Science.gov

Sample records for achieve optimal health

  1. Achieving Quality in Occupational Health

    NASA Technical Reports Server (NTRS)

    O'Donnell, Michele (Editor); Hoffler, G. Wyckliffe (Editor)

    1997-01-01

    The conference convened approximately 100 registered participants of invited guest speakers, NASA presenters, and a broad spectrum of the Occupational Health disciplines representing NASA Headquarters and all NASA Field Centers. Centered on the theme, "Achieving Quality in Occupational Health," conferees heard presentations from award winning occupational health program professionals within the Agency and from private industry; updates on ISO 9000 status, quality assurance, and information technologies; workshops on ergonomics and respiratory protection; an overview from the newly commissioned NASA Occupational Health Assessment Team; and a keynote speech on improving women's health. In addition, NASA occupational health specialists presented 24 poster sessions and oral deliveries on various aspects of current practice at their field centers.

  2. Student Health and Academic Achievement

    MedlinePlus

    ... Evaluation FAQs Additional Evaluation Resources Health & Academics Anti-Bullying Policies and Enumeration: An Infobrief for Local Education ... 11 Resources Health and Academics Data and Statistics Bullying and Absenteeism: Information for State and Local Education ...

  3. Health and Nutrition: Preconditions for Educational Achievement.

    ERIC Educational Resources Information Center

    Negussie, Birgit

    This paper discusses the importance of maternal and infant health for children's educational achievement. Education, health, and nutrition are so closely related that changes in one causes changes in the others. Improvement of maternal and preschooler health and nutrition is a precondition for improved educational achievement. Although parental…

  4. Building health research systems to achieve better health.

    PubMed

    Hanney, Stephen R; González Block, Miguel A

    2006-11-06

    Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS) provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics related to the above

  5. Disparities in academic achievement and health: the intersection of child education and health policy.

    PubMed

    Fiscella, Kevin; Kitzman, Harriet

    2009-03-01

    Recent data suggest that that the United States is failing to make significant progress toward the Healthy People 2010 goal of eliminating health disparities. One missing element from the US strategy for achieving this goal is a focus on gaps in child development and achievement. Academic achievement and education seem to be critical determinants of health across the life span and disparities in one contribute to disparities in the other. Despite these linkages, national policy treats child education and health as separate. Landmark education legislation, the No Child Left Behind Act of 2001, is due for Congressional reauthorization. It seeks to eliminate gaps in academic child achievement by 2014. It does so by introducing accountability for states, school districts, and schools. In this special article, we review health disparities and contributors to child achievement gaps. We review changes in achievement gaps over time and potential contributors to the limited success of the No Child Left Behind Act of 2001, including its unfunded mandates and unfounded assumptions. We conclude with key reforms, which include addressing gaps in child school readiness through adequate investment in child health and early education and reductions in child poverty; closing the gap in child achievement by ensuring equity in school accountability standards; and, importantly, ensuring equity in school funding so that resources are allocated on the basis of the needs of the students. This will ensure that schools, particularly those serving large numbers of poor and minority children, have the resources necessary to promote optimal learning.

  6. Achieving Population Health in Accountable Care Organizations

    PubMed Central

    Walker, Deborah Klein

    2013-01-01

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

  7. A concept analysis of optimality in perinatal health.

    PubMed

    Kennedy, Holly Powell

    2006-01-01

    This analysis was conducted to describe the concept of optimality and its appropriateness for perinatal health care. The concept was identified in 24 scientific disciplines. Across all disciplines, the universal definition of optimality is the robust, efficient, and cost-effective achievement of best possible outcomes within a rule-governed framework. Optimality, specifically defined for perinatal health care, is the maximal perinatal outcome with minimal intervention placed against the context of the woman's social, medical, and obstetric history.

  8. "Masculinity, Femininity, Achievement Conflicts and Health."

