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c SYNOPSIS Objectives. Studies that examine children's poverty and health at one point in time do not account for some children experiencing poverty briefly and others living in poverty for much of their lives. The objective of this study was to determine how duration of poverty and child race are related to child health. Methods. To assess these relationships, we
Poverty and ill-health are intertwined. Poor countries tend to have worse health outcomes than better-off countries. Within countries, poor people have worse health outcomes than better-off people. This association reflects causality running in both directions: poverty breeds ill-health, and ill-health keeps poor people poor. The evidence on inequalities in health between the poor and non-poor and on the consequences for impoverishment and income inequality associated with health care expenses is discussed in this article. An outline is given of what is known about the causes of inequalities and about the effectiveness of policies intended to combat them. It is argued that too little is known about the impacts of such policies, notwithstanding a wealth of measurement techniques and considerable evidence on the extent and causes of inequalities. PMID:11953787
The right to health as a fundamental human right is enshrined in the World Health Organization’s charter and has been reaffirmed in international agreements spanning decades. This new journal reminds us of the essential characteristic of poverty as a violent abuse of human rights. The context of poverty – its social, political and economic dimensions – remain in the reader’s mind as evidence is provided on technical solutions to managing the infectious diseases that afflict poor populations world-wide. Applying a health systems framework to a discussion on infectious diseases of poverty emerges from the papers in this journal’s first edition. Many of the articles discuss treatments, indicating the importance of pharmaceuticals for neglected diseases. Delivery strategies to reach impoverished populations also figure within this first round of papers. Innovative programs that provide diagnostics and treatment for infectious diseases to hard-to-reach rural and urban communities are needed clearly needed, and some good examples are discussed here. Future editions will explore other health system components, broadening the evidence base to increase understanding of effective and sustainable interventions to reduce the burden of infectious disease among the poor. The editors are to be congratulated on the release of this inaugural issue of the journal Infectious Diseases of Poverty. We look forward to reading subsequent editions.
The Wami Rivers basin is an important area due to its diversified use which benefits a multi-diversity of stakeholders. While large scale irrigated sugar production is the main issue of concern upstream, there are other equally important socio-economic activities which include biodiversity and environmental conservation, domestic water supply, livestock water needs, and fishing. A large water supply project has just been completed downstream of the Wami River to provide water for the Chalinze township and surrounding villages. Other important undertakings include irrigated rice farming in Dakawa area, livestock keeping activities, and the establishment of the Sadani National Park (SANAPA) and the Wami-Mbiki Wildlife Management Area (WMA). The Wami River basin forms significant parts of both the Wami-Mbiki WMA and the SANAPA wildlife conservation areas. Regardless of its importance, the basin is increasingly being degraded through deforestation for agricultural expansion, timber, and more important charcoal making. The basin is also being polluted through disposal of excess molasses from the sugar industry, and use of poisonous substances and herbs in fishing. The worsening environmental condition in the basin has become a health threat to both people in the surrounding villages and wildlife. To a large extent, such changes are intensifying poverty levels among the local population. These changes are raising concerns about the long-term environmental sustainability and health implications of the current water use competition and conflicts in the basin. The purpose of this paper is to examine the main water resource use conflicts and how they affect environmental sustainability in the long-run. It also intends to establish linkages between wildlife management, pastoralism, agricultural activities and how such linkages influence poverty alleviation efforts in the basin. An attempt has been made to examine the environmental and health implications of human activities in the basin in relation to poverty indicators, people’s lifestyle, and integrated water resource use in the Wami River basin. In the process of examining linkages and sources of conflicts, key strategies to harmonize the interests of various stakeholders and ensure integrated and sustainable use of the Wami River waters will be identified. As a conclusion to paper, issues related to population pressure, pollution, wildlife, pastoralism and many others will be discussed with the view of harmonizing the needs of various stakeholders and minimizing their effect on the river ecosystem. The discussion shows how poverty levels are linked to resources over-exploitation, hence limiting sustainability in the basin. Under the current poverty levels in almost all villages surrounding the Wami River basin, there is no alternative ways or technology to replace non-sustainable resource exploitation. Many villages depend on charcoal burning and selling as a survival strategy and source of income.
This article begins with a discussion of the relations among family poverty, poor health and employment. It argues that some lone mothers are unable to keep their children out of poverty because poor health interferes with finding or maintaining employment. These issues are discussed with reference to the international literature, and also in the light of the results of a
|This book tries to present the health care problems of the major ethnic minority groups in perspective. Although poverty is probably the most crucial variable in the genesis of these problems, there are still many subtle and not so subtle forms of discrimination operating in the health field. Unfortunately, discrimination in other aspects of…
A model for holistic care management that would enhance outcomes for economically vulnerable older adults who receive an array of disjointed services administered through the older Americans Act (OAA) and local Area Agencies on Aging (AAA) is proposed. Fragmented service delivery is typically wasteful and ineffectual, but comprehensive care management that includes an autonomous care manager, a single interagency plan of care and ongoing monitoring that is client-centered may protect those aging in poverty from negative health outcomes. PMID:21967136
Using National Longitudinal Study of Adolescent Health data, hierarchical linear modeling was conducted to estimate the association of school poverty concentration to the sexual health knowledge of 6,718 adolescents. Controlling for individual socio-economic status, school poverty had modest negative effects on sexual health knowledge. Although not directly associated with sexual health knowledge, after controlling for demographic characteristics, school poverty interactions showed that sexual health knowledge was associated with higher grade point average (GPA) and age. The combination of low GPA and high-levels of school poverty was especially detrimental for students' sexual health knowledge. There are differences in the sexual health knowledge of adolescents attending low poverty and high poverty schools that can be attributed to the school environment. PMID:22431188
Using National Longitudinal Study of Adolescent Health data, hierarchical linear modeling was conducted to estimate the association of school poverty concentration to the sexual health knowledge of 6,718 adolescents. Controlling for individual socio-economic status, school poverty had modest negative effects on sexual health knowledge. Although not directly associated with sexual health knowledge, after controlling for demographic characteristics, school poverty interactions showed that sexual health knowledge was associated with higher grade point average (GPA) and age. The combination of low GPA and high-levels of school poverty was especially detrimental for students’ sexual health knowledge. There are differences in the sexual health knowledge of adolescents attending low poverty and high poverty schools that can be attributed to the school environment.
Since the inception of planning process in India, health planning was an integral component of socio-economic planning. Recommendations of several committees, policy documents and Millennium development goals were instrumental in development of impressive health infrastructure. Several anti-poverty and employment generation programmes were instituted to remove poverty. Spectacular achievements took place in terms of maternal and child health indicators and expectancy of life at birth. However, communicable diseases and undernutrition remain cause of serious concern and non-communicable diseases are imposing unprecedented challenge to planners and policy makers. Estimates of poverty based on different criteria point that it has remained a sustained problem in the country and emphasizes on revisiting anti-poverty programmes, economic policies and social reforms. Poverty affects purchasing power and thereby, food consumption. Energy intake data has inherent limitations. It must be assessed in terms of energy expenditure. Energy balance has been least explored area of research. The studies conducted in three different representative population group of Eastern Uttar Pradesh revealed that 69.63% rural adolescent girls (10-19 years), 79.9% rural reproductive age group females and 62.3% rural geriatric subjects were in negative energy balance. Negative energy balance was significantly less in adolescent girls belonging to high SES (51.37%), having main occupation of family as business (55.3%), and highest per capita income group (57.1%) with respect to their corresponding sub-categories. In case of rural reproductive age groups, this was maximum (93.0%) in SC/ST category and least (65.7%) in upper caste group. In case of geriatric group, higher adjusted Odd's Ratio for negative energy balance for subjects not cared by family members (AOR 23.43, CI 3.93-139.56), not kept money (AOR 5.27, CI 1.58-17.56), belonging to lower and upper middle SES by Udai Pareekh Classification (AOR 3.73, CI 1.22-11.41), with lowest per capita income (AOR 15.14, CI 2.44-94.14) and in age group >80 years (AOR 5.76, CI 1.03-32.39). Of those in negative energy balance, 70.21% rural adolescent girls and 7 out of 10 geriatric subjects (activity based) were victims of CED. Extent of undernutrition and CED in rural reproductive age group females were more in those caste groups where energy deficit was also of higher magnitude. Energy balance must be visualized giving due consideration to the importance of exercise on human health. The evidence thus generated needs to be translated to the masses based on principles of translational research.
Watersheds, especially in the developing world, are increasingly being managed for both environmental conservation and poverty alleviation. How complementary are these objectives? In the context of a watershed, the actual and potential linkages between land and water management and poverty are complex and likely to be very site specific and scale dependent. This study analyzes the importance of watershed resources
Post-Taliban Afghanistan faces a wide range of complex issues. These include deep rural poverty and degraded and over-exploited natural resources. The international community and the Government of Afghanistan must mobilise resources to tackle the poverty and enhance the status of natural resources. The paper argues that, despite some recent significant improvements on strategy and policy formulation, natural resource management is
According to the US Census Bureau, the poverty rate for children under 18 years of age increased to 22% in 2010. Poverty leads to adverse health outcomes in children and adolescents such as harmful effects on learning, psychosocial development, physical health, productivity and family life. Because the citizens and residents of a country are its most valuable assets, it is unwise to allow housing instability, food insecurity and hunger to continue to exist at its current levels. Reducing poverty is likely to prevent illnesses, decrease hospitalizations, and lead to lower health care costs. There is also a need for intervention strategies to ensure equitable access to healthy foods across the world. Children who are food insecure are more likely to be in poor health and to have poor nutritional outcomes. Poverty may lead to poor dental health due to malnutrition or incorrect diet and it may also have an effect on the child's behavior in the dental office. An understanding of poverty will lessen the anger, frustration and prejudice that pediatric dentists may feel when working with low-income families. This manuscript presents a concise overview of the effects of poverty in children's lives. PMID:22353454
We investigate the impact of neighborhood structural characteristics, social organization, and culture on self-rated health in a large, cross-sectional sample of urban adults. Findings indicate that neighborhood affluence is a more pow- erful predictor of health status than poverty, above and beyond individual demographic background, socioeconomic status, health behaviors, and insur- ance coverage. Moreover, neighborhood affluence and residential stability interact
Public health initiatives have historically played major roles in preventing or reducing poverty and social injustice, both in Australia and overseas. This applies especially to meeting basic needs such as safe water, sanitation, nutrition and primar y health care. But major challenges remain and new ones are emerging. Within Australia, there can be little doubt that the highest priority is
The challenge to professionals working with the poor is the active choice and display of values. The therapist is challenged to avoid imposing individual values on others to promote conformity, and to immobilize personal values in order not to influence others. There is a need to expand our consciousness regarding poverty from our own clientele to all of humankind. An
|This article assesses the consequences of poverty between a child's prenatal year and 5th birthday for several adult achievement, health, and behavior outcomes, measured as late as age 37. Using data from the Panel Study of Income Dynamics (1,589) and controlling for economic conditions in middle childhood and adolescence, as well as demographic…
Duncan, Greg J.; Ziol-Guest, Kathleen M.; Kalil, Ariel
The Issue. Poverty has been described as an economic state that does not allow for the provision of basic family and child needs, such as adequate food, clothing, and housing. However, the debate about the effects of poverty on the growth, development, and health of children is as much involved with the culture or general context of poverty as it
The population impoverishment is a social reality whose overcoming is necessary so that we can think about health as a positive concept. This study proposes a reflection on the coping strategies adopted by the Conjunto Palmeira, a Brazilian community in the Northeast, and their interface with health promotion. This community's reality is an example of overcoming social exclusion for different regions of Brazil and other countries. The history of the Conjunto and the collective strategies of empowerment for coping with poverty and search for human development are initially presented. After that, we establish the relationship of those strategies with the action fields for health promotion. Finally, we consider that the mutual responsibility of the community with its health and its relationship with the environment in which they live are means of promoting transformation towards the conquest of a worthy social space. PMID:17934597
dos Santos Oliveira, Simone Helena; Alves Monteiro, Maria Adelane; Vieira Lopes, Maria do Socorro; Silva de Brito, Daniele Mary; Vieira, Neiva Francenely Cunha; Barroso, Maria Grasiela Teixeira; Ximenes, Lorena Barbosa
Poverty has been described as an economic state that does not allow for the provision of basic family and child needs, such as adequate food, clothing, and housing. However, the debate about the effects of poverty on the growth, development, and health of children is as much involved with the culture or general context of poverty as it is with the economics of poverty. This culture of poverty is in part mediated through environmental deprivations, such as failing schools, gangs, drugs, violence, and struggling families. Heclo(1) described this sociocultural and environmental dimension of poverty as "a condition of misery, hopelessness, and dependency." The subject of this article is to review the literature on the effects of poverty on US children as mediated through economic, ecologic, and family influences. PMID:12949326
|This document contains materials for a college course in healthmanagement developed for the State of Iowa. The course syllabus lists the course title, hours, number, description, prerequisites, learning activities, instructional units, required text, 13 references, evaluation criteria, course objectives, and course competencies. It is followed…
|It is generally agreed that spending on education and health is key to poverty reduction, but simply allocating more resources to these sectors does not ensure that poverty actually declines. On the basis of four in-depth case studies (on Indonesia, Madagascar, Peru and Tanzania) and three Technical Papers on malnutrition and primary education in…
Environmental crises and poverty are usually believed to act as a source of disturbance. Environmental crisis management seeks to minimize the impact of these events. The paper gives an overview of the results of a serious of disturbances between human social economic development and protection of natural resources in the rural poverty-stricken regions of western China. Characteristics of environmental crisis
|This commentary contrasts "Piercing the Bubble" by proposing "pull" (rather than "push") strategies as a way for business schools to more meaningfully engage poverty and social exclusion. By reframing poverty issues in such a manner that they connect with core business student interests of career opportunities, current management practices, and…
This article considers the implications for prevention science of recent advances in research on family poverty and children's mental, emotional, and behavioral health. First, we describe definitions of poverty and the conceptual and empirical challenges to estimating the causal effects of poverty on children's mental, emotional, and behavioral health. Second, we offer a conceptual framework that incorporates selection processes that
Hirokazu Yoshikawa; J. Lawrence Aber; William R. Beardslee
In the absence of formal health insurance, we argue that the strategies households adopt to finance health care have important implications for the measurement and interpretation of how health payments impact on consumption and poverty. Given data on source of finance, we propose to (a) approximate the relative impact of health payments on current consumption with a 'coping'-adjusted health expenditure
Gabriela Flores; Jaya Krishnakumar; Owen ODonnell; Eddy van Doorslaer
For centuries it has been known that there is a relationship between one's status within a social system and health. The poor and disadvantaged have traditionally carried the larger burden of disease and disability.
The persistence of extreme poverty is increasingly attributed to dynamic interactions between biophysical processes and economics, though there remains a dearth of integrated theoretical frameworks that can inform policy. Here, we present a stochastic model of disease-driven poverty traps. Whereas deterministic models can result in poverty traps that can only be broken by substantial external changes to the initial conditions, in the stochastic model there is always some probability that a population will leave or enter a poverty trap. We show that a 'safety net', defined as an externally enforced minimum level of health or economic conditions, can guarantee ultimate escape from a poverty trap, even if the safety net is set within the basin of attraction of the poverty trap, and even if the safety net is only in the form of a public health measure. Whereas the deterministic model implies that small improvements in initial conditions near the poverty-trap equilibrium are futile, the stochastic model suggests that the impact of changes in the location of the safety net on the rate of development may be strongest near the poverty-trap equilibrium. PMID:21593026
Plucinski, Mateusz M; Ngonghala, Calistus N; Bonds, Matthew H
The persistence of extreme poverty is increasingly attributed to dynamic interactions between biophysical processes and economics, though there remains a dearth of integrated theoretical frameworks that can inform policy. Here, we present a stochastic model of disease-driven poverty traps. Whereas deterministic models can result in poverty traps that can only be broken by substantial external changes to the initial conditions, in the stochastic model there is always some probability that a population will leave or enter a poverty trap. We show that a ‘safety net’, defined as an externally enforced minimum level of health or economic conditions, can guarantee ultimate escape from a poverty trap, even if the safety net is set within the basin of attraction of the poverty trap, and even if the safety net is only in the form of a public health measure. Whereas the deterministic model implies that small improvements in initial conditions near the poverty-trap equilibrium are futile, the stochastic model suggests that the impact of changes in the location of the safety net on the rate of development may be strongest near the poverty-trap equilibrium.
Plucinski, Mateusz M.; Ngonghala, Calistus N.; Bonds, Matthew H.
Nowadays climate change event and poor population vulnerability become more severe and natural resources scarcity intensity increased. In order to mitigate climate change negative effects adaptive policies such as poverty reduction Strategy and National Adaptation Plan of Action (NAPA) as effective’s responsive strategies. There are also farmers traditional adaptation methods which are consider as local mainstreaming climate change adaptation framework.
Purpose – It is clear that poverty can be a key factor to take into consideration at time of potentiating or mitigating the unexpected aftermaths of disasters. In some extent, the degree of vulnerability created by poverty leads scholars to preclude material conditions of life plays a pivotal role in disaster rebuilt. Nonetheless, the present paper aims to explore precisely
Children living in poverty are disproportionately at risk from and affected by environmental hazards. According to the National Center for Children in Poverty, 13 million children in America live in poverty. Thus, not only are millions of children living in poverty but are also living in environments that are hazardous to their health. Impoverished children are more likely to live in environments with heavily polluting industries, hazardous waste sites, contaminated water and soil, in old housing with deteriorating lead-based paint, in areas with limited access to healthy food, and more. Poor children residing in these toxic environments are either at risk or suffer from a myriad of health disparities, such as asthma, cancer, lead poisoning, obesity, and hyperactivity. This unfortunate reality is better known as environmental injustice. Environmental injustice recognizes that economically disadvantaged groups are adversely affected by environmental hazards more than other groups. To remedy this dilemma, environmental justice seeks to address these unfair burdens of environmental health hazards on poor communities. The purpose of this article is to (a) examine the environmental living conditions of children living in poverty, (b) examine the environmental health disparities of children living in poverty, (c) discuss environmental justice legislation, (d) describe government initiatives to improve environmental health, and (e) propose recommendations that executes measures to protect the health of children. PMID:22206190
|This article considers the implications for prevention science of recent advances in research on family poverty and children's mental, emotional, and behavioral health. First, we describe definitions of poverty and the conceptual and empirical challenges to estimating the causal effects of poverty on children's mental, emotional, and behavioral…
Yoshikawa, Hirokazu; Aber, J. Lawrence; Beardslee, William R.
Background We examined a model of multiple mediating pathways of income poverty, material hardship, parenting factors, and child health status to understand how material hardship and parental factors mediate the effects of poverty on child health. We hypothesized that: (a) poverty will be directly associated with material hardship, parental depression, and health status, and indirectly with parenting behaviors through its effects on parental depression and material hardship; (b) material hardship will be associated with parental depression, parenting behaviors, and health status; and (c) parental depression will be correlated with parenting behaviors, and that both parental depression and parenting behaviors will predict child health. Methods and Results We used data from the 2002 National Survey of American Families for a sample of 9,645 6-to-11 year-olds to examine a 4-step structural equation model. The baseline model included covariates and income poverty. In the hardship model, food insufficiency and medical need were added to the baseline model. The parental model included parental depression and parenting behavior and baseline model. In the full model, all the constructs were included. First, income poverty had a direct effect on health status, and an indirect effect through its association with material hardship, parental depressive affect, and parenting behaviors. Medical need and food insufficiency had negative effects on child health, and indirect effects on health through their association with parental depression and parenting behaviors. Finally, parental depression and parenting behaviors were associated with child health, and part of the effect of parental depression on health was explained by its association with parenting behaviors. Conclusions Poverty has an independent effect on health, however, its effects are partially explained by material hardship, parental depression and parental behaviors. To improve children's health would require a multi-pronged approach involving income transfers, health insurance coverage, food and nutrition assistance, and parenting interventions.
Article 25 of the Universal Declaration of Human Rights clearly emphasizes health as a human right. Poverty and social exclusion are the most important drivers of ill-health. The causes of increasing poverty are complex but one significant factor is international debt. This affects mainly sub-Saharan Africa but, with the global economic crisis in South East Asia, may spread. Structural adjustment policies which cut social spending compound the health effects of debt and poverty. Privatization of health care and user charges particularly affect women, children, the disabled, and other marginalized communities. To improve health, governments and international institutions have a duty to examine the determinants of health, including human rights and economic policy. PMID:10343295
In this paper, we attempt to verify that neighborhood economic structure influences individual health over and above other individual characteristics, and to comparatively evaluate the effects of neighborhood concentrated affluence, concentrated poverty and income inequality in relation to individual health in the USA. We also explore physical environment, health-enhancing services, social hazards (crime) and social resources as mechanisms operating at
Ming Wen; Christopher R. Browning; Kathleen A. Cagney
While a large body of literature is concerned with the interplay of health and poverty in developing countries, comparable studies for developed countries are rare. Using data drawn from the German Socio-Economic Panel (GSOEP), this paper investigates the relationships between changes in relative income poverty, income changes and health-related quality of life in Germany, i.e. in an environment with nominally equal access to medical care, education and social security. A fundamental five-dimensional health concept is introduced and tested for its empirical performance. The background of the causal analysis is formed by two hypotheses, one regarding low income as a possible cause for poor health (prevention hypothesis) and the other assuming the opposite causal direction (deprivation hypothesis). By means of a descriptive analysis and a structural equations model, the existence of a more complex relational web between health and poverty is demonstrated. PMID:9255919
The CAMPFIRE program in Zimbabwe is one of a `new breed' of strategies designed to tackle environmental management at the grassroots level. CAMPFIRE aims to help rural communities to manage their resources, especially wildlife, for their own local development. The program's central objective is to alleviate rural poverty by giving rural communities autonomy over resource management and to demonstrate to
|This article describes the current relationship between management education in Colombia and the efforts of the management program at Universidad Pontificia Bolivariana (UPB) in Medellin to reduce local poverty. The article uses the metaphor of "the bubble" to illustrate how social class, family socialization, and the current UPB management…
\\u000a In this chapter we aim at theoretically elucidating the relationship between poverty eradication and environmental sustainability.\\u000a In doing so, we will devote particular attention to water management—a basic ingredient for fostering equitable and sustainable\\u000a social development. The first nodal point around which this chapter will be structured is poverty: by using Amartya Sen’s\\u000a and Karl Polanyi’s concepts of capabilities and
In the poorest regions of the United States, especially along the Gulf Coast and in South Texas, are a group of endemic parasitic and related infections known as the neglected infections of poverty. Such infections are characterized by their chronicity, disabling features, and disproportionate impact on the estimated 46 million people who live below the U.S. poverty line. Today more Americans live in poverty than ever before in the half-century that the Census Bureau has been recording poverty rates. In association with that poverty, a group of major neglected infections of poverty have emerged in the United States. Here we describe the major neglected infections of poverty in the United States, with a brief overview of their significant epidemiological features, their links with poverty, and our approaches to their diagnosis, management, and treatment. PMID:22760004
Barry, M A; Bezek, S; Serpa, J A; Hotez, P J; Woc-Colburn, L
On almost every account people with mental health problems are among the most excluded groups in society and they consistently identify stigmatisation, discrimination and exclusion as major barriers to health, welfare and quality of life. The links between poverty and ill health are well known. Poverty and illness together make people much more vulnerable and needy at all stages of
Carmen Beatrice Pauna; Raluca Sfetcu; Marioara Iordan
The experience of poverty can be a risk factor for mental illness. Afro-American women are disproportionately represented among the poor, the majority of whom are single mothers and heads of households who are concentrated in the secondary labor market and the secondary welfare system. These economic and social factors can engender stress and can limit opportunities for its resolution or
Background Poverty is multi dimensional. Beyond the quantitative and tangible issues related to inadequate income it also has equally important social, more intangible and difficult if not impossible to quantify dimensions. In 2009, we explored these social and relativist dimension of poverty in five communities in the South of Ghana with differing socio economic characteristics to inform the development and implementation of policies and programs to identify and target the poor for premium exemptions under Ghana’s National Health Insurance Scheme. Methods We employed participatory wealth ranking (PWR) a qualitative tool for the exploration of community concepts, identification and ranking of households into socioeconomic groups. Key informants within the community ranked households into wealth categories after discussing in detail concepts and indicators of poverty. Results Community defined indicators of poverty covered themes related to type of employment, educational attainment of children, food availability, physical appearance, housing conditions, asset ownership, health seeking behavior, social exclusion and marginalization. The poverty indicators discussed shared commonalities but contrasted in the patterns of ranking per community. Conclusion The in-depth nature of the PWR process precludes it from being used for identification of the poor on a large national scale in a program such as the NHIS. However, PWR can provide valuable qualitative input to enrich discussions, development and implementation of policies, programs and tools for large scale interventions and targeting of the poor for social welfare programs such as premium exemption for health care.
Professor Lane is interviewed here by Bernadette Hoppe, an attorney and adjunct faculty member at UB Law School. . Prof Lane is medical anthropologist and epidemiologist, her research focuses on the impact of racial, ethnic, and gender disadvantage on maternal, child, and family health in urban areas of the United States and the Middle East.
