methods. RESULTS AND CONCLUSION--Cobalt exposure was associated with tungsten carbide grinding but not with stellite grinding. Chromium exposure was associated mainly with stellite welding. Saw filers had a twofold increase in phlegm and wheeze (P < 0.01) and a threefold increase in cough, phlegm, and wheeze related to work (P < 0.001), but no increase in breathlessness. Stellite welding was associated with a significant increase in nasal symptoms and cough related to work and a small decrease in airflow (forced expiratory volume in one second/forced vital capacity (FEV1/FVC%), P < 0.05). Saw filers wet grinding with tungsten carbide had significant reductions in forced expiratory lung volumes (FEV1 and FVC, P < 0.05) and were significantly more likely to have FEV1 and FVC values in the abnormal range. Cobalt exposure (in wet grinding) and duration of work that involved tungsten carbide grinding were both associated with significant reductions in FEV1 and FVC. Average cobalt exposures in this study were about 5 micrograms/m3, well below the currently accepted permissible concentration, which suggests that the current workplace limit for cobalt may be too high. PMID:7735392

Autonomous motivation is associated with the maintenance stage of behaviour change in people with affective disorders.

PubMed

Vancampfort, Davy; Moens, Herman; Madou, Tomas; De Backer, Tanja; Vallons, Veerle; Bruyninx, Peter; Vanheuverzwijn, Sarah; Mota, Cindy Teixeira; Soundy, Andy; Probst, Michel

2016-06-30

The present study examined whether in people with affective disorders motives for adopting and maintaining physical activity recommendations (as formulated by the self-determination theory) differed across the stages of behaviour change (identified by the transtheoretical model). A total of 165 (105♀) persons (45.6±14.2years) with affective disorders [major depressive disorder (n=96) or bipolar disorder (n=69)] completed the Behavioural Regulation in Exercise Questionnaire-2 and the Patient-centred Assessment and Counselling for Exercise questionnaire. Discriminant and multivariate analyses demonstrated that persons with affective disorders at the early stages of change have less autonomous and more controlled physical activity motives than those at the later stages. Our results suggest that autonomous motivation may have an important role to play in the maintenance of health recommendations in persons with affective disorders. Longitudinal and intervention studies should be designed in people with affective disorders to identify the causal pathways between motives for maintaining health recommendations, effective changes in health behaviour and physical and mental health outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Prevalence and Safety of Intravenous Immunoglobulin Administration During Maintenance Chemotherapy in Children with Acute Lymphoblastic Leukemia in First Complete Remission: A Health Maintenance Organization Perspective.

PubMed

Van Winkle, Patrick; Burchette, Raoul; Kim, Raymond; Raghunathan, Rukmani; Qureshi, Naveen

2018-04-09

Children with acute lymphoblastic leukemia (ALL) in first complete remission (CR1) experience hypogammaglobulinemia and are at risk of sepsis during maintenance chemotherapy. Intravenous immunoglobulin (IVIG) has been used to try to circumvent this risk, but no data exist regarding its safety and prevalence in a health maintenance organization. To evaluate the prevalence and safety of IVIG in children with ALL in CR1 during maintenance chemotherapy. A multicenter, retrospective cohort study of consecutive children with ALL in CR1 during maintenance chemotherapy from 2008 to 2014. Groups treated with or without IVIG were compared using nonparametric statistics. Multivariate logistic regression involved all variables available before maintenance therapy began. One hundred eighteen patients were included (53% males), aged 9 months to 19 years. Thirty of 31 patients (97%) who had immunoglobulins analyzed before IVIG were hypogammaglobulinemic. Thirty-six patients (30%) received IVIG during maintenance chemotherapy. Patients received an average of 10.5 IVIG doses (range = 1-31). Ninety-seven percent of doses were administered without a transfusion reaction. Other factors associated with IVIG use were prior double-delayed intensification (odds ratio = 5.36, 95% confidence interval = 1.3-27.49, p = 0.026) and episodes of bacteremia or fungemia before maintenance chemotherapy (odds ratio = 3.04, 95% confidence interval = 1.25-7.51, p = 0.015). Use of IVIG in children with ALL in CR1 with hypogammaglobulinemia occurred in approximately 30% of patients and was well tolerated. Administration of IVIG significantly correlated with a history of double-delayed intensification and prior bacteremia or fungemia.

An Educational Program for Sub-Professional Personnel to be Employed in Health Maintenance Organizations. Final Report.

ERIC Educational Resources Information Center

HMO Management, Inc., Los Angeles, CA.

Through Medicaid, the Health Maintenance Organization Act (HMO), and Prepaid Health Programs (PHP) approaches were established whereby the government can help alleviate the medical problems of the needy. A program to educate and train students in California in the philosophy, administration, and development of PHP was developed in response to…

30 CFR 75.1915 - Training and qualification of persons working on diesel-powered equipment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... on diesel-powered equipment. 75.1915 Section 75.1915 Mineral Resources MINE SAFETY AND HEALTH... Diesel-Powered Equipment § 75.1915 Training and qualification of persons working on diesel-powered equipment. (a) To be qualified to perform maintenance, repairs, examinations and tests on diesel-powered...

30 CFR 75.1915 - Training and qualification of persons working on diesel-powered equipment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... on diesel-powered equipment. 75.1915 Section 75.1915 Mineral Resources MINE SAFETY AND HEALTH... Diesel-Powered Equipment § 75.1915 Training and qualification of persons working on diesel-powered equipment. (a) To be qualified to perform maintenance, repairs, examinations and tests on diesel-powered...

Comparing Personal Health Practices: Individuals with mental illness and the general Canadian population.

PubMed

Schofield, Ruth; Forchui, Cheryl; Montgomery, Phyllis; Rudnic, Abraham; Edwards, Betty; Meier, Amanda; Speechley, Mark

2016-06-01

Individuals with mental illness often live in chronic poverty, which is associated with personal health practices such as tobacco use and poor nutrition that disrupt physical health. The purpose of our study was to examine whether differences exist in personal health and health practices - related to nutrition, physical activity, smoking, alcohol consumption and sleep - between a cohort of individuals with mental illness in southwestern Ontario and the general Canadian population. The study sample consisted of 250 individuals who had had a psychiatric diagnosis for at least one year. We conducted a structured quantitative interview with each person to gather information about their personal health and health practices, using question wording from the National Population Health Survey and the Canadian Community Health Survey. We calculated 95% confidence intervals for our results and used them to compare our data with Canadian norms. Individuals with mental illness are significantly more likely than the general population to have a poor diet, experience poor sleep and consume alcohol in excess. It is important for nurses, health-care organizations and policy-makers to be aware that a number of factors may be influencing the personal health and health practices of individuals with mental illness and that this population may require different health promotion strategies to support a healthy lifestyle.

Interaction of Occupational and Personal Risk Factors in Workforce Health and Safety

PubMed Central

Pandalai, Sudha; Wulsin, Victoria; Chun, HeeKyoung

2012-01-01

Most diseases, injuries, and other health conditions experienced by working people are multifactorial, especially as the workforce ages. Evidence supporting the role of work and personal risk factors in the health of working people is frequently underused in developing interventions. Achieving a longer, healthy working life requires a comprehensive preventive approach. To help develop such an approach, we evaluated the influence of both occupational and personal risk factors on workforce health. We present 32 examples illustrating 4 combinatorial models of occupational hazards and personal risk factors (genetics, age, gender, chronic disease, obesity, smoking, alcohol use, prescription drug use). Models that address occupational and personal risk factors and their interactions can improve our understanding of health hazards and guide research and interventions. PMID:22021293

Preventive, Lifestyle, and Personal Health Behaviors among Physicians

ERIC Educational Resources Information Center

Bazargan, Mohsen; Makar, Marian; Bazargan-Hejazi, Shahrzad; Ani, Chizobam; Wolf, Kenneth E.

2009-01-01

Objective: This study examines personal health behaviors and wellness, health-related lifestyles, and prevention screening practices among licensed physicians. Methods: An anonymous questionnaire was mailed to a random sample of 1,875 physicians practicing in California. Data from 763 returned questionnaires (41%) were analyzed. Results: Our data…

US Spending on Personal Health Care and Public Health, 1996-2013.

PubMed

Dieleman, Joseph L; Baral, Ranju; Birger, Maxwell; Bui, Anthony L; Bulchis, Anne; Chapin, Abigail; Hamavid, Hannah; Horst, Cody; Johnson, Elizabeth K; Joseph, Jonathan; Lavado, Rouselle; Lomsadze, Liya; Reynolds, Alex; Squires, Ellen; Campbell, Madeline; DeCenso, Brendan; Dicker, Daniel; Flaxman, Abraham D; Gabert, Rose; Highfill, Tina; Naghavi, Mohsen; Nightingale, Noelle; Templin, Tara; Tobias, Martin I; Vos, Theo; Murray, Christopher J L

2016-12-27

US health care spending has continued to increase, and now accounts for more than 17% of the US economy. Despite the size and growth of this spending, little is known about how spending on each condition varies by age and across time. To systematically and comprehensively estimate US spending on personal health care and public health, according to condition, age and sex group, and type of care. Government budgets, insurance claims, facility surveys, household surveys, and official US records from 1996 through 2013 were collected and combined. In total, 183 sources of data were used to estimate spending for 155 conditions (including cancer, which was disaggregated into 29 conditions). For each record, spending was extracted, along with the age and sex of the patient, and the type of care. Spending was adjusted to reflect the health condition treated, rather than the primary diagnosis. Encounter with US health care system. National spending estimates stratified by condition, age and sex group, and type of care. From 1996 through 2013, $30.1 trillion of personal health care spending was disaggregated by 155 conditions, age and sex group, and type of care. Among these 155 conditions, diabetes had the highest health care spending in 2013, with an estimated $101.4 billion (uncertainty interval [UI], $96.7 billion-$106.5 billion) in spending, including 57.6% (UI, 53.8%-62.1%) spent on pharmaceuticals and 23.5% (UI, 21.7%-25.7%) spent on ambulatory care. Ischemic heart disease accounted for the second-highest amount of health care spending in 2013, with estimated spending of $88.1 billion (UI, $82.7 billion-$92.9 billion), and low back and neck pain accounted for the third-highest amount, with estimated health care spending of $87.6 billion (UI, $67.5 billion-$94.1 billion). The conditions with the highest spending levels varied by age, sex, type of care, and year. Personal health care spending increased for 143 of the 155 conditions from 1996 through 2013. Spending on low

Personal Project Content and Stress: Relations to Subjective Health and Depressive Mood

ERIC Educational Resources Information Center

Wallenius, Marjut A.

2007-01-01

The aim of this study was to examine how personal project stress and stress related to different personal project contents are associated with subjective health and depressive mood among adults. Participants were 343 men and women (20-76 years old), who responded to the questionnaire including the Little's Personal Project Analysis, and health and…

The emotional health and well-being of Canadians who care for persons with mental health or addictions problems.

PubMed

Slaunwhite, Amanda K; Ronis, Scott T; Sun, Yuewen; Peters, Paul A

2017-05-01

The purpose of this project was to examine the emotional health and well-being of Canadian caregivers of persons with significant mental health or addictions problems. We assessed the emotional health of caregivers by care-receiver condition type (i.e. mental health or addictions vs. physical or other health problems), levels of caregiver stress and methods particularly for reducing stress among caregivers of persons with mental health or addictions disorders. Weighted cross-sectional data from the 2012 General Social Survey (Caregiving and Care Receiving) were modelled using weighted descriptive and logistic regression analyses to examine levels of stress and the emotional health and well-being of caregivers by care-receiver condition type. Caregivers of persons with mental health or addictions problems were more likely to report that caregiving was very stressful and that they felt depressed, tired, worried or anxious, overwhelmed; lonely or isolated; short-tempered or irritable; and resentful because of their caregiving responsibilities. The results of this study suggest that mental health and addictions caregivers may experience disparate stressors and require varying services and supports relative to caregivers of persons with physical or other health conditions. © 2016 John Wiley & Sons Ltd.

Mechanisms by which childhood personality traits influence adult health status: educational attainment and healthy behaviors.

PubMed

Hampson, Sarah E; Goldberg, Lewis R; Vogt, Thomas M; Dubanoski, Joan P

2007-01-01

The purpose of this study was to test a life span health behavior model in which educational attainment and health behaviors (eating habits, smoking, and physical activity) were hypothesized as mechanisms to account for relations between teacher ratings of childhood personality traits and self-reported health status at midlife. The model was tested on 1,054 members of the Hawaii Personality and Health cohort, which is a population-based cohort participating in a longitudinal study of personality and health spanning 40 years from childhood to midlife. Childhood Agreeableness, Conscientiousness, and Intellect-Imagination influenced adult health status indirectly through educational attainment, healthy eating habits, and smoking. Several direct effects of childhood traits on health behaviors and health status were also observed. The model extends past associations found between personality traits and health behaviors or health status by identifying a life-course pathway based on the health behavior model through which early childhood traits influence adult health status. The additional direct effects of personality traits indicate that health behavior mechanisms may not provide a complete account of relations between personality and health.

HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention.

PubMed Central

Clements-Nolle, K; Marx, R; Guzman, R; Katz, M

2001-01-01

OBJECTIVES: This study described HIV prevalence, risk behaviors, health care use, and mental health status of male-to-female and female-to-male transgender persons and determined factors associated with HIV. METHODS: We recruited transgender persons through targeted sampling, respondent-driven sampling, and agency referrals; 392 male-to-female and 123 female-to-male transgender persons were interviewed and tested for HIV. RESULTS: HIV prevalence among male-to-female transgender persons was 35%. African American race (adjusted odds ratio [OR] = 5.81; 95% confidence interval [CI] = 2.82, 11.96), a history of injection drug use (OR = 2.69; 95% CI = 1.56, 4.62), multiple sex partners (adjusted OR = 2.64; 95% CI = 1.50, 4.62), and low education (adjusted OR = 2.08; 95% CI = 1.17, 3.68) were independently associated with HIV. Among female-to-male transgender persons, HIV prevalence (2%) and risk behaviors were much lower. Most male-to-female (78%) and female-to-male (83%) transgender persons had seen a medical provider in the past 6 months. Sixty-two percent of the male-to-female and 55% of the female-to-male transgender persons were depressed; 32% of each population had attempted suicide. CONCLUSIONS: High HIV prevalence suggests an urgent need for risk reduction interventions for male-to-female transgender persons. Recent contact with medical providers was observed, suggesting that medical providers could provide an important link to needed prevention, health, and social services. PMID:11392934

30 CFR 75.1508 - Training and records for examination, maintenance and repair of refuge alternatives and components.

Code of Federal Regulations, 2010 CFR

2010-07-01

... repair, the person conducting the maintenance or repair shall make a record of all corrective action..., maintenance and repair of refuge alternatives and components. 75.1508 Section 75.1508 Mineral Resources MINE..., maintenance and repair of refuge alternatives and components. (a) Persons examining, maintaining, or repairing...

HealthATM: personal health cyberinfrastructure for underserved populations.

PubMed

Botts, Nathan E; Horan, Thomas A; Thoms, Brian P

2011-05-01

There is an opportunity for personal health record (PHR) systems to play a vital role in fostering health self-management within underserved populations. If properly designed and promoted, it is possible that patients will use PHRs to become more empowered in taking an active role toward managing their health needs. This research examines the potential of a cyberinfrastructure-based PHR to encourage patient activation in health care, while also having population health implications. A multi-phased, iterative research approach was used to design and evaluate a PHR system called HealthATM, which utilizes services from a cloud computing environment. These services were integrated into an ATM-style interface aimed at providing a broad range of health consumers with the ability to manage health conditions and encourage accomplishment of health goals. Evaluation of the PHR included 115 patients who were clients of several free clinics in Los Angeles County. The majority of patients perceived ease of use (74%) and confidence (73%) in using the HealthATM system, and thought they would like to use it frequently (73%). Patients also indicated a belief in being responsible for their own health. However, fewer felt as though they were able to maintain necessary life changes to improve their health. Findings from the field tests suggest that PHRs can be a beneficial health management tool for underserved populations. In order for these types of tools to be effective within safety-net communities, they must be technically accessible and provide meaningful opportunities to increase patient engagement in their health care. Copyright © 2011. Published by Elsevier Inc.

Pricing and performance in health maintenance organizations: a strategic management perspective.

PubMed

Conant, J S; Mokwa, M P; Burnett, J J

1989-03-01

Innovative, consumer-oriented pricing strategies have contributed to the impressive growth of health maintenance organizations (HMOs). In a national study of HMO marketing directors, the relationships between strategic management style and (1) the relative importance of pricing in competitive marketing strategy, (2) the effectiveness of price strategy planning, and (3) financial performance are examined. The findings indicate that HMOs practicing effective price planning also perform well on an overall basis. Insight into the content and substance of HMO pricing strategies is also provided.

[Present state of occupational hazards in automobile maintenance industry in Beijing, China].

PubMed

Li, Jue; Wang, Huining; Wang, Zhongxu; Wang, Hong; Niu, Dongsheng; Xu, Xiaohong; Sun, Wei

2014-06-01

To explore the present state of occupational hazards and health status of workers in the automobile maintenance industry. The monitoring results of occupational hazards in 25 automobile maintenance companies, occupational health examination results of 751 male workers in 63 automobile maintenance companies, and physical examination results of 205 male students in one Research Institute were statistically analyzed in 2012. The concentrations of benzene, toluene, xylene, ethyl acetate, and butyl acetate in the workplace were 0.3∼21.7, 0.4∼40.3, 0.4∼84.8, 1.9∼34.3, and 0.7∼516.7 mg/m(3), respectively; benzene concentration exceeded the upper limit in two workplaces, and butyl acetate concentration exceeded the upper limit in one workplace. The intensity of noise was 70.3∼ 91.3 dB (A) and exceeded the upper limit in one workplace. The prevalence of blood system involvement in spray painters was 15.6%, significant higher than that of the control group (P < 0.05). High-frequency hearing loss was detected in 53.9%of all metalers. Logistic regression analysis indicated that blood system involvement was not correlated with age and working years in spray painters; high-frequency hearing loss in metalers was positively correlated with age, but not correlated with working years. The status of occupational hazards in the automobile maintenance industry should not be neglected, and the management of noxious positions and personal protection should be strengthened in enterprises.