    ERIC Educational Resources Information Center

    Olds, Debra Eaton

    The objective of this study is to measure achievement motivation in terms of psychological masculinity and femininity rather than in terms of biological gender. The terms, psychological masculinity and femininity, refer to sets of characteristics desirable for both sexes. Masculine characteristics include independence, self-confidence,…

  9. Optimizing bone health in children and adolescents.

    PubMed

    Golden, Neville H; Abrams, Steven A

    2014-10-01

    The pediatrician plays a major role in helping optimize bone health in children and adolescents. This clinical report reviews normal bone acquisition in infants, children, and adolescents and discusses factors affecting bone health in this age group. Previous recommended daily allowances for calcium and vitamin D are updated, and clinical guidance is provided regarding weight-bearing activities and recommendations for calcium and vitamin D intake and supplementation. Routine calcium supplementation is not recommended for healthy children and adolescents, but increased dietary intake to meet daily requirements is encouraged. The American Academy of Pediatrics endorses the higher recommended dietary allowances for vitamin D advised by the Institute of Medicine and supports testing for vitamin D deficiency in children and adolescents with conditions associated with increased bone fragility. Universal screening for vitamin D deficiency is not routinely recommended in healthy children or in children with dark skin or obesity because there is insufficient evidence of the cost-benefit of such a practice in reducing fracture risk. The preferred test to assess bone health is dual-energy x-ray absorptiometry, but caution is advised when interpreting results in children and adolescents who may not yet have achieved peak bone mass. For analyses, z scores should be used instead of T scores, and corrections should be made for size. Office-based strategies for the pediatrician to optimize bone health are provided. This clinical report has been endorsed by American Bone Health.

  10. Health Risk Behaviors and Academic Achievement

    MedlinePlus

    ... 2009 † Health-Risk Behaviors Percentage of U.S. high school students who engaged in each risk behavior, by type of grades mostly earned A’s B’s C’s D’s/F’s Unintentional Injury and Violence-Related Behaviors Rarely or never wore a seat ...

  11. Primary health care: from aspiration to achievement.

    PubMed

    Diallo, I; Molouba, R; Sarr, L C

    1993-01-01

    A review is presented of Senegal's response to the Bamako Initiative, aimed at strengthening primary health care. The experience gained is of broad interest since the basic principles involved are the same everywhere. Of particular importance are users' financial contributions and improved organization and management.

  12. An Investigation of Perfectionism, Mental Health, Achievement, and Achievement Motivation in Adolescents.

    ERIC Educational Resources Information Center

    Accordino, Denise B.; Accordino, Michael P.; Slaney, Robert B.

    2000-01-01

    Examines the relationship of perfectionism with measures of achievement and achievement motivation and mental health aspects of depression and self-esteem in high school students (N=123). Results indicate that students' personal standards were significant predictors of academic achievement and academic motivation. Also reveals that as students'…

  13. Translational Geroscience: Emphasizing function to achieve optimal longevity

    PubMed Central

    Seals, Douglas R.; Melov, Simon

    2014-01-01

    Among individuals, biological aging leads to cellular and organismal dysfunction and an increased risk of chronic degenerative diseases and disability. This sequence of events in combination with the projected increases in the number of older adults will result in a worldwide healthcare burden with dire consequences. Superimposed on this setting are the adults now reaching traditional retirement ages--the baby boomers--a group that wishes to remain active, productive and physically and cognitively fit as they grow older. Together, these conditions are producing an unprecedented demand for increased healthspan or what might be termed “optimal longevity”—to live long, but well. To meet this demand, investigators with interests in the biological aspects of aging from model organisms to human epidemiology (population aging) must work together within an interactive process that we describe as translational geroscience. An essential goal of this new investigational platform should be the optimization and preservation of physiological function throughout the lifespan, including integrative physical and cognitive function, which would serve to increase healthspan, compress morbidity and disability into a shorter period of late-life, and help achieve optimal longevity. To most effectively utilize this new approach, we must rethink how investigators and administrators working at different levels of the translational research continuum communicate and collaborate with each other, how best to train the next generation of scientists in this new field, and how contemporary biological-biomedical aging research should be organized and funded. PMID:25324468

  14. Optimized Delivery System Achieves Enhanced Endomyocardial Stem Cell Retention

    PubMed Central

    Behfar, Atta; Latere, Jean-Pierre; Bartunek, Jozef; Homsy, Christian; Daro, Dorothee; Crespo-Diaz, Ruben J.; Stalboerger, Paul G.; Steenwinckel, Valerie; Seron, Aymeric; Redfield, Margaret M.; Terzic, Andre