The economic liberalisation processes initiated in the middle of the 1980s opened up Cambodia and Laos to the outside world, for people, goods and ideas. Market economy thinking has replaced central planning system and war economy ideals. Still, both countries struggle with poverty, limited human resources, and weak health care systems. The differences between urban and rural areas continue to
In this article, the authors discuss the transfer to Guatemala of an integral health education program, originally developed for indigenous women in southern Mexico. The program was implemented with some 400 indigenous women in rural Guatemala living under dire poverty, and was carried out through a closely supervised cascade process in which specially trained local women conducted workshops to their
Iwin Leenen; Martha Givaudan; Susan Pick; Tere Venguer; Judith Vera; Ype H. Poortinga
|This paper focuses on two important dimensions of Indonesia's development record: education and health. The paper investigates the extent to which the poor benefit from public and private provisioning of these services. Multiple rounds of annual household surveys document a reversal in the rate of decline in poverty and a slowdown in improvements…
Lanjouw, Peter; Pradhan, Menno; Saadah, Fadia; Sayed, Haneen; Sparrow, Robert
Living in poverty and living in areas of concentrated poverty pose multiple risks for child development and for overall health and wellbeing. Poverty is a major risk factor for several mental, emotional, and behavioral disorders, as well as for other developmental challenges and physical health problems. In this paper, the Promise Neighborhoods Research Consortium describes a science-based framework for the promotion of child health and development within distressed high-poverty neighborhoods. We lay out a model of child and adolescent developmental outcomes and integrate knowledge of potent and malleable influences to define a comprehensive intervention framework to bring about a significant increase in the proportion of young people in high-poverty neighborhoods who will develop successfully. Based on a synthesis of research from diverse fields, we designed the Creating Nurturing Environments framework to guide community-wide efforts to improve child outcomes and reduce health and educational inequalities. PMID:21468644
There are serious methodological and policy hurdles to be overcome in making integrated natural resource management effective in alleviating rural poverty while protecting environmental services in tropical watersheds. This paper reviews the development of an approach to integrate biodiversity conservation and agroforestry development through the active involvement of communities. The work was focused on the Kitanglad Range Nature Park in
Victor B. Amoroso; Samuel Koffa; Gladys Buenavista
The current mental health system is failing to meet the extensive needs of children living in urban poverty. After school\\u000a programs, whose mission includes children’s socialization, peer relations, and adaptive functioning, are uniquely positioned\\u000a to support and promote children’s healthy development. We propose that public sector mental health resources can be reallocated\\u000a to support after school settings, and we offer
|Context: Regional poverty is associated with reduced access to health care. Whether this relationship is equally strong in both rural and urban settings or is affected by the contextual and individual-level characteristics that distinguish these areas, is unclear. Purpose: Compare the association between regional poverty with self-reported unmet…
Socioeconomic status and health status are directly related across the world. Children with low-socioeconomic status not only experience greater health problems in childhood but also aspects of their socioeconomic status become biologically incorporated through both critical periods of development and cumulative effects, leading to poor health outcomes as adults. We explore 3 main influences related to child's socioeconomic status that
This volume of original chapters follows on the well-regarded Public Health Policy and Ethics (Dordrecht: Kluwer\\/Springer 2004). What is similar about this volume to its predecessor is the general position that public\\u000a health is more inclusive than just epidemiology concerning various vicious microbes and sanitation. There are many threats\\u000a to public health and these include all the usual suspects: clean
Cross-sectional studies of neighborhood context and health are subject to upward bias due to unobserved hetero- geneity and to downward bias due to overadjustment for potential mediators in the pathway between neighborhood context and health. In this study, the authors employed two strategies that addressed these two sources of bias. First, to mitigate overadjustment of mediators, they adjusted for baseline
The overall objective of our research project is to understand the spatial inequality in health in Accra, the capital city of Ghana. We also utilize GIS technology to measure the association of adverse health and mortality outcomes with neighborhood ecology. We approached this in variety of ways, including multivariate analysis of imagery classification and census data. A key element in the research has been to obtain in-person interviews from 3,200 female respondents in the city, and then relate health data obtained from the women to the ecology of the neighborhoods in which they live. Detailed maps are a requirement for these field-based activities. However, commercially available street maps of Accra tend to be highly generalized and not very useful for the kind of health and social science research being undertaken by this project, The purpose of this paper is to describe street maps that were created for the project's office in downtown Accra and used to locate households of respondents. They incorporate satellite imagery with other geographic layers to provide the most important visual interpretation of the linkage between imagery and neighborhoods. Ultimately, through a detailed analysis of spatial disparities in health in Accra, Ghana, we aim to provide a model for the interpretation of urban health inequalities in cities of urbanizing and often poor countries. PMID:23505395
Verutes, Gregory M; Fiocco, Magdalena Benza; Weeks, John R; Coulter, Lloyd L
BACKGROUND: A growing body of literature has demonstrated that higher social capital is associated with improved health conditions. However, some research indicated that the association between social capital and health was substantially attenuated after adjustment for material deprivation. Studies exploring the association between poverty, social capital and health still have some serious limitations. In China, health equity studies focusing on
Despite findings indicating that both national income level and income inequality are each determinants of public health, few have studied how national income level, poverty and inequality interact with each other to influence public health outcomes. We analyzed the relationship between gross domestic product (GDP) per capita in purchasing power parity, extreme poverty rates, the gini coefficient for personal income and three common measures of public health: life expectancy, infant mortality rates, and tuberculosis (TB) mortality rates. Introducing poverty and inequality as modifying factors, we then assessed whether the relationship between GDP and health differed during times of increasing, decreasing, and decreasing or constant poverty and inequality. Data were taken from twenty-two Latin American countries from 1960 to 2007 from the December 2008 World Bank World Development Indicators, World Health Organization Global Tuberculosis Database 2008, and the Socio-Economic Database for Latin America and the Caribbean. Consistent with previous studies, we found increases in GDP have a sizable positive impact on population health. However, the strength of the relationship is powerfully influenced by changing levels of poverty and inequality. When poverty was increasing, greater GDP had no significant effect on life expectancy or TB mortality, and only led to a small reduction in infant mortality rates. When inequality was rising, greater GDP had only a modest effect on life expectancy and infant mortality rates, and no effect on TB mortality rates. In sharp contrast, during times of decreasing or constant poverty and inequality, there was a very strong relationship between increasing GDP and higher life expectancy and lower TB and infant mortality rates. Finally, inequality and poverty were found to exert independent, substantial effects on the relationship between national income level and health. Wealthier is indeed healthier, but how much healthier depends on how increases in wealth are distributed. PMID:20471147
Biggs, Brian; King, Lawrence; Basu, Sanjay; Stuckler, David
Almost 50 years ago, John F. Kennedy told Yale's graduating class that "what is needed today is a new, difficult but essential confrontation with reality, for the great enemy of truth is very often not the lie-deliberate, contrived and dishonest-but the myth-persistent, persuasive and unrealistic." Today's myth is the belief that 30% of health care spending is due to supplier-induced demand and that this amount could be saved if high-spending regions could more closely resemble low-spending regions. The reality is that, while quality and efficiency remain important goals, the major factors driving geographic differences are related to income inequality. Yet, following the road map of the Dartmouth Atlas, the Affordable Care Act includes penalties for hospitals with excess preventable readmissions (which are mainly of the poor), incentive payments for providers in counties that have the lowest Medicare expenditures (where there tends to be less poverty), incentives for physicians and hospitals that attain new "efficiency standards" (ie, costs similar to the lowest), and a call for the Institute of Medicine to recommend additional incentive strategies based on geographic variation. This scenario iscoupled with a growing bureaucracy, following the blueprint laid out by Brennan and Berwick in the 1990s, but with no tangible measures to increase physician supply. Meaningful health care reform means accepting the reality that poverty and its cultural extensions are the major cause of geographic variation in health care utilization and a major source of escalating health care spending. And it means acknowledging Bertrand Russell's admonition that a high degree of income inequality is not compatible with political democracy, nor is it compatible with health care that this nation can afford. As solutions are sought both within and outside of the health care system, misunderstandings of how and why health care varies geographically cannot be allowed to deter these efforts, and the pervasive impact of poverty cannot be ignored. PMID:21954679
One of the difficulties in the research has long been the issue of 'drift'. This theory suggests that the greater proportion of psychiatric admissions from poorer areas and higher levels of observed psychiatric symptoms is the result of inward migration which is prompted by poor mental health, either due to decreasing income or to 'disintegration' which means that people with
This paper offers empirical evidence on the impact of the expansion in health infrastructure of the 1990s upon child nutrition in Peru, as measured by the height for age z-score. Using a pooled sample of three rounds of the Peruvian DHS, I have controlled for biases in the allocation of public investments by using a district fixed effects model. The
Poverty and infectious diseases interact in complex ways. Casting destitution as intractable, or epidemics that afflict the poor as accidental, erroneously exonerates us from responsibility for caring for those most in need. Adequately addressing communicable diseases requires a biosocial appreciation of the structural forces that shape disease patterns. Most health interventions in resource-poor settings could garner support based on cost/benefit ratios with appropriately lengthy time horizons to capture the return on health investments and an adequate accounting of externalities; however, such a calculus masks the suffering of inaction and risks eroding the most powerful incentive to act: redressing inequality. PMID:21896362
Alsan, Marcella M; Westerhaus, Michael; Herce, Michael; Nakashima, Koji; Farmer, Paul E
This paper explores how the protection of natural resources is managed in Madagascar in order to understand how and why tourism development is part of the strategy to safeguard these resources. Based on a heterodox political economy approach and using documentary analysis as well as exploratory interviews, this paper focuses on the specific case of Ranomafana National Park showing how
Standard policy prescriptions for improving public health in less developed countries (LDCs) prioritise raising average income levels over redistributive policies since it is widely accepted that 'wealthier is healthier'. It is argued that income inequality becomes a significant predictor of public health only after the 'epidemiological transition'. This paper tests this theory in India, where rising income levels have not been matched by improvements in public health. We use state-, district-, and individual-level data to investigate the relationship between infant and under-five mortality, and average income, poverty, income inequality, and literacy. Our analysis shows that at both state- and district-level public health is negatively associated with average income and positively associated with poverty. But, at both levels, controlling for poverty and literacy renders average income statistically insignificant. At state-level, only literacy remains a significant and negative predictor. At the less aggregated district-level, both poverty and literacy predict public health but literacy has a stronger effect than poverty. Inequality does not predict public health at state- or district-levels. At the individual-level, however, it is a strong predictor of self-reported ailment, even after we control for district average income, individual income, and individual education. Our analysis suggests that wealthier is indeed healthier in India - but only to the extent that high average incomes reflect low poverty and high literacy. Furthermore, inequality has a strong effect on self-reported health. Standard policy prescriptions, then, need revision: first, alleviating poverty may be more effective than raising average income levels; second, non-income goods like literacy may make an important contribution to public health; and third, policy should be based on a broader understanding of societal well-being and the factors that promote it. PMID:23702215
Rajan, Keertichandra; Kennedy, Jonathan; King, Lawrence
Drawing upon data from the third round of the National Family Health Survey (NFHS-3) conducted in India during 2005-06, this study compares the utilization of selected maternal and child health care services between the urban poor and non-poor in India and across selected Indian states. A wealth index was created, separately for urban areas, using Principal Component Analysis to identify the urban poor. The findings suggest that the indicators of maternal and child health care are worse among the urban poor than in their non-poor counterparts. For instance, the levels of antenatal care, safe delivery and childhood vaccinations are much lower among the urban poor than non-poor, especially in socioeconomically disadvantageous states. Among all the maternal and child health care indicators, the non-poor/poor difference is most pronounced for delivery care in the country and across the states. Other than poverty status, utilization of antenatal services by mothers increases the chances of safe delivery and child immunization at both national and sub-national levels. The poverty status of the household emerged as a significant barrier to utilization of health care services in urban India. PMID:23410254
The public health and development communities understand clearly the need to integrate anti-poverty efforts with HIV\\/AIDS programs. This article reports findings about the impact of the Poverty Reduction Strategy Paper (PRSP) process on Malawi’s National HIV\\/AIDS Strategic Framework (NSF). In this article we ask, how does the PRSP process support NSF accountability, participation, access to information, funding, resource planning and
The Integrated Airplane HealthManagement (IAHM) program is a Navy research activity led by The Boeing Company with support from the University of Hawaii, Referentia Systems Incorporated, and Impact Technologies, LLC. The program focuses on interoperable multi-platform aircraft healthmanagement data handling and analysis methods applicable to military aircraft and commercial air transportation. A primary goal of the program is
Greg J. Clark; John L. Vian; Michael E. West; Vassilis L. Syrmos; William F. Randolph; William J. Hardman
The goal of this article is to discuss an overview of literature published from 1968 to 1993 and dealing with links between single-parenting, poverty and mental health. A total of 56 articles were selected based on the most current data banks. Results show that the population of single-parent mothers is growing and that they are becoming increasingly poor. Of the six mental health variables listed by the author, four (psychological distress, self-esteem, perception of one's own skills and psychological isolation) clearly demonstrate that single-parent mothers are in a less healthy mental state than are mothers in two-parent families. Results also indicate that self-esteem, distress and psychological well-being are affected by economic variables. Results therefore vary according to the variable being measured. Although single-parent mothers experience more psychological discomfort than mothers in two-parent families, they do not seem to experience more serious mental health problems. The authors argue that future research on the subject should take into consideration a certain number of aspects, discussed in the conclusion of this article, which account for links between single-parenting, poverty and mental health. PMID:7794997
Despite the magnitude of the problem of health inequity within and between countries, little systematic research has been done on the social causes of ill-health. Health researchers have overwhelmingly focused on biomedical research at the level of individuals. Investigations into the health of groups and the determinants of health inequities that lie outside the control of the individual have received a much smaller share of research resources. Ignoring factors such as socioeconomic class, race and gender leads to biases in both the content and process of research. We use two such factors--poverty and gender--to illustrate how this occurs. There is a systematic imbalance in medical journals: research into diseases that predominate in the poorest regions of the world is less likely to be published. In addition, the slow recognition of women's health problems, misdirected and partial approaches to understanding women's and men's health, and the dearth of information on how gender interacts with other social determinants continue to limit the content of health research. In the research community these imbalances in content are linked to biases against researchers from poorer regions and women. Researchers from high-income countries benefit from better funding and infrastructure. Their publications dominate journals and citations, and these researchers also dominate advisory boards. The way to move forward is to correct biases against poverty and gender in research content and processes and provide increased funding and better career incentives to support equity-linked research. Journals need to address equity concerns in their published content and in the publishing process. Efforts to broaden access to research information need to be well resourced, publicized and expanded.
Poverty Reduction Strategy Papers (PRSPs) represent the World Bank and the International Monetary Fund's (IMF) most recent initiative for reducing the plight of the poor. This paper examines whether the PRSPs for Liberia, Afghanistan and Haiti follow World Bank guidance on health. The health data, analysis and strategy content of the three PRSPs are assessed with respect to the 'Health, Nutrition and Population' chapter of the World Bank's PRSP Sourcebook. This guidance states that PRSPs should include: health data on the poor and a clear analysis showing the determinants of ill health and pro-poor health strategies. Unfortunately, none of the PRSPs analysed comply with the guidance and, consequently, do not adequately portray the health situation within their countries. Thus health is not given a high priority in the PRSP process and is seemingly low on the agenda of both poor country governments and the International Financial Institutions (IFIs). If the situation for the world's poorest people is to improve, health and the right to health need to be promoted within PRSPs.
Determinants of population health such as fuel poverty (inability to afford adequate household temperatures) are difficult to highlight in the media. In this paper we analyse newspaper reports of the death of a Pacific migrant, Mrs Muliaga, who could not afford her electricity bill, and reflect on using individual cases to highlight the importance of the social determinants of health,
Water harvesting is an important tool for mitigating the adverse effects of climate change. This report investigates the trade-offs between health and poverty reduction by considering the impacts of water harvesting on health in Tigray region, northern Ethiopia. In particular, we assess the prevalence of malaria in association with ponds and wells. Moreover, the determinants of malaria incidence are explored
Fitsum Hagos; Mekonen Yohannes; Vincent Linderhof; Gideon Kruseman; A. Mulugeta; G. Girmay; A. Zenebe
This chapter gives an educational overview of: * The actual application of supply chain practice and disciplines required for service delivery improvement within the current health environment. * A rationale for the application of Supply Chain Management (SCM) approaches to the Health sector. * The tools and methods available for supply chain analysis and benchmarking. * Key supply chain success factors. PMID:20407173
Public health researchers are increasingly shifting their attention away from merely documenting those factors that determine health--a solid evidence base on health determinants now exists--to improving our understanding of how various interventions influence population health. This paper argues for greater investigations of the potential unintended health benefits associated with participation in a poverty alleviation strategy (PAS) in low-income countries. We focus on microcredit, a PAS that has been spreading across the developing world. Microcredit aims to address the "credit gap" between the poor and the better off by offering an alternative for the poor to acquire loans: small groups are formed and loans are allocated to members based on group solidarity instead of formal collateral. We argue that microcredit corresponds with activities that will help build up health capital (e.g., greater access to resources) and describe the main pathways from microcredit participation to health. We advocate that microcredit and other potential pro-health PAS be included among the range of interventions considered by public health researchers in improving the health of the poor. PMID:18435395
In this study, state-level US data for the years 2000 and 1990 are used to provide additional evidence on the roles of income inequality and poverty in population health. Five main points are noted. First, contrary to the suggestion made in several recent studies, the income inequality parameter is observed to be quite robust and carries statistical significance in mortality equations estimated from several observation sets and a fairly wide variety of specificational choices. Second, the evidence does not indicate that significance of income inequality is lost when education variables are included. Third, similarly, the income inequality parameter shows significance when a race variable is added, and also when both race and urbanization terms are entered. Fourth, while poverty is seen to have some mortality-increasing consequence, the role of income inequality appears stronger. Fifth, income inequality retains statistical significance when a quadratic income term is added and also if the log-log version of a fairly inclusive model is estimated. I therefore suggest that the recent skepticism articulated by several scholars in regard to the robustness of the income inequality parameters in mortality equations estimated from the US data should be reconsidered. PMID:15963618
The period of the last Government in the UK was marked by increases in poverty and social exclusion, with the gap widening between rich and poor, and differentials being associated with, and further entrenched by, inequalities in health. In 1994, the Audit Commission pointed to the potential contribution which proactive and well coordinated health and welfare services could make to meeting the needs of vulnerable families, and suggested the setting up of local demonstration projects. This paper reports on the achievements and limitations of Nottingham's 2-year Strategies for Practice in Disadvantaged Areas (SPIDA) Project which tested a model of team learning about poverty in relation to those registered with an inner-city doctor's practice. Members of a primary health care team engaged in a self-directed development programme which, despite numerous staff changes, enabled them to learn how to learn together, enhanced their understandings of what it means to live in poverty, and facilitated the establishment of collaborative and productive interagency working relationships at a neighbourhood level. It is suggested that staff in health and welfare organizations wishing to implement anti-poverty strategies could usefully consider adopting this model of team learning to promote collective action and change. PMID:11560617
An analysis of the differentials in selected vital and health statistics associated with residence in poverty and nonpoverty areas in 19 of the largest cities in the U.S. is provided. The analysis is based on 11 significant indexes of natality and mortali...
The political economy of urban poverty and environmental management in Asia describes the major environmental problems facing the urban poor in this regionand suggests the need for alternative avenues of action to address them. It concentrates on the current and potential role of community level initiatives, including what constrains their effectiveness and the pre-conditions for empowering and mobilizing the poor
Background In India, indigenous populations, known as Adivasi or Scheduled Tribes (STs), are among the poorest and most marginalized groups. 'Deprived' ST groups tend to display high levels of resignation and to lack the capacity to aspire; consequently their health perceptions often do not adequately correspond to their real health needs. Moreover, similar to indigenous populations elsewhere, STs often have little opportunity to voice perspectives framed within their own cultural worldviews. We undertook a study to gather policy-relevant data on the views, experiences, and priorities of a marginalized and previously enslaved tribal group in South India, the Paniyas, who have little 'voice' or power over their own situation. Methods/design We implemented a Participatory Poverty and Health Assessment (PPHA). We adopted guiding principles and an ethical code that promote respect for Paniya culture and values. The PPHA, informed by a vulnerability framework, addressed five key themes (health and illness, well-being, institutions, education, gender) using participatory approaches and qualitative methods. We implemented the PPHA in five Paniya colonies (clusters of houses in a small geographical area) in a gram panchayat (lowest level decentralized territorial unit) to generate data that can be quickly disseminated to decision-makers through interactive workshops and public forums. Preliminary findings Findings indicated that the Paniyas are caught in multiple 'vulnerability traps', that is, they view their situation as vicious cycles from which it is difficult to break free. Conclusion The PPHA is a potentially useful approach for global health researchers working with marginalized communities to implement research initiatives that will address those communities' health needs in an ethical and culturally appropriate manner.
Fiji signed the United Nations 2015 target of halving extreme poverty from its 1990 level, but like many developing countries it is facing challenges in meeting this goal. This paper presents the economic modelling using Fiji's Household Income and Expenditure Survey 2002\\/03 dataset to examine the economic and social factors crucial for poverty reduction. Two hypotheses are tested: first, we
The Millennium Development Goals (MDGs), committed to by all 191 United Nations member states, are rooted in the concept of sustainable development. Although 2007 (midway) reports indicated that programs are under way, unfortunately many countries are unlikely to reach their goals by 2015 due to high levels of poverty. Madagascar is one such example, although some gains are being made. Attempts of this island nation to achieve its MDGs, expressed most recently in the form of a Madagascar Action Plan, are notable in their emphasis on (1) conserving the country's natural resource base, (2) the effect of demographic trends on development, and (3) the importance of health as a prerequisite for development. Leadership in the country's struggle for economic growth comes from the president of the Republic, in part, through his “Madagascar Naturally” vision as well as his commitment to universal access to family planning, among other health and development interventions. However, for resource-limited countries, such as Madagascar, to get or stay “on track” to achieving the MDGs will require support from many sides. “Madagascar cannot do it alone and should not do it alone.” This position is inherent in the eighth MDG: “Develop a global partnership for development.” Apparently, it takes a village after all – a global one.
Gaffikin, Lynne; Ashley, Jeffrey; Blumenthal, Paul D.
This article is a review of the PhD thesis of Mark Collinson, titled, 'Striving against adversity: the dynamics of migration, health and poverty in rural South Africa'. The findings show that in rural South Africa, temporary migration has a major impact on household well-being and health. Remittances from migrants make a significant difference to socioeconomic status (SES) in households left behind by the migrant. For the poorest households the key factors improving SES are government grants and female temporary migration, while for the less poor it is male temporary migration and local employment. Migration is associated with HIV but not in straightforward ways. Migrants that return more frequently may be less exposed to outside partners and therefore less implicated in the HIV epidemic. There are links between migration and mortality patterns, including a higher risk of dying for returnee migrants compared with permanent residents. A mother's migration impacts significantly on child survival for South African and former refugee parents, but there is an additional mortality risk for children of Mozambican former refugees. It is recommended that national censuses and surveys account for temporary migration when collecting information on household membership, because different migration types have different outcomes. Without discriminating between different migration types, the implications for sending and receiving communities will remain lost to policy-makers. PMID:20531981
In a scenario where ecosystemic services are being eroded and there is high social inequity, a new model of development is necessary, namely one capable of promoting social development with a reduction of its ecological footprint. The 'Green Economy' model is one of the proposed models. This paper seeks to analyze the environmental, social and individual impacts on human health in the context of a 'brown economy', and discusses the contributions of a green economy on the promotion of equity and health. The assumption is that economic development and environmental sustainability are not incompatible and both contribute to the eradication of poverty. The transition to a sustainable economy depends on political decisions, and transcends technological developments. Above all, it should instigate new models of production, consumption and social organization, which promote socio-environmental justice, encouraging social participation and democratic forms of governance to define a solid agenda for the implementation of sustainable development and mechanisms to implement them at all levels. PMID:22699637
Gallo, Edmundo; Setti, Andréia Faraoni Freitas; Magalhães, Danielly de Paiva; Machado, Jorge Mesquita Huet; Buss, Daniel Forsin; Franco Netto, Francisco de Abreu; Buss, Paulo Marchiori
Malaria is one of the most important challenges to global public health. African countries south of the Sahara bear today the heaviest burden of malaria. The relationship between poverty and malaria has long been recognized but its paths are multiple and complex. Recent studies suggest that causality works both ways, trapping communities in reinforcing cycles of poverty and disease. If
|The poverty affecting 14.5 million U.S. children living below the poverty line poses long-term effects, including risks to health, educational achievement, family stability, and employment prospects. This report provides compelling evidence of the substantial costs of poverty among children to our nation's economic well-being, and shows that…
Vehicle healthmanagement (VHM) for space system avionics can ensure system readiness for launch vehicles and space-based dormant vehicles. In a research to evaluate space system avionics VHM for its guidance, navigation, and control systems (GN&C), researchers examined fault tolerance, redundancy, and levels of built-in test coverage needed to meet system performance requirements. They also analyzed ground and on-orbit test
Kathleen Radke; Paul Bursch; Ron Frazzini; Jerry Wald; Don Brown
Poverty remains a growing concern in many developing countries. Limited accessibility to production factors and credit facilities in the formal financial system by the poor is usually identified as one of the causes of poverty in Malawi. In response to this problem, there are many institutions that provide credit facilities to the poor. Most of the institutions received seed capital
Ephraim W. Chirwa; Peter M. Mvula; Lucy Namata; Evious K. Zgovu
Child poverty, as a critical indicator of the QOL, is intricately related to the social structure of the community. This hypothesis is explored for the 159 counties of Georgia for the year 2000. The influence of demographic, economic, family and health factors upon child poverty are explored through models of total, black and white child poverty.…
|Child poverty, as a critical indicator of the QOL, is intricately related to the social structure of the community. This hypothesis is explored for the 159 counties of Georgia for the year 2000. The influence of demographic, economic, family and health factors upon child poverty are explored through models of total, black and white child poverty.…
School based mental health services for children in poverty can capitalize on schools’ inherent capacity to support development and bridge home and neighborhood ecologies. We propose an ecological model informed by public health and organizational theories to refocus school based services in poor communities on the core function of schools to promote learning. We describe how coalescing mental health resources around school goals includes a focus on universal programming, mobilizing indigenous school and community resources, and supporting core teaching technologies. We suggest an iterative research–practice approach to program adaptation and implementation as a means toward advancing science and developing healthy children.
Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.; Glisson, Charles
Hospitals and health-care facilities are among the most complex, costly, and challenging buildings to design, construct and manage. To become a health facilities manager of a hospital or other medical centre in the USA, one requires knowledge not only of how to manage people, but also of how to deal with government agencies and all kinds of regulations and inspections.
Purpose – The purpose of this paper is to reduce ambiguity in diverse approaches to health knowledge management by surfacing key issues, perspectives and philosophical assumptions. Design\\/methodology\\/approach – Knowledge management research in health is critically reviewed. Issues are grouped into research domains, and examined in the light of associated knowledge management perspectives, and philosophical assumptions. Findings – Systemic complexity in
Recent years have witnessed a surge in scholarship that problematizes the linear, Eurocen- tric approach to international health communication and suggests the pressing need for a culture-centered approach. This author takes a culture-centered approach to exploring the Santali meanings of health in rural Bengal. The open-ended interviews conducted with the Santals bring to surface key issues and meaningful theories of
Poverty affects every culture and society dimensions. Poverty involves limiting access to services on education, health, decision making and lack of community facilities such as water, sanitation, roads, transport and communications. The key to sustainable development to poverty eradication is to discover hidden resources that already exist in every poor community. Poverty is a social problem and its solution can
The World Bank has released the November 1997 issue of Poverty Lines, a newsletter that summarizes current research studies on poverty. The latest issue looks at how public works programs can help people who are poor.
|Two percent of women in the United States suffer from intimate partner violence annually, with poor and minority women disproportionately affected. I provide evidence of an important negative externality associated with domestic violence by estimating a negative and causal relationship between violence during pregnancy and newborn health,…
Two percent of women in the United States suffer from intimate partner violence annually, with poor and minority women disproportionately affected. I provide evidence of an important negative externality associated with domestic violence by estimating a negative and causal relationship between violence during pregnancy and newborn health, exploiting variation in the enforcement of laws against domestic violence for identification. I
This study assesses the relative poverty and the quality of life in Turkey. The database used for the study is based on the raw data obtained from the Turkish Statistical Institute Household Budget and Consumption Expenditure questionnaires between 2003 and 2006. In the article, those that are relatively poor according to the total annual income are illustrated in crosstabs in
Despite the potential for social and economic development provided by oil generated wealth, the lack of accountability and transparency in revenues has exacerbated poor governance, conflict and poverty in the majority of oil dependent countries in Africa. Against the background of the new oil boom and the poor state of public institutions, a major development challenge at the turn of
There are 16.4 million women over age 65 in this country, compared to 11 million men. The 41 percent of this population who live alone are the poorest of the poor in this country, with an annual median income of just over $3,000 for white women and little more than $2,000 for black women. This abject poverty affects the ability of these women to…
|There are 16.4 million women over age 65 in this country, compared to 11 million men. The 41 percent of this population who live alone are the poorest of the poor in this country, with an annual median income of just over $3,000 for white women and little more than $2,000 for black women. This abject poverty affects the ability of these women to…
There must be an awareness of gender issues in poverty reduction programs. For example, program efforts that direct aid to the promotion of labor intensive employment options disregard women's already overburdened work regime. Public expenditures to benefit the poor, such as primary education or reformed agricultural extension, may be based on the assumption that men and women will benefit equally, yet there is often gender bias in the delivery of services. One recommendation is to target female headed households in budget-constrained anti-poverty programs. One of the few examples of such programs provides urban female household heads in Chile with employment training, housing, health care, child care, and legal aid services. Causes of female headship vary, and a simple correlation with poverty is not always the case. Well-intentioned women-in-development credit programs in Ghana and Bangladesh have been "hijacked" by men. Programs to address gender discrimination only among the poor may overlook other oppressed women. In India gender discrimination is often greatest among women in wealthy households. Programs must offer more than economic resources, they must help women stretch traditional gender boundaries and obtain skills such as literacy or financial management. They must help women organize collectively to protest injustices and achieve institutional reforms. PMID:12290189
The absence of appropriate financial management competencies has impeded progress in advancing the field of public health finance. It also inhibits the ability to professionalize this sector of the workforce. Financial managers should play a critical role by providing information relevant to decision making. The lack of fundamental financial management knowledge and skills is a barrier to fulfilling this role. A national expert committee was convened to examine this issue. The committee reviewed standards related to financial and business management practices within public health and closely related areas. Alignments were made with national standards such as those established for government chief financial officers. On the basis of this analysis, a comprehensive set of public health financial management competencies was identified and examined further by a review panel. At a minimum, the competencies can be used to define job descriptions, assess job performance, identify critical gaps in financial analysis, create career paths, and design educational programs. PMID:19395980
Across Colorado thousands of parents struggle to support their families with jobs that do not pay enough to meet their basic needs. To develop, implement and evaluate programs and policies to assist these families requires an understanding of the causes and characteristics of working poverty in Colorado. Many of Colorado's recent strategies to address poverty, such as Colorado's newly reformed
User fees were introduced in public health facilities in Cambodia in 1997 in order to inject funds into the health system to enhance the quality of services. Because of inadequate health insurance, a social safety net scheme was introduced to ensure that all people were able to attend the health facilities. However, continuing high rates of hospitalization and mortality from dengue fever among infants and children reflect the difficulties that women continue to face in finding sufficient cash in cases of medical emergency, resulting in delays in diagnosis and treatment. In this article, drawing on in-depth interviews conducted with mothers of children infected with dengue in eastern Cambodia, we illustrate the profound economic consequences for households when a child is ill. The direct costs for health care and medical services, and added indirect costs, deterred poor women from presenting with sick children. Those who eventually sought care often had to finance health spending through out-of-pocket payments and loans, or sold property, goods or labour to meet the costs. Costs were often catastrophic, exacerbating the extreme poverty of those least able to afford it.
The future of market-oriented health policy and practice lies in "managed consumerism," a blend of the patient-centric focus of consumer-driven health care and the provider-centric focus of managed competition. The optimal locus of incentives will vary among health services according to the nature of the illness, the clinical technology, and the extent of discretion in utilization. A competitive market will manifest a variety of comprehensive and limited benefit designs, broad and narrow contractual networks, and single-and multispecialty provider organizations. PMID:16284020
|This report describes how children bear the brunt of poverty and explains why they are central to poverty reduction in developing nations. The report also illustrates UNICEF's support for the process of improving access to, and quality of, health care, education, water and sanitation, and child protection. It describes how the participation of…
Over the years considerable progress has been made in designing and implementing policies and in building appropriate structures of incentives and institutions to combat poverty. Yet, almost a billion people in the world continue to be in abject poverty. They can not afford minimum requirements of food, clothing, shelter, and education and health facilities. Majority of the poor in live
This paper explores trends in poverty and nutrition during economic transformation and especially the impacts linked to government support for agriculture during the process. Analysis of multiyear data for 29 developing countries confirms that structural transformation raises total income and that poverty falls faster with strong support for agriculture. In turn, poverty reduction supports improved nutrition, especially in rural areas. However, transformation brings problems through health risks associated with rising obesity in rural as well as urban areas. Thus, the transition process must be managed better, through targeted support for smallholder agriculture and health interventions, if the negative consequences of obesity and chronic disease are to be mitigated.