Going Mobile: How Mobile Personal Health Records Can Improve Health Care During Emergencies

PubMed Central

Ravi, Sanjana

2014-01-01

Personal health records (PHRs), in contrast to electronic health records (EHRs) or electronic medical records (EMRs), are health records in which data are accessible to patients and not just providers. In recent years, many systems have enabled PHRs to be available in a mobile format. Mobile PHRs (mPHRs) allow patients to access health information via the Internet or telecommunication devices, such as mobile phones, personal digital assistants, and tablet computers. mPHRs have the potential to help patients and providers identify medical conditions and prescriptions from numerous locations, which may minimize medical errors and identify improvements to health behaviors during emergencies, when patients present to a new provider, or EHRs are not accessible. Despite their benefits, numerous challenges inhibit the adoption and further development of mPHRs, including integration into overall health technology infrastructure and legal and security concerns. This paper identifies the benefits of mPHRs during emergencies and the remaining challenges impeding full adoption and use, and provides recommendations to federal agencies to enhance support and use of mPHRs. PMID:25098942

Clinical Preventive Services for Older Adults: The Interface Between Personal Health Care and Public Health Services

PubMed Central

Richards, Chesley L.; Shenson, Douglas

2012-01-01

Healthy aging must become a priority objective for both population and personal health services, and will require innovative prevention programming to span those systems. Uptake of essential clinical preventive services is currently suboptimal among adults, owing to a number of system- and office-based care barriers. To achieve maximum health results, prevention must be integrated across community and clinical settings. Many preventive services are portable, deliverable in either clinical or community settings. Capitalizing on that flexibility can improve uptake and health outcomes. Significant reductions in health disparities, mortality, and morbidity, along with decreases in health spending, are achievable through improved collaboration and synergy between population health and personal health systems. PMID:22390505

Core Self-Evaluations as Personal Factors in the World Health Organization's International Classification of Functioning, Disability and Health Model: An Application in Persons with Spinal Cord Injury

ERIC Educational Resources Information Center

Yaghmanian, Rana; Smedema, Susan Miller; Thompson, Kerry

2017-01-01

Purpose: To evaluate Chan, Gelman, Ditchman, Kim, and Chiu's (2009) revised World Health Organization's International Classification of Functioning, Disability and Health (ICF) model using core self-evaluations (CSE) to account for Personal Factors in persons with spinal cord injury (SCI). Method: One hundred eighty-seven adults with SCI were…

Web-browser encryption of personal health information

PubMed Central

2011-01-01

Background Electronic health records provide access to an unprecedented amount of clinical data for research that can accelerate the development of effective medical practices. However it is important to protect patient confidentiality, as many medical conditions are stigmatized and disclosure could result in personal and/or financial loss. Results We describe a system for remote data entry that allows the data that would identify the patient to be encrypted in the web browser of the person entering the data. These data cannot be decrypted on the server by the staff at the data center but can be decrypted by the person entering the data or their delegate. We developed this system to solve a problem that arose in the context of clinical research, but it is applicable in a range of situations where sensitive information is stored and updated in a database and it is necessary to ensure that it cannot be viewed by any except those intentionally given access. Conclusion By developing this system, we are able to centralize the collection of some patient data while minimizing the risk that protected health information be made available to study personnel who are not authorized to use it. PMID:22073940

Personality differences predict health-risk behaviors in young adulthood: evidence from a longitudinal study.

PubMed

Caspi, A; Begg, D; Dickson, N; Harrington, H; Langley, J; Moffitt, T E; Silva, P A

1997-11-01

In a longitudinal study of a birth cohort, the authors identified youth involved in each of 4 different health-risk behaviors at age 21: alcohol dependence, violent crime, unsafe sex, and dangerous driving habits. At age 18, the Multidimensional Personality Questionnaire (MPQ) was used to assess 10 distinct personality traits. At age 3, observational measures were used to classify children into distinct temperament groups. Results showed that a similar constellation of adolescent personality traits, with developmental origins in childhood, is linked to different health-risk behaviors at 21. Associations between the same personality traits and different health-risk behaviors were not an artifact of the same people engaging in different health-risk behaviors; rather, these associations implicated the same personality type in different but related behaviors. In planning campaigns, health professionals may need to design programs that appeal to the unique psychological makeup of persons most at risk for health-risk behaviors.

Personal health systems and value creation mechanisms in occupational health care.

PubMed

Auvinen, Ari-Matti

2007-01-01

Personal Health Systems are believed to have great business potential among citizens, but they might reach also an important market in occupational health care. However, in reaching the occupational health care market, it is important to understand the value creation and value configuration mechanisms of this particular market. This paper also claims that in such a business-to-business market service integrators are needed to compose for the various customers specific offerings combing a tailored variety of products and services to suit their specific needs.

Remote personal health monitoring with radio waves

NASA Astrophysics Data System (ADS)

Nguyen, Andrew

2008-03-01

We present several techniques utilizing radio-frequency identification (RFID) technology for personal health monitoring. One technique involves using RFID sensors external to the human body, while another technique uses both internal and external RFID sensors. Simultaneous monitoring of many patients in a hospital setting can also be done using networks of RFID sensors. All the monitoring are done wirelessly, either continuously or periodically in any interval, in which the sensors collect information on human parts such as the lungs or heart and transmit this information to a router, PC or PDA device connected to the internet, from which patient's condition can be diagnosed and viewed by authorized medical professionals in remote locations. Instantaneous information allows medical professionals to intervene properly and timely to prevent possible catastrophic effects to patients. The continuously monitored information provides medical professionals more complete and long-term studies of patients. All of these result in not only enhancement of the health treatment quality but also significant reduction of medical expenditure. These techniques demonstrate that health monitoring of patients can be done wirelessly at any time and any place without interfering with the patients' normal activities. Implementing the RFID technology would not only help reduce the enormous and significantly growing medical costs in the U.S.A., but also help improve the health treatment capability as well as enhance the understanding of long-term personal health and illness.

Public health-specific personal disaster preparedness training: an academic-practice collaboration.

PubMed

Kohn, Sivan; Semon, Natalie; Hedlin, Haley K; Thompson, Carol B; Marum, Felicity; Jenkins, Sebra; Slemp, Catherine C; Barnett, Daniel J

2014-01-01

To measure the following three relevant outcomes of a personal preparedness curriculum for public health workers: 1) the extent of change (increase) in knowledge about personal preparedness activities and knowledge about tools for conducting personal preparedness activities; 2) the extent of change (increase) in preparedness activities performed post-training and/or confidence in conducting these tasks; and 3) an understanding of how to improve levels of personal preparedness using the Extended Parallel Process Model (EPPM) framework. Cross-sectional preinterventional and postinterventional survey using a convenience sample. During 2010, three face-to-face workshops were conducted in three locations in West Virginia. One hundred thirty-one participants (baseline survey); 69 participants (1-year resurvey)-representing West Virginia local health department (LHD) and State Health Department employees. A 3-hour interactive, public health-specific, face-to-face workshop on personal disaster preparedness. Change in 1) knowledge about, and tools for, personal preparedness activities; 2) preparedness activities performed post-training and/or confidence in conducting these activities; and 3) the relationship of EPPM categories to personal preparedness activities. One year postworkshop, 77 percent of respondents reported having personal emergency kits (40 percent at baseline) and 67 percent reported having preparedness plans (38 percent at baseline) suggesting some participants assembled supply kits and plans postworkshop. Within the context of EPPM, respondents in high-threat categories agreed more often than respondents in low-threat categories that severe personal impacts were likely to result from a moderate flood. Compared to respondents categorized as low efficacy, respondents in high-efficacy categories perceived confidence in their knowledge and an impact of their response on their job success at higher rates. Personal disaster preparedness trainings for the LHD

Perceptions of Personalized Medicine in an Academic Health System: Educational Findings.

PubMed

Vorderstrasse, Allison; Katsanis, Sara Huston; Minear, Mollie A; Yang, Nancy; Rakhra-Burris, Tejinder; Reeves, Jason W; Cook-Deegan, Robert; Ginsburg, Geoffrey S; Ann Simmons, Leigh

Prior reports demonstrate that personalized medicine implementation in clinical care is lacking. Given the program focus at Duke University on personalized medicine, we assessed health care providers' perspectives on their preparation and educational needs to effectively integrate personalized medicine tools and applications into their clinical practices. Data from 78 health care providers who participated in a larger study of personalized and precision medicine at Duke University were analyzed using Qualtrics (descriptive statistics). Individuals age 18 years and older were recruited for the larger study through broad email contacts across the university and health system. All participants completed an online 35-question survey that was developed, pilot-tested, and administered by a team of interdisciplinary researchers and clinicians at the Center for Applied Genomics and Precision Medicine. Overall, providers reported being ill-equipped to implement personalized medicine in clinical practice. Many respondents identified educational resources as critical for strengthening personalized medicine implementation in both research and clinical practice. Responses did not differ significantly between specialists and primary providers or by years since completion of the medical degree. Survey findings support prior calls for provider and patient education in personalized medicine. Respondents identified focus areas in training, education, and research for improving personalized medicine uptake. Given respondents' emphasis on educational needs, now may be an ideal time to address these needs in clinical training and public education programs.

Integrating a Stress Management Mini-Course into a Personal Health Course.

ERIC Educational Resources Information Center

Lang, Darrel

A study investigated whether stress management could be enhanced among college students after the completion of a three credit personal health course. The subjects were 20 randomly selected male and female students enrolled in a personal health course at Emporia State University (Kansas). The 20 experimental subjects and the 15 members of a…

Dental Pit and Fissure Sealants: Implications for School Health Personnel.

ERIC Educational Resources Information Center

McCormack-Brown, K. R.; And Others

1989-01-01

To promote good personal hygiene practices in students, school health personnel must be informed about dental pit and fissure sealants and related programs. Adoption and maintenance of such programs may depend on the success of school health personnel in educating administrators and policymakers. (SM)

Processes and outcomes of developing a continuity of care document for use as a personal health record by people living with HIV/AIDS in New York City.

PubMed

Gordon, Peter; Camhi, Eli; Hesse, Ron; Odlum, Michelle; Schnall, Rebecca; Rodriguez, Martha; Valdez, Esmerlin; Bakken, Suzanne

2012-10-01

To describe the processes and outcomes of developing and implementing a Continuity of Care Document (CCD), My Health Profile, as a personal health record for persons living with HIV (PLWH) in an HIV/AIDS Special Needs Plan in New York City. Multiple qualitative and quantitative data sources were used to describe the processes and outcomes of implementing My Health Profile including focus groups, Audio Computer Assisted Self Interview (ACASI) surveys, administrative databases, chart abstraction, usage logs, and project management records. Qualitative data were thematically analyzed. Quantitative data analytic methods included descriptive and multivariate statistics. Data were triangulated and synthesized using the Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) Framework. Reach - SNP members are predominantly African American or Hispanic/Latino and about one-third are female. A larger proportion of African Americans and smaller proportions of Hispanics/Latinos and Whites were trained to use My Health Profile.Efficacy/Effectiveness - CCDs were produced for 8249 unique members and updated on a monthly basis, 509 members were trained to use My Health Profile. Total number of member logins for 112 active users was 1808 and the longest duration of use was 1008 days. There were no significant differences between users and non-users of My Health Profile in clinical outcomes, perceptions of the quality of medical care, or health service utilization. Adoption -My Health Profile was well-matched to organizational mission, values, and priorities related to coordination of care for a high-risk population of PLWH. Implementation - Pre-implementation focus group participants identified potential barriers to use of My Health Profile including functional and computer literacy, privacy and confidentiality concerns, potential reluctance to use technology, and cognitive challenges. Key strategies for addressing barriers included a dedicated bilingual

Sexuality Talk During Adolescent Health Maintenance Visits

PubMed Central

Alexander, Stewart C.; Fortenberry, J. Dennis; Pollak, Kathryn I.; Bravender, Terrill; Davis, J. Kelly; Østbye, Truls; Tulsky, James A.; Dolor, Rowena J.; Shields, Cleveland G.

2015-01-01

Importance Physicians may be important sources of sexuality information and preventive services, and one-on-one confidential time during health maintenance visits is recommended to allow discussions of sexual development, behavior, and risk reduction. However, little is known about the occurrence and characteristics of physician-adolescent discussions about sexuality. Objective To examine predictors of time spent discussing sexuality, level of adolescent participation, and physician and patient characteristics associated with sexuality discussions during health maintenance visits by early and middle adolescents. Design, Setting, and Participants Observational study of audio-recorded conversations between 253 adolescents (mean age, 14.3 years; 53% female; 40% white; 47% African American) and 49 physicians (82% pediatricians; 84% white; 65% female; mean age, 40.9 years; mean [SD] duration in practice, 11.8 [8.7] years) coded for sexuality content at 11 clinics (3 academic and 8 community-based practices) located throughout the Raleigh/Durham, North Carolina, area. Main Outcomes and Measures Total time per visit during which sexuality issues were discussed. Results One hundred sixty-five (65%) of all visits had some sexual content within it. The average time of sexuality talk was 36 seconds (35% 0 seconds; 30% 1-35 seconds; and 35% ≥36 seconds). Ordinal logistic regression (outcome of duration: 0, 1-35, or ≥36 seconds), adjusted for clustering of patients within physicians, found that female patients (odds ratio [OR] = 2.58; 95% CI, 1.53-4.36), older patients (OR = 1.37; 95% CI, 1.13-1.65), conversations with explicit confidentiality discussions (OR = 4.33; 95% CI, 2.58-7.28), African American adolescents (OR = 1.58; 95% CI, 1.01-2.48), and longer overall visit (OR = 1.07; 95% CI, 1.03-1.11) were associated with more sexuality talk, and Asian physicians were associated with less sexuality talk (OR = 0.13; 95% CI, 0.08-0.20). In addition, the same significant

The use of biometrics in the Personal Health Record (PHR).

PubMed

Bonney, Wilfred

2011-01-01

The emergence of the Personal Health Record (PHR) has made individual health information more readily accessible to a wide range of users including patients, consumers, practitioners, and healthcare providers. However, increased accessibility of PHR threatens the confidentiality, privacy, and security of personalized health information. Therefore, a need for robust and reliable forms of authentication is of prime concern. The concept of biometric authentication is now highly visible to healthcare providers as a technology to prevent unauthorized access to individual health information. Implementing biometric authentication mechanisms to protect PHR facilitates access control and secure exchange of health information. In this paper, a literature review is used to explore the key benefits, technical barriers, challenges, and ethical implications for using biometric authentication in PHR.

Lifetime trauma, personality traits, and health: A pathway to midlife health status.

PubMed

Hampson, Sarah E; Edmonds, Grant W; Goldberg, Lewis R; Barckley, Maureen; Klest, Bridget; Dubanoski, Joan P; Hillier, Teresa A

2016-07-01

This study investigated whether lifetime experience of trauma is related to personality through instrumental and reactive trait processes, and whether lifetime trauma is a mechanism underlying the association between childhood conscientiousness and objectively assessed adult physical health. Participants (N = 831) were 442 women and 389 men from the Hawaii longitudinal study of personality and health. Teacher assessments of personality were obtained when the participants were in elementary school. Self-reported adult personality assessments, lifetime histories of trauma experience, and objectively assessed physiological dysregulation were obtained between ages 45-55. Women tended to report more high-betrayal trauma than men, whereas men reported more low-betrayal trauma than women. Women who were judged by their teachers to be less agreeable and less conscientious in childhood reported more lifetime trauma, suggesting instrumental trait processes. For both genders, neuroticism and openness/intellect/imagination in adulthood, but not in childhood, were associated with lifetime trauma, suggesting reactive trait processes. For both genders, trauma experience was correlated with dysregulation and with Body Mass Index (BMI). The indirect paths from childhood conscientiousness to adult dysregulation and BMI through total teen and adult trauma were significant for women, but not for men (indirect effect for women's dysregulation = -.025, p = .040, 95% confidence interval [CI] = -.048, -.001; indirect effect for women's BMI = -.037, p = .009, 95% CI = -.067, -.008). Teen and adult trauma experience appears to be a hitherto unidentified mechanism in women underlying the association between conscientiousness and health. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Lifetime Trauma, Personality Traits, and Health: A Pathway to Midlife Health Status

PubMed Central

Hampson, Sarah E.; Edmonds, Grant W.; Goldberg, Lewis R.; Barckley, Maureen; Klest, Bridget; Dubanoski, Joan P.; Hillier, Teresa A.

2016-01-01

Objective This study investigated whether lifetime experience of trauma is related to personality through instrumental and reactive trait processes, and whether lifetime trauma is a mechanism underlying the association between childhood conscientiousness and objectively assessed adult physical health. Method Participants (N = 831) were 442 women and 389 men from the Hawaii longitudinal study of personality and health. Teacher assessments of personality were obtained when the participants were in elementary school. Self-reported adult personality assessments, lifetime histories of trauma experience, and objectively assessed physiological dysregulation were obtained between ages 45–55. Results Women tended to report more high-betrayal trauma than men, whereas men reported more low-betrayal trauma than women. Women who were judged by their teachers to be less agreeable and less conscientious in childhood reported more lifetime trauma, suggesting instrumental trait processes. For both genders, neuroticism and openness/intellect/imagination in adulthood, but not in childhood, were associated with lifetime trauma, suggesting reactive trait processes. For both genders, trauma experience was correlated with dysregulation and with BMI. The indirect paths from childhood conscientiousness to adult dysregulation and BMI through total teen and adult trauma were significant for women, but not for men (indirect effect for women’s dysregulation = −.025, p = .040, 95% CI = −.048, −.001; indirect effect for women’s BMI = −.037, p = .009, 95% CI = −.067, −.008). Conclusion Teen and adult trauma experience appears to be a hitherto unidentified mechanism in women underlying the association between conscientiousness and health. PMID:27100170

Personal health care expenditures, by State: 1966-82

PubMed Central

Levit, Katharine R.

1985-01-01

Spending per capita for health care in the United States varies dramatically by State and region. In 1982, personal health care costs per capita ranged from a low of $857 in South Carolina to a high of $1,508 in Massachusetts. The focus of this article is State and regional variation in spending levels and the mix of health care services purchased. Possible causes for these differences are presented. PMID:10311335

Genome-health nutrigenomics and nutrigenetics: nutritional requirements or 'nutriomes' for chromosomal stability and telomere maintenance at the individual level.

PubMed

Bull, Caroline; Fenech, Michael

2008-05-01

It is becoming increasingly evident that (a) risk for developmental and degenerative disease increases with more DNA damage, which in turn is dependent on nutritional status, and (b) the optimal concentration of micronutrients for prevention of genome damage is also dependent on genetic polymorphisms that alter the function of genes involved directly or indirectly in the uptake and metabolism of micronutrients required for DNA repair and DNA replication. The development of dietary patterns, functional foods and supplements that are designed to improve genome-health maintenance in individuals with specific genetic backgrounds may provide an important contribution to an optimum health strategy based on the diagnosis and individualised nutritional prevention of genome damage, i.e. genome health clinics. The present review summarises some of the recent knowledge relating to micronutrients that are associated with chromosomal stability and provides some initial insights into the likely nutritional factors that may be expected to have an impact on the maintenance of telomeres. It is evident that developing effective strategies for defining nutrient doses and combinations or 'nutriomes' for genome-health maintenance at the individual level is essential for further progress in this research field.

Informed consent to opioid agonist maintenance treatment: recommended ethical guidelines.