    2014-01-01

    Background Regenerative cell-based therapies are associated with limited myocardial retention of delivered stem cells. The objective of this study is to develop an endocardial delivery system for enhanced cell retention. Methods and Results Stem cell retention was simulated in silico using one and three-dimensional models of tissue distortion and compliance associated with delivery. Needle designs, predicted to be optimal, were accordingly engineered using nitinol – a nickel and titanium alloy displaying shape memory and super-elasticity. Biocompatibility was tested with human mesenchymal stem cells. Experimental validation was performed with species-matched cells directly delivered into Langendorff-perfused porcine hearts or administered percutaneously into the endocardium of infarcted pigs. Cell retention was quantified by flow cytometry and real time quantitative polymerase chain reaction methodology. Models, computing optimal distribution of distortion calibrated to favor tissue compliance, predicted that a 75°-curved needle featuring small-to-large graded side holes would ensure the highest cell retention profile. In isolated hearts, the nitinol curved needle catheter (C-Cath) design ensured 3-fold superior stem cell retention compared to a standard needle. In the setting of chronic infarction, percutaneous delivery of stem cells with C-Cath yielded a 37.7±7.1% versus 10.0±2.8% retention achieved with a traditional needle, without impact on biocompatibility or safety. Conclusions Modeling guided development of a nitinol-based curved needle delivery system with incremental side holes achieved enhanced myocardial stem cell retention. PMID:24326777

  15. Using tailored methodical approaches to achieve optimal science outcomes

    NASA Astrophysics Data System (ADS)

    Wingate, Lory M.

    2016-08-01

    The science community is actively engaged in research, development, and construction of instrumentation projects that they anticipate will lead to new science discoveries. There appears to be very strong link between the quality of the activities used to complete these projects, and having a fully functioning science instrument that will facilitate these investigations.[2] The combination of using internationally recognized standards within the disciplines of project management (PM) and systems engineering (SE) has been demonstrated to lead to achievement of positive net effects and optimal project outcomes. Conversely, unstructured, poorly managed projects will lead to unpredictable, suboptimal project outcomes ultimately affecting the quality of the science that can be done with the new instruments. The proposed application of these two specific methodical approaches, implemented as a tailorable suite of processes, are presented in this paper. Project management (PM) is accepted worldwide as an effective methodology used to control project cost, schedule, and scope. Systems engineering (SE) is an accepted method that is used to ensure that the outcomes of a project match the intent of the stakeholders, or if they diverge, that the changes are understood, captured, and controlled. An appropriate application, or tailoring, of these disciplines can be the foundation upon which success in projects that support science can be optimized.

  16. Assessing Latin America's Progress Toward Achieving Universal Health Coverage.

    PubMed

    Wagstaff, Adam; Dmytraczenko, Tania; Almeida, Gisele; Buisman, Leander; Hoang-Vu Eozenou, Patrick; Bredenkamp, Caryn; Cercone, James A; Diaz, Yadira; Maceira, Daniel; Molina, Silvia; Paraje, Guillermo; Ruiz, Fernando; Sarti, Flavia; Scott, John; Valdivia, Martin; Werneck, Heitor

    2015-10-01

    Two commonly used metrics for assessing progress toward universal health coverage involve assessing citizens' rights to health care and counting the number of people who are in a financial protection scheme that safeguards them from high health care payments. On these metrics most countries in Latin America have already "reached" universal health coverage. Neither metric indicates, however, whether a country has achieved universal health coverage in the now commonly accepted sense of the term: that everyone--irrespective of their ability to pay--gets the health services they need without suffering undue financial hardship. We operationalized a framework proposed by the World Bank and the World Health Organization to monitor progress under this definition and then constructed an overall index of universal health coverage achievement. We applied the approach using data from 112 household surveys from 1990 to 2013 for all twenty Latin American countries. No country has achieved a perfect universal health coverage score, but some countries (including those with more integrated health systems) fare better than others. All countries except one improved in overall universal health coverage over the time period analyzed.