Despite the magnitude of the problem of health inequity within and between countries, little systematic research has been done on the social causes of ill-health. Health researchers have overwhelmingly focused on biomedical research at the level of individuals. Investigations into the health of groups and the determinants of health inequities that lie outside the control of the individual have received
In this article, select findings from a 5-year ethnographic study of homeless, pregnant women in Southern California pin-pointed the contextual constraints, along with individual factors, that framed the women's reproductive options and actions. The women had very little choice in the timing, the place, the partner, and the circumstances surrounding conception. Factors contributing to their becoming pregnant were the woman's victimization, economic survival, lack of access to contraceptives, uncertain fertility, desire for intimacy, and hope for the future. Findings suggest that even if the women were able to establish reproductive goals and had the wherewithal to acquire and effectively use contraceptives, situational constraints (homelessness, pregnancy, poverty, contraception, fertility patterns) might still prevent their success. PMID:9718882
This extensive site from World Bank offers an ongoing look at poverty in Africa and the ways in which World Bank continues to monitor it. The Africa Household Survey Database (AHSD) is featured on the site, and holds, at present, 106 completed surveys from 36 countries. The surveys in the database include Labor Force Surveys, Household Budget Surveys, Demographic and Health Surveys, Population and Housing Censuses, and more. Poverty in Africa also contains several other sections that support the AHSD, including explanations of the ways in which poverty levels are monitored and measured. Related resources offered at the site include links to Websites from other NGOs and academic sources, as well as information on the World Bank's partners in Africa, such as the African National Statistics Offices.
The authors provide an overview of how different approaches to improving public sector management relate to so-called core or essential public health functions, such as disease surveillance, health education, monitoring and evaluation, workforce development, enforcement of public health laws and regulations, public health research, and health policy development. The authors summarize key themes in the public management literature and draw
|This select bibliography on poverty in the U.S. is divided into the following areas: (1) general references; (2) economics of poverty; (3) the poor; (4) Office of Economic Opportunity Programs - General; (5) Community Action, VISTA, and participation of the poor; (6) manpower and poverty; (7) poverty and health; (8) education and the poor; (9)…
Background Partnerships are increasingly common in conducting research. However, there is little published evidence about processes in research-policy partnerships in different contexts. This paper contributes to filling this gap by analysing experiences of research-policy partnerships between Ministries of Health and research organisations for the implementation of the Mental Health and Poverty Project in Ghana, South Africa, Uganda and Zambia. Methods A conceptual framework for understanding and assessing research-policy partnerships was developed and guided this study. The data collection methods for this qualitative study included semi-structured interviews with Ministry of Health Partners (MOHPs) and Research Partners (RPs) in each country. Results The term partnership was perceived by the partners as a collaboration involving mutually-agreed goals and objectives. The principles of trust, openness, equality and mutual respect were identified as constituting the core of partnerships. The MOHPs and RPs had clearly defined roles, with the MOHPs largely providing political support and RPs leading the research agenda. Different influences affected partnerships. At the individual level, personal relationships and ability to compromise within partnerships were seen as important. At the organisational level, the main influences included the degree of formalisation of roles and responsibilities and the internal structures and procedures affecting decision-making. At the contextual level, political environment and the degree of health system decentralisation affected partnerships. Conclusions Several lessons can be learned from these experiences. Taking account of influences on the partnership at individual, organisation and contextual/system levels can increase its effectiveness. A common understanding of mutually-agreed goals and objectives of the partnership is essential. It is important to give attention to the processes of initiating and maintaining partnerships, based on clear roles, responsibilities and commitment of parties at different levels. Although partnerships are often established for a specific purpose, such as carrying out a particular project, the effects of partnership go beyond a particular initiative.
Competency in cultural sensitivity is an essential skill for health care practitioners. One strategy for improving cultural sensitivity is through a cultural immersion experience. This article reflects the experience of two university faculty members, on completion of a cultural immersion experience. The article describes the experience and the cultural practices identified that influence health and nursing care in two hospitals
Little research exists on health determinants among adults living in economically deprived regions despite the fact that these areas comprise a good part of the world. This paper examines the distribution of wealth then tests associations between wealth inequality and a variety of health outcomes, among older adults, in one of the world's poorest regions—rural Cambodia. Data from the 2004
|The aim of this study was to examine the health and nutritional status of low-income women in Upstate New York and to identify problems that interfere with their employment. Questionnaires on health and work, complete medical and employment histories, physical examination, laboratory tests, dental examination and diet recalls were obtained for…
STUDY OBJECTIVES—To establish the geographical relation of health conditions to socioeconomic status in the city of Rio de Janeiro, Brazil.?DESIGN—All reported deaths in the municipality of Rio de Janeiro, from 1987 to 1995, obtained from the Mortality Information System, were considered in the study. The 24 "administrative regions" that compose the city were used as the geographical units. A geographical information system (GIS) was used to link mortality data and population census data, and allowed the authors to establish the geographical pattern of the health indicators considered in this study: "infant mortality rate"; "standardised mortality rate"; "life expectancy" and "homicide rate". Information on location of low income communities (slums) was also provided by the GIS. A varimax rotation principal component analysis combined information on socioeconomic conditions and provided a two dimension basis to assess contextual variation.?MAIN RESULTS—The 24 administrative regions were aggregated into three different clusters, identified as relevant to reflect the socioeconomic variation. Almost all health indicator thematic maps showed the same socioeconomic stratification pattern. The worst health situation was found in the cluster composed of the harbour area and northern vicinity, precisely in the sector where the highest concentration of slum residents are present. This sector of the city exhibited an extremely high homicide rate and a seven year lower life expectancy than the remainder of the city. The sector that concentrates affluence, composed of the geographical units located along the coast, showed the best health situation. Intermediate health conditions were found in the west area, which also has poor living standards but low concentration of slums.?CONCLUSIONS—The findings suggest that social and organisation characteristics of low income communities may have a relevant role in understanding health variations. Local health and other social programmes specifically targeting these communities are recommended.???Keywords: geographical information system; health conditions; low income communities
Szwarcwald, C.; Bastos, F. I.; Barcellos, C.; Pina, M. d.; Esteves, M. A.
In the United States and other high-income countries, there is intense scholarly and programmatic interest in the effects\\u000a of household and neighborhood living standards on health. Yet few studies of developing-country cities have explored these\\u000a issues. We investigated whether the health of urban women and children in poor countries is influenced by both household and\\u000a neighborhood standards of living. Using
It is estimated that, in the United States, one in ten children and adolescents suffer from illness severe enough to cause\\u000a some level of psychosocial dysfunction. Urban children, and in particular low-income children of color, are at greater risk\\u000a of developing mental health problems, and are less likely to receive effective child mental health services. Prompt and effective\\u000a access to
It is estimated that, in the United States, one in ten children and adolescents suffer from illness severe enough to cause\\u000a some level of psychosocial dysfunction. Urban children, and in particular low-income children of color, are at greater risk\\u000a of developing mental health problems, and are less likely to receive effective child mental health services. Prompt and effective\\u000a access to
This article offers a new paradigm for eradicating poverty in India. It was assumed incorrectly by Mahatma Gandhi that a good society without mass poverty would follow after independence. India copied Western models of development and developed giant factories, big dams, and megacities. Agriculture did not expand the number of jobs for people. The Western paradigm failed in India because of the false assumption of "trickle down" of income to the masses. The targeted programs to the poor did not directly benefit enough of the poor. Mega-industrialization led to reduced employment and higher skill needs. The model failed mainly because it was a proxy and relied on indirect ways of reaching the poor. The models failed to be adapted to conditions in India. The Swadeshi paradigm is a direct model for addressing mass poverty. Poverty is affected by immediate, intermediate, and ultimate determinants. Poverty begets social and economic problems, such as ignorance, ill health, high fertility, unemployment, and crime. In India and developing countries, mass poverty results from under use of human resources; lack of equal opportunities; and an outdated non-egalitarian social structure, an unjust global economic order, human cruelty, and erosion of ethical values. Indians are squandering their precious resources mimicking Western consumerism. Poverty leads to rapid population growth. People become productive assets with universal literacy, compulsory and free education, health services and sanitation, vocational training, and work ethics. India needs people-oriented policies with less emphasis on capital accumulation. PMID:12294462
The project PARTNERS FOR AFRICA demonstrates and promotes the role of renewable energy in poverty eradication and policy-making activities in the areas of sustainable resource management, health and public health, and enterprise development. Specifically, the project succeeded in mobilizing a variety of international and local renewable energy partnerships which provide support for the development of progressive energy policy initiatives and
Rainer Janssen; Peter Helm; Maurice Pigaht; Denis Tomlinson; Francis Yamba; Salimata Wade; Silvia Vivarelli; Teodoro Sanchez; Maria Morales; Jeremy Woods
STUDY OBJECTIVESTo establish the geographical relation of health conditions to socioeconomic status in the city of Rio de Janeiro, Brazil.DESIGNAll reported deaths in the municipality of Rio de Janeiro, from 1987 to 1995, obtained from the Mortality Information System, were considered in the study. The 24 “administrative regions” that compose the city were used as the geographical units. A geographical
Célia L Szwarcwald; Francisco Inácio Bastos; Christovam Barcellos; Maria de Fátima Pina; Maria Angela Pires Esteves
Most countries of the Former Soviet Union (FSU) have either initiated or are contemplating reform of the health sector. With negative real income growth and falling government revenues, a key concern of many governments is to secure additional finance through non-budgetary sources such as hypothecated payroll taxes, voluntary insurance, and increased private finance through patient cost-sharing. However, before such reforms
This paper is based on data from focus group discussions and in-depth individual interviews carried out in two slum areas, Korogocho and Viwandani in Nairobi, Kenya. It discusses how the division between domestic sphere and public sphere impacts on survival during, and adaptation to old age. Although this paper adopts some of the tenets of the life course approach, it posits that women's participation in the domestic sphere may sometimes give them a ‘gender advantage’ over men in terms of health and adaptation to old age. The paper also discusses the impact of gender roles on the cultivation of social networks and how these networks in turn impact on health and social adjustment as people grow older. It investigates how older people are adjusting and coping with the new challenges they face as a result of high morbidity and mortality among adults in the reproductive age groups.
The management of biohazard in health care settings entails multidisciplinarity, valuing the interactions among stakeholders (General Manager, Medical Director, health care workers, prevention and protection units, infection control panels, occupational physicians), with the aim of protecting health and safety of workers, third parties and the health care service. The management issue was tackled within SIMLII guidelines on biohazards, as well as by the SIMLII Section on Preventive Medicine for Health Care Workers, followed by editorial initiatives. This contribution focuses on afield example on the management of data stemming from accidents involving biohazards, highlighting the need of information technology enabling management of enormous amount of health data. This work underlines the primacy of individual risk assessment and management, while combining information on working techniques and procedures with modern health surveillance, on the basis of accredited literature and good medical, organizational and technical practices. PMID:23405633
Porru, S; Agresta, A; Cimaglia, C; De Carli, G; Piselli, P; Puro, V; Micheloni, G P
Employers' past solutions to rising health benefit costs--adopting managed care strategies, cost shifting to employees and reducing benefits-are no longer effectively controlling costs and are depressing the value of health benefits for employee recruitment and retention. An alternative strategy is to implement healthmanagement approaches that improve the health status of employees. These programs reduce medical costs and have a documented positive impact on workers' compensation, disability costs, absenteeism and productivity. Further, this approach is complementary to health care consumerism as a strategy for health improvement and benefit cost reduction and results in improved employee health, outlook and satisfaction. PMID:16792389
The study examines the characteristics and distribution of urban poverty in major Guatemalan cities and the measures being taken to alleviate this poverty. Included are a brief analysis of the major population shifts contributing to urban poverty in Guate...
The Global Alliance for Vaccines and Immunization (GAVI), now 10 years old, was established as a successful and innovative public–private partnership to deal with a fundamental inequity. The poorest children in the poorest parts of the world were being denied access to life-saving vaccines simply on the basis of cost. GAVI has been successful in mobilizing significant funding from donors and through innovative financing instruments, immunizing large numbers of children. GAVI has been less successful, at least in the time frames first envisaged, at quickly reducing the prices of new and under-used vaccines to levels affordable by the poorest countries. Vaccines remain some of the most cost effective of public health interventions. As GAVI seeks to introduce a new set of vaccines to tackle major killers such as pneumonia and diarrhoea, and emerging threats such as cervical cancer, it needs to raise significant additional funds. There is no single solution. Multiple and new instruments will be required to raise finance both globally and at the country level, and also to incentivize industry and others to provide vaccines at affordable prices to the poorest countries.
The Global Alliance for Vaccines and Immunization (GAVI), now 10 years old, was established as a successful and innovative public-private partnership to deal with a fundamental inequity. The poorest children in the poorest parts of the world were being denied access to life-saving vaccines simply on the basis of cost. GAVI has been successful in mobilizing significant funding from donors and through innovative financing instruments, immunizing large numbers of children. GAVI has been less successful, at least in the time frames first envisaged, at quickly reducing the prices of new and under-used vaccines to levels affordable by the poorest countries. Vaccines remain some of the most cost effective of public health interventions. As GAVI seeks to introduce a new set of vaccines to tackle major killers such as pneumonia and diarrhoea, and emerging threats such as cervical cancer, it needs to raise significant additional funds. There is no single solution. Multiple and new instruments will be required to raise finance both globally and at the country level, and also to incentivize industry and others to provide vaccines at affordable prices to the poorest countries. PMID:21893535
Over the last decade, cost-containment pressures, health care reform debates, movement to case-managedhealth care, and reductions\\u000a in health care benefits have required most families to be responsible for selecting specific health care services that keep\\u000a costs to a minimum. As Eddy [17-20] discussed in a series of articles on making decisions in health care, the consensus among\\u000a health care
Carol E. Smith; Susan V. M. Kleinbeck; Karen Fernengel; Linda S. Mayer
An opinion article of health care programmes questioning the effects and benefits of their management. The AA, based on their experience in management/administration, present suggestions to identify, quantify and analyse a problem in health care. After characterising a health care problem, the AA point out the fundamental role of planning (in health care) and invited interdepartmental collaboration between the various levels of health care managers. The eventual mission of health care programmes is stressed, their structural conformity with the external environment (community) and internal environment (health care institutions), the resources affected, their process and the results to be achieved, as well as their co-ordination. The programme manager, with a specific profile and duties, is suggested as an important leadership factor. The conclusion advises health care strategists of the future importance of the programmes. PMID:7484250
Many small- and medium-sized physician practices have developed specific programs and models toward becoming a successful patient-centered medical home. This article reports on a case-control quality improvement study of a multilingual population healthmanagement program for chronic disease management at International Community Health Services. In its first 2.5 years of operation, the International Community Health Services Population HealthManagement program for patients with hypertension and diabetes is associated with significant improvements in key health outcome measures for blood pressure and hemoglobin A1c control. This has significant implications for similar practices. PMID:23448920
Tsui, Edison W; Wang, Grace; Zahler, Abbie; Simoyan, Olapeju M; White, Mark V; Mckee, Michael
The Master of Health Administration program at UNSW was extensively revised in 2006 to ensure that it effectively meets the challenging and dynamic environment of health service managers in local and global health contexts. This paper describes the innovative approach to the redesign of the healthmanagement program within the Faculty of Medicine. It outlines the method and considerations undertaken,
Lois D Meyer; Alan R Hodgkinson; Rosemary Knight; Maria Theresa Ho; Sophie K di Corpo; Sonal Bhalla
The community mental health team is now the established model for mental health service delivery in the community. Managing CMHTs requires a diverse range of managerial skills, role clarity and authority. More research needs to be undertaken on the role and effectiveness of the CMHT manager. PMID:10986955
Recently, operators of complex systems such as aircraft, power plants, and networks, have been emphasizing the need for online health monitoring for purposes of maximizing operational availability and safety. The discipline of prognostics and healthmanagement (PHM) is being formalized to address the information management and prediction requirements for addressing these needs. In this paper, we will explore how standards
John W. Sheppard; Mark A. Kaufman; Timothy J. Wilmering
Recently operators of complex systems such as aircraft, power plants, and networks have been emphasizing the need for on-line health monitoring for purposes of maximizing operational availability and safety. The discipline of prognostics and healthmanagement (PHM) is being formalized to address the information management and prediction requirements for addressing these needs. Herein, we will explore how standards currently under
Adolescents living in poverty face numerous stressors that are toxic for their mental health and well-being. There are effective strategies for coping with poverty-related stress that have been shown to reduce psychological symptoms in the face of this stress. However, stress itself weakens an adolescent's ability to use these cognitively…
Relative poverty lines such as one-half median income have been increasingly used in poverty studies. This paper contributes to the literature by developing statistical inference for testing decomposable poverty measures with relative poverty lines. The poverty lines we consider are percentages of mean income and percentages of quantiles. We show that the estimates of poverty indices with relative poverty lines
|Regression results reveal there are geographic determinants of poverty. Even when demographic, labor-market, institutional, and fiscal correlates of poverty are controlled for, counties bordering high-poverty counties have poverty rates 3.4-3.8 percentage points higher simply because of their location. Economic development resources should focus…
In "A Framework of Poverty," Ruby Payne (1998) itemizes the things that characterize poverty-stricken people. She talks about how hard it is for a person to move out of poverty. To not pass poverty on to another generation, one must have a vision. One must have a desire to achieve a better life or a strong support system. Schools must become the…
Davenport, Roy F.; Tolbert, Marsha; Myers-Oliver, Donna; Brissett, Julia M.; Roland, Annissa J.
Managed care has become one of the leading developments in health care financial management, but ignorance and confusion surround its meaning and origins. Managed care seeks to reduced costs and increase profits while maintaining quality, yet the evidence that it is able to achieve these aims is mixed. The following analysis is a review of the events leading to the establishment of managed care and what it has become. Various terms and health care organizations involved in managed care are identified, with emphasis placed on the strengths and weaknesses of managed care programs. This analysis is performed to gain insight and better understanding of the direction health care financial management is headed in the 21st century. PMID:18972972
Conditional cash transfer (CCT) programmes aim to alleviate poverty through monetary and in-kind benefits, as well as reduce future incidence of poverty by encouraging investments in education, health and nutrition. The success of CCT programmes at reducing poverty depends on whether, and the extent to which, cash transfers affect adult work incentives. In this paper we examine whether the PROGRESA
Three hundred and sixteen households in 20 western Kenyan villages - 19% of all households in these villages - managed successfully to escape from poverty in the last 25 years. However, another 325 households, (i.e., 19%) of all households of these villages, fell into abiding poverty in the same period. Different causes are associated with households falling into poverty and
Anirudh Krishna; Patti Kristjanson; Maren Radeny; Wilson Nindo
This study examines the roles of childhood neglect and childhood poverty (family and neighborhood) in predicting Posttraumatic\\u000a Stress Disorder (PTSD), Major Depressive Disorder (MDD), academic achievement, and crime in young adulthood. Using existing\\u000a data from a prospective cohort design study, 1,005 children with documented histories of neglect (N = 507) and matched controls\\u000a (N = 497) were interviewed in young adulthood (mean age 29).
Although there is a considerable literature on how adolescents make decisions which lead to risky behaviors (e.g., unprotected sex, drug use) and adversely affect the health and well-being of youth, little is known about the routine behaviors youth engage in which influence their health (e.g., having permanent teeth extracted, discontinuing antibiotics prematurely, delaying or going without treatment of subacute illnesses and minor injuries) and concomitantly the factors which influence these behaviors. In an effort to begin to fill this gap, we have undertaken a study of routine health behaviors and the factors which bear on them in adolescents from a high-poverty urban neighborhood. In this article, we present the results of the pilot phase of the study in which we documented the behavior of 10 adolescents from Camden, New Jersey, the fifth poorest city in the United States, and explored with them their perceptions of the decisions they made and the factors that gave rise to them. We found that participants had an insufficient understanding of their health problems and consequences of their health actions, problems in understanding and being understood by health care professionals, and reluctance to involve parents in routine health care decisions. The implications of these findings are discussed in relation to improving the health of vulnerable youth. PMID:20816561
Atkins, Robert; Bluebond-Langner, Myra; Read, Nichole; Pittsley, Jerri; Hart, Daniel
At the time of independence majority of Indians were poor. In spite of spending over 80 per cent of their income on food, they could not get adequate food. Living in areas of poor environmental sanitation they had high morbidity due to infections; nutrition toll due to infections was high because of poor access to health care. As a result, majority of Indians especially children were undernourished. The country initiated programmes to improve economic growth, reduce poverty, improve household food security and nutritional status of its citizens, especially women and children. India defined poverty on the basis of calorie requirement and focused its attention on providing subsidized food and essential services to people below poverty line. After a period of slow but steady economic growth, the last decade witnessed acceleration of economic growth. India is now one of the fastest growing economies in the world with gross domestic product (GDP) growth over 8 per cent. There has been a steady but slow decline in poverty; but last decade's rapid economic growth did not translate in to rapid decline in poverty. In 1970s, country became self sufficient in food production; adequate buffer stocks have been built up. Poor had access to subsidized food through the public distribution system. As a result, famines have been eliminated, though pockets of food scarcity still existed. Over the years there has been a decline in household expenditure on food due to availability of food grains at low cost but energy intake has declined except among for the poor. In spite of unaltered/declining energy intake there has been some reduction in undernutrition and increase in overnutrition in adults. This is most probably due to reduction in physical activity. Under the Integrated Child Development Services (ICDS) programme food supplements are being provided to children, pregnant and lactating women in the entire country. In spite of these, low birth weight rates are still over 30 per cent and about half the children are undernourished. While poverty and mortality rates came down by 50 per cent, fertility rate by 40 per cent, the reduction in undernutrition in children is only 20 per cent. National surveys indicate that a third of the children from high income group who have not experienced any deprivations are undernourished. The high undernutrition rates among children appears to be mainly due to high low birthweight rates, poor infant and young child feeding and caring practices. At the other end of the spectrum, surveys in school children from high income groups indicate that between 10-20 per cent are overnourished; the major factor responsible appears to be reduction in physical activity. Some aspects of the rapidly changing, complex relationship between economic status, poverty, dietary intake, nutritional and health status are explored in this review. PMID:18032800
|Improvements in the quality of national--and particularly of urban--life will require even greater expenditures than at present on the delivery of crucial services as education, health protection, recreation, waste disposal, and police and fire protection. Simultaneously, the problem of poverty continues to plague millions, even many who are in…
A university-community partnership is described that resulted in the development of community-based mental health services for young children from families living in poverty. The purpose of this pilot project was to implement an evidence-based treatment program in the homes of an at-risk population of children with significant emotional and behavior problems that were further complicated by developmental delays. Outcomes for 237 children who participated in the clinic's treatment program over a 2 year period are presented. Comparisons are included between treatment completers and non-completers and the issues of subject attrition, potential subject selection bias, and the generalizability of the results are addressed. The need for more professionals who are trained to address mental health issues in very young children who live in very challenging conditions are discussed. PMID:23054148
Discusses strategies for managinghealth and safety within science departments. Emphasizes the importance of risk assessment for both pupil activities and those carried out by technicians. Stresses the role of training and the need for security. (MM)
Current peer review literature clearly documents the economic return and Return-on-Investment (ROI) for employee healthmanagement (EHM) programs. These EHM programs are defined as: health promotion, self-care, disease management, and case management programs. The evaluation literature for the sub-set of health promotion and disease management programs is examined in this article for specific evidence of the level of economic return in medical benefit cost reduction or avoidance. The article identifies the methodological challenges associated with determination of economic return for EHM programs and summarizes the findings from 23 articles that included 120 peer review study results. The article identifies the average ROI and percent health plan cost impact to be expected for both types of EHM programs, the expected time period for its occurrence, and caveats related to its measurement. PMID:19288852
Serxner, Seth; Gold, Daniel; Meraz, Angela; Gray, Ann
Background This study uses scientometrics methodology to reveal the status quo and emerging issues of collaboration in healthmanagement. Methods We searched all the articles with the keyword “healthmanagement” in the period 1999–2011 in Web of Knowledge, then 3067 articles were found. Methods such as Social network analysis (SNA), co-authorship, co-word analysis were used in this study. Results Analysis of the past 13 years of research in the field of healthmanagement indicates that, whether the production of scientific research, or authors, institutions and scientific research collaboration at the national level, collaboration behavior has been growing steadily across all collaboration types. However, the international scientific research cooperation about healthmanagement study between countries needs to be further encouraged. 17 researchers can be seen as the academic leaders in this field. 37 research institutions play a vital role in the information dissemination and resources control in healthmanagement. The component analysis found that 22 research groups can be regarded as the backbone in this field. The 8 institution groups consisting of 33 institutions form the core of this field. USA, UK and Australia lie in the center by cohesive subgroup analysis; Based on keywords analysis, 44 keywords with high frequency such as care, disease, system and model were involved in the healthmanagement field. Conclusions This study demonstrates that although it is growing steadily, collaboration behavior about healthmanagement study needs to be enhanced, especially between different institutions or countries/regions, which would promote the progress and internationalization of healthmanagement. Besides, researchers should pay attention to the cooperation of representative scholars and institutions, as well as the hot areas of research, because their experience would help us promote the research development of our nation.
Most health care management training programmes and textbooks focus on only one or two models or conceptual frameworks, but the increasing complexity of health care organizations and their environments worldwide means that a broader perspective is needed. This paper reviews five management models developed for business organizations and analyses issues related to their application in health care. Three older, more 'traditional' models are first presented. These include the functional areas model, the tasks model and the roles model. Each is shown to provide a valuable perspective, but to have limitations if used in isolation. Two newer, more 'innovative' models are next discussed. These include total quality management (TQM) and reengineering. They have shown potential for enabling dramatic improvements in quality and cost, but have also been found to be more difficult to implement. A series of 'lessons learned' are presented to illustrate key success factors for applying them in health care organizations. In sum, each of the five models is shown to provide a useful perspective for health care management. Health care managers should gain experience and training with a broader set of business management models. PMID:12476639
In this paper, we propose an approach to investigate the hypothesis that the residential concentration of poverty affects health status more deeply than when poverty is randomly scattered in a given geographical area. To characterize the geographic pattern of poverty in the city of Rio de Janeiro, Brazil, an index that measures the heterogeneity of poverty concentration among sub-areas was
Célia Landmann Szwarcwald; Carla Lourenço Tavares de Andrade; Francisco Inácio Bastos
Crisis management teams (CMT) are necessary to ensure adequate and appropriate crisis management planning and response to unforeseen, adverse events. This study investigated the existence of CMTs, the membership of CMTs, and the degree of training received by CMTs in Australian health and allied health organisations. This cross-sectional study draws on data provided by executive decision makers in a broad selection of health and allied health organisations. Crisis management teams were found in 44.2 per cent of the health-related organisations surveyed, which is ten per cent lower than the figure for business organisations. Membership of these CMTs was not ideal and did not conform to standard CMT membership profiles. Similarly, the extent of crisis management training in health-related organisations is 20 per cent lower than the figure for business organisations. If organisations do not become pro-active in their crisis management practices, the onus is on government to improve the situation through regulation and the provision of more physical, monetary and skill resources to ensure that the health services of Australia are sufficiently prepared to respond to adverse events. PMID:22576140
BackgroundThough the concept of multidimensional poverty has been acknowledged cutting across the disciplines (among economists, public health professionals, development thinkers, social scientists, policy makers and international organizations) and included in the development agenda, its measurement and application are still limited.Objectives and MethodologyUsing unit data from the National Family and Health Survey 3, India, this paper measures poverty in multidimensional space
... were written or produced by Forest Service personnel and are in the public domain. ... Title: The Applegate Adaptive Management Area ecosystem health assessment ... Forest health through silviculture: proceedings of the 1995 National ... U.S. Government employees on official time, and is therefore in the public domain.
With the number of market-approved biotech drugs approved by the U.S. Food and Drug Administration expected to jump soon, health plans are scrambling to redesign benefit structures, manage utilization, and get a handle on the costs of these new therapies. Here’s how four health plans are addressing these issues.