PubMed

Carter, Adrian; Hall, Wayne

2008-02-01

Some bioethicists have questioned whether opioid addicted individuals are able to provide free and informed consent to opioid agonist maintenance treatment. Conflicting motives for providing such treatment (e.g. improving the personal health of addicts and protecting public health and order) can also influence what individuals are required to consent to, and how that consent is obtained. We discuss both issues and attempt to specify the conditions for obtaining informed consent to agonist maintenance treatment for opioid addiction. We briefly review the neuroscientific literature on the effects of addiction on the autonomy and decision-making capacity of opioid dependent individuals, and ascertain how informed consent to the treatment of opioid addiction should be obtained. We also provide an ethical analysis of the competing social and medical forces that influence the consent process and make some recommendations on how to ensure that individuals enter maintenance treatment that is provided in an effective and ethical way. Our analysis shows that whilst the autonomy of opioid dependent individuals is impaired by their addiction, they do retain the ability to consent to treatment provided they are not in acute withdrawal or intoxication. These symptoms should have abated, either by supervised withdrawal or stabilisation on agonist maintenance, before they are asked to consent to a detailed treatment contract. Once stabilised, individuals should be provided with detailed information about the risks and benefits of all treatments, and restrictions and regulations under which they are provided. Informed consent is an important part of the treatment process that should be obtained in ways that increase the autonomy and decision-making capacity in opioid addicts.

Health-relevant personality is associated with sensitivity to sound (hyperacusis).

PubMed

Villaume, Karin; Hasson, Dan

2017-04-01

Hyperacusis, over-sensitivity to sounds, causes distress and disability and the etiology is not fully understood. The study aims to explore possible associations between health-relevant personality traits and hyperacusis. Hyperacusis was assessed using the Hyperacusis Questionnaire (HQ), and clinical uncomfortable loudness levels (ULL). Personality was measured with the Health-relevant Personality (HP5i) Inventory. The study sample was 348 (140 men and 208 women; age 23-71 years). Moderate correlations were found between the personality trait negative affectivity (NA; a facet of neuroticism) and dimensions of the HQ and weak correlations were found with the ULLs. Hedonic capacity (a facet of extraversion) was significantly correlated with the HQ but not with the ULLs. Impulsivity (a facet of conscientiousness) was correlated with the HQ and the ULLs. A significant difference in mean values was found in all hyperacusis measures and different levels of NA - those with higher levels displayed more severe signs of hyperacusis. A multiple logistic regression analysis showed that higher levels of NA increases the odds of having hyperacusis on average 4.6 times for men and 2.4 times for women. These findings imply that health-relevant personality traits should be considered in the diagnosis and treatment of hyperacusis. © 2017 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Pricing health care services: applications to the health maintenance organization.

PubMed

Sweeney, R E; Franklin, S P

1986-01-01

This article illustrates how management in one type of service industry, the health maintenance organization (HMO), have attempted to formalize pricing. This effort is complicated by both the intangibility of the service delivered and the relatively greater influence in service industries of non-cost price factors such as accessibility, psychology, and delays. The presentation describes a simple computerized approach that allows the marketing manager to formally estimate the effect of incremental changes in rates on the firm's projected patterns of enrollment growth and net revenues. The changes in turn reflect underlying variations in the mix of pricing influences including psychological and other factors. Enrollment projections are crucial to the firm's financial planning and staffing. In the past, most HMO enrollment and revenue projections of this kind were notoriously unreliable. The approach described here makes it possible for HMOs to fine-tune their pricing policies. It also provides a formal and easily understood mechanism by which management can evaluate and reach consensus on alternative scenarios for enrollment growth, staff recruitment and capacity expansion.

Patient-Centered Personal Health Record and Portal Implementation Toolkit for Ambulatory Clinics: A Feasibility Study.

PubMed

Nahm, Eun-Shim; Diblasi, Catherine; Gonzales, Eva; Silver, Kristi; Zhu, Shijun; Sagherian, Knar; Kongs, Katherine

2017-04-01

Personal health records and patient portals have been shown to be effective in managing chronic illnesses. Despite recent nationwide implementation efforts, the personal health record and patient portal adoption rates among patients are low, and the lack of support for patients using the programs remains a critical gap in most implementation processes. In this study, we implemented the Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit in a large diabetes/endocrinology center and assessed its preliminary impact on personal health record and patient portal knowledge, self-efficacy, patient-provider communication, and adherence to treatment plans. Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit is composed of Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General, clinic-level resources for clinicians, staff, and patients, and Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit Plus, an optional 4-week online resource program for patients ("MyHealthPortal"). First, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General was implemented, and all clinicians and staff were educated about the center's personal health record and patient portal. Then general patient education was initiated, while a randomized controlled trial was conducted to test the preliminary effects of "MyHealthPortal" using a small sample (n = 74) with three observations (baseline and 4 and 12 weeks). The intervention group showed significantly greater improvement than the control group in patient-provider communication at 4 weeks (t56 = 3.00, P = .004). For other variables, the intervention group tended to show greater improvement; however, the differences were not significant. In this preliminary study, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit showed potential for filling the gap in the current

Movement Advocacy, Personal Relationships, and Ending Health Care Disparities.

PubMed

Chin, Marshall H

2017-01-01

Deep-rooted structural problems drive health care disparities. Compounding the difficulty of attaining health equity, solutions in clinics and hospitals require the cooperation of clinicians, administrators, patients, and the community. Recent protests over police brutality and racism on campuses across America have opened fresh wounds over how best to end racism, with lessons for achieving health equity. Movement advocacy, the mobilizing of the people to raise awareness of an injustice and to advocate for reform, can break down ingrained structural barriers and policies that impede health equity. However, simultaneously advocates, clinicians, and health care organizations must build trusting relationships and resolve conflict with mutual respect and honesty. Tension is inherent in discussions about racial and ethnic disparities. Yet, tension can be constructive if it forces self-examination and spurs systems change and personal growth. We must simultaneously advocate for policy reform, build personal relationships across diverse groups, and honestly examine our biases. Copyright © 2016 National Medical Association. Published by Elsevier Inc. All rights reserved.

Movement Advocacy, Personal Relationships, and Ending Health Care Disparities

PubMed Central

Chin, Marshall H.

2017-01-01

Deep-rooted structural problems drive health care disparities. Compounding the difficulty of attaining health equity, solutions in clinics and hospitals require the cooperation of clinicians, administrators, patients, and the community. Recent protests over police brutality and racism on campuses across America have opened fresh wounds over how best to end racism, with lessons for achieving health equity. Movement advocacy, the mobilizing of the people to raise awareness of an injustice and to advocate for reform, can break down ingrained structural barriers and policies that impede health equity. However, simultaneously advocates, clinicians, and health care organizations must build trusting relationships and resolve conflict with mutual respect and honesty. Tension is inherent in discussions about racial and ethnic disparities. Yet, tension can be constructive if it forces self-examination and spurs systems change and personal growth. We must simultaneously advocate for policy reform, build personal relationships across diverse groups, and honestly examine our biases. PMID:28259213

Modeling the Personal Health Ecosystem.

PubMed

Blobel, Bernd; Brochhausen, Mathias; Ruotsalainen, Pekka

2018-01-01

Complex ecosystems like the pHealth one combine different domains represented by a huge variety of different actors (human beings, organizations, devices, applications, components) belonging to different policy domains, coming from different disciplines, deploying different methodologies, terminologies, and ontologies, offering different levels of knowledge, skills, and experiences, acting in different scenarios and accommodating different business cases to meet the intended business objectives. For correctly modeling such systems, a system-oriented, architecture-centric, ontology-based, policy-driven approach is inevitable, thereby following established Good Modeling Best Practices. However, most of the existing standards, specifications and tools for describing, representing, implementing and managing health (information) systems reflect the advancement of information and communication technology (ICT) represented by different evolutionary levels of data modeling. The paper presents a methodology for integrating, adopting and advancing models, standards, specifications as well as implemented systems and components on the way towards the aforementioned ultimate approach, so meeting the challenge we face when transforming health systems towards ubiquitous, personalized, predictive, preventive, participative, and cognitive health and social care.

Determinants of Internet use as a preferred source of information on personal health.

PubMed

Lemire, Marc; Paré, Guy; Sicotte, Claude; Harvey, Charmian

2008-11-01

To understand the personal, social and cultural factors likely to explain recourse to the Internet as a preferred source of personal health information. A cross-sectional survey was conducted among a population of 2923 Internet users visiting a firmly established website that offers information on personal health. Multiple regression analysis was performed to identify the determinants of site use. The analysis template comprised four classes of determinants likely to explain Internet use: beliefs, intentions, user satisfaction and socio-demographic characteristics. Seven-point Likert scales were used. An analysis of the psychometric qualities of the variables provided compelling evidence of the construct's validity and reliability. A confirmatory factor analysis confirmed the correspondence with the factors predicted by the theoretical model. The regression analysis explained 35% of the variance in Internet use. Use was directly associated with five factors: perceived usefulness, importance given to written media in searches for health information, concern for personal health, importance given to the opinions of physicians and other health professionals, and the trust placed in the information available on the site itself. This study confirms the importance of the credibility of information on the frequency of Internet use as a preferred source of information on personal health. It also shows the potentially influential role of the Internet in the development of personal knowledge of health issues.

Personal Grooming: "Let's Fact It!". Health and the Consumer.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee. Div. of Elementary and Secondary Education.

Personal grooming is the topic of this learning activity package, which is one part of a consumer education series for secondary students. The module attempts to make students aware of the importance of personal appearance and grooming and to emphasize the direct correlation between maintaining good health and looking good. The learning package…

Health Self-Advocacy Training for Persons with Intellectual Disabilities

ERIC Educational Resources Information Center

Feldman, M. A.; Owen, F.; Andrews, A.; Hamelin, J.; Barber, R.; Griffiths, D.

2012-01-01

Background: People with intellectual disabilities (ID) have unequal access to health care. While systemic efforts are addressing health inequalities, there remains a need to demonstrate that persons with ID can increase their health self-advocacy skills. Method: A randomised control design with up to 6-month follow-up was used to evaluate the 3Rs…

32 CFR 935.140 - Motor vehicle maintenance and equipment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 6 2011-07-01 2011-07-01 false Motor vehicle maintenance and equipment. 935.140... AND INSULAR REGULATIONS WAKE ISLAND CODE Motor Vehicle Code § 935.140 Motor vehicle maintenance and equipment. (a) Each person who has custody of a motor vehicle on Wake Island shall present that vehicle for...

Potential and challenges of body area networks for personal health.

PubMed

Penders, Julien; van de Molengraft, Jef; Brown, Lindsay; Grundlehner, Bernard; Gyselinckx, Bert; Van Hoof, Chris

2009-01-01

This paper illustrates how body area network technology may enable new personal health concepts. A BAN technology platform is presented, which integrates technology building blocks from the Human++ research program on autonomous wireless sensors. Technology evaluation for the case of wireless sleep staging and real-time arousal monitoring is reported. Key technology challenges are discussed. The ultimate target is the development of miniaturized body sensor nodes powered by body-energy, anticipating the needs of emerging personal health applications.

The relationship between burnout symptoms and Type D personality among health care professionals in Turkey.

PubMed

Tekin, Atilla; Karadağ, Hekim; Yayla, Sinan

2017-05-04

The aim of this study was to investigate the relationship between burnout and Type D personality in health care professionals. The study randomly included 120 health care professionals (73 nurses, 47 doctors). Sociodemographic data form, Maslach Burnout Inventory, and Type D Personality Scale were applied to each participant; 38.3% of the health care professionals (n = 46) had the Type D personality. Emotional exhaustion and depersonalization of health care professionals with Type D personality were higher than of those without Type D personality (p = .006 and p = .005). Stepwise regression analysis indicated that Type D personality was a predictor of emotional exhaustion and depersonalization (p = .005 and p = .001, respectively). Our results suggest that Type D personality is associated with higher burnout levels.

The cost-effectiveness of methadone maintenance as a health care intervention.

PubMed

Barnett, P G

1999-04-01

Cost-effectiveness analysis using life-years of survival as the measure of treatment benefit is widely used in the economic evaluation of health care interventions but has not been applied to substance abuse treatment. The cost-effectiveness of methadone maintenance was evaluated to demonstrate the feasibility of applying this method to substance abuse treatment. A literature review was undertaken to determine the effect of methadone treatment on the rate of mortality associated with opiate addiction. Information was also obtained on the average cost and duration of treatment. A two-state Markov model was used to estimate the incremental effect of methadone on the life span and treatment cost of a cohort of 25-year-old heroin users. Providing opiate addicts with access to methadone maintenance has an incremental cost-effectiveness ratio of $5915 per life-year gained (that is, for every year of life that is saved by providing methadone to opiate addicts, an additional $5915 in treatment costs are incurred). One-way sensitivity analysis determined that the ratio was less than $10,000 per-life year over a wide range of modeling assumptions. The ratio determined for methadone is lower than that of many common medical therapies, and well within the $50,000 threshold for judging cost-effectiveness. Even if decision makers do not wish use the same ratio that is applied to the general population, this method allows substance abuse treatment enhancements to be compared to improvements in health services offered to individuals with substance abuse disorders. Future work will require information on the impact of methadone treatment on the cost of health care and public programs, the indirect costs incurred by patients, and adjustments to reflect quality of life.

Relationships between activities, participation, personal factors, mental health, and life satisfaction in persons with spinal cord injury.

PubMed

van Leeuwen, Christel M; Post, Marcel W; Westers, Paul; van der Woude, Lucas H; de Groot, Sonja; Sluis, Tebbe; Slootman, Hans; Lindeman, Eline

2012-01-01

To clarify relationships between activities, participation, mental health, and life satisfaction in persons with spinal cord injury (SCI) and specify how personal factors (self-efficacy, neuroticism, appraisals) interact with these components. We hypothesized that (1) activities are related directly to participation, participation is related directly to mental health and life satisfaction, and mental health and life satisfaction are 2 interrelated outcome variables; and (2) appraisals are mediators between participation and mental health and life satisfaction, and self-efficacy and neuroticism are related directly to mental health and life satisfaction and indirectly through appraisals. Follow-up measurement of a multicenter prospective cohort study 5 years after discharge from inpatient rehabilitation. Eight Dutch rehabilitation centers with specialized SCI units. Persons (N=143) aged 18 to 65 years at the onset of SCI. Not applicable. Mental health was measured by using the Mental Health subscale of the 36-Item Short Form Health Survey and life satisfaction with the sum score of "current life satisfaction" and "current life satisfaction compared with life satisfaction before SCI." Structural equation modeling showed that activities and neuroticism were related to participation and explained 49% of the variance in participation. Self-efficacy, neuroticism, and 2 appraisals were related to mental health and explained 35% of the variance in mental health. Participation, 3 appraisals, and mental health were related to life satisfaction and together explained 50% of the total variance in life satisfaction. Mental health and life satisfaction can be seen as 2 separate but interrelated outcome variables. Self-efficacy and neuroticism are related directly to mental health and indirectly to life satisfaction through the mediating role of appraisals. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Consumer Health Informatics Aspects of Direct-to-Consumer Personal Genomic Testing.

PubMed

Gray, Kathleen; Stephen, Remya; Terrill, Bronwyn; Wilson, Brenda; Middleton, Anna; Tytherleigh, Rigan; Turbitt, Erin; Gaff, Clara; Savard, Jacqueline; Hickerton, Chriselle; Newson, Ainsley; Metcalfe, Sylvia

2017-01-01

This paper uses consumer health informatics as a framework to explore whether and how direct-to-consumer personal genomic testing can be regarded as a form of information which assists consumers to manage their health. It presents findings from qualitative content analysis of web sites that offer testing services, and of transcripts from focus groups conducted as part a study of the Australian public's expectations of personal genomics. Content analysis showed that service offerings have some features of consumer health information but lack consistency. Focus group participants were mostly unfamiliar with the specifics of test reports and related information services. Some of their ideas about aids to knowledge were in line with the benefits described on provider web sites, but some expectations were inflated. People were ambivalent about whether these services would address consumers' health needs, interests and contexts and whether they would support consumers' health self-management decisions and outcomes. There is scope for consumer health informatics approaches to refine the usage and the utility of direct-to-consumer personal genomic testing. Further research may focus on how uptake is affected by consumers' health literacy or by services' engagement with consumers about what they really want.

US Spending on Personal Health Care and Public Health, 1996–2013

PubMed Central

Dieleman, Joseph L.; Baral, Ranju; Birger, Maxwell; Bui, Anthony L.; Bulchis, Anne; Chapin, Abigail; Hamavid, Hannah; Horst, Cody; Johnson, Elizabeth K.; Joseph, Jonathan; Lavado, Rouselle; Lomsadze, Liya; Reynolds, Alex; Squires, Ellen; Campbell, Madeline; DeCenso, Brendan; Dicker, Daniel; Flaxman, Abraham D.; Gabert, Rose; Highfill, Tina; Naghavi, Mohsen; Nightingale, Noelle; Templin, Tara; Tobias, Martin I.; Vos, Theo; Murray, Christopher J. L.

2017-01-01

IMPORTANCE US health care spending has continued to increase, and now accounts for more than 17% of the US economy. Despite the size and growth of this spending, little is known about how spending on each condition varies by age and across time. OBJECTIVE To systematically and comprehensively estimate US spending on personal health care and public health, according to condition, age and sex group, and type of care. DESIGN AND SETTING Government budgets, insurance claims, facility surveys, household surveys, and official US records from 1996 through 2013 were collected and combined. In total, 183 sources of data were used to estimate spending for 155 conditions (including cancer, which was disaggregated into 29 conditions). For each record, spending was extracted, along with the age and sex of the patient, and the type of care. Spending was adjusted to reflect the health condition treated, rather than the primary diagnosis. EXPOSURES Encounter with US health care system. MAIN OUTCOMES AND MEASURES National spending estimates stratified by condition, age and sex group, and type of care. RESULTS From 1996 through 2013, $30.1 trillion of personal health care spending was disaggregated by 155 conditions, age and sex group, and type of care. Among these 155 conditions, diabetes had the highest health care spending in 2013, with an estimated $101.4 billion (uncertainty interval [UI], $96.7 billion–$106.5 billion) in spending, including 57.6% (UI, 53.8%–62.1%) spent on pharmaceuticals and 23.5% (UI, 21.7%–25.7%) spent on ambulatory care. Ischemic heart disease accounted for the second-highest amount of health care spending in 2013, with estimated spending of $88.1 billion (UI, $82.7 billion–$92.9 billion), and low back and neck pain accounted for the third-highest amount, with estimated health care spending of $87.6 billion (UI, $67.5 billion–$94.1 billion). The conditions with the highest spending levels varied by age, sex, type of care, and year. Personal

Racial/Ethnic Differences in Knowledge of Personal and Target Levels of Cardiovascular Health Indicators.

PubMed

Ma, Mindy; Ma, Alyson

2015-10-01

This study aimed to examine ethnic differences in knowledge of personal and target levels of cardiovascular health indicators between non-Hispanic whites and African Americans. A secondary objective was to evaluate the associations between knowledge of cardiovascular health indicators and health promotion behaviors. Participants (66.7% female) consisted of 265 whites and 428 African Americans, ages 18 and older recruited from primary care clinics and churches. Respondents completed a brief survey on blood pressure (BP), total cholesterol, blood glucose, body mass index (BMI), diet, and physical activity. Whites were more likely than African Americans to report knowing their personal and target levels of cardiovascular health indicators. Knowledge of personal BP and/or BMI was positively associated with actual physical activity, and awareness of personal blood glucose was positively associated with healthy dietary practices for participants in both groups. Among whites, awareness of personal BP and knowledge of target levels for BP, total cholesterol, and BMI were also associated with healthy diet. Results suggest there are racial/ethnic disparities in knowledge of personal and ideal levels of cardiovascular health indicators, and that this knowledge is related to health promotion behaviors. Targeted educational efforts are warranted to enhance knowledge of personal risk indicators among African Americans.