  17. Toward achieving optimal response: understanding and managing antidepressant side effects

    PubMed Central

    Kelly, Karen; Posternak, Michael; Jonathan, E. Alpert

    2008-01-01

    The safety and tolerability of antidepressants have improved considerably over the past two decades, Nevertheless, antidepressant side effects are still common and problematic. The majority of patients treated with contemporary agents experience one or more bothersome side effects. These side effects often create barriers to achieving depressive remission, as well as to preventing relapse and recurrence. Clinicians tend to underestimate the prevalence of side effects, and as many as one quarter of patients discontinue their antidepressants because of difficult-to-tolerate side effects; others may continue on antidepressant therapy but experience diminished quality of life related to troublesome side effects. This article reviews the prevalence of side effects, the impact of side effects on treatment adherence, and methodological issues including the challenge of distinguishing side effects from residual depressive symptoms, discontinuation effects, and general medical problems. In addition, we address the most common side effects such as sexual dysfunction, gastrointestinal problems, sleep disturbance, apathy, and fatigue, and offer strategies for management that may help patients achieve optimal response to pharmacotherapy. PMID:19170398

  18. Adolescent Health Behavior, Contentment in School, and Academic Achievement

    ERIC Educational Resources Information Center

    Kristjansson, Alfgeir Logi; Sigfusdottir, Inga Dora; Allegrante, John P.; Helgason, Asgeir R.

    2009-01-01

    Objectives: To examine the association between health behavior indicators, school contentment, and academic achievement. Methods: Structural equation modeling with 5810 adolescents. Results: Our model explained 36% of the variance in academic achievement and 24% in school contentment. BMI and sedentary lifestyle were negatively related to school…

  19. The Bangladesh paradox: exceptional health achievement despite economic poverty.

    PubMed

    Chowdhury, A Mushtaque R; Bhuiya, Abbas; Chowdhury, Mahbub Elahi; Rasheed, Sabrina; Hussain, Zakir; Chen, Lincoln C

    2013-11-23

    Bangladesh, the eighth most populous country in the world with about 153 million people, has recently been applauded as an exceptional health performer. In the first paper in this Series, we present evidence to show that Bangladesh has achieved substantial health advances, but the country's success cannot be captured simplistically because health in Bangladesh has the paradox of steep and sustained reductions in birth rate and mortality alongside continued burdens of morbidity. Exceptional performance might be attributed to a pluralistic health system that has many stakeholders pursuing women-centred, gender-equity-oriented, highly focused health programmes in family planning, immunisation, oral rehydration therapy, maternal and child health, tuberculosis, vitamin A supplementation, and other activities, through the work of widely deployed community health workers reaching all households. Government and non-governmental organisations have pioneered many innovations that have been scaled up nationally. However, these remarkable achievements in equity and coverage are counterbalanced by the persistence of child and maternal malnutrition and the low use of maternity-related services. The Bangladesh paradox shows the net outcome of successful direct health action in both positive and negative social determinants of health--ie, positives such as women's empowerment, widespread education, and mitigation of the effect of natural disasters; and negatives such as low gross domestic product, pervasive poverty, and the persistence of income inequality. Bangladesh offers lessons such as how gender equity can improve health outcomes, how health innovations can be scaled up, and how direct health interventions can partly overcome socioeconomic constraints.

  20. Adolescent mental health, behavior problems, and academic achievement.

    PubMed

    McLeod, Jane D; Uemura, Ryotaro; Rohrman, Shawna

    2012-01-01

    Prior research on the association of mental health and behavior problems with academic achievement is limited because it does not consider multiple problems simultaneously, take co-occurring problems into account, and control for academic aptitude. We addressed these limitations using data from the National Longitudinal Study of Adolescent Health (N = 6,315). We estimated the associations of depression, attention problems, delinquency, and substance use with two indicators of academic achievement (high school GPA and highest degree received) with controls for academic aptitude. Attention problems, delinquency, and substance use were significantly associated with diminished achievement, but depression was not. Combinations of problems involving substance use were especially consequential. Our results demonstrate that the social consequences of mental health problems are not the inevitable result of diminished functional ability but, rather, reflect negative social responses. These results also encourage a broader perspective on mental health by demonstrating that behavior problems heighten the negative consequences of more traditional forms of distress.