The financial management of pharmacies and health systems is a combination of the traditional management of personnel and drug and supply costs with the management of the total costs of care. It includes determining the consequences of less than optimal drug therapy, improving drug therapy, and reengineering pharmacy departments and services across all patient care settings to deliver optimal pharmacotherapy. Prevention and reduction of adverse drug events, disease state management, and other methods to improve quality of care are of major importance. Future articles in this series on the financial management of pharmacy practice in health care systems will provide examples of applications of financial management in acute care, ambulatory care, long term care, and across sites of care. They also will include the justification of the development of new types of patient care services. PMID:10164163
This research examines the impact of the Poverty Simulation Project, an experiential learning modality, on students' understanding of life in poverty. A total of 101 students representing 5 undergraduate majors in the College of Health and Human Services completed measures of critical thinking, understanding of others, and the active learning scales. Results indicate that although students did not change their
Etty Vandsburger; Rana Duncan-Daston; Emily Akerson; Tom Dillon
BackgroundIndigenous populations tend to have the poorest health outcomes worldwide and they have limited opportunities to present their own perspectives of their situation and shape priorities in research and policy. This study aims to explain low healthcare utilisation rates and opportunities to cope with illness among a deprived indigenous group - based on their own experiences and views.MethodsA participatory poverty
Diabetes affects 25.8 million persons in the United States, and these persons make more than 35 million ambulatory care visits annually. Yet, less than half of persons with diabetes meet the recommended levels of A1C, blood pressure and lipid control. One innovative approach is to use mobile health technologies to help patients better manage their diabetes and related conditions, and 85% to 90% of patients have access to mobile health technology. A brief review of the guidelines for diabetes care and mobile health technology that can support the guidelines are reported related to (1) glycemic control and self-monitoring of blood glucose, (2) pharmacological approaches and medication management, (3) medical nutrition therapy, (4) physical activity and resistance training, (5) weight loss, (6) diabetes self-management education and (7) blood pressure control and hypertension. The patient and provider are encouraged to explore possibilities for mobile health technologies that can support behavior change. PMID:23531961
Sieverdes, John C; Treiber, Frank; Jenkins, Carolyn
. This paper explores the axiomatic foundation of multidimensional poverty indices. Departing from the income approach which\\u000a measures poverty by aggregating shortfalls of incomes from a pre-determined poverty-line income, a multidimensional index\\u000a is a numerical representation of shortfalls of basic needs from some pre-specified minimum levels. The class of subgroup consistent\\u000a poverty indices introduced by Foster and Shorrocks (1991) is
This article offers a cross-country overview of child poverty, changes in child poverty, and the impact of public policy in North America and Europe. Levels and changes in child poverty rates in 12 Organisation for Economic Co-operation and Development (OECD) countries during the 1990s are documented using data from the Luxembourg Income Study project, and a decomposition analysis is used to uncover the relative role of demographic factors, labor markets, and income transfers from the state in determining the magnitude and direction of the changes. Child poverty rates fell noticeably in only three countries and rose in three others. In no country were demographic factors a force for higher child poverty rates, but these factors were also limited in their ability to cushion children from adverse shocks originating in the labor market or the government sector. Increases in the labor market engagement of mothers consistently lowered child poverty rates, while decreases in the employment rates and earnings of fathers were a force for higher rates. Finally, there is no single road to lower child poverty rates. Reforms to income transfers intended to increase labor supply may or may not end up lowering the child poverty rate.
|Articles in this theme issue are based on presentations at the Pathways from Poverty Workshop held in Albuquerque, New Mexico, on May 18-25, 1995. The event aimed to foster development of a network to address rural poverty issues in the Western Rural Development Center (WRDC) region. Articles report on outcomes from the Pathways from Poverty…
This study attempts to investigate the relationship between shadow economy and poverty by explaining the mechanism through which shadow economy affects poverty via its impact on government size and economic growth, and using the human poverty index (HPI) for developing and developed countries. In order to achieve this objective, the three-way interaction model is utilized using data of 139 developing
|In response to the highest poverty rate among children since the 1960s, this report examines existing Federal policies to assist poor families with children and analyzes over 40 policy alternatives. Chapter 1 discusses how poverty is measured, recent trends and current patterns of childhood poverty as officially measured, and the effects of using…
|This second edition of "Poverty Profile", published by the Missionary Society of St. Paul the Apostle as part of their Campaign for Human Development, updates the data examined in the earlier (1972) edition and examines some of the current social welfare programs designed to alleviate the affects of poverty. The extent to which poverty affects…
This paper is a critical review of researches in psychology of poverty in India. In spite of the fact that poverty remains to be the foremost problem of India, there seems to be a general negligence on the part of the Indian behavioral scientists in studying it with researcher’s rigour. Poverty in India is typically a unique Indian problem deeply
This article reviews quality of health care initiatives beginning with the quality assessment/quality assurance movement of the 1970s. Conceptually, modern quality of care management is rooted in the intellectual work of Avedis Donabedian who defined quality of care as a combination of structure, process, and outcome. Donabedian's model is presented and some limitations are pointed out. In the late 1980s and 1990s. the health care industry adopted total quality management (TQM). More recently, the pursuit of health care quality has led to substantial performance measurement initiatives such as ORYX by the Joint Commission on Accreditation of Healthcare Organizations and MEDIS by the National Commission of Quality Assurance. The importance of CONQUEST, a freely available performance measurement database developed at the Harvard School of Public Health, is noted and discussed. The article concludes with a list of challenges facing public and private parties interests in health care quality improvement. PMID:15188996
This year's annual Poverty Report from the United Nations Development Program (UNDP), the world's largest aid agency, breaks new ground in the way it directly indicates poor governance as a leading cause of continued poverty in many nations. The question of government and poverty has been a matter of some contention within the UN and between aid agencies and countries seeking assistance. This report identifies effective governance as "the 'missing link' between national anti-poverty efforts and poverty reduction," and concludes that "for many countries it is in improving governance that external assistance is needed." The authors call for a new and more sharply focused global strategy to combat poverty, one that emphasizes good government, the integration of poverty programs on the national and international level, and empowering people. The full text of the report is available by chapter at the site, along with an executive summary, country profiles, and a PowerPoint slide show. The text and summary are also available in Arabic, Chinese, French, Russian, and Spanish.
User fees were introduced in public health facilities in Cambodia in 1997 in order to inject funds into the health system to enhance the quality of services. Because of inadequate health insurance, a social safety net scheme was introduced to ensure that all people were able to attend the health facilities. However, continuing high rates of hospitalization and mortality from
The recent focus on collaborative relationships in health care means that people and groups must cooperate to accomplish clinical and management tasks. This increasing interdependence may also cause increased organizational conflict. The management of conflicts is critical to the effectiveness of an organization. Negotiating strategies, based on Fisher and Ury's method of "principled negotiation," include establishing superordinate goals, separating the people from the problem, focussing on interests, inventing options, using objective criteria and defining success in terms of gains.
Significance of effectively managing civil infrastructure systems (CIS) throughout CIS life-cycles, and especially during and after natural or man-made disasters is well recognized. Disaster mitigation includes preparedness for hazards to avoid casualties and human suffering, as well as to ensure that critical CIS components can become operational within a short amount of time following a disaster. It follows that mitigating risk due to disasters and CIS managementare intersecting and interacting societal concerns. A coordinated, multi-disciplinary approach that integrates field, theoretical and laboratory research is necessary for innovating both hazard mitigation and infrastructure management. Health monitoring (HM) of CIS is an emerging paradigm for effective management, including emergency response and recovery management. Challenges and opportunities in health monitoring enabled by recent advances in information technology are discussed in this paper. An example of HM research on an actual CIS test-bed is presented.
Aktan, A. Emin; Catbas, Fikret N.; Grimmelsman, Kirk A.; Pervizpour, Mesut; Curtis, Joshua M.; Shen, Kaizhen; Qin, Xiaoli
AH employers are ethically required to provide a safe and healthy workplace for their employees. Health and safety professionals (HSP) may of ten be employed either full-time or part-time to achieve this end. The HSP should be viewed as a non-partisan provider of safety and health services at the workplace. He is equally on the side of management and worker
This study compares community-based managed forests under different purposes of management, namely, state-driven “conservation” or community-designed utilization in two villages located in the Sopsai watershed, Nan Province, northern Thailand. The forest health under different intensity of uses is assessed in association with the collective behaviors and long-term purposes embedded in village social–cultural context. The study found no significant differences in
Nitaya Kijtewachakul; Ganesh P. Shivakoti; Edward L. Webb
Myths impede the effective management of health care, for example that the system is failing (indeed, that is a system), and can be fixed by detached social engineering and heroic leadership, or treating it more like a business. This field needs to reframe its management, as distributed beyond the "top"; its strategy as venturing, not planning; its organizing as collaboration beyond control, and especially itself, as a system beyond its parts. PMID:23342753
|This paper estimates multidimensional poverty in China by applying the Alkire-Foster methodology to the China Health and Nutrition Survey 2000-2009 data. Five dimensions are included: income, living standard, education, health and social security. Results suggest that rapid economic growth has resulted not only in a reduction in income poverty…
Quality management has become one of the most important and most debated topics within the service sector. This is especially true for health care, as the controversy rages on how the existing American system should be restructured. Health care reform aimed at reducing costs and ensuring access to all Americans cannot be allowed to jeopardize the quality of care. As such, total quality management (TQM) has become a vital ingredient to strategic planning within the health care domain. At the heart of any such quality improvement effort is the issue of measurement. TQM cannot be effectively utilized as a competitive weapon unless quality can be accurately defined, measured, evaluated, and monitored over time. Through such analysis a hospital can elect how to expend its limited resources toward those quality improvement projects which will impact customer perceptions of service quality the most. Thus, the purpose of this report is to establish a framework by which to approach the issue of quality measurement, delineate the various components of quality that exist in health care, and explore how these elements affect one another. We propose that the issue of quality measurement in health care be approached as an integration of service quality attributes common to other service organizations and technical quality attributes unique to health care. We hope that this research will serve as a first step toward the synthesis of the various quality attributes inherent in the health care domain and encourage other researchers to address the interactions of the various quality attributes. PMID:8763215
How to offer broad access to services while simultaneously containing costs? These potentially conflicting goals often collide painfully within the individual clinician. We teach an academic seminar, part of a managed mental health care fellowship organized within an HMO. As we describe the guiding principles and methods of this seminar as well as its curriculum and process, we demonstrate how
JAMES M. DONOVAN; SHARON M. STEINBERG; JAMES E. SABIN
OBJECTIVE: We wished to determine the impact of managedhealth care on resident education in obstetrics and gynecology. STUDY DESIGN: A multiquestion survey was mailed to program directors of the 267 obstetrics-gynecology resident training programs in the United States. The questions ascertained departmental philosophy regarding the role of obstetrician-gynecologists as primary care versus specialist physicians, the extent of involvement with
Ira M. Golditch; Ralph J. Anderson; Sterling B. Williams
This paper reviews the occurrence and properties of cyanobacterial toxins, with reference to the recognition and management of the human health risks which they may present. Mass populations of toxin-producing cyanobacteria in natural and controlled waterbodies include blooms and scums of planktonic species, and mats and biofilms of benthic species. Toxic cyanobacterial populations have been reported in freshwaters in over
Geoffrey A. Codd; Louise F. Morrison; James S. Metcalf
This paper describes methodologies and tools to anticipate in real-time, the onset of failures in electronic equipment. Currently developed techniques for prognostics and healthmanagement (PHM), depend on the observation of precursor variables and an imputation from them of impending failure. In electronic systems, such variables are difficult, impossible or expensive to obtain, so we propose a model-based technique utilizing
Chris Wilkinson; Dave Humphrey; Bert Vermeire; J. Houston
Prologue: The term risk contracting has become a familiar part of the vocabulary and the landscape of managed care. Risk contracting refers to an arrangement whereby the cost or claims risk for an insured population is borne by the entity that is desig- nated to bear risk: a prepaid plan or, as is increasingly the case for mental health care,
Richard G. Frank; Thomas G. McGuire; Joseph P. Newhouse
Background The unmet needs for health care have been used as an alternative measurement to monitor equity in health services. We sought to examine contextual influences on unmet needs for health care whereas precedent studies have been focused on individual characteristics on them. Methods and Findings The current study conducted multilevel logistic regression analysis to assess the effects of individual- and contextual-level predictors in meeting individual health care needs in South Korea. We sampled 7,200 individuals over the age of 19 in the Fourth Korea National Health and Nutrition Examination Survey in 2009. Included in the regression model were individual predictors such as demographic variables, socio-economic status, and self-rated health; the density of beds and physicians in public and private sectors within different regions were used as contextual-level predictors. This study showed the inverse association between unmet needs and regional resources in private sectors after controlling for the effects of individual-level predictors. Conclusion Our findings suggest that increasing regional resources in private sectors might produce inefficiency in the health care system and inequity in access to health services, particularly where the competition in private health care sectors was highly stimulated under the fee-for-service reimbursement scheme. Policies for the reallocation of health care resources and for reduction of individual health care costs are needed in Korea.
Heo, Jongho; Oh, Juwhan; Kim, Jukyung; Lee, Manwoo; Lee, Jin-seok; Kwon, Soonman; Subramanian, S. V.; Kawachi, Ichiro
|The tables in this compilation provide information about poverty and income trends in 1995. In some cases, trend data are available back to the 1950s. The first section of tables, "Poverty Trends," focuses on poverty thresholds and poverty among children. Some tables present information on poverty by ethnic group, and others present information…
Although there is a large body of research dedicated to exploring public attributions for poverty, considerably less attention has been directed to public understandings about the effects of poverty. In this paper, we describe lay understandings of the effects of poverty and the factors that potentially influence these perceptions, using data from a telephone survey conducted in 2002 on a random sample (n=1671) of adults from eight neighbourhoods in two large Canadian cities (Edmonton and Toronto). These data were supplemented with interview data obtained from 153 people living in these same neighbourhoods. Multivariate linear and logistic regressions were used to determine the effects of basic demographic variables, exposure to poverty and attribution for poverty on three dependent variables relating to the effects of poverty: participation in community life, the relationship between poverty and health and challenges facing low-income people. Ninety-one per cent of survey respondents agreed that poverty is linked to health, while 68% agreed that low-income people are less likely to participate in community life. Affordable housing was deemed especially difficult to obtain by 96%, but other resources (obtaining healthy food, giving children a good start in life, and engaging in healthy behaviours) were also viewed as challenging by at least 70% of respondents. The regression models revealed that when controlling for demographics, exposure to poverty explained some of the variance in recognising the effects of poverty. Media exposure positively influenced recognition of the poverty-health link, and attending formal talks was strongly related to understanding challenges of poverty. Attributions for poverty accounted for slightly more of the variance in the dependent variables. Specifically, structural and sociocultural attributions predicted greater recognition of the effects of poverty, in particular the challenges of poverty, while individualistic attributions predicted less recognition. Older and female respondents were more likely to acknowledge the effects of poverty. Income was positively associated with recognition of the poverty-health link, negatively associated with understanding the challenges of low-income people, and unrelated to perceptions of the negative effect of poverty on participation in community life. PMID:16218981
Reutter, Linda I; Veenstra, Gerry; Stewart, Miriam J; Raphael, Dennis; Love, Rhonda; Makwarimba, Edward; McMurray, Susan
We describe design and prototyping efforts for a Personal HealthManagement 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. PMID:20937478
Ferguson, G; Quinn, J; Horwitz, C; Swift, M; Allen, J; Galescu, L
Objectives To improve understanding of how families living in adverse conditions perceive their encounters with public services and how past experiences influence current and future attempts to seek help. Design Qualitative interviews with adult members of households living in poverty in deprived areas, plus observations conducted in the surrounding neighbourhoods and service settings. Participants Purposive sample of 25 adults living in a deprived area, on welfare benefits. Setting Eight sites in disadvantaged areas in Merseyside, North Wales, London and Greater Manchester in 2004/05. Results Participants generally perceived public services as a source of distrust and a potential risk to well?being. Encounters with a range of services were perceived as risky in terms of losing resources, being misunderstood or harshly judged, and carrying the ultimate threat of losing custody of their children. Participants perceived that they were subjected to increasing levels of surveillance, with fear of “being told on” by neighbours, in addition to service providers, adding to anxiety. Adverse consequences included avoiding child health and social services, anxiety and self?imposed isolation. Conclusions Approaching services was perceived as akin to taking a gamble that might or might not result in their needs being met. Faced with this “choice”, participants employed strategies to minimise the risks that on the surface may appear risky to health. If public services are to succeed in providing support to disadvantaged families, greater efforts are needed to build trust and demonstrate understanding for the strategies these families use to maintain their well?being against formidable odds.
Canvin, Krysia; Jones, Chris; Marttila, Anneli; Burstrom, Bo; Whitehead, Margaret
Community health psychology provides a framework for local citizens themselves to systematically affect change in health and social inequalities, particularly through Participatory Action Research (PAR). The Cambodian NGO SiRCHESI launched a 24-month Hotel Apprenticeship Program (HAP) in 2006 to provide literacy, English, social skills, health education, hotel skills-training, work experience and a living wage to women formerly selling beer in restaurants; there they had faced workplace risks including HIV/AIDS, alcohol overuse, violence and sexual coercion. Quantitative and qualitative analyses indicate changes in health-related knowledge, behaviour, self-image and empowerment, as HAP trainees were monitored and evaluated within their new career trajectories. PMID:20616182
Objectives: The research provides an overview of the health care management literature and the indexing coverage of core journal literature. Method: Citations from five source journals for the years 2002 through 2004 were studied using the protocols of the Mapping the Literature of Allied Health Project and Mapping the Literature of Nursing Project. The productivity of cited journals was analyzed by applying Bradford's Law of Scattering. Results: Journals were the most frequently cited format, followed by books. Only 3.2% of the cited journal titles from all 5 source journals generated two-thirds of the cited titles. When only the health care management practitioner–oriented source journals were considered, two-thirds of the output of cited journal titles came from 10.8% of the titles. Science Citation Index and PubMed provided the best overall coverage of the titles cited by all 5 source journals, while the cited titles from the 2 practitioner-oriented journals were covered most completely by Social Sciences Citation Index and Business Source Complete. Conclusions: Health care management is a multidisciplinary field. Librarians must consider the needs of their users and assist them by providing the necessary materials and combination of indexes to access this field adequately.
Taylor, Mary K.; Gebremichael, Meseret D.; Wagner, Catherine E.
The purpose of the study was to determine prevalent conflict management styles chosen by students in nursing and to contrast these styles with those chosen by students in allied health professions. The associations among the level of professional health care education and the style chosen were also determined. A convenience sample of 126 students in a comprehensive university completed the Thomas-Kilmann Conflict Mode Instrument (TKI), which requires respondents to choose behaviors most characteristic of their response to conflict and classifies these behaviors as one of five styles. There was no significant difference between the prevalent conflict management styles chosen by graduate and undergraduate nursing students and those in allied health. Some of the students were already licensed in their discipline; others had not yet taken a licensing exam. Licensure and educational level were not associated with choice of styles. Women and men had similar preferences. The prevalent style for nursing students was compromise, followed by avoidance. In contrast, avoidance, followed by compromise and accommodation, was the prevalent style for allied health students. When compared to the TKI norms, slightly more than one half of all participants chose two or more conflict management styles, commonly avoidance and accommodation at the 75th percentile or above. Only 9.8% of the participants chose collaboration at that level. Implications for nurse educators, researchers, and administrators are discussed. PMID:17540319
|Managed care organizations (MCOs) and school health programs share some common goals and some competing, conflicting priorities. Partnerships between the two are important for the effective coordination and delivery of comprehensive adolescent health services. This paper discusses adolescent clinical preventive services, school health services,…
Santelli, John; Vernon, Mary; Lowry, Richard; Osorio, Jenny; DuShaw, Martha; Lancaster, Mary Sue; Pham, Ngoc; Song, Elisa; Ginn, Elizabeth; Kolbe, Lloyd J.
Managed care organizations (MCOs) and school health programs share some common goals and some competing, conflicting priorities. Partnerships between the two are important for the effective coordination and delivery of comprehensive adolescent health services. This paper discusses adolescent clinical preventive services, school health services,…
Santelli, John; Vernon, Mary; Lowry, Richard; Osorio, Jenny; DuShaw, Martha; Lancaster, Mary Sue; Pham, Ngoc; Song, Elisa; Ginn, Elizabeth; Kolbe, Lloyd J.
BACKGROUND: The aim of this study was to establish the prevalence of posttraumatic stress disorder (PTSD) and depression among Rwandese and Somali refugees resident in a Ugandan refugee settlement, as a measure of the mental health consequences of armed conflict, as well as to inform a subsequent mental health outreach program. The study population comprised a sample from 14400 (n
Lamaro P Onyut; Frank Neuner; Verena Ertl; Elisabeth Schauer; Michael Odenwald; Thomas Elbert
Rangeland health assessment provides qualitative information on ecosystem attributes. Successional management is a conceptual framework that allows managers to link information gathered in rangeland health assessment to ecological processes that need to be repaired to allow vegetation to change in ...
Background The aim of this study was to establish the prevalence of posttraumatic stress disorder (PTSD) and depression among Rwandese and Somali refugees resident in a Ugandan refugee settlement, as a measure of the mental health consequences of armed conflict, as well as to inform a subsequent mental health outreach program. The study population comprised a sample from 14400 (n = 519 Somali and n = 906 Rwandese) refugees resident in Nakivale refugee settlement in South Western Uganda during the year 2003. Methods The Posttraumatic Diagnostic Scale (PDS) and the Hopkins Symptom Checklist 25 were used to screen for posttraumatic stress disorder and depression. Results Thirty two percent of the Rwandese and 48.1% of the Somali refugees were found to suffer from PTSD. The Somalis refugees had a mean of 11.95 (SD = 6.17) separate traumatic event types while the Rwandese had 8.86 (SD = 5.05). The Somalis scored a mean sum score of 21.17 (SD = 16.19) on the PDS while the Rwandese had a mean sum score of 10.05 (SD = 9.7). Conclusion Mental health consequences of conflict remain long after the events are over, and therefore mental health intervention is as urgent for post-conflict migrant populations as physical health and other emergency interventions. A mental health outreach program was initiated based on this study.
|After the introduction defined poverty and the feminization of poverty, this paper cited U.S. Census data that includes earnings, family status, and education attained which were posited as major factors for the economic condition of women. The first section on earnings presented female-dominated occupations, such as secretaries, teachers,…
|This article presents the author's rejoinder on commentaries of his article which illustrate the variety of perspectives with which people approach poverty measurement issues. Some of the comments highlight the theoretical concerns underpinning poverty measurement efforts, whereas others focus on empirical considerations. As a social scientist,…
On 24 November 1989 the Canadian House of Commons unanimously passed an all-party resolution to eliminate poverty among Canadian children by the year 2000. Yet in 2005 a report by UNICEF placed Canada nineteenth in a ranking of the relative poverty of children in 26 of the world's richest countries (Greece, Hungary, and Poland all had a significantly better record).
This commentary is designed to provide a critique of Jeffrey Sachs' The End of Poverty: How We Can Make It Happen In Our Lifetime, highlighting in particular the difficulties that arise from his focus on absolute poverty and his proposed recipe for its elimination. It begins by emphasising the many strengths of Sachs' arguments, but then suggests that these could
Since 1999 quality care issues have become a primary concern for health care organisational management. During this year, the Institute of Medicine (IOM) released a report that indicated that 98,000 preventable deaths occur each year in the US. Additionally, the report revealed that the individual competence of the practitioner is not the primary source of blame. Rather, it was the
Many laboratories focus their attention on topics like Alzheimer's research, but this laboratory at MIT focuses on poverty. The objective of their work at the Poverty Action Lab is "to improve the effectiveness of poverty programs by providing policy makers with clear scientific results that help shape successful polices to combat poverty." The Lab was started in June 2003 by a group of professors at MIT and their collaborators. Visitors to the site will note that the materials here are divided into sections that include "Research", "People", "News", and "Courses". The "Research" section is a great place to start as policy makers and others can look over their completed projects (such as "Discrimination in the Job Market") and their publications. Moving on, visitors can click on the "People" section to learn more about their staff and directors. Finally, those who are curious about the reach of the Poverty Lab's work will want to look at their media features in the "News" section.
BACKGROUND: The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for healthmanagers
Maye Omar; Nancy Gerein; Ehsanullah Tarin; Christopher Butcher; Stephen Pearson; Gholamreza Heidari
Healthmanagement is a philosophy that merges component and system level health monitoring, consisting of anomaly detection, diagnostic and prognostic technologies, with the operations and maintenance arenas. The concepts of healthmanagement, in particular health monitoring system design, have not traditionally been an integral aspect of the overall system design process. This may be partly due to the fact that
Gregory J. Kacprzynski; Michael J. Roemer; Andrew J. Hess; Ken R Bladen
Purpose – This paper's purpose is to examine the nature and correlates of poverty in Ghana. Design\\/methodology\\/approach – Using the most recently published household living standards survey; the paper computes poverty indicators using the Foster et al., and Theil's inequality indicators to examine the nature of poverty. It also does a qualitative analysis on the nature of poverty by examining
Research Findings: The purpose of this study was to investigate how neighborhoods and neighborhood socioeconomic disadvantage impact school readiness over time. School readiness was measured using the Early Development Instrument (EDI) for 3 populations of kindergartners in 2001, 2003, and 2005 in Saskatoon, Saskatchewan, Canada. EDI results revealed that mean scores for the EDI domains of (a) physical health and
Jennifer A. Cushon; Lan T. H. Vu; Bonnie L. Janzen; Nazeem Muhajarine
The impact of individual environmental and biological risks and the number of risks on the home environment of 3-year-olds is examined in a sample of low birth weight, premature infants enrolled in the Infant Health and Development Program (IHDP). The IHDP is a large clinical trial designed to test the efficacy of early intervention services. The effects of 13 risk
"Data Trends" reports present summaries of research on mental health services for children and adolescents and their families. The article summarized in this "Data Trends" asks: Does the stress and adversity associated with poverty cause mental illness or is poverty the result of downward social mobility of persons with mental illness? This is the…
Research and Training Center on Family Support and Children's Mental Health, 2004
Poverty concentration has a significant negative effect on the fiscal health of cities in that it increases spending on antipoverty programs and also raises the cost of providing more general public services such as police and fire protection. Spending patterns among Southern California cities over the last two decades show that poverty strongly influences local public expenditures after controlling for
Pascale M. Joassart-Marcelli; Juliet A. Musso; Jennifer R. Wolch
|"Data Trends" reports present summaries of research on mental health services for children and adolescents and their families. The article summarized in this "Data Trends" asks: Does the stress and adversity associated with poverty cause mental illness or is poverty the result of downward social mobility of persons with mental illness? This is…
Research and Training Center on Family Support and Children's Mental Health, 2004
|This publication offers a portrait of poverty in San Antonio (Texas) based on an analysis of available statistical data and focusing on health, education, employment, housing, and human services. Five chapters each contain statistics regarding poverty in the United States, Texas, and San Antonio. Each chapter also begins with true stories about…
In recent times there have been a proliferation of national, sectoral and local development policies on poverty eradication in the developing countries. This study of the Jamaican poverty reduction initiative aimed to find out whether some of these programmes have transcended some of the elementary policy problems that have been widely covered in the development management literature since the 1960s.
The achievement of national and international health goals requires better-performing health systems. Strengthening leadership and management of health systems thus becomes essential for achieving greater efficiency and responsiveness, ultimately improving health outcomes. Building a global framework of core competencies for leadership and management needs to be approached with systems thinking and methodologies akin to complexity science that takes into account all components and levels of the health system and the possible interactions between them that influence outcomes. The results will have important policy implications for national health authorities seeking to strengthen management capacity and building transformational leadership in health systems. PMID:23342754
The growing Latino presence in the United States underscores the need to address Latino poverty, previously overlooked in public policy discussions. Latinos are the fastest growing U.S. minority group, and Latino poverty is also rising. In 1990, one in every four Latinos was poor, and 40 percent of Latino children lived in poverty. Latino poverty…
There is growing evidence to suggest that childhood deprivation is linked to social inequalities and has important consequences for health in later life. Past studies tend to focus on the influence of cumulative deprivation on the risk of developing a particular disease. This study is innovative because it explores how deprivation in childhood may be linked to how people (who
|If developing a healthy workforce is critical to reining in the skyrocketing cost of health care, then why have so many attempts at preventive health or disease management fallen short? How can employers connect with employees to engage them in changing unhealthy habits or lifestyles? Duke University has launched an innovative new approach called…
Poverty is a widely used and understood concept but its definition is highly contested. The term'poverty'can be considered to have a cluster of different overlapping meanings depending on what subject area or discourse is being examined (Gordon and Spicker, 1998). For example, poverty, like evolution or health, is both a scientific and a moral concept. Many of the problems of
Data from 14 villages representing contrasting circumstances around the basin indicate that the incidence of poverty is higher in the flood plain than in the other parts of the basin. Within the floodplain, there are distinct patterns of poverty and livelihood dynamics in areas associated with different approaches to land ownership and irrigation management. Over the last ten years, poverty
Brent Swallow; Leah Onyango; Ruth Meinzen-Dick; Nienke Holl
Prognostics and healthmanagement (PHM) is an enabling discipline consisting of technologies and methods to assess the reliability of a product in its actual life cycle conditions to determine the advent of failure and mitigate system risk. Sensor systems are needed for PHM to monitor environmental, operational, and performance-related characteristics. The gathered data can be analyzed to assess product health and predict remaining life. In this paper, the considerations for sensor system selection for PHM applications, including the parameters to be measured, the performance needs, the electrical and physical attributes, reliability, and cost of the sensor system, are discussed. The state-of-the-art sensor systems for PHM and the emerging trends in technologies of sensor systems for PHM are presented.
Cheng, Shunfeng; Azarian, Michael H.; Pecht, Michael G.
The focus of the May-June issue is on outage management and health physics. Major articles/reports in this issue include: A design with experience for the U.S., by Michael J. Wallace, Constellation Generation Group; Hope to be among the first, by Randy Hutchinson, Entergy Nuclear; Plans to file COLs in 2008, by Garry Miller, Progress Energy; Evolution of ICRP's recommendations, by Lars-Erik Holm, ICRP; European network on education and training in radiological protection, by Michele Coeck, SCK-CEN, Belgium; Outage managment: an important tool for improving nuclear power plant performance, by Thomas Mazour and Jiri Mandula, IAEA, Austria; and Plant profile: Exploring new paths to excellence, by Anne Thomas, Exelon Nuclear.
The focus of the May-June issue is on outage management and health physics. Major articles include: Outage optimization initiatives, by George B. Beam, AREVA NP, Inc.; New plant based on excellent track records, by Jim Scarola, Progress Energy; Meeting customer needs and providing environmental benefits, by Peter S. Hastings, Duke Energy; Plants with 3-D design, by Jack A. Bailey, Tennessee Valley Authority; and Highest quality with exceptional planning, by Jason A. Walls, Duke Energy. Industry innovation articles include: Integrated exposure reduction plan, by Ed Wolfe, Exelon; Performance-based radiation worker training, by Joe Giuffre and Timothy Vriezerma, American Electric Power.