Semantic Web, Reusable Learning Objects, Personal Learning Networks in Health: Key Pieces for Digital Health Literacy.

PubMed

Konstantinidis, Stathis Th; Wharrad, Heather; Windle, Richard; Bamidis, Panagiotis D

2017-01-01

The knowledge existing in the World Wide Web is exponentially expanding, while continuous advancements in health sciences contribute to the creation of new knowledge. There are a lot of efforts trying to identify how the social connectivity can endorse patients' empowerment, while other studies look at the identification and the quality of online materials. However, emphasis has not been put on the big picture of connecting the existing resources with the patients "new habits" of learning through their own Personal Learning Networks. In this paper we propose a framework for empowering patients' digital health literacy adjusted to patients' currents needs by utilizing the contemporary way of learning through Personal Learning Networks, existing high quality learning resources and semantics technologies for interconnecting knowledge pieces. The framework based on the concept of knowledge maps for health as defined in this paper. Health Digital Literacy needs definitely further enhancement and the use of the proposed concept might lead to useful tools which enable use of understandable health trusted resources tailored to each person needs.

Personal Protective Equipment. Module SH-12. Safety and Health.

ERIC Educational Resources Information Center

Center for Occupational Research and Development, Inc., Waco, TX.

This student module on personal protective equipment is one of 50 modules concerned with job safety and health. This module explains the need for personal protective equipment, how it is selected, and the way in which the equipment is supposed to work. Following the introduction, 13 objectives (each keyed to a page in the text) the student is…

Inequalities in maintenance of health and performance between young adult women and men in higher education.

PubMed

Löve, Jesper; Dellve, Lotta; Eklöf, Mats; Hagberg, Mats

2009-04-01

Because of ageing populations, most high-income countries are facing an imminent scarcity of labour. Maintenance of health and performance in young adults therefore becomes a crucial prerequisite for sustainable societies. One major obstruction to this accomplishment is the striking health inequalities between young women and young men. Previously these inequalities have mainly been studied in a cross-sectional way, focusing on ill-health. In this study, we compared the prevalence of maintained health and performance between young adult women and men and the predictors for this outcome. The cohort consisted of 1266 participants from a homogenous sample of university students in Sweden. A combined assessment of self-rated 'very good' health and un-impaired performance took place at three time points (i.e. maintained health and performance). Potential predictors covered stable conditions in health-related behaviours, conditions at work/school and work-home interference. Young women had less maintained health and performance than young men. No major differences in predictors were found. However, there was a tendency for psychosocial factors to be the most important predictors, especially in women. That young women had less maintained health and performance in a homogenous sample beyond well-known differentiating factors suggests explanations other than observable structural differences between the sexes. This was also indicated by the importance attached to perceived demands, and work-home interference, especially in women. The combination of less scheduled, and more unscheduled, schoolwork (i.e. time-flexibility) negatively affected the maintenance of health and performance in our study population, suggesting a focus for future studies.

The use of self-quantification systems for personal health information: big data management activities and prospects

PubMed Central

2015-01-01

Self-quantification in personal health maintenance appears promising and exciting. However, more studies are needed to support its use in this field. The proposed model will in the future lead to developing a measure for assessing the effectiveness of interventions to support using SQS for health self-management (e.g., assessing the complexity of self-quantification activities, and activation of the individuals). PMID:26019809

It's "Supposed" to Be Personal: Personal and Educational Factors Associated with Sexual Health Attitudes, Knowledge, Comfort and Skill in Health Profession Students

ERIC Educational Resources Information Center

West, Lindsey M.; Stepleman, Lara M.; Wilson, Christina K.; Campbell, Jeff; Villarosa, Margo; Bodie, Brittany; Decker, Matthew

2012-01-01

The health professional and the patient are cultural beings with beliefs and attitudes that are shaped by family traditions, social development, and exposure to novel experiences. As such, it is especially important for health profession students to gain awareness about the personal and educational factors that likely inform their practice and…

A personally controlled electronic health record for Australia

PubMed Central

Pearce, Christopher; Bainbridge, Michael

2014-01-01

Objective On July 1, 2012 Australia launched a personally controlled electronic health record (PCEHR) designed around the needs of consumers. Using a distributed model and leveraging key component national eHealth infrastructure, the PCEHR is designed to enable sharing of any health information about a patient with them and any other health practitioner involved in their care to whom the patient allows access. This paper discusses the consumer-facing part of the program. Method Design of the system was through stakeholder consultation and the development of detailed requirements, followed by clinical design assurance. Results Patients are able to access any posted information through a web-accessible ‘consumer portal.’ Within the portal they are able to assert access controls on all or part of their record. The portal includes areas for consumers to record their own personal information. Discussion The PCEHR has the potential to transform the ability of patients to actively engage in their own healthcare, and to enable the emerging partnership model of health and healthcare in medicine. The ability to access health information traditionally kept within the closed walls of institutions also raises challenges for the profession, both in the language clinicians choose and the ethical issues raised by the changed roles and responsibilities. Conclusions The PCEHR is aimed at connecting all participants and their interventions, and is intended to become a system-wide activity. PMID:24650635

The Big Five personality dimensions and mental health: The mediating role of alexithymia.

PubMed

Atari, Mohammad; Yaghoubirad, Mahsa

2016-12-01

The role of personality constructs on mental health has attracted research attention in the last few decades. The Big Five personality traits have been introduced as parsimonious dimensions of non-pathological traits. The five-factor model of personality includes neuroticism, agreeableness, conscientiousness, extraversion, and openness to experience. The present study aimed to examine the relationship between the Big Five dimensions and mental health considering the mediating role of alexithymia as an important emotional-processing construct. A total of 257 participants were recruited from non-clinical settings in the general population. All participants completed the Ten-Item Personality Inventory (TIPI), 20-item Toronto Alexithymia Scale (TAS-20), and General Health Questionnaire-28 (GHQ-28). Structural equation modeling was utilized to examine the hypothesized mediated model. Findings indicated that the Big Five personality dimensions could significantly predict scores of alexithymia. Moreover, alexithymia could predict mental health scores as measured by indices of depression, anxiety, social functioning, and somatic symptoms. The fit indices (GFI=0.94; CFI=0.91; TLI=0.90; RMSEA=0.071; CMIN/df=2.29) indicated that the model fits the data. Therefore, the relationship between the Big Five personality dimensions and mental health is mediated by alexithymia. Copyright © 2016 Elsevier B.V. All rights reserved.

Maintenance of a smoking cessation program in public health clinics beyond the experimental evaluation period.

PubMed Central

Manfredi, C.; Crittenden, K.; Cho, Y. I.; Engler, J.; Warnecke, R.

2001-01-01

OBJECTIVES: As phase 3 of a study to evaluate a smoking cessation program in public health practice, the authors assess the maintenance and impact of the It's Time smoking cessation program in seven public maternal and child health clinics in Chicago. METHODS: The authors interviewed 404 clinic patients in the study's baseline phase (prior to introduction of the It's Time intervention program), and 610 in the program maintenance phase (in the year after experimental evaluation had ended) to assess exposure to smoking cessation interventions offered at the clinic, and smoking cessation outcomes (quit, actions toward quitting, scores on action, motivation, readiness, and confidence scales). The authors controlled for clustering of smokers within clinics, smokers' characteristics prior to clinic visit, and type of clinic service. They compared outcomes by study group (control or intervention) to which each clinic had been assigned in the earlier experimental phase. RESULTS: Compared to baseline, smokers in the maintenance phase had greater exposure to posters, provider advice and booklet, and better outcomes on seven of eight smoking cessation measures, including quitting. These improvements were larger for clinics with prior experience implementing It's Time. CONCLUSION: Participation in the experimental evaluation of the It's Time program prepared and possibly motivated the clinics to continue the program. Continuing the program resulted in greater delivery of interventions and improved smoking cessation outcomes for smokers in the clinics. PMID:11889280

Personality Change following Internet-Based Cognitive Behavior Therapy for Severe Health Anxiety

PubMed Central

Hedman, Erik; Andersson, Gerhard; Lindefors, Nils; Gustavsson, Petter; Lekander, Mats; Rück, Christian; Andersson, Erik; Ljótsson, Brjánn

2014-01-01

Personality traits have traditionally been viewed as stable, but recent studies suggest that they could be affected through psychological treatment. Internet-based cognitive behavior therapy (ICBT) for severe health anxiety (DSM-IV hypochondriasis) has been shown to be effective in reducing health anxiety, but its effect on measures of personality traits has not been investigated. The main aim of this study was to investigate the impact of ICBT on personality traits in the three broad dimensions - neuroticism, extraversion and aggression. We hypothesized that participants in ICBT would reduce their level of neuroticism compared to controls that did not receive the active treatment. No specific predictions were made regarding extraversion and aggression. Data from a randomized controlled trial were used in which participants were allocated to 12 weeks of ICBT (n = 40) or to a basic attention control condition (n = 41). Personality traits were assessed with the Swedish Universities Scales of Personality and the primary outcome of health anxiety was the Health Anxiety Inventory. There was a significant interaction effect of group and time on neuroticism-related scales, indicating larger pre- to post-treatment reductions in the Internet-based CBT group compared to the control condition. Analyses at 6-month follow-up showed that changes were stable. Traits relating to extraversion and aggression were largely unchanged. This study is the first to demonstrate that a brief ICBT intervention for severe health anxiety causes long-term changes in measures of personality traits related to neuroticism. The treatment thus has a broader impact than just reducing health anxiety. Trial Registration Clinicaltrials.gov (ID NCT00828152) PMID:25437150

Carotenoid maintenance handicap and the physiology of carotenoid-based signalisation of health

NASA Astrophysics Data System (ADS)

Vinkler, Michal; Albrecht, Tomáš

2010-01-01

Despite a reasonable scientific interest in sexual selection, the general principles of health signalisation via ornamental traits remain still unresolved in many aspects. This is also true for the mechanism preserving honesty of carotenoid-based signals. Although it is widely accepted that this type of ornamentation reflects an allocation trade-off between the physiological utilisation of carotenoids (mainly in antioxidative processes) and their deposition in ornaments, some recent evidence suggests more complex interactions. Here, we further develop the models currently proposed to explain the honesty of carotenoid-based signalisation of heath status by adding the handicap principle concept regulated by testosterone. We propose that under certain circumstances carotenoids may be dangerous for the organism because they easily transform into toxic cleavage products. When reserves of other protective antioxidants are insufficient, physiological trade-offs may exist between maintenance of carotenoids for ornament expression and their removal from the body. Furthermore, we suggest that testosterone which enhances ornamentation by increasing carotenoid bioavailability may also promote oxidative stress and hence lower antioxidant reserves. The presence of high levels of carotenoids required for high-quality ornament expression may therefore represent a handicap and only individuals in prime health could afford to produce elaborate colourful ornaments. Although further testing is needed, this ‘carotenoid maintenance handicap’ hypothesis may offer a new insight into the physiological aspects of the relationship between carotenoid function, immunity and ornamentation.

21 CFR 211.58 - Maintenance.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Maintenance. 211.58 Section 211.58 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... Maintenance. Any building used in the manufacture, processing, packing, or holding of a drug product shall be...

21 CFR 211.58 - Maintenance.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Maintenance. 211.58 Section 211.58 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... Maintenance. Any building used in the manufacture, processing, packing, or holding of a drug product shall be...

21 CFR 211.58 - Maintenance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Maintenance. 211.58 Section 211.58 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... Maintenance. Any building used in the manufacture, processing, packing, or holding of a drug product shall be...

21 CFR 211.58 - Maintenance.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Maintenance. 211.58 Section 211.58 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... Maintenance. Any building used in the manufacture, processing, packing, or holding of a drug product shall be...

21 CFR 211.58 - Maintenance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Maintenance. 211.58 Section 211.58 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... Maintenance. Any building used in the manufacture, processing, packing, or holding of a drug product shall be...

Commercial products that convey personal health information in emergencies.

PubMed

Potini, Vishnu C; Weerasuriya, Dilani N; Lowery-North, Douglas W; Kellermann, Arthur L

2011-12-01

Describe commercially available products and services designed to convey personal health information in emergencies. The search engine Google®, supplemented by print ads, was used to identify companies and organizations that offer relevant products and services to the general market. Disease-specific, health system, and health plan-specific offerings were excluded. Vendor web sites were the primary sources of information, supplemented by telephone and e-mail queries to sales representatives. Perfect inter-rater agreement was achieved. Thirty-nine unique vendors were identified. Eight sell engraved jewelry. Three offer an embossed card or pamphlet. Twelve supply USB drives with various features. Eleven support password-protected web sites. Five maintain national call centers. Available media differed markedly with respect to capacity and accessibility. Quoted prices ranged from a one-time expenditure of $3.50 to an annual fee of $200. Associated features and annual fees varied widely. A wide range of products and services exist to help patients convey personal health information. Health care providers should be familiar with their features, so they can access the information in a disaster or emergency.

32 CFR 935.140 - Motor vehicle maintenance and equipment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Motor vehicle maintenance and equipment. 935.140 Section 935.140 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE TERRITORIAL AND INSULAR REGULATIONS WAKE ISLAND CODE Motor Vehicle Code § 935.140 Motor vehicle maintenance and equipment. (a) Each person who has custod...

Gender: shaping personality, lives and health of women in Pakistan.

PubMed

Rizvi, Narjis; S Khan, Kausar; Shaikh, Babar T

2014-04-01

Gender norms determine the status of Pakistani women that influence their life including health. In Pakistan, the relationship between gender norms and health of women is crucial yet complex demanding further analysis. This paper: determines the reasons for reiteration of gender roles; describes the societal processes and mechanisms that reproduce and reinforce them; and identifies their repercussions on women's personality, lives and health especially reproductive health. As part of a six-country study titled 'Women's Empowerment in Muslim Contexts', semi-structured group discussions (n = 30) were conducted with women (n = 250) who were selected through snowballing from different age, ethnic and socio-economic categories. Discussion guidelines were used to collect participant's perceptions about Pakistani women's: characteristics, powers, aspirations, needs and responsibilities; circumstances these women live in such as opportunities, constraints and risks; and influence of these circumstances on their personality, lifestyle and health. The society studied has constructed a 'Model' for women that consider them 'Objects' without rights and autonomy. Women's subordination, a prerequisite to ensure compliance to the constructed model, is maintained through allocation of lesser resources, restrictions on mobility, seclusion norms and even violence in cases of resistance. The model determines women's traits and responsibilities, and establishes parameters for what is legitimate for women, and these have implications for their personality, lifestyle and health, including their reproductive behaviours. There is a strong link between women's autonomy, rights, and health. This demands a gender sensitive and a, right-based approach towards health. In addition to service delivery interventions, strategies are required to counter factors influencing health status and restricting access to and utilization of services. Improvement in women's health is bound to have

Personal Health Records: A Systematic Literature Review

PubMed Central

2017-01-01

Background Information and communication technology (ICT) has transformed the health care field worldwide. One of the main drivers of this change is the electronic health record (EHR). However, there are still open issues and challenges because the EHR usually reflects the partial view of a health care provider without the ability for patients to control or interact with their data. Furthermore, with the growth of mobile and ubiquitous computing, the number of records regarding personal health is increasing exponentially. This movement has been characterized as the Internet of Things (IoT), including the widespread development of wearable computing technology and assorted types of health-related sensors. This leads to the need for an integrated method of storing health-related data, defined as the personal health record (PHR), which could be used by health care providers and patients. This approach could combine EHRs with data gathered from sensors or other wearable computing devices. This unified view of patients’ health could be shared with providers, who may not only use previous health-related records but also expand them with data resulting from their interactions. Another PHR advantage is that patients can interact with their health data, making decisions that may positively affect their health. Objective This work aimed to explore the recent literature related to PHRs by defining the taxonomy and identifying challenges and open questions. In addition, this study specifically sought to identify data types, standards, profiles, goals, methods, functions, and architecture with regard to PHRs. Methods The method to achieve these objectives consists of using the systematic literature review approach, which is guided by research questions using the population, intervention, comparison, outcome, and context (PICOC) criteria. Results As a result, we reviewed more than 5000 scientific studies published in the last 10 years, selected the most significant approaches

[Personalized medicine, privatized medicine? legal and public health stakes].

PubMed

Rial-Sebbag, Emmanuelle

2014-11-01

Personalized medicine is booming. It tends to provide a medical management "tailored" for groups of patients, or for one unique patient, but also to identify risk groups to develop public health strategies. In this context, some radicalization phenomenon can emerge, leading to not only personalized medicine but also privatized medicine, which can lead to a capture of the medical public resource. If the "privatization" of medicine is not limited to producing adverse effects, several potentially destabilizing phenomena for patients still remain. First, some objective factors, like the adjustment of scientific prerequisites, are emerging from personalized medicine practices (clinical trial, public health policy) and are interfering with the medical doctor/patient relationship. Another risk emerges for patients concomitantly to their demand for controlling their own health, in terms of patients' security although these risks are not clearly identified and not effectively communicated. These practices, related to a privatized medicine, develop within the healthcare system but also outside, and the government and legislators will have to take into account these new dimensions in drafting their future regulations and policies. © 2014 médecine/sciences – Inserm.

Personality traits and dysfunctional construal of online health promotion messages.

PubMed

Lee, Yaeeun; Kurtz, John E

2017-10-20

With the Internet becoming increasingly popular as a source of information, blogs offering healthy lifestyle techniques and knowledge have become popular and accessible. Despite their focus on health, these blogs portray content that may be negatively construed by viewers, especially those with or at risk for eating disorders. The present study investigated changes in affect and self-esteem after viewing a prototypic health blog. Personality traits, specifically neuroticism and conscientiousness, were also investigated. A prototypic health blog was constructed after extensive review of existing blogs. A parallel format was then followed to create a home décor website for a control condition. Female undergraduate students were randomly assigned to one of two blog sites, and participants completed an earlier personality assessment and post-viewing study questionnaires. Contrary to the hypothesis that readers of the health blog will report more negative outcomes, no main effect of blog condition was found. However, individuals high in trait neuroticism experienced greater differences in negative affect, but not self-esteem, when viewing the health blog versus the control blog. This study found that viewing health blogs did not have immediate effects on affect and self-esteem, but more neurotic individuals were more inclined to experience negative affect when viewing health promotion messages. Personality traits assessed prior to the experiment were more predictive of negative affect and self-esteem during the experiment than blog viewing conditions. No level of evidence, experimental study.