  1. Ten great public health achievements--worldwide, 2001-2010.

    PubMed

    2011-06-24

    Worldwide, a child born in 1955 had an average life expectancy at birth of only 48 years. By 2000, the average life expectancy at birth had increased to 66 years and, if past trends continue, is projected to rise to 73 years by 2025. These improvements in longevity have resulted from improved living conditions overall, advances in medical science, and a number of population-level interventions. However, major disparities persist. During the past decade, in low-income countries, average life expectancy at birth increased from 55 to 57 years (3.6%), while increasing from 78 to 80 years (2.6%) in high-income countries. Analogous to the recent MMWR report highlighting 10 public health achievements that occurred in the United States over the first 10 years of the new century, this report describes global public health achievements during the same period. Experts in global public health were asked to nominate noteworthy public health achievements that occurred outside of the United States during 2001-2010. From them, 10 have been summarized in this report. As with the previous report, the 10 global public health achievements are not ranked in any order. Additional information regarding these achievements is available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6019a5_addinfo.htm.

  2. Personality, Preventive Health Behaviour and Comparative Optimism about Health Problems.

    PubMed

    Ingledew, D K; Brunning, S

    1999-03-01

    The aim was to test a model whereby personality influences preventive health behaviour which in turn influences comparative optimism about possible future health problems. Students (N 5 150) completed measures of personality (five-factor), preventive health behaviour and comparative optimism. The model was tested using structural equation modelling with observed variables. In the final model, agreeableness and conscientiousness had positive main effects and an interactive effect upon preventive health behaviour. Preventive health behaviour had a positive effect upon comparative optimism. In addition, extraversion had a direct positive effect (not mediated by preventive health behaviour) upon comparative optimism. It is speculated that agreeableness and conscientiousness combine to produce a general regard for social convention that is conducive to healthier behaviour. The effect of extraversion is explicable in terms of positive affectivity.

  3. Morocco's policy choices to achieve Universal health coverage

    PubMed Central

    Tinasti, Khalid

    2015-01-01

    Morocco's health system remains weak in spite of the improvement of other development indicators in the last ten years. Health remains one of the major challenges to lower the social disparities that are the priority for the authorities. Despite the goodwill of all stakeholders, significant reforms implemented respond only partially to the needs of the population. Morocco established several public insurance schemes, of which one focuses on the poorest, to achieve financial-risk protection for its population. Nevertheless, achieving universal health coverage through one of its dimensions is not sufficient, and all the effort being concentrated in one area has shown the deterioration of equity in access to and quality of health services. Moreover, the insurance schemes did not reach their objectives of protecting a majority of Moroccans from financial hardship. PMID:26405489

  4. Health Behaviour and Academic Achievement in Icelandic School Children

    ERIC Educational Resources Information Center

    Sigfusdottir, Inga Dora; Kristjansson, Alfgeir Logi; Allegrante, John P.

    2007-01-01

    Interest in the relationship between health behaviours and academic achievement has recently intensified in the face of an epidemic of childhood and adolescent obesity and converging school reforms in the United States and other nations with advanced economies. Epidemiologic research has demonstrated that poor diet and lack of adequate physical…

  5. The Longitudinal Link between Student Health and Math Achievement Scores

    ERIC Educational Resources Information Center

    Garcy, Anthony M.

    2009-01-01

    This study investigated the relationship between health conditions suffered over time and student scores on the Stanford Achievement Test 9 in Yuma County, Arizona, public grade schools. The majority of children in Yuma County were of Hispanic origin. The poverty and low income status of most of these children placed them at greater risk for…

  6. The Impossibility of Achieving Consistently Good Mental Health.

    ERIC Educational Resources Information Center

    Ellis, Albert

    1987-01-01

    People disturb themselves with irrational beliefs, some of which are obvious and blatant while others are subtle and tricky. The latter type make people more disturbed than do the former kind. Even when helped by the most efficient forms of psychotherapy, humans have difficulty achieving and maintaining good mental health. (Author/VM)

  7. The quantum mitochondrion and optimal health

    PubMed Central

    Nunn, Alistair V.W.; Guy, Geoffrey W.; Bell, Jimmy D.