Are there additional costs associated with achieving goals of sustainable health care? Will going green enhance or impede financial performance? These are questions that all health care managers should confront, yet there is little evidence to show that health care sustainability is affordable or profitable. This article considers what is presently known and suggests that health care managers use an assessment framework to determine whether they are ready to achieve health care sustainability. PMID:21808179
A number of international organizations are committed to helping end child poverty, and one of the best known of their number is the Global Volunteer Network. Through their advocacy work and the Stop Child Poverty campaign, they are dedicated to the proposition that child poverty can be completed eradicated. Through sections titled "Learn It", "Live It", and "Pass it On", visitors to this site will learn about the "big picture" of child poverty and how they can become directly involved in any number of volunteer projects. The "Pass It On" area is quite fine in this regard, as visitors can look over a message board where they can discuss the campaign, and then use a zip-code search engine to find volunteer opportunities in their area.
Leishmaniasis, a neglected tropical disease, has strong but complex links with poverty. The burden of leishmaniasis falls disproportionately on the poorest segments of the global population. Within endemic areas, increased infection risk is mediated through poor housing conditions and environmental sanitation, lack of personal protective measures and economically driven migration and employment that bring nonimmune hosts into contact with infected sand flies. Poverty is associated with poor nutrition and other infectious diseases, which increase the risk that a person (once infected) will progress to the clinically manifested disease. Lack of healthcare access causes delays in appropriate diagnosis and treatment and accentuates leishmaniasis morbidity and mortality, particularly in women. Leishmaniasis diagnosis and treatment are expensive and families must sell assets and take loans to pay for care, leading to further impoverishment and reinforcement of the vicious cycle of disease and poverty. Public investment in treatment and control would decrease the leishmaniasis disease burden and help to alleviate poverty. PMID:17023215
This paper deals with the evaluation of poverty sensitivity to growth and distributional changes in Italy, across its regions and over a three- decade period, spanning from 1977 to 2004. We use the \\\\Survey on Household Income and Wealth\\
OBJECTIVE--To examine whether the historical link between tuberculosis and poverty still exists. DESIGN--Retrospective study examining the notifications of all forms of tuberculosis by council ward over a six year period and correlating this with four indices of poverty; council housing, free school meals, the Townsend overall deprivation index, and the Jarman index. SETTING--The 33 electoral wards of the city of
Presents models suggesting how research evidence can best be operationalised within health care commissioning. Models were derived from data gathered from surveys of Scottish health board managers and GP fundholders regarding the use of information in commissioning from 1995 to 1997. Feedback on the models was obtained subsequently from practitioners in 1998. Two models, one for health board managers and
The implementation of managed care for children with special health care needs is often associ- ated with apprehension regarding new barriers to health care services. At times, these barriers may overshadow opportunities for improvement. This statement discusses such opportunities, identifies challenges, and proposes active roles for pediatricians and families to improve managed care for children with special health care needs.
It has been said that managing change is a synonym for managing people through change. No other industry has experienced more change in the past ten years than the health-care industry. In order to regulate all of this change, managers in health-care organizations must identify new ways to deal with the changes. The issues are as old as time: job
|Curriculum objectives for health care financial management, a bibliography and examples of financial management curricula are presented. The outline of curriculum objectives identifies a core of knowledge and skills in financial management that health administration students might obtain in their academic training. The outline's content is…
September 1999Research confirms that poor child growth outcomes in Guatemala are the result of widespread poverty. The better the parents' education and household income, the less likely children are to suffer from malnutrition. Children also fare better where community infrastructure (such as piped water and garbage disposal) and health care facilities are better.Gragnolati investigates the extent and determinants of poor
The relationship between poverty and human development touches on a central aim of the International Breastfeeding Journal's editorial policy which is to support and protect the health and wellbeing of all infants through the promotion of breastfeeding. It is proposed that exclusive breastfeeding for 6 months, followed by continued breastfeeding to 12 months, could prevent 1,301,000 deaths or 13% of
|This book combines scholarship and personal experiences as several facets of the urban experience are investigated. Eight major chapters focus on poverty, unemployment, welfare, law enforcement, urban finance, housing, education, and health care. Each chapter examines each problem and provides recommendations for dealing with it. The chapter on…
Good management, supported by accurate, timely and reliable health information, is vital for increasing the effectiveness of Health Information Systems (HIS). When it comes to managing the under-resourced health systems of developing countries, information-based decision making is particularly important. This paper reports findings of a self-report survey that investigated perceptions of local healthmanagers (HMs) of their own regional HIS in Sri Lanka. Data were collected through a validated, pre-tested postal questionnaire, and distributed among a selected group of HMs to elicit their perceptions of the current HIS in relation to information generation, acquisition and use, required reforms to the information system and application of information and communication technology (ICT). Results based on descriptive statistics indicated that the regional HIS was poorly organised and in need of reform; that management support for the system was unsatisfactory in terms of relevance, accuracy, timeliness and accessibility; that political pressure and community and donor requests took precedence over vital health information when management decisions were made; and use of ICT was unsatisfactory. HIS strengths included user-friendly paper formats, a centralised planning system and an efficient disease notification system; weaknesses were lack of comprehensiveness, inaccuracy, and lack of a feedback system. Responses of participants indicated that HIS would be improved by adopting an internationally accepted framework and introducing ICT applications. Perceived barriers to such improvements were high initial cost of educating staff to improve computer literacy, introduction of ICTs, and HIS restructure. We concluded that the regional HIS of Central Province, Sri Lanka had failed to provide much-needed information support to HMs. These findings are consistent with similar research in other developing countries and reinforce the need for further research to verify causes of poor performance and to design strategic reforms to improve HIS in regional Sri Lanka. PMID:23087080
Home health aides are at the front line of the home health industry, raising quality of care issues and human resource (HR) management challenges. Total quality management (TQM) provides a framework to help meet those challenges. The authors investigated the relationship between TQM and HR effectiveness in home health agencies. Results suggest that TQM practices are related to HR effectiveness. Suggestions are offered to make human resource management consistent with a TQM culture. PMID:8968324
We report on quantitative techniques for managinghealth information as well as for the marketing and the management of health libraries and other health information centres. Important for marketing and management of libraries are the p.r. (public relations) and p.a. (public awareness) activities. We discuss reports (e.g. case studies, annual reports, ...) as important tools in this and pay special
This article uses a pyramid model to illustrate the key components of consumer-directed health care. Consumer-directed health care is considered the essential strategy needed to lower health care costs and is valuable for making significant strides in health care reform. Consumer-directed health care presents new challenges and opportunities for all health care stakeholders and their managers. The viability of the health system depends on the success of managers to respond rapidly and with precision to changes in the system; thus, new and modified roles of managers are necessary to successfully sustain consumerism efforts to control costs while maintaining access and quality. PMID:20436329
The government often uses the Federal Employees Health Benefits (FEHB) Program as a model for both public and private health policy choices. In 2001, the U.S. Office of Personnel Management (OPM) implemented full parity, requiring that FEHB carriers offer mental health and substance abuse benefits equal to general medical benefits. OPM instructed carriers to alter their benefit design but permitted them to determine whether they would manage care and what structures or processes they would use. This article reports on the experience of 156 carriers and the government-wide BlueCross and BlueShield Service Benefit Plan. Carriers dropped cost-restraining benefit limits. A smaller percentage also changed the management of the benefit, but these changes affected the care of many enrollees, making the overall parity effect noteworthy.
Ridgely, M Susan; Burnam, M Audrey; Barry, Colleen L; Goldman, Howard H; Hennessy, Kevin D
Medicaid provides health insurance for 54 million Americans. Using the Census Bureau's Supplemental Poverty Measure (which subtracts out-of-pocket medical expenses from family resources), we estimated the impact of eliminating Medicaid. In our counterfactual, Medicaid beneficiaries would become uninsured or gain other insurance. Counterfactual medical expenditures were drawn stochastically from propensity-score-matched individuals without Medicaid. While this method captures the importance of risk protection, it likely underestimates Medicaid's impact due to unobserved differences between Medicaid and non-Medicaid individuals. Nonetheless, we find that Medicaid reduces out-of-pocket medical spending from $871 to $376 per beneficiary, and decreases poverty rates by 1.0% among children, 2.2% among disabled adults, and 0.7% among elderly individuals. When factoring in institutionalized populations, an additional 500,000 people were kept out of poverty. Overall, Medicaid kept at least 2.6 million-and as many as 3.4 million-out of poverty in 2010, making it the U.S.'s third largest anti-poverty program. PMID:23835200
This study examined whether the relationship between high poverty and infant mortality rates (IMRs) varied across race- and ethnic-specific populations in large urban areas. Data were drawn from 1990 Census and 1992-1994 Vital Statistics for selected U.S. metropolitan areas. High-poverty areas were defined as neighborhoods in which > or = 40% of the families had incomes below the federal poverty threshold. Bivariate models showed that high poverty was a significant predictor of IMR for each group; however, multivariate analyses demonstrate that maternal health and regional factors explained most of the variance in the group-specific models of IMR. Additional analysis revealed that high poverty was significantly associated with minority-white IMR disparities, and country of origin is an important consideration for ethnic birth outcomes. Findings from this study provide a glimpse into the complexity associated with infant mortality in metropolitan areas because they suggest that the factors associated with infant mortality in urban areas vary by race and ethnicity.
This study examined whether the relationship between high poverty and infant mortality rates (IMRs) varied across race- and ethnic-specific populations in large urban areas. Data were drawn from 1990 Census and 1992-1994 Vital Statistics for selected U.S. metropolitan areas. High-poverty areas were defined as neighborhoods in which > or = 40% of the families had incomes below the federal poverty threshold. Bivariate models showed that high poverty was a significant predictor of IMR for each group; however, multivariate analyses demonstrate that maternal health and regional factors explained most of the variance in the group-specific models of IMR. Additional analysis revealed that high poverty was significantly associated with minority-white IMR disparities, and country of origin is an important consideration for ethnic birth outcomes. Findings from this study provide a glimpse into the complexity associated with infant mortality in metropolitan areas because they suggest that the factors associated with infant mortality in urban areas vary by race and ethnicity. PMID:17444423
Abstract This paper considers how operational research and management science can improve the design of health systems and the delivery of health care, particularly in low-resource settings. It identifies some gaps in the way operational research is typically used in global health and proposes steps to bridge them. It then outlines some analytical tools of operational research and management science and illustrates how their use can inform some typical design and delivery challenges in global health. The paper concludes by considering factors that will increase and improve the contribution of operational research and management science to global health.
Health care waste is considered a major public health hazard. The objective of this study was to assess health care waste management (HCWM) practices currently employed at health care centers (HCCs) in the West Bank – Palestinian Territory. Survey data on solid health care waste (SHCW) were analyzed for generated quantities, collection, separation, treatment, transportation, and final disposal. Estimated 4720.7m3
The African continent is distinguished by a much higher fertility rate than other regions. Fertility in Africa has remained almost constant at slightly over six children per woman on average, while important declines have occurred elsewhere over the past 25 years. High fertility in Africa is often attributed to poor diffusion of family planning, early marriage, and low female educational attainment, but other cultural and economic factors are involved. The significant decline of infant mortality over the past several decades has produced growth rates never before observed. Africa's very young populations may be at the origin of uncontrollable political disorder, as young persons with bleak prospects fall easy prey to ethnic, religious, and political extremism. Demographic growth has become an additional barrier to development. High fertility is tolerated or encouraged as constituting a cultural trait, but the resulting population growth is not a cultural trait. Demographic pressure has increased environmental problems in many regions. It is estimated that over ten million rural residents of the Sahel have been affected by soil degradation. The per capita availability of arable land fell from one-half to one-third hectare between 1965 and 1987. Shortages of firewood and water have become more common. The relationship between demographic growth, environmental crisis, and poverty in the countryside depends on other factors such as production techniques, modes of access to land and water, and the degree of security of land tenure. Population pressure was not the initial factor that disturbed the balance of the traditional societies, but it exacerbated the effects of other forces such as the introduction of cash crops and monetarization of the economy. Rural exodus and accelerated urban migration have been prompted in large part by the higher incomes and greater availability of services of all types in the cities. Achieving control of fertility in Africa will require stabilization of rural populations, territorial management, and reduction of disparities between rural and urban areas. PMID:12179395
The focus of the May-June issue is on outage management and health physics. Major articles include the following: Planning and scheduling to minimize refueling outage, by Pat McKenna, AmerenUE; Prioritizing safety, quality and schedule, by Tom Sharkey, Dominion; Benchmarking to high standards, by Margie Jepson, Energy Nuclear; Benchmarking against U.S. standards, by Magnox North, United Kingdom; Enabling suppliers for new build activity, by Marcus Harrington, GE Hitachi Nuclear Energy; Identifying, cultivating and qualifying suppliers, by Thomas E. Silva, AREVA NP; Creating new U.S. jobs, by Francois Martineau, Areva NP. Industry innovation articles include: MSL Acoustic source load reduction, by Amir Shahkarami, Exelon Nuclear; Dual Methodology NDE of CRDM nozzles, by Michael Stark, Dominion Nuclear; and Electronic circuit board testing, by James Amundsen, FirstEnergy Nuclear Operating Company. The plant profile article is titled The future is now, by Julia Milstead, Progress Energy Service Company, LLC.
The poultry industry in the USA is a fully integrated system of animal agriculture. Each company has control over the bird husbandry and healthmanagement aspects of production, including the use of antimicrobial agents. The three segments of the industry-broiler chickens, turkeys, and layer chickens-have few antibiotics available for the therapeutic treatment of bacterial diseases. Prior to approval of the fluoroquinolones, tetracyclines were the major antibiotics approved for the treatment of the most economically important disease in broiler chickens and turkeys, Escherichia coli airsacculitis. This resulted in levels of resistance to the tetracyclines in clinical E. coli isolates in excess of 90%. The integrated nature of the poultry industry lends itself well to preventive medicine utilizing the tools of biosecurity and vaccination. Therefore, very few flocks of birds require antibiotic therapy. When a flock must be treated, the poultry veterinarian will usually base the recommendation of the drug to use on culture and antibiogram results. PMID:23570167
The focus of the May-June issue is on outage management and health physics. Major articles/reports in this issue include: India: a potential commercial opportunity, a U.S. Department of Commerce Report, by Joe Neuhoff and Justin Rathke; The changing climate for nuclear energy, by Skip Bowman, Nuclear Energy Insitute; Selecting protective clothing, by J. Mark Price, Southern California Edison; and Succssful refurbishment outage, by Sudesh K. Gambhir, Omaha Public Power District. Industry innovation articles in this issue are: Containment radiation monitoring spiking, by Michael W. Lantz and Robert Routolo, Arizona Public Service Company; Improved outage performance, by Michael Powell and Troy Wilfong, Arizona Public Service Company, Palo Verde Nuclear Generating Station; Stop repacking valves and achieve leak-free performance, by Kenneth Hart, PPL Susquehanna LLC; and Head assembly upgrade package, by Timothy Petit, Dominion Nuclear.
\\u000a Health informatics has the potential to improve the quality and provision of care while reducing the cost of health care delivery.\\u000a However, health informatics is often falsely regarded as synonymous with information management (IM). This chapter (i) provides\\u000a a clear definition and characteristic benefits of health informatics and information management in the context of health care\\u000a delivery, (ii) identifies and
Regina Gyampoh-Vidogah; Robert Moreton; David Sallah
As their populations age, many countries are facing the increasing economic pressure of providing healthcare to their people. In Taiwan, this problem is exacerbated by an increasing rate of obesity and obesity-related conditions. Encouraging the adoption of personal healthmanagement services is one way to maintain current levels of personal health and to efficiently manage the distribution of healthcare resources. This study introduces Mobile HealthManagement Services (MHMS) and employs the Technology Acceptance Model (TAM) to explore the intention of students in Executive Master of Business Management programs to adopt mobile healthmanagement technology. Partial least squares (PLS) was used to analyze the collected data, and the results revealed that "perceived usefulness" and "attitude" significantly affected the behavioral intention of adopting MHMS. Both "perceived ease of use" and "perceived usefulness," significantly affected "attitude," and "perceived ease of use" significantly affected "perceived usefulness" as well. The results also show that the determinants of intention toward MHMS differed with age; young adults had higher intention to adopt MHMS to manage their personal health. Therefore, relevant governmental agencies may profitably promote the management of personal health among this population. Successful promotion of personal healthmanagement will contribute to increases in both the level of general health and the efficient management of healthcare resources. PMID:20878452
People in southern Africa are facing escalating levels of risk, uncertainty and consequently vulnerability as a result of multiple interacting stressors, including HIV\\/AIDS, poverty, food insecurity, weak governance, climate change and land degradation, to name but a few. Vulnerability or livelihood insecurity emerges when poor people as individuals or social units have to face harmful threats or shocks with inadequate
People in southern Africa are facing escalating levels of risk, uncertainty and consequently vulnerability as a result of multiple interacting stressors, including HIV\\/AIDS, poverty, food insecurity, weak governance, climate change and land degradation, to name but a few. Vulnerability or livelihood insecurity emerges when poor people as individuals or social units have to face harmful threats or shocks with inadequate
There is a body of evidence, and a group of advocates, supporting the need for integrated system healthmanagement for space exploration systems. The advocates include operators responsible for complex and inherently risky decisions, and the technologists working in the domain of healthmanagement and looking for application for their products. Others in the decision loops take the view that
This article reviews the forces leading to the current emphases on managed mental health systems. Rapidly escalating costs, especially for inpatient care, and associated concerns for quality and patient outcomes, have led third-party payers and employers to demand more eifective cost and quality controls. The article describes and illustrates methodologies for managing mental health costs, and reviews issues related to
|Introduction: For more than 70 years, health care management in the Soviet Union reflected a centralized directive style familiar to the Soviet political system. Market-oriented reform in post-Soviet Russia is pushing practicing physicians and physician-executives to acquire new information and skills regarding health care management. To assist…
The articles in this special section of the Journal of Behavioral Health Services & Research (30:1) present results from evaluations of publicly funded managed care initiatives for substance abuse and mental health treatment in Arizona, Iowa, Maryland, and Nebraska. This overview outlines the four managed care programs and summarizes the results from the studies. The evaluations used administrative data and
The movement towards managed care in the public mental health system has surpassed efforts to develop a systematic literature concerning its theory, practice, and outcome. In particular little has been written about potential challenges and difficulties in translating managed care systems from their origins in the private sector to the delivery of public sector mental health services. This paper provides
Brian J. Cuffel; Lonnie Snowden; Mary Masland; Giorgio Piccagli
The link between high fertility and poverty is well established. However, this paper shows how infertility may also generate poverty among childless families in Bangladesh. An ethnographic study was conducted, involving various qualitative research methods that revealed economic consequences to be one of the crucial sequelae of childlessness in Bangladesh. This paper details how the poverty/fertility relationship is dependent on social and institutional characteristics, including patriarchal values, education, urban-rural location and health services. Empirical data show that childlessness generates poverty in various ways, including the deprivation of children's earnings, decline in women's mobility, demoralisation of men to earn an income, marriage devaluation by the husband, disbursements for treatment and denial of microcredit (very small loans to those in poverty, which support them to become self-employed to generate income). The current study shows that the infertility/poverty relationship is mostly contingent upon class and gender. It is therefore the rural poor childless women who are most badly affected economically in Bangladesh rather than the urban middle class childless women. In other words, this study reveal that along with gender, class plays a dominant role in terms of the economic consequences of childlessness in Bangladesh. It sheds light on a different and unusual aspect of poverty and aims to contribute to the gender discussion of livelihood and poverty. PMID:22313219
Poverty incidence has been declining in the Philippines over the past 10 years. However, with the advent of the Asian crisis in 1997, there was a reversal in poverty trends. Estimates indicate that the headcount index has gone up to 40 percent in 1998 from 31.8 percent in 1997. Other nonincome-based measures of poverty also suggest deterioration in the welfare
Rapid change in the health care environment mandates a more comprehensive approach to the education of future health administrators. The area of consideration in this study is that of health care strategic management. A comprehensive literature review suggests microcomputer-based simulation as an appropriate vehicle for addressing the needs of both educators and students. Seven strategic management software packages are reviewed and rated with an instrument adapted from the Infoworld review format. The author concludes that a primary concern is the paucity of health care specific strategic management simulations.
Intensive Health Care at Home Kids can need intensive health care at home after they have been in the hospital ... dolls to help you practice different procedures. Home Health Care Assistance The hospital social worker can help families ...
The sickle cell disease is a genotypic affection, suited to the black race, characterized by the presence of an abnormal haemoglobin S (HbS). The purpose of this survey was to assess the knowledge, the attitudes and the practices of the health professionals on management of children with sickle cells diseases. We carried out a cross-sectional survey in the health centres and involved 140 health professional of Community Health Centres (CSCOM) and 6 health districts in Bamako. The study found that 72% of health professionals had between 24 and 39 year old; 39% were physician; 77% didn't know the name of the drugs used in case of non complicate sickle cells diseas. Among the health professionals, 81% knew that the sickle cells disease was a blood illness. Our findings suggest that management of children with sickle cells diseases was not performed better due to the knowledge insufficiency of health professionals. We recommend training the health staff. PMID:19434959
Large employers are beginning to create much more robust and potentially effective systems of integrated healthmanagement interventions. This organization-wide activity is referred to as a "Population HealthManagement" (PHM) approach. Best practices are also beginning to emerge in this area, and a number of technical developments are helping shape the patterns of response from innovative employers. This initiative is rapidly emerging as a critical part of overall business and health care strategy. PMID:16706008
The purpose of this paper is to describe the development and use of management support measures in two worksite health promotion\\u000a intervention trials. Results from the two intervention trials suggest that management support for health promotion can be\\u000a assessed and tracked over time using both perceptual and observational measures. These results also provide initial evidence\\u000a that an increase in management
David M. Dejoy; Heather M. Bowen; Kristin M. Baker; Bethany H. Bynum; Mark G. Wilson; Ron Z. Goetzel; Rod K. Dishman
This report synthesizes the collective experiences of four managed behavioral health care organizations (MBHOs) that hold public sector managed care carve-out contracts. Four representatives of these MBHOs participated in a daylong focus group meeting, an...
The poor are disproportionately vulnerable to environmental change because they have the least amount of resources with which to adapt, and they live in areas (e.g. flood plains, low-lying coastal areas, and marginal drylands) that are particularly vulnerable to the manifestations of climate change. By quantifying the various environmental, economic, and social factors that can contribute to poverty, we identify
G. van der Vink; E. Franco; N. S. Fuckar; E. R. Kalmbach; E. Kayatta; K. Lankester; R. E. Rothschild; A. Sarma; M. L. Wall
There is no necessary connection between pov erty and income distribution. When poverty is defined by relative measures, the proportion of impoverished families is the same as it was in 1950. As a result, the urban problems of the United States have been exacerbated. What people spend on house paint, how they travel to work, how long they send their
|This collection documents how far we still are in the United States from putting our knowledge about child well being and policy into practice. It provides an overview of the changing nature of child poverty in the United States through the contributions of authors who use a number of qualitative and quantitative approaches to look at children in…
|This contribution suggests that if we are serious about adult education in the context of poverty eradication we require some shifts away from neo-liberal assumptions and values. Women and/in the informal economy should become the central focus, and livelihood studies would better allow us to understand the complex daily struggle for food and the…
Books in the Opposing Viewpoints Series present debates about current issues that can be used to teach critical reading and thinking skills. The varied opinions in each collection explore aspects of a social, cultural, or political issue. A great deal of money has been spent in this country to eradicate poverty, but the problem remains. Some…
Using a rice village in the Philippines as a social observatory, the impacts of modernization forces under globalization on rural poverty are assessed based on data collected from recurrent household surveys over the past three decades. After cultivation frontiers closed in the early 1950s relentless population increases continued to press hard on limited land resources in this village. This pauperizing
|Geography teachers can use mathematics to teach fourth, fifth, and sixth grade students about critical global issues. Five sample problems concerning population, poverty, waste, the arms race, and hunger are presented. The global issue related to each problem is discussed, and the solution and mathematical skill are provided. (RM)|
The aim of the present paper is to understand the relationship between malnutrition and poverty, and how to generate ideas and concepts for developing studies leading to policy and programme implementation in the context of establishing collaborating networks among South-East Asian Ministers of Education Organization (SEAMEO) centres. Malnutrition is found at all stages of life, from the fetus to older
Poverty remains an endemic state ofman. The curse imposed by an angry god on Adam and his descendants describes the human fate. Man experienced over history, with rare exceptions, toil, hard- ship and oppression. The uncertain and stringent conditions of life challenged man's awareness. He sought foranswers explaining this fate and these were couched in the form ofmyths and legends.
|These guidelines are the product of a new Pediatric Asthma Initiative aimed at integrating environmental management of asthma into pediatric health care. This document outlines competencies in environmental health relevant to pediatric asthma that should be mastered by primary health care providers, and outlines the environmental interventions…
Reviews the changes managedhealth care has brought to the delivery and use of medical services and recommends specific steps that will make the existing system more responsive to the needs of children. Systemwide health care reforms must give children stable medical care that emphasizes preventive health and developmental services. (SLD)
Deal, Lisa W.; Shiono, Patricia H.; Behrman, Richard E.
During World War II Mexican and US health professionals and organizations constructed a transnational organizational field to manage the border's public health problems. Despite barriers to inter-organizational cooperation, including disparate administrative structures and North–South stratification, the field's transnational approach to health on the border has continued for 60 years. Using archival data to track changes in the number and types
This pilot study assessed occupational health and safety (OHS) management system audit finding reliability using a modified test–retest method. Two industrial hygienists with similar training and education conducted four, 1-day management system audits in four dissimilar organizational environments. The researchers examined four auditable sections (employee participation, training, controls, and communications) contained in a publicly available OHS management system assessment instrument.
Integration of occupational health and safety matters into environmental management systems can bring many benefits to industrial companies. They can avoid duplicated measures and find optimal solutions, because the principles of prevention are similar in environmental protection and safety management. However, the methods currently used in environmental management and engineering such as life-cycle assessments, best available technology reports, and the
Providing care to children with special health care needs within a managed care environment presents special challenges for providers and parents alike. The goal of managed care is to contain costs by encouraging or requiring members to obtain services through a designated network. In managed care programs, children and families may experience limited access to specialized care and services, along
The management of change within a clinical health information technology (HIT) project traditionally focuses on cost, schedule and scope, considered ldquohardrdquo change management (CM). Despite massive funding, clinical HIT projects continue to fail suggesting that the management of risk associated with hard change elements alone, is not effective. The cause of clinical HIT failure is usually attributed to user resistance
Disability is both a cause and consequence of poverty. Eliminating world poverty is unlikely to be achieved unless the rights and needs of people with disabilities are taken into account. According to the United Nations, one person in 20 has a disability. More than three out of four of these live in a developing country. More often than not they are among the poorest of the poor. Recent World Bank estimates suggest they may account for as many as one in five of the world's poorest. Disability limits access to education and employment, and leads to economic and social exclusion. Poor people with disabilities are caught in a vicious cycle of poverty and disability, each being both a cause and a consequence of the other. A large proportion of disability is preventable. Achieving the international development targets for economic, social and human development will undoubtedly reduce the levels of disability in many poor countries. However, general improvements in living conditions will not be enough. Specific steps are still required, not only for prevention, but also to ensure that people with disabilities are able to participate fully in the development process, obtain a fair share of the benefits, and claim their rights as full and equal members of society. An integrated approach is required, linking prevention and rehabilitation with empowerment strategies and changes in attitudes. This paper assesses the significance of disability as a key development issue, and its importance in relation to poverty, human rights, and the achievement of internationally agreed development targets. It also sets out ways in which development co-operation, including DFID's own work, can help incorporate the rights and needs of people with disabilities into the mainstream of poverty reduction work and the achievement of human rights. PMID:12221831
The poor are disproportionately vulnerable to environmental change because they have the least amount of resources with which to adapt, and they live in areas (e.g. flood plains, low-lying coastal areas, and marginal drylands) that are particularly vulnerable to the manifestations of climate change. By quantifying the various environmental, economic, and social factors that can contribute to poverty, we identify populations that are most vulnerable to poverty and poverty traps due to environmental change. We define vulnerability as consisting of risk (probability of event and exposed elements), resiliency, and capacity to respond. Resiliency captures the social system's ability to absorb a natural disaster while retaining the same basic structure, organization, and ways of functioning, as well as its general capacity to adapt to stress and change. Capacity to respond is a surrogate for technical skills, institutional capabilities, and efficacy within countries and their economies. We use a "climate change multiplier" to account for possible increases in the frequency and severity of natural events due to climate change. Through various analytical methods, we quantify the social, political, economic, and environmental factors that contribute to poverty or poverty traps. These data sets are then used to determine vulnerability through raster multiplication in geospatial analysis. The vulnerability of a particular location to climate change is then mapped, with areas of high vulnerability clearly delineated. The success of this methodology indicates that it is indeed possible to quantify the effects of climate change on global vulnerability to natural disasters, and can be used as a mechanism to identify areas where proactive measures, such as improving adaptation or capacity to respond, can reduce the humanitarian and economic impacts of climate change.
van der Vink, G.; Franco, E.; Fuckar, N. S.; Kalmbach, E. R.; Kayatta, E.; Lankester, K.; Rothschild, R. E.; Sarma, A.; Wall, M. L.