Risk management assessment of Health Maintenance Organisations participating in the National Health Insurance Scheme

PubMed Central

Campbell, Princess Christina; Korie, Patrick Chukwuemeka; Nnaji, Feziechukwu Collins

2014-01-01

Background: The National Health Insurance Scheme (NHIS), operated majorly in Nigeria by health maintenance organisations (HMOs), took off formally in June 2005. In view of the inherent risks in the operation of any social health insurance, it is necessary to efficiently manage these risks for sustainability of the scheme. Consequently the risk-management strategies deployed by HMOs need regular assessment. This study assessed the risk management in the Nigeria social health insurance scheme among HMOs. Materials and Methods: Cross-sectional survey of 33 HMOs participating in the NHIS. Results: Utilisation of standard risk-management strategies by the HMOs was 11 (52.6%). The other risk-management strategies not utilised in the NHIS 10 (47.4%) were risk equalisation and reinsurance. As high as 11 (52.4%) of participating HMOs had a weak enrollee base (less than 30,000 and poor monthly premium and these impacted negatively on the HMOs such that a large percentage 12 (54.1%) were unable to meet up with their financial obligations. Most of the HMOs 15 (71.4%) participated in the Millennium development goal (MDG) maternal and child health insurance programme. Conclusions: Weak enrollee base and poor monthly premium predisposed the HMOs to financial risk which impacted negatively on the overall performance in service delivery in the NHIS, further worsened by the non-utilisation of risk equalisation and reinsurance as risk-management strategies in the NHIS. There is need to make the scheme compulsory and introduce risk equalisation and reinsurance. PMID:25298605

Product differentiation among health maintenance organizations: causes and consequences of offering open-ended products.

PubMed

Wholey, D R; Christianson, J B

1994-01-01

Open-ended products that allow an HMO enrollee to use providers who are not affiliated with the HMO have become an important component of the Clinton administration's health reform proposal, because these products maintain consumer freedom of choice of any provider. However, little is known about the consequences of offering an open-ended product from an organizational standpoint. This paper uses a theory of "spatial competition" to examine the decisions of health maintenance organizations to offer an open-ended product and the effect of offering an open-ended product on their enrollment.

Basic health, women's health, and mental health among internally displaced persons in Nyala Province, South Darfur, Sudan.

PubMed

Kim, Glen; Torbay, Rabih; Lawry, Lynn

2007-02-01

We assessed basic health, women's health, and mental health among Sudanese internally displaced persons in South Darfur. In January 2005, we surveyed 6 registered internally displaced persons camps in Nyala District. Using systematic random sampling, we surveyed 1293 households, interviewing 1 adult female per household (N=1274); respondents' households totaled 8643 members. We inquired about respondents' mental health, opinions on women's rights, and the health status of household members. A majority of respondents had access to rations, shelter, and water. Sixty-eight percent (861 of 1266) used no birth control, and 53% (614 of 1147) reported at least 1 unattended birth. Thirty percent (374 of 1238) shared spousal decisions on timing and spacing of children, and 49% (503 of 1027) reported the right to refuse sex. Eighty-four percent (1043 of 1240) were circumcised. The prevalence of major depression was 31% (390 of 1253). Women also expressed limited rights regarding marriage, movement, and access to health care. Eighty-eight percent (991 of 1121) supported equal educational opportunities for women. Humanitarian aid has relieved a significant burden of this displaced population's basic needs. However, mental and women's health needs remain largely unmet. The findings indicate a limitation of sexual and reproductive rights that may negatively affect health.

Intelligent personal health record: experience and open issues.

PubMed

Luo, Gang; Tang, Chunqiang; Thomas, Selena B

2012-08-01

Web-based personal health records (PHRs) are under massive deployment. To improve PHR's capability and usability, we previously proposed the concept of intelligent PHR (iPHR). By introducing and extending expert system technology and Web search technology into the PHR domain, iPHR can automatically provide users with personalized healthcare information to facilitate their daily activities of living. Our iPHR system currently provides three functions: guided search for disease information, recommendation of home nursing activities, and recommendation of home medical products. This paper discusses our experience with iPHR as well as the open issues, including both enhancements to the existing functions and potential new functions. We outline some preliminary solutions, whereas a main purpose of this paper is to stimulate future research work in the area of consumer health informatics.

Annual Research Review: Building a science of personalized intervention for youth mental health.

PubMed

Ng, Mei Yi; Weisz, John R

2016-03-01

Within the past decade, health care service and research priorities have shifted from evidence-based medicine to personalized medicine. In mental health care, a similar shift to personalized intervention may boost the effectiveness and clinical utility of empirically supported therapies (ESTs). The emerging science of personalized intervention will need to encompass evidence-based methods for determining which problems to target and in which order, selecting treatments and deciding whether and how to combine them, and informing ongoing clinical decision-making through monitoring of treatment response throughout episodes of care. We review efforts to develop these methods, drawing primarily from psychotherapy research with youths. Then we propose strategies for building a science of personalized intervention in youth mental health. The growing evidence base for personalizing interventions includes research on therapies adapted for specific subgroups; treatments targeting youths' environments; modular therapies; sequential, multiple assignment, randomized trials; measurement feedback systems; meta-analyses comparing treatments for specific patient characteristics; data-mining decision trees; and individualized metrics. The science of personalized intervention presents questions that can be addressed in several ways. First, to evaluate and organize personalized interventions, we propose modifying the system used to evaluate and organize ESTs. Second, to help personalizing research keep pace with practice needs, we propose exploiting existing randomized trial data to inform personalizing approaches, prioritizing the personalizing approaches likely to have the greatest impact, conducting more idiographic research, and studying tailoring strategies in usual care. Third, to encourage clinicians' use of personalized intervention research to inform their practice, we propose expanding outlets for research summaries and case studies, developing heuristic frameworks that

NASA work unit system file maintenance manual

NASA Technical Reports Server (NTRS)

1972-01-01

The NASA Work Unit System is a management information system for research tasks (i.e., work units) performed under NASA grants and contracts. It supplies profiles on research efforts and statistics on fund distribution. The file maintenance operator can add, delete and change records at a remote terminal or can submit punched cards to the computer room for batch update. The system is designed for file maintenance by a person with little or no knowledge of data processing techniques.

Disaster preparedness in home health and personal-care agencies: are they ready?

PubMed

Daugherty, Jill D; Eiring, Hilary; Blake, Sarah; Howard, David

2012-01-01

The use of home health care and personal-care agencies in the United States has increased by nearly 1,000% in less than 20 years. Despite the numerous advantages of keeping older and disabled people at home and fairly independent, new concerns have emerged about how to keep home health care and personal-care clients safe during emergencies and large-scale disasters. To date, little is known about the disaster preparedness activities of home health and personal-care agencies, including what oversight they have for their patients and what capabilities they sustain for preparing their clients for disasters. The purpose of this study was to explore the disaster preparedness policies and practices of these agencies and to identify opportunities for coordination with disaster preparedness officials. Semi-structured interviews were conducted by phone and in person with 21 home health and personal-care administrators across Georgia and Southern California. Transcripts from the interviews were analyzed for disaster preparedness themes. We found that most agencies have very limited disaster plans and capabilities. Despite this, most stated either their intentions or outlined past experience which demonstrated their commitment to provide services to clients on a case-by-case basis throughout a large-scale emergency or disaster. The findings from our study help to contribute to the growing interest in disaster preparedness among home health and personal-care agencies and point to the fact that these agencies need assistance to properly lay out their disaster preparedness plans. Copyright © 2012 S. Karger AG, Basel.

Maintenance Process Strategic Analysis

NASA Astrophysics Data System (ADS)

Jasiulewicz-Kaczmarek, M.; Stachowiak, A.

2016-08-01

The performance and competitiveness of manufacturing companies is dependent on the availability, reliability and productivity of their production facilities. Low productivity, downtime, and poor machine performance is often linked to inadequate plant maintenance, which in turn can lead to reduced production levels, increasing costs, lost market opportunities, and lower profits. These pressures have given firms worldwide the motivation to explore and embrace proactive maintenance strategies over the traditional reactive firefighting methods. The traditional view of maintenance has shifted into one of an overall view that encompasses Overall Equipment Efficiency, Stakeholders Management and Life Cycle assessment. From practical point of view it requires changes in approach to maintenance represented by managers and changes in actions performed within maintenance area. Managers have to understand that maintenance is not only about repairs and conservations of machines and devices, but also actions striving for more efficient resources management and care for safety and health of employees. The purpose of the work is to present strategic analysis based on SWOT analysis to identify the opportunities and strengths of maintenance process, to benefit from them as much as possible, as well as to identify weaknesses and threats, so that they could be eliminated or minimized.

A call for collaboration on respectful, person-centered health care in family planning and maternal health.

PubMed

Holt, Kelsey; Caglia, Jacquelyn M; Peca, Emily; Sherry, James M; Langer, Ana

2017-02-02

Striking tales of people judged, disrespected, or abused in reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services are commonly exchanged among friends and families throughout the world while remaining sorely under-addressed in global health. Disrespect and abuse of individuals and providers in health services across the RMNCAH continuum must be stopped through collaborative, multi-tiered efforts. A new focus on health care quality in the Sustainable Development Goals offers an opportunity to seriously reexamine user experiences and their impact on health care utilization. The new framework provides an opening to redress the insidious problem of negative interactions with care across the RMNCAH services continuum and redraft the blueprint for service delivery and performance measurement, placing individuals and their needs at the center. Both the maternal health and family planning fields are at a turning point in their histories of defining and addressing individuals' experiences of care. In this commentary, we review these histories and the current state-of-the-art in both fields. Though the approaches and language in each sub-field vary, person-centered care principles related to the essential role of individuals' preferences, needs and values, and the importance of informed decision-making, respect, privacy and confidentiality, and non-discrimination, are integral to all. Promoting respectful, person-centered care also requires recognizing the factors that lead to poor treatment of clients, including gender norms and unsupportive working conditions for providers. Lessons can be learned from innovative efforts across the continuum to support health care providers to provide respectful, person-centered care. Efforts in the maternal health and family planning fields to define respectful, person-centered care provide a useful foundation from which to connect across the continuum of RMNCAH services. Now is the time to creatively work

Personal factors associated with health-related quality of life in persons with morbid obesity on treatment waiting lists in Norway.

PubMed

Lerdal, Anners; Andenæs, Randi; Bjørnsborg, Eva; Bonsaksen, Tore; Borge, Lisbet; Christiansen, Bjørg; Eide, Hilde; Hvinden, Kari; Fagermoen, May Solveig

2011-10-01

To explore relationships of socio-demographic variables, health behaviours, environmental characteristics and personal factors, with physical and mental health variables in persons with morbid obesity, and to compare their health-related quality of life (HRQoL) scores with scores from the general population. A cross-sectional correlation study design was used. Data were collected by self-reported questionnaire from adult patients within the first 2 days of commencement of a mandatory educational course. Of 185 course attendees, 142 (76.8%) volunteered to participate in the study. Valid responses on all items were recorded for 128 participants. HRQoL was measured with the Short Form 12v2 from which physical (PCS) and mental component summary (MCS) scores were computed. Other standardized instruments measured regular physical activity, social support, self-esteem, sense of coherence, self-efficacy and coping style. Respondents scored lower on all the HRQoL sub-domains compared with norms. Linear regression analyses showed that personal factors that included self-esteem, self-efficacy, sense of coherence and coping style explained 3.6% of the variance in PCS scores and 41.6% in MCS scores. Personal factors such as self-esteem, sense of coherence and a high approaching coping style are strongly related to mental health in obese persons.

Influence of worldview on health care choices among persons with chronic pain.

PubMed

Buck, Tina; Baldwin, Carol M; Schwartz, Gary E

2005-06-01

The aim of this research was to examine relationships between the Pepperian worldviews of people with chronic pain and the health care choices that they make. A convenience sample survey was done. University Medical Center Pain Clinic, Tucson, Arizona. Men and women patients (n = 96) with nonmalignant chronic pain. World Hypothesis Scale; Health Care Choice List. Findings indicate that the combination of age and formistic worldview are statistically significant predictors of conventional health care choices by participants in this study. Older patients and persons with a predominantly formistic worldview were less likely to use complementary and alternative medicine (CAM) as a choice among this sample with chronic nonmalignant pain. Borderline significant associations were noted between persons with formistic or mechanistic worldviews and conventional health care choices, and persons with contextualistic, organismic, or equal scores in two worldview categories and CAM health care choices. Although rates of CAM use did not significantly differ from conventional choices, the prevalence rate for CAM use was high (55.2%) based on national findings. Results of this study provide a link to understanding how underlying philosophies can contribute to the reasons people with chronic pain make health care decisions. Further exploration of worldviews might very well contribute to best practices for consumer health care by engaging in communication styles and belief systems consistent with consumers' personal schemas.

Borderline personality symptomatology and compliance with general health care among internal medicine outpatients.

PubMed

Sansone, Randy A; Bohinc, R Jordan; Wiederman, Michael W

2015-06-01

The extant literature on borderline personality disorder (BPD) and compliance with mental health treatment contains conflicting findings. However, among those individuals with this type of personality dysfunction, reduced compliance with mental health treatment appears to be the predominant theme. To our knowledge, the relationship between BPD and compliance with general health care has not been studied. In addition, there is no prior study in this area examining a primary care population. Using a cross-sectional survey methodology among a sample of internal medicine outpatients (N = 261), we assessed borderline personality symptoms with two self-report measures and general health care compliance or adherence with four self-report measures. With the exception of on-time arrival for doctor appointments, the remaining compliance variables demonstrated statistically significant relationships at the p < 0.01-0.001 levels, with borderline personality symptoms predicting reduced compliance (i.e., conscientiousness with medical treatment, regular dental check-ups, timely completion of laboratory work, following doctor's exercise and nutrition instructions, remembering to take medications, and Medical Outcomes Study General Adherence Score). Compared with participants without borderline personality symptoms, those participants with such symptoms in this study evidenced lower general health care compliance.

Characteristics of personal health records: findings of the Medical Library Association/National Library of Medicine Joint Electronic Personal Health Record Task Force.

PubMed

Jones, Dixie A; Shipman, Jean P; Plaut, Daphne A; Selden, Catherine R

2010-07-01

The Medical Library Association (MLA)/National Library of Medicine (NLM) Joint Electronic Personal Health Record Task Force examined the current state of personal health records (PHRs). A working definition of PHRs was formulated, and a database was built with fields for specified PHR characteristics. PHRs were identified and listed. Each task force member was assigned a portion of the list for data gathering. Findings were recorded in the database. Of the 117 PHRs identified, 91 were viable. Almost half were standalone products. A number used national standards for nomenclature and/or record structure. Less than half were mobile device enabled. Some were publicly available, and others were offered only to enrollees of particular health plans or employees at particular institutions. A few were targeted to special health conditions. The PHR field is very dynamic. While most PHR products have some common elements, their features can vary. PHRs can link their users with librarians and information resources. MLA and NLM have taken an active role in making this connection and in encouraging librarians to assume this assistance role with PHRs.

Sharing Personal Reflections on Health Locally

NASA Astrophysics Data System (ADS)

Grimes, Andrea

Researchers are becoming increasingly interested in developing systems that help people live healthier lifestyles. Little attention has been paid, however, to how technology can address the significant health disparities in populations such as low-income African Americans. To address this research gap, I designed EatWell specifically for residents in low-income African American communities in Atlanta, GA. EatWell is a system for cell phones that lets people share how they have tried to eat healthfully with individuals in their local neighborhoods. In this chapter, I discuss the characteristics of the community that was created as people shared their personal stories and reflections in EatWell. Specifically, I describe the users themselves (the who), the context of use (the where), the kind of content people created (the what), and the way in which they interacted with the content (the how). Finally, I discuss the implications of designing health applications for people in local contexts, a class of systems that I call deeply local health applications.

Maintenance of Ideal Cardiovascular Health and Coronary Artery Calcium Progression in Low-Risk Men and Women in the Framingham Heart Study.

PubMed

Hwang, Shih-Jen; Onuma, Oyere; Massaro, Joseph M; Zhang, Xiaoling; Fu, Yi-Ping; Hoffmann, Udo; Fox, Caroline S; O'Donnell, Christopher J

2018-01-01

Ideal cardiovascular health (CVH) is associated with a lower risk of cardiovascular disease and freedom from coronary artery calcium (CAC). Prospective data on the association between maintenance of optimal CVH and the progression of subclinical coronary atherosclerosis are limited. We assessed the influence of unfavorable versus favorable CVH on the incidence of CAC progression. The study population consisted of 1119 FHS (Framingham Heart Study) participants who attended the serial FHS MDCT I and MDCT II study (Multi-Detector Computed Tomography) and had a zero Agatston CAC score at baseline. CVH status was defined using 6 CVH metrics from the American Heart Association definition. CAC progression was defined by an increase in Agatston CAC score to ≥3.4. Generalized estimating equations were applied to identify significant associations of CAC progression with both the baseline measurement of CVH and the longitudinal maintenance of CVH. After follow-up (mean, 6.1 years), we observed CAC progression in 191 participants (17.1%). Participants with unfavorable CVH at baseline had a greater risk of CAC progression (odds ratio, 2.43; 95% confidence interval, 1.40-4.23; P =0.0017). In addition, each unit decrease in ideal CVH metric was associated with an increase in CAC progression (odds ratio, 1.15; 95% confidence interval, 0.99-1.34; P =0.067), after adjustment for baseline ideal CVH metrics. Significant associations between an unfavorable CVH profile and CAC progression support public health measures that seek to prevent cardiovascular disease by promoting favorable CVH profiles in persons free of clinical and subclinical cardiovascular disease. © 2018 American Heart Association, Inc.

21 CFR 1250.35 - Health of persons handling food.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Health of persons handling food. 1250.35 Section 1250.35 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION INTERSTATE CONVEYANCE...

21 CFR 1250.35 - Health of persons handling food.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Health of persons handling food. 1250.35 Section 1250.35 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION INTERSTATE CONVEYANCE...

Personalized Strategies to Activate and Empower Patients in Health Care and Reduce Health Disparities

ERIC Educational Resources Information Center

Chen, Jie; Mullins, C. Daniel; Novak, Priscilla; Thomas, Stephen B.

2016-01-01

Designing culturally sensitive personalized interventions is essential to sustain patients' involvement in their treatment and encourage patients to take an active role in their own health and health care. We consider patient activation and empowerment as a cyclical process defined through patient accumulation of knowledge, confidence, and…

Health maintenance organization environments in the 1980s and beyond

PubMed Central

Morrison, Ellen M.; Luft, Harold S.

1990-01-01

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

Fit and Strong!: bolstering maintenance of physical activity among older adults with lower-extremity osteoarthritis.

PubMed

Hughes, Susan L; Seymour, Rachel B; Campbell, Richard T; Desai, Pankaja; Huber, Gail; Chang, H Justina

2010-01-01

To compare the impact of negotiated vs. mainstreamed follow-up with telephone reinforcement (TR) on maintenance of physical activity (PA) after Fit and Strong! ended. A multisite comparative effectiveness trial with repeated measures. Single group random effects analyses showed significant improvements at 2, 6, 12, and 18 months on PA maintenance, lower-extremity (LE) pain and stiffness, LE function, sit-stand, 6-minute distance walk, and anxiety/depression. Analyses by follow-up condition showed persons in the negotiated with TR group maintained a 21% increase in caloric expenditures over baseline at 18 months, with lesser benefits seen in the negotiated-only, mainstreamed-with-TR, and mainstreamed-only groups. Significant benefits of telephone dose were also seen on LE joint stiffness, pain, and function as well as anxiety and anxiety/depression. The negotiated follow-up contract that Fit and Strong! uses, bolstered by TR, is associated with enhanced long-term PA maintenance and health outcomes.