    2016-01-01

    A sufficiently complex set of molecules, if subject to perturbation, will self-organize and show emergent behaviour. If such a system can take on information it will become subject to natural selection. This could explain how self-replicating molecules evolved into life and how intelligence arose. A pivotal step in this evolutionary process was of course the emergence of the eukaryote and the advent of the mitochondrion, which both enhanced energy production per cell and increased the ability to process, store and utilize information. Recent research suggest that from its inception life embraced quantum effects such as ‘tunnelling’ and ‘coherence’ while competition and stressful conditions provided a constant driver for natural selection. We believe that the biphasic adaptive response to stress described by hormesis–a process that captures information to enable adaptability, is central to this whole process. Critically, hormesis could improve mitochondrial quantum efficiency, improving the ATP/ROS ratio, whereas inflammation, which is tightly associated with the aging process, might do the opposite. This all suggests that to achieve optimal health and healthy aging, one has to sufficiently stress the system to ensure peak mitochondrial function, which itself could reflect selection of optimum efficiency at the quantum level. PMID:27528758

  8. Achieving a "Grand Convergence" in global health by 2035.

    PubMed

    Mahmoud, Adel

    2017-01-20

    Historical evidence demonstrates the validity of the concept "Grand Convergence". The Lancet commission identified the major challenges facing low and lower middle income countries including the unfinished agenda, non-communicable diseases and injuries and an approach to funding and achieving these objectives along with progress towards universal health care. The role of vaccines is summarized as a major approach to accomplish a Grand Convergence in a generation.

  9. Multidisciplinary optimization for engineering systems: Achievements and potential

    NASA Technical Reports Server (NTRS)

    Sobieszczanski-Sobieski, Jaroslaw

    1989-01-01

    The currently common sequential design process for engineering systems is likely to lead to suboptimal designs. Recently developed decomposition methods offer an alternative for coming closer to optimum by breaking the large task of system optimization into smaller, concurrently executed and, yet, coupled tasks, identified with engineering disciplines or subsystems. The hierarchic and non-hierarchic decompositions are discussed and illustrated by examples. An organization of a design process centered on the non-hierarchic decomposition is proposed.

  10. Aircraft optimization by a system approach: Achievements and trends

    NASA Technical Reports Server (NTRS)

    Sobieszczanski-Sobieski, Jaroslaw

    1992-01-01

    Recently emerging methodology for optimal design of aircraft treated as a system of interacting physical phenomena and parts is examined. The methodology is found to coalesce into methods for hierarchic, non-hierarchic, and hybrid systems all dependent on sensitivity analysis. A separate category of methods has also evolved independent of sensitivity analysis, hence suitable for discrete problems. References and numerical applications are cited. Massively parallel computer processing is seen as enabling technology for practical implementation of the methodology.

  11. Achieving Optimal Privacy in Trust-Aware Social Recommender Systems

    NASA Astrophysics Data System (ADS)

    Dokoohaki, Nima; Kaleli, Cihan; Polat, Huseyin; Matskin, Mihhail

    Collaborative filtering (CF) recommenders are subject to numerous shortcomings such as centralized processing, vulnerability to shilling attacks, and most important of all privacy. To overcome these obstacles, researchers proposed for utilization of interpersonal trust between users, to alleviate many of these crucial shortcomings. Till now, attention has been mainly paid to strong points about trust-aware recommenders such as alleviating profile sparsity or calculation cost efficiency, while least attention has been paid on investigating the notion of privacy surrounding the disclosure of individual ratings and most importantly protection of trust computation across social networks forming the backbone of these systems. To contribute to addressing problem of privacy in trust-aware recommenders, within this paper, first we introduce a framework for enabling privacy-preserving trust-aware recommendation generation. While trust mechanism aims at elevating recommender's accuracy, to preserve privacy, accuracy of the system needs to be decreased. Since within this context, privacy and accuracy are conflicting goals we show that a Pareto set can be found as an optimal setting for both privacy-preserving and trust-enabling mechanisms. We show that this Pareto set, when used as the configuration for measuring the accuracy of base collaborative filtering engine, yields an optimized tradeoff between conflicting goals of privacy and accuracy. We prove this concept along with applicability of our framework by experimenting with accuracy and privacy factors, and we show through experiment how such optimal set can be inferred.