This analysis uses in-depth interview data collected from 145 African American, European American and Native American men and women aged 70 and older who reside in two rural North Carolina counties to understand the role of religious faith and prayer in the health self-management of these older adults. The analysis addresses three specific questions: how do these older adults use religion to help them manage their health; are there ethnic and gender differences in the use of religion; and are differences in health status related to differences in the use of religion? The integral role of religion in the lives of these older rural adults is an overarching theme present in the interview texts. Six major themes link religion and health self-management: (1) prayer and faith in health self-management, (2) reading the Bible, (3) church services, (4) mental and spiritual health, (5) stories of physical healing, and (6) ambivalence. Faith and religious activities provide an anchor in the lives of these older adults. There is little variation in the use of religion for health self-management by gender, ethnicity or health status. These results suggest that the strength of religion in rural culture may limit the effectiveness of general religiosity scales to discern the relationship of religion to health and health behavior in rural populations. PMID:14618010
This article explores identity dynamics in public health working at the level of the institutional identity ascribed to public health professionals, and the identity work that public health workers perform. Drawing on focus group research with school nurses and community midwives in England, the article identifies two important but neglected areas for interrogating public health worker's identity work: boundary management
This paper develops an aggregate macro framework that captures the links between foreign aid, the level and composition of public investment, growth, and poverty reduction. Foreign aid is decomposed into food and non- food assistance, whereas public investment is disaggregated into spending on education, infrastructure, and health. Both supply- and demand-side effects of (quality-adjusted) public capital in infrastructure are accounted
Pierre-Richard Agénor; Nihal Bayraktar; Karim El Aynaoui
While the challenges of the next pandemic outbreak are overwhelming, either from swine flu, other infectious disease, bioterrorism, timely detection of disease outbreaks is most important for public health surveillance and society safety and stability. In public health surveillance, the objective is to systematically collect, analyze, and interpret public health data (chronic or infectious diseases) in order to understand trends,
In 2009, the City of Toronto, Ontario, Canada, experienced a six-week labor disruption involving 24,000 city workers that included solid waste and public health employees. In an attempt to control illegal dumping and to manage garbage storage across the city during this period, 24 temporary garbage storage sites were established by the city (mostly in local parks) for residents to dispose of their household waste. No other municipality in North America has attempted to operate this many temporary sites for this long a period. Management and nonunion staff from Healthy Environments in Toronto Public Health performed daily inspections, responded to community questions, issued public health orders, and worked closely with Solid Waste Management and the Ministry of the Environment to actively manage the public health concerns associated with these sites. This intensive oversight mitigated public health risks to the community and facilitated an effective, safe solution to the temporary garbage storage problem. PMID:22010330
Murti, Michelle; Ayre, Reg; Shapiro, Howard; de Burger, Ron
Pesticides have a role in public health as part of sustainable integrated mosquito management. Other components of such management include surveillance, source reduction or prevention, biological control, repellents, traps, and pesticide-resistance management. We assess the future use of mosquito control pesticides in view of niche markets, incentives for new product development, Environmental Protection Agency registration, the Food Quality Protection Act, and improved pest management strategies for mosquito control.
Child poverty in the United States persists despite a range of social services designed to reduce poverty rates and improve the economic self-sufficiency of families. The economic downturns resulting in job losses and the housing crisis have converged to create a new group of families who were managing to remain out of poverty prior to the recession but are now
Elizabeth K. Anthony; Bryn King; Michael J. Austin
The Business Coalition on Health is concerned about the future of Connecticut's health care system and its ability to provide high quality care that is accessible to state residents. The development of medical technologies and interventions to improve the...
Do infants reared in poverty exhibit certain physiological traits that make them susceptible to the positive and negative features of their caregiving environment? Guided by theories of differential susceptibility and biological sensitivity to context, we evaluated whether high baseline respiratory sinus arrhythmia (RSA) operates as a susceptibility factor among infants reared in poverty (N = 73). Baseline RSA at 5 months, the quality of the attachment relationship at 17 months, and the interaction of these two factors were included in our models as predictors of problem behavior at 17 months. Consistent with theory, results showed no significant differences in problem behavior among infants with low baseline RSA; however, infants with high baseline RSA exhibited the lowest levels of problem behavior if reared in an environment that fostered security, and they exhibited the highest levels of problem behavior if reared in an environment that fostered disorganization. These results have important implications for the psychological health of infants living in poverty.
Conradt, Elisabeth; Measelle, Jeffrey; Ablow, Jennifer C.
The management capabilities and performance of primary health care (PHC) can be improved by strengthening the information system. This study focuses on the Palestinian HealthManagement Information System (HMIS), used in PHC and reports on the achievements and shortcomings. A retrospective review and content analysis of the HMIS documentation was carried out and a Strengths, Weaknesses, Opportunities, and Threats (SWOT)
Tayser Abu Mourad; Mohammed A. Afifi; Suzanne Shashaa; Dimitris Kounalakis; Christos Lionis; Anastas Philalithis
The annual health devices achievement award competition provides a valuable opportunity for us to learn about--and share--some of the outstanding technology management initiatives implemented by our members. This year's top submissions describe best practices and effective techniques that other healthcare facilities can emulate to improve patient safety, reduce costs, and facilitate better strategic management of health technology. PMID:21309305
|This article examines the impact of poverty on the quality of life in families of children with disabilities. A literature review found a variety of effects of poverty on the five dimensions of family, including health (e.g., hunger, limited health care access), productivity, physical environment, emotional well-being, and family interaction.…
Park, JiYeon; Turnbull, Ann P.; Turnbull, H. Rutherford, III
This English version of >u>Poverty in Japan>\\/u> is based mainly on a series of seminar reports delivered by individual chapter authors at the Japan Economic Research Center in August 1975 and published in the >u>Japan Economic Research Center Bulletin>\\/u>, No. 256 (September 15, 1975), 35-59, and No. 257 (October 1, 1975), 40-45. In preparing the English version, the reports were
|Purpose--The purpose of this paper is to investigate the dramatic reforms in the health service in recent years. Design/methodology/approach--Examines management development in health care, and explores the experiences of clinical nurse managers. Findings--Duplication of agencies and multiplication of roles have led to tensions in terms of both…
This article looks at household and individual poverty rates in Venezuela over the past seven years. For more than a year, the statement that poverty in Venezuela has increased under the government of President Hugo Chávez has appeared in scores of major newspapers, on major television and radio programs, and even in publications devoted to foreign policy. There are no data to support such statements, and in fact the available data show a decline in poverty for both individuals and households over the seven-year period: the percentage of people in poverty declined from 50 percent in the first quarter of 1999 to 43.7 percent in 2005. Further, there is no evidence to suggest any change in the methodology for measuring poverty during this period, as has been alleged in a number of reports. The article also examines briefly the impact of significant changes in non-cash benefits such as free health care, which are not taken into account in the measured poverty rate, on poor people in Venezuela. Finally, the authors look at how the mistakes in reporting on Venezuela's poverty rate were made; an appendix gives examples of mistakes in major media and foreign policy publications. PMID:17175848
A sound basis to guide the community in the conception and implementation of ISHM (Integrated System HealthManagement) capability in operational systems was provided. The concept of 'ISHM Model of a System' and a related architecture defined as a unique ...
Information requirements of mental health providers are sufficiently different from those of other health care managers to warrant a different approach to the development of management information systems (MIS). Advances in computer technology and increased demands for fiscal accountability have led to developing integrated mental health information systems (MHIS) that support clinical and management requirements. In a study made to define a set of generic information requirements of mental health providers that can be supported by an MHIS, it was found that basic data needs can be defined and classified in functional terms: clinical, management, and consultation/education requirements. A basic set of data to support these needs was defined: demographic, financial, clinical, programmatic, and service delivery data.
A comprehensive analytical review of the risk assessment, risk management, and risk communication approaches currently being undertaken by key national, provincial/state, territorial, and international agencies was conducted. The information acquired for review was used to identify the differences, commonalities, strengths, and weaknesses among the various approaches, and to identify elements that should be included in an effective, current, and comprehensive approach applicable to environmental, human health and occupational health risks. More than 80 agencies, organizations, and advisory councils, encompassing more than 100 risk documents, were examined during the period from February 2000 until November 2002. An overview was made of the most important general frameworks for risk assessment, risk management, and risk communication for human health and ecological risk, and for occupational health risk. In addition, frameworks for specific applications were reviewed and summarized, including those for (1)contaminated sites; (2) northern contaminants; (3) priority substances; (4) standards development; (5) food safety; (6) medical devices; (7) prescription drug use; (8) emergency response; (9) transportation; (10) risk communication. Twelve frameworks were selected for more extensive review on the basis of representation of the areas of human health, ecological, and occupational health risk; relevance to Canadian risk management needs; representation of comprehensive and well-defined approaches; generalizability with their risk areas; representation of "state of the art" in Canada, the United States, and/or internationally; and extent of usage of potential usage within Canada. These 12 frameworks were: 1. Framework for Environmental Health Risk Management (US Presidential/Congressional Commission on Risk Assessment and Risk Management, 1997). 2. Health Risk Determination: The Challenge of Health Protection (Health and Welfare Canada, 1990). 3. Health Canada Decision-Making Framework for Identifying, Assessing and ManagingHealth Risks (Health Canada, 2000). 4. Canadian Environmental Protection Act: Human Health Risk Assessment of Priority Substances(Health Canada, 1994). 5. CSA-Q8550 Risk Management: Guidelines for Decision-Makers (Canada Standards Association, 1997). 6. Risk Assessment in the Federal Government: Managing the Process (US National Research Council, 1983). 7. Understanding Risk: Informing Decisions in a Democratic Society (US National Research Council, 1996). 8. Environmental Health Risk Assessment (enHealth Council of Australia, 2002). 9. A Framework for Ecological Risk Assessment (CCME, 1996). 10. Ecological Risk Assessments of Priority Substances Under the Canadian Environmental Protection Act (Environment Canada, 1996).11. Guidelines for Ecological Risk Assessment (US EPA, 1998b). 12. Proposed Model for Occupational Health Risk Assessment and Management (Rampal & Sadhra, 1999). Based on the extensive review of these frameworks, seven key elements that should be included in a comprehensive framework for human health, ecological, and occupational risk assessment and management were identified: 1. Problem formulation stage. 2. Stakeholder involvement. 3. Communication. 4. Quantitative risk assessment components. 5. Iteration and evaluation. 6. Informed decision making. 7. Flexibility. On the basis of this overarching approach to risk management, the following "checklist" to ensure a good risk management decision is proposed: - Make sure you're solving the right problem. - Consider the problem and the risk within the full context of the situation, using a broad perspective. - Acknowledge, incorporate, and balance the multiple dimensions of risk. - Ensure the highest degree of reliability for all components of the risk management process. - Involve interested and effected parties from the outset of the process. - Commit to honest and open communication between all parties. - Employ continuous evaluation throughout the process (formative, process, and outcome evaluation), and be prepared t
The 1990 Rural Sociological Society's Task Force on Persistent Rural Poverty describes rural poverty, comparing it to urban poverty; rejects human-capital, economic-organization, and culture-of-poverty theories of rural poverty and proposes research on 10 other theories; and discusses rural policy and its inequitable emphasis on farmers. (KS)
The decisions and actions of health care managers are oftentimes heavily scrutinized by the public. Given the current economic climate, managers may feel intense pressure to produce higher results with fewer resources. This could inadvertently test their moral fortitude and their social consciousness. A study was conducted to determine what corporate social responsibility orientation and viewpoint future health care managers may hold. The results of the study indicate that future health care managers may hold patient care in high regard as opposed to profit maximization. However, the results of the study also show that future managers within the industry may continue to need rules, laws, regulations, and legal sanctions to guide their actions and behavior. PMID:21045586
This paper describes a conceptual organizing scheme for managing knowledge within the health setting. First, a brief review of the notions of knowledge and knowledge management is provided. This is followed by a detailed depiction of our proposed knowledge management framework, which focuses on the concepts of production, use, and refinement of three specific knowledge sources-policy, evidence, and experience. These concepts are operationalized through a set of knowledge management methods and tools tailored for the health setting. We include two case studies around knowledge translation on parent-child relations and virtual networks in community health research to illustrate how this knowledge management framework can be operationalized within specific contexts and the issues involved. We conclude with the lessons learned and implications.
Accountability of air quality management is often measured by tracking ambient pollution concentrations over time. These changes\\u000a in ambient air quality are rarely linked to changes in public health, a major driver for such programs. We propose a method\\u000a to assess the accountability of air quality management programs with respect to improvements in public health by estimating\\u000a national temporal trends
Hwashin Hyun Shin; Richard T. Burnett; David M. Stieb; Barry Jessiman
In this article, the authors provide an overview of the effectiveness of managedhealth care systems and their impact on mental health counselors. They review ethical and legal dilemmas involving informed consent, confidentiality, client autonomy, competence, treatment plans, and termination that had not existed prior to the introduction of…
Little is known about how Deaf people perceive, access, and utilize interpersonal and media sources for health information. In light of the scarcity of research on health information management among this group, a two-phase study was conducted that included eight focus groups (N=39) and survey data (N=366) with Deaf participants to determine the…
|Little is known about how Deaf people perceive, access, and utilize interpersonal and media sources for health information. In light of the scarcity of research on health information management among this group, a two-phase study was conducted that included eight focus groups (N=39) and survey data (N=366) with Deaf participants to determine the…
In this paper, we propose a new architecture for managing data in a Ubiquitous Health Monitoring System (UHMS). The purpose of this architecture is to enhance the privacy of patients and furthermore to decongest the Health Monitoring Center (HMC) from the enormous amount of biomedical data generated by the users' wearable sensors. This is achieved by using personal agents that
state with both correct function and satisfactory performance at the same time. To realize healthmanagement of ATE, the self-test and calibration method is introduced. High light is focused on ATE calibration interval prediction. To predict calibration intervals, a health state modeling and prognostic method was proposed based on Weibull distribution, which can provide an accurate prediction even with small
Parents always desire to take good care of their children and manage their numerous responsibilities. One of parents' main responsibilities is to manage their children's health. Through their actions of caring for their children, parents want to know they're doing the best job to ensure their children's well being. Unfortunately, much of the time this responsibility is a challenge-particularly for
In Pennsylvania, certified school nurses were governed by the same educational rules and administrative directives as teachers. School nurses were supervised and evaluated by non-nurse managers who had no knowledge of the scope of school nurse practice. A focus of the study was to examine the efficacy of management for school health programs. The…
|In Pennsylvania, certified school nurses were governed by the same educational rules and administrative directives as teachers. School nurses were supervised and evaluated by non-nurse managers who had no knowledge of the scope of school nurse practice. A focus of the study was to examine the efficacy of management for school health programs. The…
Purpose – The purpose of this paper is to study the managing of emergencies pertinent to public health which is critical to the well-being of a society; as such, the management mechanisms employed should be of great interest and significance for research. Design\\/methodology\\/approach – This paper first relies on extensive literature to describe the mechanism used in the USA from
This paper builds effective wireless patient management system (WPMS) using open software that can be accessed via a personal digital assistance (PDA) or a cell phone. This allows health care professionals to gain access to patient information from anywhere at anytime. In this project, the wireless patient management system was built using Java technology. The client side was implemented using
Stress management training interventions have become one of the most popular treatment programs in health psychology practice. Although numerous clinical approaches are available, limited attention is given to the matching of intervention with the clinical needs of individuals. As a result, stress management programs are more frequently marketed in clinical and community settings as palliative techniques without sufficient exploration of
GPs did not recognise much of the mental health issues that presented in their practices. However the re- sults of the MaGPIe study strongly discounts this view. This study showed that GPs recognise the pres- ence of significant mental health con- cerns in over 50% of consultations.2 My view is that the GP needs to have a low threshold when
|This booklet is intended to assist midlevel health care managers in assessing and improving their health care management skills. The first chapter uses the story of one health care manager's recognition of his own weaknesses and subsequent self-improvement to illustrate the qualities and skills that make a good manager. The second chapter, which…
This article examines the intersection of professionalism and complexity science as a source of new insights for improving the health care industry from both a clinical and business point of view. Viewing health care organizations as professional complex adaptive systems suggests eight leadership tasks for addressing the circumstances that engulf health care. Managers who adopt this view will be able to create new levers for positive movement in their organizations. PMID:10710732
By 1995, 108 million Americans were enrolled in managed care mental health programs. Managed care is likely to have a differential impact on women, as indicated by epidemiologic patterns, psychodynamic theory, and data from outcome and cost studies. The challenge of providing compassionate, confidential, and effective care within a budget can be solved by a combination of new treatment methods, better focused managed care interventions, and legislation. PMID:9127996
Socioeconomic status affects a variety of mental and physical health outcomes, such as language development. Indeed, with poverty, disparities in the development of language processing are arguably among the most consistently found— with decreases in vocabulary, phonological awareness, and syntax at many different developmental stages. In this review, after considering basic brain systems affected by low socioeconomic status that are important for language development and related peripartum issues, we focus on two theoretical models that link poverty with the brain systems affected in language problems. The family stress model connects poverty with parental emotional distress that affects parenting, whereas the parental investment model involves a focus on basic needs that affects children’s language. Understanding the mechanisms through which poverty affects the brain, parenting behaviors and language development may have implications for identification and treatment of individuals as well as social policy.
Business and industry are currently focused on increasing employee productivity, reducing employee injuries and lost work time, and minimizing costs. Absence from work due to either injury or health-related leave negatively affects both direct and indirect costs. Absenteeism, regardless of reason, negatively impacts company profit. To decrease the multiple costs of unplanned absences, the occupational health nurse can collaborate with Human Resources professionals and management to create cost-saving short- and long-term disability programs, manage Family and Medical Leave Act programs, and case manage the care of all employees with workers' compensation claims. PMID:19338262
At the onset of health system decentralization as a primary health care strategy, which constituted a key feature of health sector reforms across the developing world, efficient and effective healthmanagement information systems (HMIS) were widely acknowledged and adopted as a critical element of district healthmanagement strengthening programmes. The focal concern was about the performance and long-term sustainability of
This article explores the ways in which the British campaign coalition Make Poverty History represented Africa throughout 2005. Focusing particularly on the G8 Gleneagles summit, Make Poverty History (MPH) asserted a series of justice claims which had no geographical reference. Nevertheless, as a result of internal tensions within the coalition, and especially as a result of the ways in which
|In this article, the author focuses on the possibilities--and the limits--of undergraduate courses on the literature of poverty. He describes an undergraduate course he has taught on U.S. literature about poverty, but he also expresses doubt that such courses can help produce major social change. He argues that something about the literature of…
The aim of the article, based on field data collected from a continuing education program for primary health clinic administrators, was to analyze the functioning of a health service management strategy called "management committees". Different meanings and operational modalities emerged in the committees. Various antimonies appeared in the way the committees operate (autonomy versus heteronomy, reproduction of "instituted" versus "instituting" processes, and communicative versus instrumental reasoning), thus reflecting the level of complexity in this management mechanism. Healthcare provision per se by the clinics only appeared occasionally on the committees' agenda, which mainly focused on administrative issues. The article suggests that further research is needed on the coordinator's involvement in the field of forces constituting the management committee, besides developing pedagogical strategies to support the clinic coordinators and health teams in building the committees. The primary data were submitted to an epistemological discussion anchored in the idea of double hermeneutics, multiple validation of research results, and the relationship between theory and practice. PMID:20464074
This handbook, prepared for the National Health Service Corps outlines the set of written administrative policies and procedures necessary for each medical facility receiving a National Service Corps assignee. In addition, these policies and procedures pe...
This project applied qualitative methods to gain insight into the experiences of vulnerable childrens families: how they define their childrens health needs, decisions regarding where and when to seek care, and their experiences with care received.
Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens. PMID:21051258
|Poverty is widespread and its consequence of poorer health increases the likelihood that nurses will provide care for poor clients and their families in many health care settings. Although the importance of understanding attitudes toward the poor is recognized, there have been few studies of attitudes of nursing students. The purpose of this…
Background Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. Methods A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques. Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district healthmanagement teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district healthmanagement teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. Results The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource management practices such as performance appraisal and the provision of job descriptions were not present in many cases. Health workers felt that they were inadequately supervised, with no feedback on performance. In contrast to health workers, managers did not perceive these human resources management deficiencies in the system as having an impact on motivation. Conclusion A strong human resource management function operating at the district level is likely to improve worker motivation and performance.
This study contributes to the health governance discussion by presenting a new data set that allows for comparisons of the management of health resources among Brazilian municipalities. Research on Brazil is particularly important as the provision of health services was decentralized in 1988 and since then municipalities have been given greater responsibilities for the management of fiscal resources for public health service provision. Based on detailed information on corruption practices (such as over-invoicing, illegal procurement and fake receipts) from audit reports of health programmes in 980 randomly selected Brazilian municipalities, this study deepens understanding of the relationship between health governance institutions and the incidence of corruption at the local level by exploring the extent to which horizontal and vertical accountabilities contribute to reducing the propensity of municipal government officials to divert public health resources for private gain. The results of our multiple regression analysis suggest that the experience of health municipal councils is correlated with reductions in the incidence of corruption in public health programmes. This impact is significant over time, with each additional year of health council experience reducing corruption incidence levels by 2.1% from baseline values. The findings reported in this study do not rely on the subjectivity of corruption measures which usually conflate the actual incidence of corruption with its perception by informants. Based on our results, we provide recommendations that can assist policy makers to reduce corruption. PMID:23411119
Adams uses a large, nationally representative household survey to analyze the impact of internal remittances (from Guatemala) and international remittances (from the United States) on poverty in Guatemala. With only one exception, he finds that both internal and international remittances reduce the level, depth, and severity of poverty in Guatemala. However, he finds that remittances have a greater impact on
The paper seeks to assess the extent to which the concepts of social class and culture are useful in understanding poverty and welfare dependency, and in particular for understanding the inheritance of poverty and dependency from one generation to the nex...
How does labor market competitiveness frame the impact of greater labor productivity and lower inequality on poverty? Specifically, does greater competitiveness increase the impact of higher labor productivity and lower inequality on poverty reduction? In a simple model, we show that there is complementarity between competitiveness and productivity – the greater is one, the larger is the impact of the
The primary goal of agricultural research has been to increase agricultural production, particularly in high-potential areas. This has contributed enormously to reducing the number of people living in poverty worldwide, as well as to reducing food prices for all. Despite these gains, about 1 billion rural people still live in poverty in the developing world. In an era in which
|In this paper, principal components methodology is used to derive simplified and cost effective indexes of water poverty. Using a well known data set for 147 countries from which an earlier five-component water poverty index comprising of "Resources," "Access," "Capacity," "Use" and "Environment" was constructed, we find that a simplified…
Spatial price dispersion varies because of climatic fluctuations, marketimperfections, economic growth or economic policies. These variations areoften neglected in poverty studies.In this paper, we propose a simple simulation formula to assess the effecton poverty of a change in the spatial mean or spatial variance of price indiceswithout having to model each household situation. This approach constitutes aconvenient first step of
The article presents results from a survey of 98 top executives at Baylor Health Care System (BHCS), a large, multifunction health care organization in Dallas, Texas. The survey assessed the executives' perceptions of current BHCS quality practices using the first survey developed for the health care industry based on the Malcolm Baldrige National Quality Award (MBNQA) criteria. Findings regarding the quality of BHCS internal and external data and information include the need for a $50 million information system transformation to achieve seven critical success factors for all business units and improved internal and external data and information for the business process redesign and quality transformation. Results highlight the need for further research investigating the information and analysis MBNQA criteria. PMID:10174724
This study aims to compare and contrast how specific information health technologies (IHTs) have been debated, how they have\\u000a proliferated, and what they have enabled in Germany’s and England’s healthcare systems. For this a discourse analysis was\\u000a undertaken that specifically focussed on future-scenarios articulated in policy documents and strategy papers released by\\u000a relevant actors from both healthcare systems. The study
Diabetes in pregnancy is increasing and therefore it is important to raise awareness of the associated health risks to the mother, the growing fetus, and the future child. Perinatal mortality and morbidity is increased in diabetic pregnancies through increased stillbirths and congenital malformation rates. These are mainly the result of early fetal exposure to maternal hyperglycaemia. In the mother, pregnancy
Objective: Contemporary health care places enormous health information management demands on laypeople. Insights into their skills and habits complements current developments in consumer health innovations, including personal health records. Using a five-element human factors model of work, health information management in the household (HIMH) is characterized by the tasks completed by individuals within household organizations, using certain tools and technologies in a given physical environment. Design: We conducted a descriptive-exploratory study of the work of HIMH, involving 49 community-dwelling volunteers from a rural Midwestern community. Measurements: During in-person interviews, we collected data using semistructured questionnaires and photographs of artifacts used for HIMH. Results: The work of HIMH is largely the responsibility of a single individual, primarily engaged in the tasks of acquiring, managing, and organizing a diverse set of health information. Paper-based tools are most common, and residents develop strategies for storing information in the household environment aligned with anticipated use. Affiliative relationships, e.g., parent-child or spousal, within the household serve as the organization that gives rise to health information management practices. Synthesis of these findings led to identification of several storage strategies employed in HIMH. These strategies are labeled “just-in-time,” “just-because,” “just-in-case,” and “just-at-hand,” reflecting location of the artifacts of health information and anticipated urgency in the need to retrieve it. Conclusion: Laypeople develop and employ robust, complex strategies for managinghealth information in the home. Capitalizing on these strategies will complement and extend current consumer health innovations to provide functional support to people who face increasing demands to manage personal health information.
OBJECTIVE: To study the ways in which allocating the risk for behavioral health care expenses between employers and a managed behavioral health organization affects costs and the use of services. DATA SOURCES: Claims from 87 plans that cover mental health and substance abuse services covering over one million member years in 1996/1997. STUDY DESIGN: Multi-part regression models for health care cost are used. Dependent variables are health care costs decomposed into access to any care, costs per user, any inpatient use, costs per outpatient user, and costs per inpatient user. The study compares full-risk plans, in which the managed care organization provides managed care services and acts as the insurer by assuming the risk for claims costs, with contracts in which the managed care organization only manages care (for a fixed administrative fee) and the employer retains the risk for claims. PRINCIPAL FINDINGS: Full-risk plans are not statistically significantly different from non-risk plans in terms of any mental health specialty use or hospitalization rates, but costs per user are significantly lower, in particular for inpatients. CONCLUSIONS: Risk contracts do not affect initial access to mental health specialty care or hospitalization rates, but patients in risk contracts have lower costs, either because of lower intensity of care or because they are treated by less expensive providers.
Developing strategies to address the health needs of the National Health Services (NHS) workforce are of concern to many health care managers. Focal to the development of such strategies are of being in receipt of baseline information about employees expressed health needs and concerns. This article addresses obtaining such baseline information and presents the findings of a health needs survey of acute hospital staff in a trust in North Wales. The total population of trust employees were surveyed (n = 2300) and a 44% (n = 1021) response rate was achieved. A number of positive findings are given. Included are that the majority of those surveyed stated that their current health status is good, are motivated to improve their health further, do not smoke and their alcohol consumption is within recommended levels. There appears, however, to be a number of areas where trust managers can help its staff improve their health. Included are trust initiatives that focus on weight control and taking more exercise. In addition, there appears to be a reported lack of knowledge and positive health behaviour amongst the male respondents surveyed that would imply the trust needs to be more effective in promoting well man type issues. Finally there appears to be a general lack of pride in working for the trust and a pervasive feeling that the trust does not care about its employees that needs to be addressed. It is concluded that the findings of this survey have implications for management practices in the trust where the survey was conducted and also wider applicability to the management of health care professionals. For example, addressing work-related psychological and physical problems of employees are of importance to all health care managers. This is especially so when considering recruitment and retention issues. PMID:12930541
Child welfare involvement is related to involvement with poverty, but the dimensions of that relationship have not been fully explored. Data from the National Survey of Child and Adolescent Well-Being were used to test the relationship between poverty indicators and placement into foster care. Poverty, ages of children, urban or nonurban settings, and the presence of mental health disorders interact to contribute to placement decisions. In urban areas, poverty is strongly associated with involvement with child welfare services, but children's mental health problems are not. In nonurban areas, children's mental health problems are a far greater contributor to child welfare involvement than poverty. Implications for understanding the dual functions of child welfare placements are provided. Child welfare services continue to address the needs of families with children with substantial behavioral problems--yet, federal child welfare policy includes no recognition of this important role. PMID:16981814
Barth, Richard P; Wildfire, Judy; Green, Rebecca L
|Critical decisions that need to be made by faculties of health administration education programs when developing and assessing the health services management portion of the curriculum are identified. Decisions should draw from the information available concerning professional target roles of graduates, graduate behavior expected, resources for…
Association of Univ. Programs in Health Administration, Washington, DC.
Lifestyle is a key determinant in the prevention and management of chronic diseases. If we would exercise regularly, eat healthy, control our weight, sleep enough, manage stress, not smoke and use alcohol only moderately, 90% of type II diabetes, 80% of coronary heart disease, and 70% of stroke could be prevented. Health statistics show that lifestyle related diseases are increasing
Anita Honka; Kirsikka Kaipainen; Henri Hietala; Niilo Saranummi
In a country where poverty is prevalent, a significant number of children are likely to be illiterate, malnourished, and prone to abuse and physical violence. The Philippines is no different. Using known indicators on education, social protection, poverty, and health, this report summarizes the Filipino children's welfare and living conditions taking account the disparities in gender, income, and geographic location.