‘My health is not a job’: a qualitative exploration of personal health management and imperatives of the ‘new public health’

PubMed Central

2014-01-01

Background There is an increasing push in Western healthcare for people to ‘manage’ their health, a key aspect of what has been called the ‘new public health’. It has been argued that this ‘personal health management’ – informal work done to monitor, inform, or influence one’s health – may be a burden, with potential to contribute to poor health outcomes. However, there is little research actually examining perceptions of personal health management and the ‘burden’ of these activities, particularly for generally healthy individuals. Methods We conducted exploratory qualitative interviews with 30 generally healthy men and women about their perceptions and experiences of personal health management. Questions focused on health behaviours (e.g., information seeking), as well as feelings about these behaviours and perceptions of the time dedicated to health. Audio-recorded interviews were transcribed and analyzed qualitatively using NVivo 10. Where appropriate, quantitative codes were applied and descriptive statistics are reported alongside qualitative findings. Results Participants were generally satisfied with the amount of time spent on their health and few perceived personal health management as a burden. Many participants took issue with the concept of ‘work’ being associated with health and stressed the importance of taking personal responsibility for health. Conclusions Our findings suggest that generally healthy people have internalised the notion of the ‘new public health’ and accepted the imperative of personal health responsibility. On the one hand, this bodes well for healthy individuals; their positive attitude may lead to better health outcomes, and the manageable amount of time spent suggests personal health management is unlikely to cause negative health consequences associated with stress. On the other hand, our findings may indicate that other factors, such as social determinants of health, are ignored in health promotion

Study design and protocol for a theory-based behavioral intervention focusing on maintenance of weight loss: the Maintenance After Initiation of Nutrition TrAINing (MAINTAIN) study.

PubMed

Voils, Corrine I; Gierisch, Jennifer M; Olsen, Maren K; Maciejewski, Matthew L; Grubber, Janet; McVay, Megan A; Strauss, Jennifer L; Bolton, Jamiyla; Gaillard, Leslie; Strawbridge, Elizabeth; Yancy, William S

2014-09-01

Obesity is a significant public health problem. Although various lifestyle approaches are effective for inducing significant weight loss, few effective behavioral weight maintenance strategies have been identified. It has been proposed that behavior maintenance is a distinct state that involves different psychological processes and behavioral skills than initial behavior change. Previously, we created a conceptual model that distinguishes behavior initiation from maintenance. This model was used to generate Maintenance After Initiation of Nutrition TrAINing (MAINTAIN), an intervention to enhance weight loss maintenance following initiation. The effectiveness of MAINTAIN is being evaluated in an ongoing trial, the rationale and procedures of which are reported herein. Veterans aged ≤ 75 with body mass index ≥ 30 kg/m(2) participate in a 16-week, group-based weight loss program. Participants who lose ≥ 4 kg by the end of 16 weeks (target n = 230) are randomized 1:1 to receive (a) usual care for 56 weeks or (b) MAINTAIN, a theoretically-informed weight loss maintenance intervention for 40 weeks, followed by 16 weeks of no intervention contact. MAINTAIN involves 3 in-person group visits that transition to 8 individualized telephone calls with decreasing contact frequency. MAINTAIN focuses on satisfaction with outcomes, weight self-monitoring, relapse prevention, and social support. We hypothesize that, compared to usual care, MAINTAIN will result in at least 3.5 kg less regain and better relative levels of caloric intake and physical activity over 56 weeks, and that it will be cost-effective. If effective, MAINTAIN could serve as a model for redesigning existing weight loss programs. NCT01357551. Published by Elsevier Inc.

Structural health and prognostics management for the enhancement of offshore wind turbine operations and maintenance strategies

DOE PAGES

Griffith, D. Todd; Yoder, Nathanael C.; Resor, Brian; ...

2013-09-19

Offshore wind turbines are an attractive source for clean and renewable energy for reasons including their proximity to population centers and higher capacity factors. One obstacle to the more widespread installation of offshore wind turbines in the USA, however, is that recent projections of offshore operations and maintenance costs vary from two to five times the land-based costs. One way in which these costs could be reduced is through use of a structural health and prognostics management (SHPM) system as part of a condition-based maintenance paradigm with smart loads management. Our paper contributes to the development of such strategies bymore » developing an initial roadmap for SHPM, with application to the blades. One of the key elements of the approach is a multiscale simulation approach developed to identify how the underlying physics of the system are affected by the presence of damage and how these changes manifest themselves in the operational response of a full turbine. A case study of a trailing edge disbond is analysed to demonstrate the multiscale sensitivity of damage approach and to show the potential life extension and increased energy capture that can be achieved using simple changes in the overall turbine control and loads management strategy. Finally, the integration of health monitoring information, economic considerations such as repair costs versus state of health, and a smart loads management methodology provides an initial roadmap for reducing operations and maintenance costs for offshore wind farms while increasing turbine availability and overall profit.« less

Evaluating a health behaviour model for persons with and without an intellectual disability.

PubMed

Brehmer-Rinderer, B; Zigrovic, L; Weber, G

2014-06-01

Based on the idea of the Common Sense Model of Illness Representations by Leventhal as well as Lohaus's concepts of health and illness, a health behaviour model was designed to explain health behaviours applied by persons with intellectual disabilities (ID). The key proposal of this model is that the way someone understands the concepts of health, illness and disability influences the way they perceive themselves and what behavioural approaches to them they take. To test this model and explain health differences between the general population and person with ID, 230 people with ID and a comparative sample of 533 persons without ID were included in this Austrian study. Data were collected on general socio-demographics, personal perceptions of illness and disability, perceptions of oneself and health-related behaviours. Psychometric analysis of the instruments used showed that they were valid and reliable and hence can provide a valuable tool for studying health-related issues in persons with and without ID. With respect to the testing of the suggested health model, two latent variables were defined in accordance to the theory. The general model fit was evaluated by calculating different absolute and descriptive fit indices. Most indices indicated an acceptable model fit for all samples. This study presents the first attempt to explore the systematic differences in health behaviour between people with and without ID based on a suggested health model. Limitations of the study as well as implications for practice and future research are discussed. © 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Nonlinearities in personalization-privacy paradox in mHealth adoption: the mediating role of perceived usefulness and attitude.

PubMed

Zhang, Xiaofei; Guo, Xitong; Guo, Feng; Lai, Kee-Hung

2014-01-01

Personalization in healthcare refers to individualizing services and products based on patients' health conditions and interests. In order to deliver highly personalized offerings, mHealth providers need to use patients' health information, which provokes patients' concerns over personal health information leakage. So the personalization-privacy paradox is an important issue in the mHealth context. To gain a better understanding of this paradox, we take the personalization and privacy paradox factors as independent variables, incorporating the nonlinear relationships between personalization and privacy, and take attitude and perceived usefulness as middle variables to study mHealth adoption. The hypothesized model is tested through an empirical research of a 489-respondent sample in China. PLS is used for data analysis. (1) Personalization and privacy are found to influence mHealth adoption intention via attitude and perceived usefulness; (2) there is a substitution relationship, also called negative synergy between personalization and privacy in mHealth contexts; (3) attitude mediates the effect of perceived usefulness on intention, indicating a significant role of attitude.

The Meaning and Predictive Value of Self-rated Mental Health among Persons with a Mental Health Problem.

PubMed

McAlpine, Donna D; McCreedy, Ellen; Alang, Sirry

2018-06-01

Self-rated health is a valid measure of health that predicts quality of life, morbidity, and mortality. Its predictive value reflects a conceptualization of health that goes beyond a traditional medical model. However, less is known about self-rated mental health (SRMH). Using data from the Medical Expenditure Panel Survey ( N = 2,547), we examine how rating your mental health as good-despite meeting criteria for a mental health problem-predicts outcomes. We found that 62% of people with a mental health problem rated their mental health positively. Persons who rated their mental health as good (compared to poor) had 30% lower odds of having a mental health problem at follow-up. Even without treatment, persons with a mental health problem did better if they perceived their mental health positively. SRMH might comprise information beyond the experience of symptoms. Understanding the unobserved information individuals incorporate into SRMH will help us improve screening and treatment interventions.

Co-production of Health enabled by next generation personal health systems.

PubMed

Boye, Niels

2012-01-01

This paper describes the theoretical principles for the establishment of a parallel and complementary modality of healthcare delivery - named Coproduction of Health (CpH). This service-model activates digital data, information, and knowledge about health, healthy choices, and the individuals' health-state and computes through personalized models context-aware communication and advice. "Lightweight technologies" (smartphones, tablets, application stores) would serve as the technology close to the end-users (citizens, patients, clients, customers), connecting them with "big data" in conventionally and non-conventionally organized data repositories. The CpH modality aims at providing synergies between professional healthcare, selfcare, informal care and provides data-fusion from several sources such as health characteristics of consumer goods, from sensors, actuators, and health related data-repositories, and turns this into "health added value" for the individual. A theoretical business model respecting healthcare values, ethics, and legal foundation is also sketched out.

Exercise, diet, health behaviors, and risk factors among persons with epilepsy based on the California Health Interview Survey, 2005.

PubMed

Elliott, John O; Lu, Bo; Moore, J Layne; McAuley, James W; Long, Lucretia

2008-08-01

Based on the 2005 California Health Interview Survey, persons with a history of epilepsy report lower educational attainment, lower annual income, and poorer health status, similar to other state-based epidemiological surveys. Previous studies have found persons with epilepsy exercise less and smoke more than the nonepilepsy population. The medical literature has also shown that antiepileptic drugs may cause nutritional deficiencies. Persons with a history of epilepsy in the 2005 CHIS report they walk more for transportation, drink more soda, and eat less salad than the nonepilepsy population. Exercise and dietary behaviors at recommended levels have been found to reduce mortality from many comorbid conditions such as cardiovascular disease, stroke, depression, anxiety, and osteoporosis for which persons with epilepsy are at increased risk. Health professionals in the epilepsy field should step up their efforts to engage patients in health promotion, especially in the areas of exercise, diet, and smoking cessation.

Medicaid patients in a private health maintenance organization: patterns of chemical dependency treatment.

PubMed

Walter, Lawrence J; Parthasarathy, Sujaya; Allen, Steven; Ackerson, Lynn

2002-02-01

Although many Medicaid beneficiaries receive health care through commercial health maintenance organizations (HMOs), the impact of private managed care on low-income individuals seeking treatment for substance abuse has rarely been studied. This study examined treatment patterns of 234 Medicaid recipients who presented for care at an HMO between 1995 and 1997. After adjustment for demographic factors and duration of health plan membership, the Medicaid patients returned to start treatment after intake less often (odds ratio = 0.60) and dropped out of treatment sooner (median = 14 versus 28 days) than non-Medicaid patients. While many Medicaid patients received significant amounts of substance abuse treatment, further research is needed to explain the observed treatment gap and to identify areas where HMOs can improve services for some of their most vulnerable members.

Students' Mental Health: Personal and University Determinants

ERIC Educational Resources Information Center

Khodarahimi, Siamak; Rasti, Ali; Khajehie, Malihe; Sattar, Rea

2009-01-01

The present study was to examine the effects of personal and university bounded factors in students mental health in north of Fars province, Iran. The effects of these factors on university students' psychopathology within a survey design were investigated among 300 participants--94 males and 206 females, who were selected through random sampling…

25 CFR 43.17 - Release of information for health or safety emergencies.

Code of Federal Regulations, 2013 CFR

2013-04-01

... appropriate persons in an emergency if the information is necessary to protect the health or safety of a... 25 Indians 1 2013-04-01 2013-04-01 false Release of information for health or safety emergencies... MAINTENANCE AND CONTROL OF STUDENT RECORDS IN BUREAU SCHOOLS § 43.17 Release of information for health or...

25 CFR 43.17 - Release of information for health or safety emergencies.

Code of Federal Regulations, 2012 CFR

2012-04-01

... appropriate persons in an emergency if the information is necessary to protect the health or safety of a... 25 Indians 1 2012-04-01 2011-04-01 true Release of information for health or safety emergencies... MAINTENANCE AND CONTROL OF STUDENT RECORDS IN BUREAU SCHOOLS § 43.17 Release of information for health or...

25 CFR 43.17 - Release of information for health or safety emergencies.

Code of Federal Regulations, 2011 CFR

2011-04-01

... appropriate persons in an emergency if the information is necessary to protect the health or safety of a... 25 Indians 1 2011-04-01 2011-04-01 false Release of information for health or safety emergencies... MAINTENANCE AND CONTROL OF STUDENT RECORDS IN BUREAU SCHOOLS § 43.17 Release of information for health or...

25 CFR 43.17 - Release of information for health or safety emergencies.

Code of Federal Regulations, 2014 CFR

2014-04-01

... appropriate persons in an emergency if the information is necessary to protect the health or safety of a... 25 Indians 1 2014-04-01 2014-04-01 false Release of information for health or safety emergencies... MAINTENANCE AND CONTROL OF STUDENT RECORDS IN BUREAU SCHOOLS § 43.17 Release of information for health or...

Investigating the over‐representation of older persons in do‐it‐yourself home maintenance injury and barriers to prevention

PubMed Central

Ashby, K; Ozanne‐Smith, J; Fox, B

2007-01-01

Objective To examine why older persons undertake high‐risk do‐it‐yourself (DIY) home maintenance and under what circumstances, what constitutes acceptable low‐risk alternatives to DIY, and to assess if alternatives are feasible in the current context. Design Exploratory qualitative study using focus‐group methodology. Setting and subjects Fifteen focus groups were conducted, involving 118 persons aged 60 years and older, in two Melbourne communities. Participants resided locally, participated in local seniors groups, or received treatment for a DIY injury at one of two public hospitals serving these communities. Results Older persons' involvement in DIY ranged from necessity to choice. A number chose DIY for general fitness enhancement, satisfaction and pride in a job well done, and giving meaning and enjoyment to daily tasks. However, some older, frailer seniors were forced into DIY because of difficulties in choosing appropriate alternatives; lack of knowledge of some available resources and services; the challenge of accessing cost‐effective and reliable private service providers; and fear of vulnerability to overcharging, overservicing or their personal security. Preferred DIY alternatives were local government providers, local paper advertised services, recommendations to private service providers and family, friends or neighbors. Lack of knowledge of other existing alternatives was an impediment to preventing DIY injury, or accessing DIY alternatives. A number of potentially feasible alternatives to DIY were identified from our review. Conclusions This research is an important first step in understanding issues facing community‐dwelling seniors remaining at home, and provides a basis on which government agencies and other providers can develop services to meet increasing needs. PMID:17916890

Investigating the over-representation of older persons in do-it-yourself home maintenance injury and barriers to prevention.

PubMed

Ashby, K; Ozanne-Smith, J; Fox, B

2007-10-01

To examine why older persons undertake high-risk do-it-yourself (DIY) home maintenance and under what circumstances, what constitutes acceptable low-risk alternatives to DIY, and to assess if alternatives are feasible in the current context. Exploratory qualitative study using focus-group methodology. Fifteen focus groups were conducted, involving 118 persons aged 60 years and older, in two Melbourne communities. Participants resided locally, participated in local seniors groups, or received treatment for a DIY injury at one of two public hospitals serving these communities. Older persons' involvement in DIY ranged from necessity to choice. A number chose DIY for general fitness enhancement, satisfaction and pride in a job well done, and giving meaning and enjoyment to daily tasks. However, some older, frailer seniors were forced into DIY because of difficulties in choosing appropriate alternatives; lack of knowledge of some available resources and services; the challenge of accessing cost-effective and reliable private service providers; and fear of vulnerability to overcharging, overservicing or their personal security. Preferred DIY alternatives were local government providers, local paper advertised services, recommendations to private service providers and family, friends or neighbors. Lack of knowledge of other existing alternatives was an impediment to preventing DIY injury, or accessing DIY alternatives. A number of potentially feasible alternatives to DIY were identified from our review. This research is an important first step in understanding issues facing community-dwelling seniors remaining at home, and provides a basis on which government agencies and other providers can develop services to meet increasing needs.

Differentiating Behavior Initiation and Maintenance: Theoretical Framework and Proof of Concept

ERIC Educational Resources Information Center

Voils, Corrine I.; Gierisch, Jennifer M.; Yancy, William S., Jr.; Sandelowski, Margarete; Smith, Rose; Bolton, Jamiyla; Strauss, Jennifer L.

2014-01-01

Although many interventions are effective for health behavior initiation, maintenance has proven elusive. Interventions targeting maintenance often extend the duration with which initiation content is delivered or the duration of follow-up without intervention. We posit that health behavior initiation and maintenance require separate psychological…

Personal incentives as determinants of adolescent health behavior: the meaning of behavior.

PubMed

Spruijt-Metz, D

1995-09-01

It has been suggested that prevailing theories do not fully incorporate the less rational, more emotional elements of adolescent health and risk behavior. To address this limitation, the perceived incentives construct from Tappe's Model of Personal Investment is split into intrinsic and extrinsic incentives, with the intrinsic incentives representing personal meanings of adolescent health and risk behaviors. Intrinsic incentives were operationalized using transcripts from focus group interviews for three behavioral domains: sleeping habits, eating habits at lunch and eating habits after school. The ensuing questionnaire was completed by 416 Dutch secondary school students with a mean age of 14 years. Intrinsic incentives, or the personal meaning with which behavior is imbued, predicted health and risk behaviors well in all three behavioral domains. The implications of these results for further research and for the development of health education programs are discussed.

Dollar for Dollar: Racial and ethnic inequalities in health and health-related outcomes among persons with very high income.

PubMed

Wilson, Kanetha B; Thorpe, Roland J; LaVeist, Thomas A

2017-03-01

Racial and ethnic disparities in health have been well-documented, and low SES is widely considered to be a driver of this relationship. However, the race-social class-health interrelationship is complex, as several studies have found race disparities between racial/ethnic minorities and whites at middle- income levels. Research on higher income persons is complicated by the lack of data for persons with incomes about $75,000. Most national datasets collect income data in categories with the highest income category being $75,000 and above. In our study, we examined racial/ethnic disparities in health status and behaviors among persons of very high income, reported income of $175,000 or above per year. Data are from the Medical Expenditure Panel Surveys (MEPS). Our findings revealed health disparities in 10 of the 16 health-related outcomes selected. African Americans were most dissimilar to whites at this income and with disadvantages on 6 health outcomes relative to whites. While results also showed some disparities for Asian Americans and Hispanic Americans relative to whites, these groups were advantaged, relative to whites on several health outcomes. Our findings indicate that income does not fully explain racial/ethnic disparities in health. Most public interventions are targeted to low income persons. However, public health interventions should target minority individuals of very high income as well, especially African Americans. Copyright © 2016. Published by Elsevier Inc.

Championing person-first language: a call to psychiatric mental health nurses.