  12. Gout: optimizing treatment to achieve a disease cure.

    PubMed

    Bernal, José Antonio; Quilis, Neus; Andrés, Mariano; Sivera, Francisca; Pascual, Eliseo

    2016-03-01

    Gout is one of the most common inflammatory arthritides. The disease is due to the deposition of monosodium urate crystals. These deposits are reversible with proper treatment, suggesting that gout is a curable disease. The main aim in gout is to lower serum uric acid levels to a pre-established target; there are different urate-lowering drugs (xanthine oxidase inhibitors, uricosurics and uricases) through which this can be achieved. Proper treatment of gout also involves correct management of acute flares and their prevention. To ensure treatment adherence it is necessary to explain to the patient what the objectives are.

  13. Gout: optimizing treatment to achieve a disease cure

    PubMed Central

    Bernal, José Antonio; Quilis, Neus; Andrés, Mariano; Sivera, Francisca; Pascual, Eliseo

    2016-01-01

    Gout is one of the most common inflammatory arthritides. The disease is due to the deposition of monosodium urate crystals. These deposits are reversible with proper treatment, suggesting that gout is a curable disease. The main aim in gout is to lower serum uric acid levels to a pre-established target; there are different urate-lowering drugs (xanthine oxidase inhibitors, uricosurics and uricases) through which this can be achieved. Proper treatment of gout also involves correct management of acute flares and their prevention. To ensure treatment adherence it is necessary to explain to the patient what the objectives are. PMID:26977282

  14. Concurrently adjusting interrelated control parameters to achieve optimal engine performance

    DOEpatents

    Jiang, Li; Lee, Donghoon; Yilmaz, Hakan; Stefanopoulou, Anna

    2015-12-01

    Methods and systems for real-time engine control optimization are provided. A value of an engine performance variable is determined, a value of a first operating condition and a value of a second operating condition of a vehicle engine are detected, and initial values for a first engine control parameter and a second engine control parameter are determined based on the detected first operating condition and the detected second operating condition. The initial values for the first engine control parameter and the second engine control parameter are adjusted based on the determined value of the engine performance variable to cause the engine performance variable to approach a target engine performance variable. In order to cause the engine performance variable to approach the target engine performance variable, adjusting the initial value for the first engine control parameter necessitates a corresponding adjustment of the initial value for the second engine control parameter.

  15. Design Optimization of Structural Health Monitoring Systems

    SciTech Connect

    Flynn, Eric B.

    2014-03-06

    Sensor networks drive decisions. Approach: Design networks to minimize the expected total cost (in a statistical sense, i.e. Bayes Risk) associated with making wrong decisions and with installing maintaining and running the sensor network itself. Search for optimal solutions using Monte-Carlo-Sampling-Adapted Genetic Algorithm. Applications include structural health monitoring and surveillance.

  16. Faculty Sense of Academic Optimism and Its Relationship to Students' Achievement in Well Performing High Schools

    ERIC Educational Resources Information Center

    Cromartie, Michael Tyrone

    2013-01-01

    The aim of this study was to determine the organizational characteristics and behaviors that contribute to sustaining a culture of academic optimism as a mechanism of student achievement. While there is a developing research base identifying both the individual elements of academic optimism as well as the academic optimism construct itself as…

  17. Neoliberal Optimism: Applying Market Techniques to Global Health.

    PubMed

    Mei, Yuyang

    2016-09-23

    Global health and neoliberalism are becoming increasingly intertwined as organizations utilize markets and profit motives to solve the traditional problems of poverty and population health. I use field work conducted over 14 months in a global health technology company to explore how the promise of neoliberalism re-envisions humanitarian efforts. In this company's vaccine refrigerator project, staff members expect their investors and their market to allow them to achieve scale and develop accountability to their users in developing countries. However, the translation of neoliberal techniques to the global health sphere falls short of the ideal, as profits are meager and purchasing power remains with donor organizations. The continued optimism in market principles amidst such a non-ideal market reveals the tenacious ideological commitment to neoliberalism in these global health projects.