Poverty is widespread in the rural areas, where the people are in a state of human deprivation with regard to incomes, clothing, housing, health care, education, sanitary facilities and human rights. Nearly 61 percent of the country’s populations live in rural areas. In Pakistan poverty has been increased in rural areas and is higher than urban areas. Of the total
Amara Amjad Hashmi; Maqbool H. Sial; Maaida Hussain Hashmi
|Poverty, inequality, and discrimination endanger women's well-being. Poverty is a consistent predictor of depression in women. Economic inequalities relate to reduced life expectancy and various negative physical health consequences. Discrimination maintains inequalities, lessens economic security, and exposes women to unmerited contempt.…
The Management Academy for Public Health is a management development program with the goals of helping public healthmanagers learn to manage people, data, and finance, to think and plan like entrepreneurs, and to strengthen public health organizations. Managers enroll as teams and develop business plans in the Academy's extensive project-based learning component. Extensive internal and external evaluation shows that the program improves managers' knowledge, skills, and confidence in key curriculum areas; that participants apply many of the skills in their jobs; that many of the business plans receive funding, resulting in new public health programs; that the training experience helped agencies respond and plan after September 11, 2001; and that many participants report beginning to think more like entrepreneurs through activities like teaming, partnering, innovating, negotiating, finding funds, and generating revenue. The program demonstrates that robust training including extensive work-based project work with coaching can help public healthmanagers gain many skills needed for the drive to "reinvent" government. PMID:16912605
Umble, Karl E; Orton, Stephen; Rosen, Benson; Ottoson, Judith
The paper investigates the impact of growth on poverty in Ethiopia by analysing panel data covering 1994–97, a period of economic recovery driven by peace, good weather, and much improved macroeconomic management. The analysis of poverty shows land ownership, education, type of crops planted, occupations in urban areas, dependency ratios, and location to be important determinants. The characteristics of households
|In December of 2009, many within the American community of analysts, policymakers, and program managers are looking expectantly at the possibility of change in the basic measure used to gauge poverty in the United States. A broad consensus has emerged that the current official measure of poverty in the United States is deeply flawed, in the…
Natural resources perform multiple functions as a driver, maintainer, potential exit route, and also an effective escape mechanism in the context of poverty dynamics, especially in a predominantly agrarian economy such as India. The discourse on poverty reduction however, has often overlooked some of the major concerns of natural resource management, despite recognizing the criticality of agricultural growth for reducing
Both, poverty reduction and preservation of biodiversity are high on the global agenda on sustainable development. The relationships between poverty, biodiversity of agro-ecosystems and agricultural development are complex and poorly understood. In this paper, we present an integrated framework for analysis of agricultural development and natural resource management options at agro-ecosystem level, using Pujiang county, in Zhejiang province, China as
Huib Hengsdijk; Wang Guanghuo; Marrit M. Van den Berg; Wang Jiangdi; Joost Wolf; Lu Changhe; Reimund P. Roetter; Herman Van Keulen
As nursing has been subject to successive waves of 'managerialism' there has been a drive on the part of government and elements within the profession to enhance the science base and promote cost-effective health care interventions. This has generated new interest in the 'economics of nursing' as efficiency and 'value for money' are viewed as necessary precondition for the provision of a high quality nursing service. As an academic subject health economics has brought an elegant set of theories to bear on the topic of health and health care. However, mainstream health economics is premised on a series of simplifying assumptions that, if applied uncritically, can induce a range of unintended and adverse consequences. This paper asks how ideas developed in one sphere (health economics) can be become influential in another (nursing management and practice) and it seeks explanations in the theories of Michel Foucault, specifically in his exploration of the reciprocal relationship between power and knowledge. How are our assumptions about what is possible and desirable shaped, how far do mechanisms of surveillance and self-subjugation extend? A range of alternative economic approaches have been developed which challenge many mainstream health economics assumptions. Some of these are better suited to the complex social environment present within health care. Nurses, nurse managers and researchers should question the assumptions of dominant economic models and explore a range of economic frameworks when planning services and evaluating their practice. PMID:16108775
Fault detection and isolation for advanced rocket engine controllers are discussed focusing on advanced sensing systems and software which significantly improve component failure detection for engine safety and healthmanagement. Aerojet's Space Transportation Main Engine controller for the National Launch System is the state of the art in fault tolerant engine avionics. Healthmanagement systems provide high levels of automated fault coverage and significantly improve vehicle delivered reliability and lower preflight operations costs. Key technologies, including the sensor data validation algorithms and flight capable spectrometers, have been demonstrated in ground applications and are found to be suitable for bridging programs into flight applications.
Health services management, which is described as the process of mobilizing and deploying resources for the efficient provision of effective health services, has taken the center stage in business discussions across the globe. Poor management is unanimously blamed for the diminishing fortunes of most health industries. The present study was designed to review the managerial skills of health administrators and
Coordinated multi-vehicle autonomous systems can provide incredible functionality, but off-nominal conditions and degraded system components can render this capability ineffective. This paper presents techniques to improve mission-level functional reliability through better system self-awareness and adaptive mission planning. In particular, we extend the traditional definition of healthmanagement, which has historically referred to the process of actively monitoring and managing vehicle
Mario Valenti; Brett Bethke; Daniela Pucci de Farias; John Vian
This analysis uses in-depth interview data collected from 145 AfricanAmerican, European American and Native American men and women aged 70and older who reside in two rural North Carolina counties to understand therole of religious faith and prayer in the health self-management of theseolder adults. The analysis addresses three specific questions: how do theseolder adults use religion to help them manage
Thomas A. Arcury; Sara A. Quandt; Juliana McDonald; Ronny A. Bell
This work presents an automated contingency management (ACM) software simulation test bed developed in Simulink that can be applied to various unmanned platforms for developing; testing and verifying automated fault accommodation strategies. Specifically, this paper introduces the required software components and integrated healthmanagement and control architecture for performing these tasks and applies it to the unmanned combat armed rotorcraft
Jianhua Ge; Michael I. Roemer; George Vachtsevanos
We discuss the effects of managed care on the structure of the health care delivery system, focusing on managed-care-induced consolidation among health care providers. We empirically investigate the relationship between HMO market share and mammography providers. We find evidence of consolidation: increases in HMO activity are associated with reductions in the number of mammography providers and with increases in the number of services produced by remaining providers. We also find that increases in HMO market share are associated with reductions in costs for mammography and with increases in waiting times for appointments, but not with worse health outcomes. PMID:10558503
Recent developments in social protection have shifted its focus on to risk and vulnerability. These contribute to poverty directly, but also indirectly through the response of poor households to risk. The extent to which social protection interventions could address chronic poverty is unclear. A hard and fast distinction between transient and chronic poverty suggests a bifurcation in anti-poverty policy, with
Noting that young children in poverty face a greater likelihood of impaired development because of their increased exposure to a number of risk factors associated with poverty, this report presents statistical information on the incidence of poverty during early childhood. The report notes that the poverty rate for U.S. children under age 3…
More subtle than the manifestations of poverty are the paradigmatic means of sustaining, deepening or lessening it. Indeed, dominant knowledge structures are insinuated in policy making and conventional anti-poverty measures, some of which reflect the poverty of the intellect. Ensconced in distinctive contexts, poverty itself is shaped by the template of neoliberal globalisation. This paradigm promises that economic gain will
Multidimensionality of poverty defies a neat demarcation. Often several but not separable meanings can be attributed to poverty which essentially should encompass totality of deprivation experienced by an individual or group of individuals. Encyclopedia of social sciences for instances suggests that definition of poverty is convention specific and distinguishes between Social Poverty and Pauperism. The former includes economic inequality or
This paper presents a profile of poverty in Egypt for 1997. It assesses the magnitude of poverty and its distribution across geographic and socioeconomic groups, provides information on the characteristics of the poor, illustrates the heterogeneity among the poor, and helps identify empirical correlates of poverty. The poverty profile is constructed using data from the recently completed Egypt Integrated Household
Total Quality Management (TQM) is defined as the management approach of the organization aimed at long-term success through client satisfaction, and which benefits all members of the organization and society (ISO 8402; International Organization for Standardization, 1994a). The objective of the study was to evaluate management methods applied to improve working conditions in Polish enterprises implementing TQM. The investigation was conducted in the form of interviews, which covered relevant connections between the TQM concept and occupational health and safety (OHS) systematic management rules. The results revealed that the criteria adopted in investigated enterprises for OHS management systems, as well as the implemented management methods and tools, can be evaluated positively. However, many require significant improvement in order to ensure better compliance with the existing law provisions. Elements of OHS management systems also require better integration with the overall management system of the enterprise. PMID:10828155
Childhood poverty in the USA remains an issue that concerns the child, the family, the community, each state, and the nation. It also is a topic that pediatricians must become cognizant of because of the impact it has on the children we care for daily. It goes beyond the specific income threshold that sets the federal poverty level; rather it impacts on the ability of families to acquire life's basic needs to allow their children the opportunity to reach their full potential. These basic needs include adequate nutrition to grow and develop in an optimal fashion and a secure and stable home in a safe neighborhood, which allows for play, exploration, and physical activity. It must also include access to health insurance coverage as well as a physician, health center, and health system to meet their medical needs. In addition, we must provide early education opportunities to nurture the social and emotional health of our children and prepare each child for school. The school environment must promote academic achievement and the broader community must foster opportunities to minimize violence and reduce the need for incarceration. The integration of such provisions represents a broadening and redefinition of the Social Safety Net that incorporates both public and private sector efforts to maximize the life potential of each child. PMID:21051022
This paper, and the former report on the experience of adolescent care in an ambulatory and multidisciplinary center based on a bifocal medical and psychological strategy. This process integrates the health care providers in the center as well as family and school people interacting with the adolescent who is looked at as the central issue. In this paper, the initial elucidation of the adolescent complaint and its content are detailed and illustrated. The follow-up modalities are also discussed, particularly the variable temporal sequence in medical and psychological intervention. PMID:9713213
While most of the world has enjoyed exponential economic growth, more than one-sixth of the world is today roughly as poor as their ancestors were many generations ago. Widely accepted general explanations for the persistence of such poverty have been elusive and are needed by the international development community. Building on a well-established model of human infectious diseases, we show how formally integrating simple economic and disease ecology models can naturally give rise to poverty traps, where initial economic and epidemiological conditions determine the long-term trajectory of the health and economic development of a society. This poverty trap may therefore be broken by improving health conditions of the population. More generally, we demonstrate that simple human ecological models can help explain broad patterns of modern economic organization.
Bonds, Matthew H.; Keenan, Donald C.; Rohani, Pejman; Sachs, Jeffrey D.
Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers' udder healthmanagement, tools such as instruction cards, treatment plans, checklists and software were developed following an argument-based comprehensive "central route." These tools were used during on-farm study group meetings for farmers organized by veterinarians and also during individual veterinarian-farmer interactions. The second strategy aimed at adopting a single management practice to increase the use of milking gloves during milking. This approach followed a straightforward "peripheral" route that used implicit persuasion techniques. Results of an online survey of 374 Dutch dairy farmers showed that most farmers were able and willing to use the educational management tools to increase udder health on their farms. They evaluated the tools positively regardless of the mastitis problems on their farms. This seems to indicate that the central route of communication is most effective when farmers are motivated to work on udder health in general. Results of repeated random telephone surveys before, during, and after the campaign on the use of milking gloves showed that the use of gloves increased from 20.9 to 42.0% of the respondents. Respondents' opinions about milking gloves also changed favorably, indicating that a relatively short peripheral campaign on a single action can have a sustained effect on farmers' behavior. Both communication strategies seem to be potentially successful in disseminating knowledge to a specific target group of farmers and in changing that group's behavior. However, to reach as many farmers as possible, the strategies should be combined. When optimizing these strategies, both the farmers' motivation to work on udder health and the aim of the campaign should be considered. When aiming to improve general udder healthmanagement, the central route seems to be effective if farmers are already motivated to optimize their udder healthmanagement. For farmers who are less motivated to work on udder health, the peripheral route seems to be most effective when aiming to change a single management practice. The evaluated communication strategies are examples of how management practices to control mastitis can be effectively communicated to farmers. As such, this study contributes to optimizing future programs to control and prevent diseases. PMID:20105532
In health care, multidisciplinary collaboration is both indispensable and complicated. We discuss organizational problems that occur in situations where multiple health care providers are required to cooperate for patients with complex needs. Four problem categories, labelled as communication, patient safety, waiting times and integration are distinguished. Then we develop a supply chain perspective on these problems in the sense of discussing remedies according to supply chain management (SCM) literature. This perspective implies a business focus on inter-organizational conditions and requirements necessary for delivering health care and cure across organizational borders. We conclude by presenting some strategic and policy recommendations. PMID:21069770
Meijboom, Bert R; Bakx, Saskia J W G C; Westert, Gert P
With the institutionalization of participation in health, through conferences and management councils at national, state, municipal and local levels, a process of democratization is initiated in the health area. However, in relation to the health councils in particular, there is still much to be done, including improving the quality of the decision-making process. This work aims to place the decision-making process in its theoretical context in terms of participatory democracy, elements which make up, factors which influence its development, and finally, to explore some possibilities of this theoretical basis to analyze the practices of the health councils in the area of health. It is hoped that it will make a theoretical contribution to the analyses carried out in this area, in order to provide a decision-making process that is more inclusive in terms of participation. PMID:18041561
Wireless sensing is part of our lives; major technological breakthroughs in the areas of sensors, integrated circuits, and also on wireless communications, led to the creation of wireless sensor networks (WSNs). Such networks have multiple uses, from monitoring and tracking of people and goods, to the coordination and processing of activities in different contexts; they are used in industry, defence and healthcare applications. As part of this use in healthcare applications KeepCare, a solution based on monitoring, tracking and processing of healthcare related information, is presented in this paper. This solution uses a WSN based application to monitor peoples' health and quality of life through vital signs and activity information received via wireless sensors. This solution monitors users such as elderly, people suffering from chronic conditions in their home environment, but can as well be used in athletes or other professionals (e.g. first responders) that need to be monitored under hazardous conditions. PMID:22942032
Petroleum is used widely in health care—primarily as a transport fuel and feedstock for pharmaceuticals, plastics, and medical supplies—and few substitutes for it are available. This dependence theoretically makes health care vulnerable to petroleum supply shifts, but this vulnerability has not been empirically assessed. We quantify key aspects of petroleum use in health care and explore historical associations between petroleum supply shocks and health care prices. These analyses confirm that petroleum products are intrinsic to modern health care and that petroleum supply shifts can affect health care prices. In anticipation of future supply contractions lasting longer than previous shifts and potentially disrupting health care delivery, we propose an adaptive management approach and outline its application to the example of emergency medical services.
This paper measures rural poverty in Hubei Province and Inner Mongolia in China. The poverty lines we derived by Ravallion's method differ from the official Chinese poverty lines. The official pan-country poverty line underestimates rural poverty in Hubei Province and overestimates rural poverty in Inner Mongolia. Poverty determinants are estimated by Logit as well as Probit models. The study notes
|The authors suggest that many managed mental health care (MMHC) practices have oppressive effects on members of cultural and ethnic minority groups. They examine the dissonance between institutional practices and cultural traditions that reflect insensitivity and forced conformity, particularly regarding time, pace, and intervention uniformity as…
This article presents the reflections of three faculty members from New York University based on more than two years of experience in a healthmanagement education (HME) partnership with institutions in the Republic of Albania. The most significant point to be shared with colleagues considering similar initiatives in other countries is that aiding other professionals in developing healthmanagement education programs involves much more than the transfer of technical information among professionals. Based on experience in Albania, we argue that the development of viable management and policy analysis programs will require assistance to counterparts in Central and Eastern Europe in: (1) building constituencies for these activities among influential leaders and sustaining this support through changes in government; (2) providing models of and motivations for using styles of pedagogy that vary significantly from those now common in this part of the world; and (3) reconciling conflicts between pressures for investments in the largely hospital-based activity of healthmanagement and the largely public-health-based needs of relatively poor countries. PMID:10387233
|This article discusses industry-based efforts to improve the quality of work life through various methods including health promotion programs; early intervention and disability management; and rehabilitation of industrially injured workers. Program models in each of these areas are described. (CB)|
Majority of the health risks and diseases in the modern world are related to lifestyles, e.g., overweight, unhealthy diet, physical inactivity, sleep deprivation, and stress. Behavioral change towards healthy lifestyles is the key to the prevention and management of these risks, but early and efficient interventions are scarcely available. We present the Nuadu Concept, an ICT (Information and Communication Technologies)
E. Mattila; I. Korhonen; R. Lappalainen; A. Ahtinen; L. Hopsu; T. Leino
According to the electrical power supply system analysis, a system of prognostic and healthmanagement (PHM) for the electrical power supply system is presented. The PHM system can accomplish the condition assessment of the key characteristics and device in the electrical power supply system without additional test equipment. The condition of rotating rectifier, contact resistance and so on can be
|The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…
The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…
The purpose of this paper is to informally lay out for health planning agencies the basic principles of personal time management. It does not address the general problem of budgeting overall staff time through the use of agency work programs. Rather, it f...
The serious problems of contaminants and environment impacts produced by human action in the subsurface (air, groundwater and rock in interaction with human activities), particularly in underground mines, require an integrated approach in terms of specific rules, laws and management systems in the domain of Occupational Safety and Health. As the ISO 14001 standard is mostly directed for the prevention
Nurses working within managed care systems often face moral conflicts. Ethical nursing practice seems to require justice with integrity, that is, treating persons in like circumstances similarly (formal justice); helping to shape public policy regarding the provision of health care benefits and burdens (distributive justice): discussing with patients the benefits that are and are not provided by particular insurance policies
The paper presents a model of systematic occupational health and safety management of a company with focus on three feedback loops where exposed hazards and risk are channelled through a regulatory regime, market stakeholders and the industrial system. The purpose of this paper is to improve the understanding of how an enterprise, as part of an industrial context, develops barriers
|The Lifestyle Management Project is a health promotion project and research study conducted in the spring of 1984 at five Los Angeles junior college campuses. Its goal was to increase knowledge of cardiovascular disease (CHD) risk factors among 400 to 2000 junior college students in each campus. This was done via five risk factor activities:…
Purpose – This paper seeks to concentrate on the question whether any parallels can be found between the industrial sector and health care services with respect to the developments that have taken place in the area of Supply Chain Management. Starting from an analysis of existing literature, it is intended that different modes of Supply Chain integration will be discussed.
This paper presents an integrated approach to switching mode power supply healthmanagement that implements techniques from engineering disciplines including statistical reliability modeling, damage accumulation models, physics of failure modeling, and sensor-based condition monitoring using automated reasoning algorithms. Novel features extracted from sensed parameters such as temperature, power quality, and efficiency were analyzed using advanced fault detection and damage accumulation
Rolf Orsagh; Douglas Brown; Michael Roemer; T. Dabnev; Andrew Hess
The focus of this paper is to present the advances, benefits and challenges in measuring, monitoring and managing the health of aircraft avionics systems as well as the support equipment used to test these systems. Most people are skeptical when avionics and prognostics are used in the same sentence. For the purpose of this discussion, we will grant that most
Larry V. Kirkland; T. Pombo; K. Nelson; F. Berghout
This paper presents a comparison of different pattern recognition algorithms to identify slow time scale anomalies for healthmanagement of aircraft gas turbine engines. A new tool of anomaly detection, based on symbolic dynamics and information theory, is compared with traditional pattern recognition tools of principal component analysis (PCA) and artificial neural network (ANN). Time series data of the observed
This article considers the critical roles of risk and risk assessment in the management of health emergencies and disasters. The Task Force on Quality Control of Disaster Management (TFQCDM) has defined risk as the "objective (mathematical) or subjective (inductive) probability that something negative will occur (happen)". Risks with the greatest relevance to health emergency management include: (1) the probability that a health hazard exists or will occur; (2) the probability that the hazard will become an event; (3) the probability that the event will lead to health damage; and (4) the probability that the health damage will lead to a health disaster. The overall risk of a health disaster is the product of these four probabilities. Risk assessments are the tools that help systems at risk-healthcare organizations, communities, regions, states, and countries-transform their visceral reactions to threats into rational strategies for risk reduction. Type I errors in risk assessment occur when situations are predicted that do not occur (risk is overestimated). Type II errors in risk assessment occur when situations are not predicted that do occur (risk is underestimated). Both types of error may have serious, even lethal, consequences. Errors in risk assessment may be reduced through strategies that optimize risk assessment, including the: (1) adoption of the TFQCDM definition of risk and other terms; (2) specification of the system at risk and situations of interest (hazard, event, damage, and health disaster); (3) adoption of a best practice approach to risk assessment methodology; (4) assembly of the requisite range of expert participants and information; (5) adoption of an evidence-based approach to using information; (6) exclusion of biased, irrelevant, and obsolete information; and (7) complete characterizations of any underlying fault and event trees. PMID:16018501
This study aims to analyze the influences of human development factors in the experience of disabled people based on social scenarios of inequality. The data collected were standardized and allocated in thematic categories. The analysis was based on liberal utilitarianism. The conclusion is that there is legislation in Brazil that guarantees the disabled people's development in areas such as health, education and work. However despite the attempts of decision makers in combating discriminatory behaviors and the theory based on equity, these people still face difficulties in breaking the barrier of poverty and achieving all humans rights deserved. PMID:17934595
Xavier de França, Inacia Sátiro; Freitag Pagliuca, Lorita Marlena
Availability of emergency preparedness funding between 2002 and 2009 allowed the North Dakota Department of Health to build public health response capabilities. Five of the 15 public health preparedness capability areas identified by the Centers for Disease Control and Prevention in 2011 have been thoroughly tested by responses to flooding in North Dakota in 2009, 2010, and 2011; those capability areas are information sharing, emergency operations coordination, medical surge, material management and distribution, and volunteer management. Increasing response effectiveness has depended on planning, implementation of new information technology, changes to command and control procedures, containerized response materials, and rapid contract procedures. Continued improvement in response and maintenance of response capabilities is dependent on ongoing funding. PMID:23348522
Wiedrich, Tim W; Sickler, Juli L; Vossler, Brenda L; Pickard, Stephen P
Health-care organizations are beginning to apply the principles of total quality management (TQM). Implementing TQM in a health-care laboratory requires incorporating quality improvement (QI) and quality planning (QP) with quality laboratory practices (QLP), quality control (QC), and quality assurance (QA) to provide a complete quality management system. QI and QP can be initiated by developing a strategic plan as a pilot QI project. QI project teams are then introduced to accomplish the highest priority goals. This implementation approach improves strategic planning by using group problem-solving tools and techniques, such as process flow charts, brainstorming, nominal group, fishbone diagrams, consensus decision making, and Pareto analysis. The approach also improves the success of project teams by providing a clear management agenda and a commitment to project-by-project QI. PMID:10113715
Despite an acknowledged lack of evidence of investment payoff, health plan initiatives to promote health and wellness are now commonplace, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. Much of the impetus has come from employers--primarily large employers--that are incorporating health and wellness activities into benefit designs that place more responsibility on employees for health care decisions and costs. Health plans now offer a range of health and wellness activities, including traditional worksite health fairs, screenings and educational seminars; access to behavior modification programs, such as weight management and smoking cessation; and online tools, including health risk assessments. Engaging enrollees in these activities, however, is challenging because participation typically is voluntary. Another barrier is employee privacy concerns. More health plans and employers are turning to financial incentives to secure greater participation. Ultimately, however, the credibility of health and wellness activities as mechanisms to improve health and contain costs is dependent on evidence demonstrating their clinical and financial effectiveness, as well as consumers' acceptance and validation of their legitimacy. PMID:18536150
\\u000a In recent years there has been an increased interest to study and understand poverty and how it impacts on disease and epidemics\\u000a (Boucekkine and Laffargue, 2007). In particular, the focus has been to understand the relationship between poverty and HIV\\/AIDS,\\u000a especially in sub-Saharan Africa, where HIV prevalence is high and consequences are also harsh on already vulnerable communities\\u000a (Cohen, 1998).
From February 2008 through April 2011, School Health Connection, a program of the Louisiana Public Health Institute, developed an electronic health information management system for newly established school-based health centers in Greater New Orleans. School Health Connection was established as part of a broader effort to restore community health…
The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management. PMID:16622359
Poor and ethnic minority children are at increased risk for exposure to violence within the family and in the community. However, there is limited research examining the differential effects of co-occurring and interrelated forms of violence on children's mental health. This study utilizes an ecological, developmental psychopathology, systems approach, theorizing that exposure to family and community violence impacts mental health
Presented is the report by the Working Group on the education of managers in health services in the World Health Organization, European Region. The report is organized into the following sections: health care management and managers; key issues in health service management (public policy-making and health care management, the managerial role of…
World Health Organization, Copenhagen (Denmark). Regional Office for Europe.
|Presented is the report by the Working Group on the education of managers in health services in the World Health Organization, European Region. The report is organized into the following sections: health care management and managers; key issues in health service management (public policy-making and health care management, the managerial role of…
World Health Organization, Copenhagen (Denmark). Regional Office for Europe.
Currently, many organizations are using a department-centered approach to managehealth risks at work. In such a model, segregated departments are providing employee benefits such as health insurance, workers' compensation, and short- and long-term disability or benefits addressing work-life issues. In recent years, a new model has emerged: health and productivity management (HPM). This is an employee-centered, integrated approach, designed to increase efficiency, reduce competition for scarce resources, and increase employee participation in prevention activities. Evidence suggests that corporations using integrated HPM programs achieve better health outcomes for their employees, with consequent increased productivity and decreased absenteeism. Occupational health nurses are well positioned to assume leadership roles in their organizations by coordinating efforts and programs across departments that offer health, wellness, and safety benefits. To assume their role as change agents to improve employees' health, nurses should start using the language of business more often by improving their communication skills, computer skills, and ability to quantify and articulate results of programs and services to senior management. PMID:17323873
Although many employers offer some components of worksite-based population healthmanagement (PHM), most do not yet invest in comprehensive programs. This hesitation to invest in comprehensive programs may be attributed to numerous factors, such as other more pressing business priorities, reluctance to intervene in the personal health choices of employees, or insufficient funds for employee health. Many decision makers also remain skeptical about whether investment in comprehensive programs will produce a financial return on investment (ROI). Most peer-reviewed studies assessing the financial impact of PHM were published before 2000 and include a broad array of program and study designs. Many of these studies have also included indirect productivity savings in their assessment of financial outcomes. In contrast, this review includes only peer-reviewed studies of the direct health care cost impact of comprehensive PHM programs that meet rigorous methodological criteria. A systematic search of health sciences databases identified only 5 studies with program designs and study methods meeting these selection criteria published after 2007. This focused review found that comprehensive PHM programs can yield a positive ROI based on their impact on direct health care costs, but the level of ROI achieved was lower than that reported by literature reviews with less focused and restrictive qualifying criteria. To yield substantial short-term health care cost savings, the longer term financial return that can credibly be associated with a comprehensive, prevention-oriented population health program must be augmented by other financial impact strategies. PMID:22313443
Grossmeier, Jessica; Terry, Paul E; Anderson, David R; Wright, Steven
Poverty level affects mental health status. African Americans living below the poverty level, as compared to those over twice the poverty level, are 3 ... compared to 120% of Non-Hispanic Whites. 1 MENTAL HEALTH STATUS: Serious psychological distress among adults 18 years ...
In developed countries, the predominant health problems are those lifestyle-related illnesses associated with increased wealth. In contrast, diseases occurring in developing countries can largely be attributed to poverty, poor healthcare infrastructure, and limited access to care. However, many developing countries such as India have undergone economic and demographic growth in recent years resulting in a transition from diseases caused by
Jeyaraj D. Pandian; Velandai Srikanth; Stephen J. Read; Amanda G. Thrift
Past studies have identified nutrition exclusively with nutrient intake. A better definition of nutrition would critically affect the link between poverty and malnutrition and would affect the implications for policies designed to improve the nutritional status of the poor. This paper focuses on the relationship between household income and their nutritional and health status. It presents new evidence on these
This paper makes detailed population and poverty projections that take into account expected demographic changes (in terms of fertility, mortality, migration, and education) as well as differentials in social mobility by household type. Such projections could be useful for a variety of purposes ranging from assessment of necessary social investments (education facilities, health facilities, pension systems, etc), projections of the
In this paper, we investigate factors affecting total household consumption and poverty in Uganda using household survey data. Our analysis indicates that household wellbeing can be improved by expanding education at all levels (primary, secondary, and university), expanding formal employment, increasing the number of microenterprises, reducing the average household size, expanding the number of schools and health facilities so that
|The article presents a case study in which business leaders deal with challenging problems related to poverty, involving multiple stakeholders. This emphasizes the importance of training prospective global leaders to manage stakeholder relationships and engage in stakeholder dialogue. The authors highlight the stakeholder role played by…
Reade, Carol; Todd, Anne Marie; Osland, Asbjorn; Osland, Joyce
Background: Managers’ lives have become a never-ending race against time, technology, and targets. This race creates tension, which leads to dissatisfaction and frustration and eventually manifests itself as psychological and physiological stress with mental and emotional drain. This modern lifestyle intensifies the stress leading to “Excessive Tension” and consequent deterioration in “Executive Efficiency.” Objective: To assess mental health in managers undergoing yoga-based Self-Management of Excessive Tension (SMET) program. Materials and Methods: 72 managers with 48.75±3.86 years of mean age were participated in this study of single group pre–post design. The General Health Questionnaire data were taken on the first and sixth day of 5 days SMET program. Results: The data analysis showed 68.25% decrease (P<0.001) in somatic symptoms, 66.29% decrease (P<0.001) in anxiety and insomnia, 65.00% decrease (P<0.001) in social dysfunction, 87.08% decrease (P<0.001) in severe depression, and 71.47% decrease (P<0.001) in all medical complaints. Conclusion: These results suggest that participation in a SMET program was associated with improvement in mental health and may have implications for “Executive Efficiency.”