PubMed

Jensen, Mary E; Pease, Elizabeth A; Lambert, Kris; Hickman, Diane R; Robinson, Ora; McCoy, Kathleen T; Barut, Jennifer K; Musker, Kathleen M; Olive, Dana; Noll, Connie; Ramirez, Jeffery; Cogliser, Dawn; King, Joan Kenerson

2013-01-01

At the heart of recovery-oriented psychiatric mental health care are the dignity and respect of each person and the ways in which helping professionals convey a person's uniqueness, strengths, abilities, and needs. "Person-first language" is a form of linguistic expression relying on words that reflect awareness, a sense of dignity, and positive attitudes about people with disabilities. As such, person-first language places emphasis on the person first rather than the disability (e.g., "person with schizophrenia" rather than "a schizophrenic"). This article champions the use of person-first language as a foundation for recovery-oriented practice and enhanced collaborative treatment environments that foster respect, human dignity, and hope.

Understanding views on everyday use of personal health information: Insights from community dwelling older adults.

PubMed

Hartzler, A L; Osterhage, K; Demiris, G; Phelan, E A; Thielke, S M; Turner, A M

2018-09-01

Older adults apply various strategies to pursue healthy aging, but we know little about their views and use of personal health information to accomplish those ends. As a first step in formulating the role of personal health information management (PHIM) in healthy aging, we explored the perspectives of older adults on health and health information used in their everyday lives through four focus groups with 25 community-dwelling adults aged 60 and over. We found that the concept of wellness-the holistic and multidimensional nature of health and wellbeing-plays prominently in how older adults think about health and health information. Participants expressed wellness from a position of personal strength, rather than health-related deficits, by focusing on wellness activities for staying healthy through: (1) personal health practices, (2) social network support, and (3) residential community engagement. Although these themes involve personal health information, existing PHIM systems that focus on disease management are generally not designed to support wellness activities. Substantial opportunity exists to fill this wellness support gap with innovative health information technology designed for older adults. Findings carry implications for the design of PHIM tools that support healthy aging and methods for engaging older adults as co-producers of this critical support.

School Ethos and Personal, Social, Health Education

ERIC Educational Resources Information Center

Brown, Jackie; Busfield, Robert; O'Shea, Alison; Sibthorpe, Joanne

2011-01-01

This paper will discuss research undertaken within a London borough in 2009 that aimed to examine how Personal, Social, Health and Economic education (PSHE) was perceived and delivered. The ethos of schools was incorporated into the enquiry as a key determinate of both perception and delivery of PSHE. The findings are presented with particular…

Interaction of personality traits with social deprivation in determining mental wellbeing and health behaviours.

PubMed

Packard, Chris J; Cavanagh, Jonathan; McLean, Jennifer S; McConnachie, Alex; Messow, Claudia-Martina; Batty, G David; Burns, Harry; Deans, Kevin A; Sattar, Naveed; Shiels, Paul G; Velupillai, Yoga N; Tannahill, Carol; Millar, Keith

2012-12-01

Associations between personality traits, mental wellbeing and good health behaviours were examined to understand further the social and psychological context of the health divide. In a cross-sectional study, 666 subjects recruited from areas of high and low socioeconomic deprivation had personality traits and mental wellbeing assessed, and lifestyle behaviours quantified. Regression models (using deprivation as a moderating variable) assessed the extent to which personality traits and mental wellbeing predicted health behaviour. Deprived (vs. affluent) subjects exhibited similar levels of extraversion but higher levels of neuroticism and psychoticism, more hopelessness, less sense of coherence, lower self-esteem and lower self-efficacy (all P< 0.001). They ate less fruit and vegetables, smoked more and took less aerobic exercise (all P< 0.001). In the deprived group, personality traits were significantly more important predictors of mental wellbeing than in the least deprived group (P< 0.01 for interaction), and mental wellbeing and extraversion appeared more strongly related to good health behaviours. Persistence of a social divide in health may be related to interactions between personality, mental wellbeing and the adoption of good health behaviours in deprived areas. Effectiveness of health messages may be enhanced by accommodating the variation in the levels of extraversion, neuroticism, hopelessness and sense of coherence.

PCASSO: a design for secure communication of personal health information via the internet.

PubMed

Baker, D B; Masys, D R

1999-05-01

The Internet holds both promise and peril for the communications of person-identifiable health information. Because of technical features designed to promote accessibility and interoperability rather than security, Internet addressing conventions and transport protocols are vulnerable to compromise by malicious persons and programs. In addition, most commonly used personal computer (PC) operating systems currently lack the hardware-based system software protection and process isolation that are essential for ensuring the integrity of trusted applications. Security approaches designed for electronic commerce, that trade known security weaknesses for limited financial liability, are not sufficient for personal health data, where the personal damage caused by unintentional disclosure may be far more serious. To overcome these obstacles, we are developing and evaluating an Internet-based communications system called PCASSO (Patient-centered access to secure systems online) that applies state of the art security to health information. PCASSO includes role-based access control, multi-level security, strong device and user authentication, session-specific encryption and audit trails. Unlike Internet-based electronic commerce 'solutions,' PCASSO secures data end-to-end: in the server; in the data repository; across the network; and on the client. PCASSO is designed to give patients as well as providers access to personal health records via the Internet.

Association of financial and health literacy with cognitive health in old age.

PubMed

Wilson, Robert S; Yu, Lei; James, Bryan D; Bennett, David A; Boyle, Patricia A

2017-03-01

We tested the hypothesis that higher financial and health literacy is associated with better cognitive health in 755 older persons who completed a literacy measure (M = 67.9, SD = 14.5) and then had annual clinical evaluations for a mean of 3.4 years. In proportional hazards models, higher literacy was associated with decreased risk of developing incident Alzheimer's disease (n = 68) and results were similar for financial and health literacy subscales and after adjustment for potential confounders. In mixed-effects models, higher literacy was related to higher baseline level of cognition and reduced cognitive decline in multiple domains. Among the 602 persons without any cognitive impairment at baseline, higher literacy was associated with a reduced rate of cognitive decline and risk of developing incident mild cognitive impairment (n = 142). The results suggest that higher levels of financial and health literacy are associated with maintenance of cognitive health in old age.

Personal Health Records: A Systematic Literature Review.

PubMed

Roehrs, Alex; da Costa, Cristiano André; Righi, Rodrigo da Rosa; de Oliveira, Kleinner Silva Farias

2017-01-06

Information and communication technology (ICT) has transformed the health care field worldwide. One of the main drivers of this change is the electronic health record (EHR). However, there are still open issues and challenges because the EHR usually reflects the partial view of a health care provider without the ability for patients to control or interact with their data. Furthermore, with the growth of mobile and ubiquitous computing, the number of records regarding personal health is increasing exponentially. This movement has been characterized as the Internet of Things (IoT), including the widespread development of wearable computing technology and assorted types of health-related sensors. This leads to the need for an integrated method of storing health-related data, defined as the personal health record (PHR), which could be used by health care providers and patients. This approach could combine EHRs with data gathered from sensors or other wearable computing devices. This unified view of patients' health could be shared with providers, who may not only use previous health-related records but also expand them with data resulting from their interactions. Another PHR advantage is that patients can interact with their health data, making decisions that may positively affect their health. This work aimed to explore the recent literature related to PHRs by defining the taxonomy and identifying challenges and open questions. In addition, this study specifically sought to identify data types, standards, profiles, goals, methods, functions, and architecture with regard to PHRs. The method to achieve these objectives consists of using the systematic literature review approach, which is guided by research questions using the population, intervention, comparison, outcome, and context (PICOC) criteria. As a result, we reviewed more than 5000 scientific studies published in the last 10 years, selected the most significant approaches, and thoroughly surveyed the health

European consumers' perceived seriousness of their eating habits relative to other personal health risks.

PubMed

Hoefkens, Christine; Valli, Veronica; Mazzocchi, Mario; Traill, W Bruce; Verbeke, Wim

2013-11-01

Poor eating habits are a key priority on the European public health agenda due to their large health and economic implications. Healthy eating interventions may be more effective if consumers perceive their eating habits as a more serious personal health risk. This study investigates European consumers' perceived seriousness of their eating habits, its determinants and relative importance among other potential personal health risks including weight, stress and pollution. A quantitative survey was conducted during Spring 2011 among samples representative for age, gender and region in five European countries (n=3003). Participants were neutral towards the seriousness of their eating habits for personal health. Eating habits were ranked third after stress and weight. Gender, age, country, health motive, body mass index, and subjective health status were important determinants of the perceived seriousness of their eating habits, whereas perceived financial condition, smoking and education were insignificant. Eating habits were perceived more seriously by women, Italians, obese, and younger individuals with stronger health motives and fair subjective health status. Nevertheless, other health risks were often considered more important than eating habits. More or specific efforts are required to increase Europeans' awareness of the seriousness of their eating habits for personal health. © 2013.

Associations between the Five-Factor Model of Personality and Health Behaviors among College Students

ERIC Educational Resources Information Center

Raynor, Douglas A.; Levine, Heidi

2009-01-01

Objective: In fall 2006, the authors examined associations between the five-factor model of personality and several key health behaviors. Methods: College students (N = 583) completed the American College Health Association-National College Health Assessment and the International Personality Item Pool Big Five short-form questionnaire. Results:…

How personality became treatable: The mutual constitution of clinical knowledge and mental health law

PubMed Central

2013-01-01

In recent years, personality disorders – psychiatric constructs understood as enduring dysfunctions of personality – have come into ever-greater focus for British policymakers, mental health professionals and service-users. Disputes have focussed largely on highly controversial attempts by the UK Department of Health to introduce mental health law and policy (now enshrined within the 2007 Mental Health Act of England and Wales). At the same time, clinical framings of personality disorder have dramatically shifted: once regarded as untreatable conditions, severe personality disorders are today thought of by many clinicians to be responsive to psychiatric and psychological intervention. In this article, I chart this transformation by means of a diachronic analysis of debates and institutional shifts pertaining to both attempts to change the law, and understandings of personality disorder. In so doing, I show how mental health policy and practice have mutually constituted one another, such that the aims of clinicians and policymakers have come to be closely aligned. I argue that it is precisely through these reciprocally constitutive processes that the profound reconfiguration of personality disorder from being an obdurate to a plastic condition has occurred; this demonstrates the significance of interactions between law and the health professions in shaping not only the State’s management of pathology, but also perceptions of its very nature.

Gender: shaping personality, lives and health of women in Pakistan

PubMed Central

2014-01-01

Background Gender norms determine the status of Pakistani women that influence their life including health. In Pakistan, the relationship between gender norms and health of women is crucial yet complex demanding further analysis. This paper: determines the reasons for reiteration of gender roles; describes the societal processes and mechanisms that reproduce and reinforce them; and identifies their repercussions on women’s personality, lives and health especially reproductive health. Methods As part of a six-country study titled ‘Women’s Empowerment in Muslim Contexts’, semi-structured group discussions (n = 30) were conducted with women (n = 250) who were selected through snowballing from different age, ethnic and socio-economic categories. Discussion guidelines were used to collect participant’s perceptions about Pakistani women’s: characteristics, powers, aspirations, needs and responsibilities; circumstances these women live in such as opportunities, constraints and risks; and influence of these circumstances on their personality, lifestyle and health. Results The society studied has constructed a ‘Model’ for women that consider them ‘Objects’ without rights and autonomy. Women’s subordination, a prerequisite to ensure compliance to the constructed model, is maintained through allocation of lesser resources, restrictions on mobility, seclusion norms and even violence in cases of resistance. The model determines women’s traits and responsibilities, and establishes parameters for what is legitimate for women, and these have implications for their personality, lifestyle and health, including their reproductive behaviours. Conclusion There is a strong link between women’s autonomy, rights, and health. This demands a gender sensitive and a, right-based approach towards health. In addition to service delivery interventions, strategies are required to counter factors influencing health status and restricting access to and utilization

24 CFR 891.863 - Maintenance as supportive housing units for elderly persons and persons with disabilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... units for elderly persons and persons with disabilities. 891.863 Section 891.863 Housing and Urban... ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SUPPORTIVE HOUSING FOR THE ELDERLY AND PERSONS WITH DISABILITIES For-Profit Limited Partnerships and Mixed-Finance...

24 CFR 891.863 - Maintenance as supportive housing units for elderly persons and persons with disabilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... units for elderly persons and persons with disabilities. 891.863 Section 891.863 Housing and Urban... ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SUPPORTIVE HOUSING FOR THE ELDERLY AND PERSONS WITH DISABILITIES For-Profit Limited Partnerships and Mixed-Finance...

Health information: reconciling personal privacy with the public good of human health.

PubMed

Gostin, L O

2001-01-01

The success of the health care system depends on the accuracy, correctness and trustworthiness of the information, and the privacy rights of individuals to control the disclosure of personal information. A national policy on health informational privacy should be guided by ethical principles that respect individual autonomy while recognizing the important collective interests in the use of health information. At present there are no adequate laws or constitutional principles to help guide a rational privacy policy. The laws are scattered and fragmented across the states. Constitutional law is highly general, without important specific safeguards. Finally, a case study is provided showing the important trade-offs that exist between public health and privacy. For a model public health law, see www.critpath.org/msphpa/privacy.

Personalized Strategies to Activate and Empower Patients in Health Care and Reduce Health Disparities.

PubMed

Chen, Jie; Mullins, C Daniel; Novak, Priscilla; Thomas, Stephen B

2016-02-01

Designing culturally sensitive personalized interventions is essential to sustain patients' involvement in their treatment and encourage patients to take an active role in their own health and health care. We consider patient activation and empowerment as a cyclical process defined through patient accumulation of knowledge, confidence, and self-determination for their own health and health care. We propose a patient-centered, multilevel activation and empowerment framework (individual-, health care professional-, community-, and health care delivery system-level) to inform the development of culturally informed personalized patient activation and empowerment (P-PAE) interventions to improve population health and reduce racial and ethnic disparities. We discuss relevant Affordable Care Act payment and delivery policy reforms and how they affect patient activation and empowerment. Such policies include Accountable Care Organizations and value-based purchasing, patient-centered medical homes, and the community health benefit. Challenges and possible solutions to implementing the P-PAE are discussed. Comprehensive and longitudinal data sets with consistent P-PAE measures are needed to conduct comparative effectiveness analyses to evaluate the optimal P-PAE model. We believe the P-PAE model is timely and sustainable and will be critical to engaging patients in their treatment, developing patients' abilities to manage their health, helping patients express concerns and preferences regarding treatment, empowering patients to ask questions about treatment options, and building up strategic patient-provider partnerships through shared decision making. © 2015 Society for Public Health Education.

A new indicator of the oral hygiene habits of disabled persons: relevance of the carer's personal appearance and interest in oral health.

PubMed

Limeres, J; Martínez, F; Feijoo, J F; Ramos, I; Liñares, A; Diz, P

2014-05-01

To investigate whether there is a relationship between the oral hygiene habits of individuals with severe disability the carer's personal appearance and interest in oral health. The study group was formed of 60 disabled persons and their respective carers who came for the first time to consultation in the Special-Needs Dentistry Unit of the University of Santiago de Compostela, Spain. All the carers answered a standardised questionnaire of 28 questions divided into four sections: disabled individual's demographic data, disabled individual's general medical details, social aspects of the carer (personal appearance of the carer and interest in oral health), and disabled individual's oral hygiene habits. The personal appearance of the carers and their interest in the disabled individual's oral health were evaluated using independent scales designed specifically for the study, with five binary items in each scale. The carer's personal appearance and interest in the disabled individual's oral health showed a statistically significant relationship with the individual's oral hygiene habits, particularly with respect to the frequency and duration of toothbrushing, need for physical restraint during toothbrushing, use of a manual toothbrush and use of toothpaste. The carer's personal appearance and interest in the disabled individual's oral health are good indicators of the oral hygiene habits of an individual with severe disability. Consideration should be given to the inclusion of these aspects as a complementary element of the dental record. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

e-Patients Perceptions of Using Personal Health Records for Self-management Support of Chronic Illness.

PubMed

Gee, Perry M; Paterniti, Debora A; Ward, Deborah; Soederberg Miller, Lisa M

2015-06-01

Chronic illness self-management is largely moving from healthcare professionals and into the hands of the patient. One tool that has been promoted to facilitate self-management support of chronic illness by policymakers, health advocates, providers, and consumers is the personal health record. Little is known about how consumers effectively use personal health records for self-management support and for productive patient-provider interactions. The purpose of this study was to learn from chronically ill engaged, experienced, and educated (e-patient) adults how and why they use personal health records for self-management support and productive patient-provider interactions. Eighteen purposively selected consumers were interviewed in two communities. Qualitative description methods were used, and we used a grounded theory approach to analyzing interview data, which was digitally recorded and transcribed verbatim. We identified four major thematic categories that capture the perceptions of the chronically ill using personal health records: (1) patient engagement and health self-management, (2) access to and control over personal health data, (3) promotion of productive communication, and (4) opportunities for training and education. Knowledge gained from the e-patient personal health record users suggest that making improvements to the portal system and providing education to consumers and providers will increase the utility among the experienced users and encourage new users to embrace adoption and use.

[Taking personal responsibility in practice: what does it mean?--Insights into daily clinical routines].

PubMed

Hansen, Leonhard

2012-01-01

In our society, taking personal responsibility is basically regarded as a key step to adopting a more active lifestyle. In health care, however, personal responsibility is primarily equated with higher levels of financial contribution from patients. Obviously, the individual's responsibility for his or her health and towards the mutually supportive community is a highly emotional and ideological issue, so the debate is usually rather heated. This is, however, at odds with the "empowered patient" concept. In the present paper "personal responsibility in practice" will be understood to include both physician and patient responsibility. Examples will be employed to demonstrate that, on an individual level, physicians are responsible for diagnosing and treating their patients as indicated and that, on a collective level, they are expected to make responsible use of the resources allocated. Here, patient responsibility will be defined as both taking care for one's own health and the individual's obligation to contribute to the maintenance of our solidarity-based health care system. The tensions between solidarity and subsidiarity and personal responsibility, respectively, will be outlined, and a readjustment of the relation between external support and individual strengths, between solidarity and personal responsibility in terms of Sect. 1 of the Social Book Code V will be advocated. Copyright © 2012. Published by Elsevier GmbH.

Personality and Persuasive Technology: An Exploratory Study on Health-Promoting Mobile Applications

NASA Astrophysics Data System (ADS)

Halko, Sajanee; Kientz, Julie A.

Though a variety of persuasive health applications have been designed with a preventive standpoint toward diseases in mind, many have been designed largely for a general audience. Designers of these technologies may achieve more success if applications consider an individual's personality type. Our goal for this research was to explore the relationship between personality and persuasive technologies in the context of health-promoting mobile applications. We conducted an online survey with 240 participants using storyboards depicting eight different persuasive strategies, the Big Five Inventory for personality domains, and questions on perceptions of the persuasive technologies. Our results and analysis revealed a number of significant relationships between personality and the persuasive technologies we evaluated. The findings from this study can guide the development of persuasive technologies that can cater to individual personalities to improve the likelihood of their success.

Five-Factor Model Personality Traits, Spirituality/Religiousness, and Mental Health among People Living With HIV

PubMed Central

Löckenhoff, Corinna E.; Ironson, Gail H.; O’Cleirigh, Conall; Costa, Paul T.

2008-01-01

We examined the association between five-factor personality domains and facets and spirituality/religiousness as well as their joint association with mental health in a diverse sample of people living with HIV (n = 112, age range 18 – 66). Spirituality/religiousness showed stronger associations with Conscientiousness, Openness, and Agreeableness than with Neuroticism and Extraversion. Both personality traits and spirituality/religiousness were significantly linked to mental health, even after controlling for individual differences in demographic measures and disease status. Personality traits explained unique variance in mental health above spirituality and religiousness. Further, aspects of spirituality and religiousness were found to mediate some of the links between personality and mental health in this patient sample. These findings suggest that underlying personality traits contribute to the beneficial effects of spirituality/religiousness among vulnerable populations. PMID:19686457

Five-factor model personality traits, spirituality/religiousness, and mental health among people living with HIV.

PubMed

Löckenhoff, Corinna E; Ironson, Gail H; O'Cleirigh, Conall; Costa, Paul T

2009-10-01

We examined the association between five-factor personality domains and facets and spirituality/religiousness as well as their joint association with mental health in a diverse sample of people living with HIV (n=112, age range 18-66). Spirituality/religiousness showed stronger associations with Conscientiousness, Openness, and Agreeableness than with Neuroticism and Extraversion. Both personality traits and spirituality/religiousness were significantly linked to mental health, even after controlling for individual differences in demographic measures and disease status. Personality traits explained unique variance in mental health above spirituality and religiousness. Further, aspects of spirituality and religiousness were found to mediate some of the links between personality and mental health in this patient sample. These findings suggest that underlying personality traits contribute to the beneficial effects of spirituality/religiousness among vulnerable populations.

Know me - a journey in creating a personal electronic health record.

PubMed

Buckley, Amanda; Fox, Suzanne

2015-01-01

KnowMe is a patient created personal story of key life events both medical and non-medical that enables clinicians to understand what matters to the patient, not what's the matter with them. By shifting the Electronic Health Record (EHR) focus to knowing when a patient was at their best, what's important to them, their personal health goals, and care preferences, clinicians and patients can collaboratively work together in creating a treatment plan that aligns resources tailored to the their needs.

[Health among persons with intellectual disability in Spain: the European POMONA-II study].

PubMed

Martínez-Leal, Rafael; Salvador-Carulla, Luis; Gutiérrez-Colosía, Mencía Ruiz; Nadal, Margarida; Novell-Alsina, Ramón; Martorell, Almudena; González-Gordón, Rodrigo G; Mérida-Gutiérrez, M Reyes; Ángel, Silvia; Milagrosa-Tejonero, Luisa; Rodríguez, Alicia; García-Gutiérrez, Juan C; Pérez-Vicente, Amado; García-Ibáñez, José; Aguilera-Inés, Francisco

2011-10-01

International studies show that both the pattern of health and the healthcare provided for persons with intellectual disability (ID) and the general population are different. To obtain data about the state of health of persons with ID and to compare them with data about the general population. The P15 set of health indicators was used in a sample of 111 subjects with ID. The health data that were found were compared according to the subjects' type of residence and the 2006 National Health Survey was used to compare these data with those for the general population. RESULTS; The sample with ID presented 25 times more cases of epilepsy and twice as many cases of obesity. Twenty per cent presented pain in the mouth and the presence of sensory and mobility problems, as well as psychosis, was high. We also found, however, a low presence of pathologies like diabetes, hypertension, osteoarthritis and osteoporosis. They also displayed a lower rate of participation in prevention and health promotion programmes, a higher number of hospital admissions and a lower usage of emergency services. The pattern of health of persons with ID differs from that of the general population, and they use healthcare services differently. It is important to develop programmes of health promotion and professional training that are specifically designed to attend to the needs of persons with ID. Likewise, it is also necessary to implement health surveys that include data about this population.

Empathy deficit in antisocial personality disorder: a psychodynamic formulation.

PubMed

Malancharuvil, Joseph M

2012-09-01

Empathic difficulty is a highly consequential characteristic of antisocial personality structure. The origin, maintenance, and possible resolution of this profound deficit are not very clear. While reconstructing empathic ability is of primary importance in the treatment of antisocial personality, not many proven procedures are in evidence. In this article, the author offers a psychodynamic formulation of the origin, character, and maintenance of the empathic deficiency in antisocial personality. The author discusses some of the treatment implications from this dynamic formulation.

Extending health maintenance organization insurance to the uninsured. A controlled measure of health care utilization.

PubMed

Bograd, H; Ritzwoller, D P; Calonge, N; Shields, K; Hanrahan, M

1997-04-02

To investigate the utilization of health care services of previously uninsured low-income patients after becoming insured by a health maintenance organization (HMO). Retrospective study of utilization in a previously uninsured study group compared with an age- and sex-matched randomly selected control group of commercial HMO enrollees. Group model HMO. A study group of 346 previously uninsured low-income patients and 382 controls. utpatient visits for primary and specialty care, outpatient pharmacy, laboratory, and radiology use, and inpatient admissions and hospital days over a 2-year period. Self-reported health status measures were obtained to control for differences in health status. There were no differences between the study and control groups in hospital admissions, hospital days, and measures of outpatient laboratory, pharmacy, and radiology use. The odds of having an outpatient visit per patient per month was 30% higher for the study group. Approximately half the increase in the odds ratio for outpatient visits was related to the worse self-perceived health status of the study group. While both groups utilized more services in the early phase of their enrollment, the intensity of this start-up effect was similar for both groups. Compared with a commercial group of the same age and sex, the patterns of utilization were similar and the financial costs of care were only moderately more for a previously uninsured group provided with comprehensive HMO insurance. With the growth of managed care, these data should be beneficial in the development of health care programs for the growing number of uninsured Americans.

A personalized health-monitoring system for elderly by combining rules and case-based reasoning.

PubMed

Ahmed, Mobyen Uddin

2015-01-01

Health-monitoring system for elderly in home environment is a promising solution to provide efficient medical services that increasingly interest by the researchers within this area. It is often more challenging when the system is self-served and functioning as personalized provision. This paper proposed a personalized self-served health-monitoring system for elderly in home environment by combining general rules with a case-based reasoning approach. Here, the system generates feedback, recommendation and alarm in a personalized manner based on elderly's medical information and health parameters such as blood pressure, blood glucose, weight, activity, pulse, etc. A set of general rules has used to classify individual health parameters. The case-based reasoning approach is used to combine all different health parameters, which generates an overall classification of health condition. According to the evaluation result considering 323 cases and k=2 i.e., top 2 most similar retrieved cases, the sensitivity, specificity and overall accuracy are achieved as 90%, 97% and 96% respectively. The preliminary result of the system is acceptable since the feedback; recommendation and alarm messages are personalized and differ from the general messages. Thus, this approach could be possibly adapted for other situations in personalized elderly monitoring.

Is change bad? Personality change is associated with poorer psychological health and greater metabolic syndrome in midlife.

PubMed

Human, Lauren J; Biesanz, Jeremy C; Miller, Gregory E; Chen, Edith; Lachman, Margie E; Seeman, Teresa E

2013-06-01

Personality change is emerging as an important predictor of health and well-being. Extending previous research, we examined whether two types of personality change, directional and absolute, are associated with both subjective and objective indicators of health. Utilizing the longitudinal Midlife in the United States survey (MIDUS) data, we examined whether both types of change over 10 years were associated with psychological well-being, self-reported global health, and the presence of metabolic syndrome (MetS) components and diagnosis. Socially undesirable personality change (e.g., becoming less conscientious and more neurotic) and absolute personality change were independently associated with worse perceived health and well-being at Time 2. Notably, absolute personality change, regardless of the direction, was also associated with having a greater number of MetS components and a greater probability of diagnosis at Time 2. In sum, too much personality change may be bad for one's health: Socially undesirable and absolute personality change were both associated with worse psychological health and worse metabolic profiles over 10 years. These findings suggest that personality change may contribute to psychological and physical health, and provide initial insight into potential intermediate links between personality change and distal outcomes such as mortality. © 2012 Wiley Periodicals, Inc.

Is change bad? Personality change is associated with poorer psychological health and greater metabolic syndrome in midlife

PubMed Central

Human, Lauren J.; Biesanz, Jeremy C.; Miller, Gregory E.; Chen, Edith; Lachman, Margie E.; Seeman, Teresa E.

2013-01-01

Objective Personality change is emerging as an important predictor of health and well-being. Extending previous research, we examined whether two types of personality change, directional and absolute, are associated with both subjective and objective indicators of health. Method Utilizing the longitudinal Midlife in the United States Survey (MIDUS) data, we examined whether both types of change over 10 years were associated with psychological well-being, self-reported global health, and the presence of metabolic syndrome (MetS) components and diagnosis. Results Socially undesirable personality change (e.g., becoming less conscientious and more neurotic) and absolute personality change were independently associated with worse perceived health and well-being at Time 2. Notably, absolute personality change, regardless of the direction, was also associated with having a greater number of MetS components and a greater probability of diagnosis at Time 2. Conclusions In sum, too much personality change may be bad for one’s health: socially undesirable and absolute personality change were both associated with worse psychological health and worse metabolic profiles over 10 years. These findings suggest that personality change may contribute to psychological and physical health, and provide initial insight into potential intermediate links between personality change and distal outcomes such as mortality. PMID:22924900

Assessing conscientious personality in primary care: an opportunity for prevention and health promotion.

PubMed

Israel, Salomon; Moffitt, Terrie E

2014-05-01

The articles in this special section bolster the already strong evidence base that personality differences in the trait of conscientiousness predict health. What is now needed is a research agenda for translating documented risk associations between low conscientiousness and poor health into policies and interventions that improve health outcomes for individuals and populations. In this commentary, we highlight 1 such avenue: introducing brief personality assessment into primary care practice. We provide examples of how conscientiousness assessment may help health care professionals get to know their patients better and potentially serve as a guide for more personalized care. We also raise key considerations for implementation research aimed at examining the feasibility and utility of integrating conscientiousness assessment into primary care settings. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

The personal calculus of moral reasoning and identity in global health professions work.

PubMed

Razack, Saleem

2017-04-01

In this personal essay, the author reflects on experiences in global health professions education projects, and the moral reasoning that might be required to define explicitly what constitutes ethical participation. Three interrelated notions are explored: The decision to engage or not through a discussion of the concepts of safety, understanding power dynamics, and analysis of personal and institutional motivations for the projectThe ultimate goals to promote human flourishing and improve equity, through attention to local inequities potentially experienced by either participants or colleagues from home.Attention to the personal transformative potential of participation in global health professions projects. A framework for exploring moral reasoning in global health professions education work using these three concepts is presented as one that the author has found helpful in his own work in global health professions education.

Is research on borderline personality disorder underfunded by the National Institute of Health?

PubMed

Zimmerman, Mark; Gazarian, Doug

2014-12-30

The relationship between bipolar disorder and borderline personality disorder has generated intense interest. Similar to patients with bipolar disorder, patients with borderline personality disorder are frequently hospitalized, are chronically unemployed, abuse substances, attempt and commit suicide. However, one significant difference between the two disorders is that patients with borderline personality disorder are often viewed negatively by mental health professionals. In the present paper we examined whether this negative bias against borderline personality disorder might be reflected in the level of research funding on the disorder. We searched the National Institute of Health (NIH) Research Portfolio Online Portfolio Reporting Tool (RePORT) for the past 25 years and compared the number of grants funded and the total amount of funding for borderline personality disorder and bipolar disorder. The yearly mean number of grants receiving funding was significantly higher for bipolar disorder than for borderline personality disorder. Results were the same when focusing on newly funded grants. For every year since 1990 more grants were funded for bipolar disorder than borderline personality disorder. Summed across all 25 years, the level of funding for bipolar disorder was more than 10 times greater than the level of funding for borderline personality disorder ($622 million vs. $55 million). These findings suggest that the level of NIH research funding for borderline personality disorder is not commensurate with the level of psychosocial morbidity, mortality, and health expenditures associated with the disorder.

Encryption Characteristics of Two USB-based Personal Health Record Devices

PubMed Central

Wright, Adam; Sittig, Dean F.

2007-01-01

Personal health records (PHRs) hold great promise for empowering patients and increasing the accuracy and completeness of health information. We reviewed two small USB-based PHR devices that allow a patient to easily store and transport their personal health information. Both devices offer password protection and encryption features. Analysis of the devices shows that they store their data in a Microsoft Access database. Due to a flaw in the encryption of this database, recovering the user’s password can be accomplished with minimal effort. Our analysis also showed that, rather than encrypting health information with the password chosen by the user, the devices stored the user’s password as a string in the database and then encrypted that database with a common password set by the manufacturer. This is another serious vulnerability. This article describes the weaknesses we discovered, outlines three critical flaws with the security model used by the devices, and recommends four guidelines for improving the security of similar devices. PMID:17460132

Designing smart analytical data services for a personal health framework.

PubMed

Koumakis, Lefteris; Kondylakis, Haridimos; Chatzimina, Maria; Iatraki, Galatia; Argyropaidas, Panagiotis; Kazantzaki, Eleni; Tsiknakis, Manolis; Kiefer, Stephan; Marias, Kostas

2016-01-01

Information in the healthcare domain and in particular personal health record information is heterogeneous by nature. Clinical, lifestyle, environmental data and personal preferences are stored and managed within such platforms. As a result, significant information from such diverse data is difficult to be delivered, especially to non-IT users like patients, physicians or managers. Another issue related to the management and analysis is the volume, which increases more and more making the need for efficient data visualization and analysis methods mandatory. The objective of this work is to present the architectural design for seamless integration and intelligent analysis of distributed and heterogeneous clinical information in the PHR context, as a result of a requirements elicitation process in iManageCancer project. This systemic approach aims to assist health-care professionals to orient themselves in the disperse information space and enhance their decision-making capabilities, to encourage patients to have an active role by managing their health information and interacting with health-care professionals.

49 CFR 193.2707 - Operations and maintenance.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... (c) Corrosion control procedures under § 193.2605(b), including those for the design, installation, operation, and maintenance of cathodic protection systems, must be carried out by, or under the direction of, a person qualified by experience and training in corrosion control technology. ...

49 CFR 193.2707 - Operations and maintenance.

Code of Federal Regulations, 2011 CFR

2011-10-01

.... (c) Corrosion control procedures under § 193.2605(b), including those for the design, installation, operation, and maintenance of cathodic protection systems, must be carried out by, or under the direction of, a person qualified by experience and training in corrosion control technology. ...

Estimating the Effect of Health Insurance on Personal Prescription Drug Importation

PubMed Central

Zullo, Andrew R.; Howe, Chanelle J.; Galárraga, Omar

2016-01-01

Personal prescription drug importation occurs in the United States because of the high cost of U.S. medicines and lower cost of foreign equivalents. Importation carries a risk of exposure to counterfeit (i.e., falsified, fraudulent), adulterated, and substandard drugs. Inadequate health insurance may increase the risk of importation. We use inverse probability weighted marginal structural models and data on 87,494 individuals from the 2011-2013 National Health Interview Survey to estimate the marginal association between no health insurance and importation within U.S. subpopulations. The marginal prevalence difference [95% confidence limits] for those without (prevalence = 0.031) versus those with health insurance was 0.016 [0.011, 0.021]. The prevalence difference was higher among persons who were Hispanic, born in Latin America, Russia, or Europe, traveled to developing countries, and did not use the Internet to fill prescriptions or to find health information. Health insurance coverage may effectively reduce importation, especially among particular subpopulations. PMID:26837427

Towards a Personal Health Management Assistant.

PubMed

Ferguson, G; Quinn, J; Horwitz, C; Swift, M; Allen, J; Galescu, L

2010-10-01

We describe design and prototyping efforts for a Personal Health Management Assistant for heart failure patients as part of Project HealthDesign. An assistant is more than simply an application. An assistant understands what its users need to do, interacts naturally with them, reacts to what they say and do, and is proactive in helping them manage their health. In this project, we focused on heart failure, which is not only a prevalent and economically significant disease, but also one that is very amenable to self-care. Working with patients, and building on our prior experience with conversational assistants, we designed and developed a prototype system that helps heart failure patients record objective and subjective observations using spoken natural language conversation. Our experience suggests that it is feasible to build such systems and that patients would use them. The system is designed to support rapid application to other self-care settings. Copyright © 2010 Elsevier Inc. All rights reserved.

The Enduring Impact of Maladaptive Personality Traits on Relationship Quality and Health in Later Life

PubMed Central

Gleason, Marci E. J.; Weinstein, Yana; Balsis, Steve; Oltmanns, Thomas F.

2013-01-01

Over the past five years, the St. Louis Personality and Aging Network (SPAN) has been collecting data on personality in later life with an emphasis on maladaptive personality, social integration, and health outcomes in a representative sample of 1630 adults aged 55–64 living in the St. Louis area. This program has confirmed the importance of considering both the normal range of personality and in particular the role of maladaptive traits in order to understand individuals’ relationships, life events, and health outcomes. In the current paper we discuss the explanatory benefits of considering maladaptive traits or traits associated with personality disorders when discussing the role of personality on social and health outcomes with an emphasis on adults in middle to later life, and integrate these findings into the greater literature. PMID:23998798

Segmenting health maintenance organizations to study productivity and profitability.

PubMed

Sobol, M G

2000-01-01

As the decade ended, health maintenance organizations (HMOs) were increasing in popularity as a means of health care delivery. These groups take many forms, so it is important for the analyst to see if the efficiency and financial results for these different forms vary. The four major forms are profit vs. not-for-profit, chain vs. non-chain, group/staff vs. individual practice association (IPA), and federally qualified vs. non-federally qualified. Using a nationwide database of all the HMOs in the United States, the article compares liquidity rates, leverage ratios, profitability ratios, marketing, and per member ratios across the four groups using paired t tests. The two classifications that showed the most differences were group/staff vs. IPA and federally qualified vs. non-federally qualified. IPAs have a better liquidity position and lower leverage ratios than group/staff but their administrative costs are higher and the time to receive payments and to pay debts is higher. Non-federally qualified have somewhat higher liquidity ratios and higher profitability ratios. These significant differences in financial outcomes indicate that studies of HMOs should segment different major forms of organizations and study them separately before trying to show the effects of different policies on HMO efficiency and effectiveness.

Research on large equipment maintenance system in life cycle

NASA Astrophysics Data System (ADS)

Xu, Xiaowei; Wang, Hongxia; Liu, Zhenxing; Zhang, Nan

2017-06-01

In order to change the current disadvantages of traditional large equipment maintenance concept, this article plans to apply the technical method of prognostics and health management to optimize equipment maintenance strategy and develop large equipment maintenance system. Combined with the maintenance procedures of various phases in life cycle, it concluded the formulation methods of maintenance program and implement plans of maintenance work. In the meantime, it takes account into the example of the dredger power system of the Waterway Bureau to establish the auxiliary platform of ship maintenance system in life cycle.

Health care utilisation among older persons with intellectual disability and dementia: a registry study.

PubMed