Health crisis management is a crisis management of life, body, and mind. This is the most important role for today's public health center. However, few of the personnel realize health crisis as an urgent problem. Through the establishment of a coordinated system in the region and the implementation of cooperative practice, we are keenly aware of the importance of agreeing
...FRL-9197-7] Best Management Practices for Unused Pharmaceuticals at Health Care Facilities AGENCY: Environmental...document entitled, Best Management Practices for Unused Pharmaceuticals at Health Care Facilities. The...
The primary health care model of public health has been implemented in many countries around the globe since the Declaration of Alma Ata in 1978, without pilot testing the primary health care model. Therefore, many public health researchers have sought methods of improving primary health care by creating evidence-based models. Many of these researchers recognize the role of behavioral models in public health. These offshoots of primary health care include the ecological, care, central human capabilities, and the SPECIES models. Holistic self-management education and support is a capacity-building philosophy that ensures active involvement of consumers of health care in the planning and implementation and evaluation of health care services. It helps consumers of health care to achieve the desired improved quality of health and life in managing and sustaining their health at the grassroots level. The care model addresses disease management ideals of the in the original primary health care model. The SPECIES model addresses those aspects of the primary health care model that include the cultural and social factors, as well as individual health education and support in the original primary health care model. The ecological model offers an improvement of the socioeconomic ideal in the original primary health care model. Improving the health of individuals will prevent illness, thereby reducing health care costs and lessening the current strain on an overburdened health care system in Zimbabwe. Holistic self-management education and support links health care delivery systems with social processes. It is a best practices model that could better serve Zimbabwean girls and women by contributing positively to the national challenges in health care, thereby meeting the Zimbabwean primary health care and safe motherhood goals. It is here recommended that holistic self-management education and support must be pilot tested before being adopted as the most appropriate model for ensuring population health. PMID:16844675
We describe the impact of community health workers (CHWs) providing community-based support services to enrollees who are high consumers of health resources in a Medicaid managed care system. We conducted a retrospective study on a sample of 448 enrollees who were assigned to field-based CHWs in 11 of New Mexico's 33 counties. The CHWs provided patients education, advocacy and social support for a period up to 6 months. Data was collected on services provided, and community resources accessed. Utilization and payments in the emergency department, inpatient service, non-narcotic and narcotic prescriptions as well as outpatient primary care and specialty care were collected on each patient for a 6 month period before, for 6 months during and for 6 months after the intervention. For comparison, data was collected on another group of 448 enrollees who were also high consumers of health resources but who did not receive CHW intervention. For all measures, there was a significant reduction in both numbers of claims and payments after the community health worker intervention. Costs also declined in the non-CHW group on all measures, but to a more modest degree, with a greater reduction than in the CHW group in use of ambulatory services. The incorporation of field-based, community health workers as part of Medicaid managed care to provide supportive services to high resource-consuming enrollees can improve access to preventive and social services and may reduce resource utilization and cost. PMID:21953498
Total quality management (TQM) is a participative, systematic approach to planning and implementing a continuous organizational improvement process. Its approach is focused on satisfying customers' expectations, identifying problems, building commitment, and promoting open decision-making among workers. TQM applies analytical tools, such as flow and statistical charts and check sheets, to gather data about activities within an organization. TQM uses process techniques, such as nominal groups, brainstorming, and consensus forming to facilitate communication and decision making. TQM applications in the public sector and particularly in public health agencies have been limited. The process of integrating TQM into public health agencies complements and enhances the Model Standards Program and assessment methodologies, such as the Assessment Protocol for Excellence in Public Health (APEX-PH), which are mechanisms for establishing strategic directions for public health. The authors examine the potential for using TQM as a method to achieve and exceed standards quickly and efficiently. They discuss the relationship of performance standards and assessment methodologies with TQM and provide guidelines for achieving the full potential of TQM in public health organizations. The guidelines include redefining the role of management, defining a common corporate culture, refining the role of citizen oversight functions, and setting realistic estimates of the time needed to complete a task or project.
We assess the satisfaction of mental health providers using four dimensions from the medical practice literature--degree of autonomy, relationship with patients, compensation, and administrative burden--and extend current work on professional satisfaction to include frontline service providers rather than only psychiatrists or other physicians. In contrast to results reported for primary care settings, we find that the impact of managed care on satisfaction is minimal for the mental health providers in our study of a Medicaid capitation demonstration in the southeastern US. Instead, variables relevant to everyday working conditions have an important effect on job satisfaction. PMID:19002581
Isett, Kimberley R; Ellis, Alan R; Topping, Sharon; Morrissey, Joseph P
Media relations is an important function in the operation of any health organization, yet it is often relegated as a simple task function. Such an orientation can be problematic, particularly in times of crisis. This article provides an overview of some of the inherent internal conflicts within health organizations that may mitigate against the best media relations practices in times of crises. The article surveys some of the predominant theoretical models used for crisis management, and suggests directions for the further development of media relations and crisis communication theory and practice. PMID:19042529
The heterogeneity of e-health systems encourages the use of standards such as Health Level 7 (HL7v3) to ensure interoperability. Many actual implementations address this problem by unoptimized high level programming of top-range portable computing platforms. However, this approach could pose excessive demands on battery-powered mid-range terminals. In this work, we propose low-level support for portable HL7v3-compatible embedded systems in order to better exploit their limited processing and communications capabilities. In particular, we present our experience in mobile communication management through two different approaches, which proves the feasibility of this proposal.
Oral health information was included in 89.5% of diabetes education programs in states with high diabetes prevalence compared to 85.9% in low prevalence states (P = 0.22). Comparing the high to low diabetes prevalence states, there were significant differences in odds for responding "yes" to the topics "show patients proper tooth brushing (and flossing) techniques" and "managing dry mouth" (Ps = 0.02). However, management of dry mouth, demonstrations and return demonstrations of oral hygiene techniques were covered by 27.0%, 10.1% and < 1% programs, respectively. PMID:21030100
Yuen, Hon K; Marlow, Nicole M; Mahoney, Samantha; Slate, Elizabeth; Jenkins, Carolyn; London, Steven
... Printing Office. 2006. DeNavas-Walt C, Proctor BD, Smith J. Income, poverty, and health insurance coverage in ... Printing Office. 2007. DeNavas-Walt C, Proctor BD, Smith JC. Income, poverty, and health insurance coverage in ...
...outcomes. Case management involves the...members of the health care team. Quality...the cost of health care, case management has proven its...determine the health care priorities...the PHN case management program...
In the mid-1970s, some 120 million Latin Americans were unable to satisfy their most basic material needs. 55 million of them were in extreme indigency, unable to satisfy their minimal food needs even by using their entire incomes for that purpose. The rapid rate of demographic growth in Latin America influences the growth of the poor strata, who in absolute and relative terms show the highest rates of population growth. Despite heterogeneity in the manifestations of poverty, the poor have certain traits in common: employment outside the modern sector, with low productivity and little hope of generating stable incomes, low consumption capability, and lack of political power. 1 of the great problems of economic development in Latin America is the exclusion of the poorest strata from employment in better paid jobs. The high rate of fertility and rapid population growth provoke a negative interaction between population and development, in which the poorest strata reproduce most rapidly, becoming even poorer. A program of family planning within a development effort providing employment and income is needed to mitigate the problem, and no avenue or effort of implementation should be neglected on ideological grounds. Between 1960-70, the share of the poorest 20% of the population declined from 3.1% to 2.5% of the toal income of the region, while that of the poorest 1/2 increased slightly from 13.4% to 13.9%. In 1970 the poorest 20% had a per capita income of about US $70/year. It has been estimated that the proportion of the poor in Latin America declined from 51% in 1960 to 40% in 1970 and 33% at present, but the absolute number of persons affected continues to increase. PMID:12339314
Healthcare waste streams are persistent waste streams and which are consistently increasing in volume and complexity in developed and developing countries. When poorly managed, through inappropriate health care waste management systems, they can cause adverse effects to human health and the environment.This paper presents an evaluation of health care waste management systems in Cameroon, based on a survey of five
Veronica E. Manga; Osric Tening Forton; Linus A. Mofor; Ryan Woodard
A review of English-language journals published since 1990 and three global mental health reports identified 11 community studies on the association between poverty and common mental disorders in six low- and middle-income countries. Most studies showed an association between indicators of poverty and the risk of mental disorders, the most consistent association being with low levels of education. A review of articles exploring the mechanism of the relationship suggested weak evidence to support a specific association with income levels. Factors such as the experience of insecurity and hopelessness, rapid social change and the risks of violence and physical ill-health may explain the greater vulnerability of the poor to common mental disorders. The direct and indirect costs of mental ill-health worsen the economic condition, setting up a vicious cycle of poverty and mental disorder. Common mental disorders need to be placed alongside other diseases associated with poverty by policy-makers and donors. Programmes such as investment in education and provision of microcredit may have unanticipated benefits in reducing the risk of mental disorders. Secondary prevention must focus on strengthening the ability of primary care services to provide effective treatment. PMID:14576893
BACKGROUND: Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for
Poverty rates are now widely available, but are they reliable. Wide variations in estimated poverty rates for the same poverty line, year and country reflect an underlying reality: there is no widely accepted procedure for estimating national poverty rate...
This paper presents applications of A.I. in turbine engines fault diagnosis and healthmanagement. Self-organizing map and back-propagation neural networks supported with fuzzy-logic decision-making tool were developed and integrated together as diagnostics software for turbine engines. Two different neural network architectures were trained and used. An unsupervised network (SOM) was used to cluster sensors data to distinct locations on a
Richard Hans Mgaya; Charles D. McCurry; Saleh Zein-Sabatto
This article describes considerations in health and behavioral sciences small grant management and describes lessons learned during post-award implementation. Using the components by W. Sahlman [Sahlman, W. (1997). How to write a great business plan. Harvard Business Review, 75(4), 98–108] as a business framework, a plan was developed that included (a) building relationships with people in the research program and
Teresa J. Sakraida; Jessica D'Amico; Erica Thibault
The contribution of public health officers is of crucial importance in both the preparedness planning process and the response to health threats since the implementation of public health measures lies within the competence of the public health system. Thus, public health officers on regional and district level have to be involved in every stage of the planning process for crisis management. Federal structures of health systems as equivalent to the political structure of a country pose specific challenges for both the planning process and the response itself. The most important instrument for the evaluation of crisis plans, including the assessment of the public health officers' preparedness, is the performance of exercises. The success of a simulation exercise depends mainly on careful planning process, clear evaluation criteria and a work plan, that allows for necessary improvements of crisis plans of all involved organisations. Simulation exercises are an integrated element of preparedness activities on all administrative levels of the public health system. Depending on the nature of the exercise public health officers on regional and district level are involved as planners or as players PMID:18768125
This nonexperimental quantitative descriptive-correlative research study was performed to describe the sources with the greatest influence on the participants’ decision to enroll in a postsecondary educational program with the intent of working toward a career in health information management. Participants were asked, “Which sources have the greatest influence on an individual's decision to enroll in a postsecondary educational program with the intent of working toward a career in health information management (HIM)?” The study population was composed of matriculated students enrolled in accredited postsecondary schools offering an undergraduate medical billing and coding program at a brick-and-mortar campus in a two-county area of a South Atlantic state. The study found that an environmental source, specifically career job opportunities, was statistically significant as the greatest source of influence for these participants. This research aims to support efforts to provide the health information management subsector of the healthcare industry with a sufficient number of trained professionals to fill the identified need for trained HIM professionals, particularly medical coding specialists.
BACKGROUND: This paper addresses the health care system from a global perspective and the importance of human resources management (HRM) in improving overall patient health outcomes and delivery of health care services. METHODS: We explored the published literature and collected data through secondary sources. RESULTS: Various key success factors emerge that clearly affect health care practices and human resources management.
Stefane M. Kabene; Carole Orchard; John M. Howard; Mark A. Soriano; Raymond Leduc
Moral distress is a concept used to date in clinical literature to describe the experience of staff in circumstances in which they are prevented from delivering the kind of bedside care they believe is expected of them, professionally and ethically. Our research objective was to determine if this concept has relevance in terms of key health care managerial functions, such as priority setting and resource allocation. We conducted interviews and focus groups with mid- and senior-level managers in two British Columbia (Canada) health authorities. Transcripts were analyzed qualitatively using constant comparison to identify key themes related to moral distress. Both mid- and senior-level managers appear to experience moral distress, with both similarities and differences in how their experiences manifest. Several examples of this concept were identified including the obligation to communicate or 'sell' organizational decisions or policies with which a manager personally may disagree and situations where scarce resources compel managers to place staff in situations where they meet with predictable and potentially avoidable risks. Given that moral distress appears to be a relevant issue for at least some health care managers, further research is warranted into its exact nature, prevalence, and possible organizational and personal responses. PMID:20217482
The volcano on Montserrat, after being dormant for over 400 years, has been active for the past two years, last erupting on 27 June, 1997. With the capital, Plymouth, in the unsafe zone, major dislocation of people, facilities and services has occurred. The Health Department is splintered over five sites across an eight mile span and the temporary 30 bed hospital, sited at a primary school, is separated from its Casualty and Out-patient Department and Operating Theatre by 0.25 mile. In order to maintain continuity of care for communities, efforts have been made to keep evacuated clients and their community health workers as close together as possible. The mass emigration has depleted the health services, creating severe stress for those remaining. Elderly relatives have frequently been left behind, necessitating the establishment of special geriatric care facilities to cater to their needs. Increased and continuous health surveillance and mass media education have been integral to the prevention of major disease outbreak--particularly with added challenges to food safety, and management of liquid and solid waste disposal. Cooperation from neighbouring states, particularly Antigua, Barbados and Guadeloupe, as well as from the United Kingdom, has been critical in the management of the continuing crisis. PMID:10368618
Triggered by corporate scandals, there is increased oversight by governmental bodies and in part by the Sarbanes-Oxley Act of 2002. Corporations are developing corporate governance compliance initiatives to respond to the scrutiny of regulators, legislators, the general public and constituency groups such as investors. Due to state attorney general initiatives, new legislation and heightened oversight from the Internal Revenue Service, nonprofit entities are starting to share the media spotlight with their for-profit counterparts. These developments are changing nonprofit health care organizations as well as the traditional role of the risk manager. No longer is the risk manager focused solely on patients' welfare and safe passage through a complex delivery system. The risk manager must be aware of corporate practices within the organization that could allow the personal objectives of a few individuals to override the greater good of the community in which the nonprofit organization serves. PMID:20200865
Troyer, Glenn T; Brashear, Andrea D; Green, Kelly J
This qualitative study describes the challenges of managing chronic diseases in small, rural, health care practices in Missouri. Four recurrent themes were identified from each of the nine focus groups: the similarity of their patient population and community characteristics, their unfamiliarity with aspects of the chronic care model, the consistent problem of poverty as a barrier to health care access for patients, and the uncertainty about what health care reform will mean for rural practice settings. PMID:22860289
Enriquez, Maithe; Moormeier, Jill; Lafferty, William
This paper examines three aspects of the relationship between the permanence of poverty and the housing situation of poor households: whether permanent poverty is a good predictor of housing deprivation; the relation between permanency of housing deprivat...
This paper estimates trends in absolute poverty in urban China from 1988 to 2002 using the Chinese Household Income Project (CHIP) surveys. Poverty incidence curves are plotted, showing that poverty has fallen markedly during the period regardless of the exact location of the poverty line. Income inequality rose from 1988 to 1995 but has been fairly constant thereafter. Models of
Summary This paper estimates trends in absolute poverty in urban China using the Chinese Household Income Project surveys. Poverty incidence curves are plotted, showing lower poverty in 2002 than in 1988 irrespective of the poverty line chosen. Incomes of the poorest fell during 1988-95, contributing to a rise in inequality. However, inequality has been fairly constant thereafter. Models of the
This paper analyzes poverty-affected females in the Amhara region of Ethiopia. As the measurement of poverty, the paper uses body mass index (BMI) because it is one of the effective tools for measuring individual poverty level. The results of the BMI analysis show that the most poverty-affected female group is the female household heads in urban areas. The results, however,
|The paper analyzes subjective poverty in Hungary and compares it to the objective poverty concepts. Subjective poverty is defined by examining who people consider to be poor. Based on the Easterlin paradox, the initial hypothesis states that subjective and absolute poverty concepts are highly correlated. Taking into account that Hungary is a…
Abstract: This paper presents a profile of poverty in Egypt for 1997. It assesses the magnitude,of poverty,and,its distribution across geographic and socioeconomic groups, provides information on the characteristics of the poor, illustrates the heterogeneity amongst the poor, and helps identify empirical correlates of poverty. This poverty profile is constructed using data from the Egypt Integrated Household Survey (EIHS), which is
Despite serious methodological problems, quantitative studies of poverty by U.S. sociologists predominantly rely on the official U.S. measure. After reviewing the shortcomings of the U.S. measure, this article examines several theoretical and methodological advances in poverty measurement. After synthesizing literature on poverty measurement, I argue that ideal measures of poverty should: (1) measure comparative historical variation effectively; (2) be relative
\\u000a Millions of children are experiencing poverty all over the world. It is a problem that exists in both rich and poor countries.\\u000a As poverty has numerous dimensions, it threatens children by depriving them of the material, spiritual and emotional resources\\u000a necessary to grow up into healthy, happy and productive adults. Poverty in childhood is the root cause of poverty in
In this paper, using the EU-SILC 2006 data-set, we seek to explore the extent to which a consideration of welfare regime and socio-economic differences in poverty levels and patterns and variation in the consequences of poverty for economic stress can assist us in making informed choices between alternative poverty indicators. Poverty in the EU is normally defined in terms of
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…
July 2005 saw 225,000 people march through Edinburgh in the city's largest ever demonstration. Their cause was the idealistic injunction to \\\\'Make Poverty History\\\\' (MPH). This paper presents an analysis of the MPH march, focusing particularly on the interplay between protestors, the police and the media. Drawing on ongoing research, it interrogates the disjunction between projected and actual outcomes, paying
This article intervenes in the ongoing ‘globalization debate’ by focusing on two apparently separate debates: on the links between trade liberalization, growth and poverty reduction; and on theories that give too much explanatory weight to the concept of globalization. These two separate debates have close parallels, and in both cases causality and outcome are conflated, with the result that globalization
In order to meet the ever increasing demand for energy, the United States nuclear industry is turning to life extension of existing nuclear power plants (NPPs). Economically ensuring the safe, secure, and reliable operation of aging nuclear power plants presents many challenges. The 2009 Light Water Reactor Sustainability Workshop identified online monitoring of active and structural components as essential to the better understanding and management of the challenges posed by aging nuclear power plants. Additionally, there is increasing adoption of condition-based maintenance (CBM) for active components in NPPs. These techniques provide a foundation upon which a variety of advanced online surveillance, diagnostic, and prognostic techniques can be deployed to continuously monitor and assess the health of NPP systems and components. The next step in the development of advanced online monitoring is to move beyond CBM to estimating the remaining useful life of active components using prognostic tools. Deployment of prognostic healthmanagement (PHM) on the scale of a NPP requires the use of an integrated healthmanagement (IHM) framework - a software product (or suite of products) used to manage the necessary elements needed for a complete implementation of online monitoring and prognostics. This paper provides a thoughtful look at the desirable functions and features of IHM architectures. A full PHM system involves several modules, including data acquisition, system modeling, fault detection, fault diagnostics, system prognostics, and advisory generation (operations and maintenance planning). The standards applicable to PHM applications are indentified and summarized. A list of evaluation criteria for PHM software products, developed to ensure scalability of the toolset to an environment with the complexity of a NPP, is presented. Fourteen commercially available PHM software products are identified and classified into four groups: research tools, PHM system development tools, deployable architectures, and peripheral tools.
|This article analyses the extent and persistence of child poverty in Portugal between 1995 and 2001. Data from the Portuguese component of the European Community Household Panel Survey (ECHP) are used to estimate child poverty rates and children's flows in and out of poverty. The article focuses upon an analysis based on family income and on a…
The paper considers child poverty in rich English-speaking countries – the US, Canada, Australia, New Zealand, the UK, and Ireland. Do all these countries really stand out from other OECD countries for their levels of child poverty, as is sometimes assumed? And what policies have they adopted to address the problem? ‘Poverty’ is interpreted broadly and hence the available cross-national
|Epidemiological studies have consistently reported a significant association between poverty and the prevalence of intellectual disabilities. The available evidence suggests that this association reflects two distinct processes. First, poverty causes intellectual disabilities, an effect mediated through the association between poverty and…
|Almost one quarter of American children live in poverty, and the effects of poverty on these children are mediated by many family and social conditions. Poverty affects parenting practices and the home environment, with consequential effects on child adjustment and functioning. Changes in income cause changes in parenting and the quality of the…
|During 1981-84, migration patterns of both the poor and nonpoor consistently reinforced preexisting spatial concentrations of poverty. High migration rates of the poor into and out of high poverty counties suggest an equilibrium condition. A locale's persistent poverty may result not from lack of opportunity but from an opportunity structure that…
The Capability Approach (henceforth CA) views poverty as a multidimensional phenomenon that is not only characterised by lows levels of achievement in the various dimensions but also by a restricted opportunity to choose among different ways of life. The CA thus puts a lot of emphasis on (limited) freedom of choice as a crucial aspect of poverty. If poverty is
Epidemiological studies have consistently reported a significant association between poverty and the prevalence of intellectual disabilities. The available evidence suggests that this association reflects two distinct processes. First, poverty causes intellectual disabilities, an effect mediated through the association between poverty and exposure…
Examines consequences of family poverty for child development, noting evidence that deep or persistent poverty early in childhood adversely affects children's ability and achievement. Argues that although the 1996 welfare reforms spurred many welfare-to-work transitions, their time limits and sanctions are likely to deepen poverty among some…
...2013-04-01 2013-04-01 false Poverty rate. 598.115 Section 598.115...Eligibility Requirements Â§ 598.115 Poverty rate. (a) General. In order to be eligible for designation, an area's poverty rate must satisfy the following...
...2013-01-01 2013-01-01 false Poverty rate. 25.104 Section 25.104...COMMUNITIES Area Requirements Â§ 25.104 Poverty rate. (a) General. Eligibility of an area on the basis of poverty shall be established in accordance...
|Poverty is a dehumanising condition for every one. It erodes human rights of the affected whether women or men. Poverty subjects an individual to a state of powerlessness, hopelessness, and lack of self-esteem, confidence, and integrity, leading to a situation of multidimensional vulnerability. Poverty has a gender dimension since women and men…
and the factors behind the poverty increase of Latinos in these neighborhoods. Results show that Latinos in Latino tracts rank worse than US Latinos on virtually all socioeconomic measures. Recent immigrants raise Latino neighborhood poverty, while long-term immigrants reduce it. The 1979 to 1989 increase in poverty in Latino neighborhoods can be explained better by changes in the payoffs of
Poverty profiles are a useful way of summarizing information on the levels of poverty and the characteristics of the poor in a society, but they are limited by the bivariate nature of their informational content. Using the 1997 Egypt Integrated Household Survey (EIHS), this article estimates models of household consumption in the first stage and then predicts poverty rates corresponding
Poverty, a complex, multidimensional, and universal problem, has been conceptualized as income and material deprivation. In this article, we discuss poverty and related factors in Turkey. The absolute poverty line for Turkey was US $4 per capita per day. Turkey was ranked 92nd out of 177 countries with moderate human development in the 2006 Hu- man Development Report. The individual
This paper analyzes the determinants of rural poverty in India, contrasting the situation of the Scheduled Caste (SC) and Schedule Tribe (ST) households with the non-scheduled population. The incidence of poverty among SC and ST households is significantly higher than non-scheduled households. Using a probit decomposition analysis, we decompose the difference in the poverty rates between the scheduled castes (or
After the fall of the apartheid system in South Africa, it has been an especially interesting country to examine in trying to determine what causes poverty today. Historically, poverty was forced upon the blacks specifically through the apartheid system. This paper utilizes 2002 labor force data to examine the presence of poverty and how it may have shifted across the
This paper investigates the impacts of trade liberalisation on poverty reduction in Vietnam during the period of economic reform. Using a combined approach dealing with four transmitting channels from trade to poverty, the major findings are summarised as follows. First, Vietnam's trade liberalisation has fostered economic growth, which has helped to raise per capita GDP and reduce poverty. Second, trade
This paper presents an overview of poverty, changes in poverty over time, and some of the causes of these changes. It opens with a discussion of various concepts of poverty, paying particular attention to recent controversy over nutritional norms and to t...
As an agricultural country and one of the world’s major food exporters, Thailand relies heavily on the use of pesticides to protect crops and increase yields. During the past decade, the Kingdom of Thailand has experienced an approximate four-fold increase in pesticide use. This increase presents a challenge for the Royal Thai Government in effectively managing and controlling pesticide use based upon the current policies and legal infrastructure. We have reviewed several key components for managing agricultural pesticides in Thailand. One of the main obstacles to effective pesticide regulation in Thailand is the lack of a consolidated, uniform system designed specifically for pesticide management. This deficit has weakened the enforcement of existing regulations, resulting in misuse/overuse of pesticides, and consequently, increased environmental contamination and human exposure. This article provides a systematic review of how agricultural pesticides are regulated in Thailand. In addition, we provide our perspectives on the current state of pesticide management, the potential health effects of widespread, largely uncontrolled use of pesticides on the Thai people and ways to improve pesticide management in Thailand.
Panuwet, Parinya; Siriwong, Wattasit; Prapamontol, Tippawan; Ryan, P. Barry; Fiedler, Nancy; Robson, Mark G.; Barr, Dana Boyd
The construct of the ‘feminisation of poverty’ has helped to give gender an increasingly prominent place within international discourses on poverty and poverty reduction. Yet the way in which gender has been incorporated pragmatically – predominantly through the ‘feminisation’ of anti-poverty programmes – has rarely relieved women of the onus of coping with poverty in their households, and has sometimes exacerbated their burdens. In
Lifestyle is a key determinant in the prevention and management of chronic diseases. If we would exercise regularly, eat healthy, control our weight, sleep enough, manage stress, not smoke and use alcohol only moderately, 90% of type II diabetes, 80% of coronary heart disease, and 70% of stroke could be prevented. Health statistics show that lifestyle related diseases are increasing at an alarming rate. Public health promotion campaigns and healthcare together are not effective enough to stop this "tsunami". The solution that is offered is to empower people to manage their health with the assistance of ICT-enabled services. A lot of R&D and engineering effort is being invested in Personal Health Systems. Although some progress has been made, the market for such systems has not yet emerged. The aim of this critical review is to identify the barriers which are holding back the growth of the market. It looks into the theoretical foundations of behavior change support, the maturity of the technologies for behavior change support, and the business context in which behavior change support systems are used. PMID:22273795
Honka, Anita; Kaipainen, Kirsikka; Hietala, Henri; Saranummi, Niilo
Health and human service organizations are becoming increasingly liable for violations of patient privacy as a result of recent federal mandates at both state and federal levels of government. Under such conditions it would seem likely that managers would act to quickly implement such guidelines and mandates, especially in sensitive specialty areas such as mental health. This study sought to examine the degree and type of patient information confidentiality measures adopted in mental health delivery settings, through a national survey of accredited US health information managers. Results suggest that significant nonadoption of basic confidentiality measures continues to exist, despite federal mandates to the contrary. Further examined was the degree to which confidentiality management varies across adoption levels of computerized patient records. Significant variation was found in adoption of patient confidentiality measures between highly computerized and paper-based medical record functions. Similar levels of variation in adoption across practice settings was also discovered. Ramifications for national policy and patient information protection are discussed. PMID:15255227
This summary reports on the state of environmental conditions in 1993 and is a reprint from an ICPD publication. This summary refers to a Roundtable Meeting held in November 1993, preliminary to the 1994 UN Conference on the Environment and Development, and an environmental report by Mary Berberis. The report identifies five regions with serious environmental degradation and resource depletion (the Bay of Bengal; the former forested uplands of Indonesia, Nepal, the Philippines, and Thailand; the forests of Central America; the arid regions of sub-Saharan Africa; and the small South Pacific island states). These regions are not just beset with environmental problems, but those problems are exacerbated by problems with land supply and use, poverty, waste, and lack of technology. The report emphasizes that a focus solely on population growth issues obscures the urgent demand for dealing with poverty alleviation, land reform, waste reduction, and improved technologies. Environmental degradation is also caused to a great extent by unsustainable patterns of consumption by affluent groups and by the processes of urban expansion, deforestation, and cultivation of marginal lands in both developed and developing countries. Mary Barberis in her summary of the literature on the causes of environmental conditions considers that the most serious environmental damage is generated by conditions of poverty and population pressure. Environmentally unsound practices are supported by inappropriate farming and soil management techniques, unequal access to resources, and government policies. The example of Bangladesh illustrates that urban population growth has occurred mostly in poor areas, and the problems of water supply, drainage, solid waste disposal, and sanitation are compounded by population growth. Rivers and marine fisheries is contaminated by urban discharges, untreated industrial waste, and fertilizers. Increased salinization degrades the land. Harvesting of wood depletes the mangrove forests, aggravated flooding, and increased soil erosion. Delicate coastal ecosystems are degraded by expanded cultivation of land. The examples from Thailand, the Philippines, Central America, sub-Saharan Africa, and island states show similar interactions between poverty, policies, and inappropriate land use patterns. PMID:12290570