  18. Standardization and optimization of CT protocols to achieve low dose.

    PubMed

    Trattner, Sigal; Pearson, Gregory D N; Chin, Cynthia; Cody, Dianna D; Gupta, Rajiv; Hess, Christopher P; Kalra, Mannudeep K; Kofler, James M; Krishnam, Mayil S; Einstein, Andrew J

    2014-03-01

    The increase in radiation exposure due to CT scans has been of growing concern in recent years. CT scanners differ in their capabilities, and various indications require unique protocols, but there remains room for standardization and optimization. In this paper, the authors summarize approaches to reduce dose, as discussed in lectures constituting the first session of the 2013 UCSF Virtual Symposium on Radiation Safety and Computed Tomography. The experience of scanning at low dose in different body regions, for both diagnostic and interventional CT procedures, is addressed. An essential primary step is justifying the medical need for each scan. General guiding principles for reducing dose include tailoring a scan to a patient, minimizing scan length, use of tube current modulation and minimizing tube current, minimizing tube potential, iterative reconstruction, and periodic review of CT studies. Organized efforts for standardization have been spearheaded by professional societies such as the American Association of Physicists in Medicine. Finally, all team members should demonstrate an awareness of the importance of minimizing dose.

  19. Optimizing Health Care Coalitions: Conceptual Frameworks and a Research Agenda.

    PubMed

    Hupert, Nathaniel; Biala, Karen; Holland, Tara; Baehr, Avi; Hasan, Aisha; Harvey, Melissa

    2015-12-01

    The US health care system has maintained an objective of preparedness for natural or manmade catastrophic events as part of its larger charge to deliver health services for the American population. In 2002, support for hospital-based preparedness activities was bolstered by the creation of the National Bioterrorism Hospital Preparedness Program, now called the Hospital Preparedness Program, in the US Department of Health and Human Services. Since 2012, this program has promoted linking health care facilities into health care coalitions that build key preparedness and emergency response capabilities. Recognizing that well-functioning health care coalitions can have a positive impact on the health outcomes of the populations they serve, this article informs efforts to optimize health care coalition activity. We first review the landscape of health care coalitions in the United States. Then, using principles from supply chain management and high-reliability organization theory, we present 2 frameworks extending beyond the Office of the Assistant Secretary for Preparedness and Response's current guidance in a way that may help health care coalition leaders gain conceptual insight into how different enterprises achieve similar ends relevant to emergency response. We conclude with a proposed research agenda to advance understanding of how coalitions can contribute to the day-to-day functioning of health care systems and disaster preparedness.

  20. Multiphase Nano-Composite Coatings for Achieving Energy Optimization

    SciTech Connect

    Nainaparampil, Jose

    2012-03-26

    UES Inc. and ANL teamed in this work to develop novel coating systems for the protection of surfaces from thermal degradation mainly in two applications; Machining and Die casting. These coatings were specifically designed for the purpose by incorporating required material phases and the overall architecture, which led to reduce the energy usage and increase efficiency of the operations. Following the UES/ANL's feasibility work, the coatings were developed utilizing High power impulse magnetron sputtering (HiPMS) and Large area filtered arc deposition (LAFAD) techniques. Toughness, hardness and oxidation resistance: contrasting qualities have been mixed in the right proportion to attain the suitable material characteristic for the cause. Hafnium diboride (HfB2) based materials provided such a system and its properties were tamed to attain the right combination of toughness and hardness by working on the microstructure and architecture of coatings. An effective interfacing material (graded concentrations of topcoat) was also achieved in this work to provide the required adhesion between the substrate and the coating. Combination of an appropriate bond coat and a functional top coat provided the present thermal degradation resistant coating for cutting tools and die-casting applications. Laboratory level performance tests and industrial level application tests by partner companies (Beta Site Testing) were used for the development of these coatings.

  1. Improving mental health outcomes: achieving equity through quality improvement

    PubMed Central

    Poots, Alan J.; Green, Stuart A.; Honeybourne, Emmi; Green, John; Woodcock, Thomas; Barnes, Ruth; Bell, Derek

    2014-01-01

    Objective To investigate equity of patient outcomes in a psychological therapy service, following increased access achieved by a quality improvement (QI) initiative. Design Retrospective service evaluation of health outcomes; data analysed by ANOVA, chi-squared and Statistical Process Control. Setting A psychological therapy service in Westminster, London, UK. Participants People living in the Borough of Westminster, London, attending the service (from either healthcare professional or self-referral) between February 2009 and May 2012. Intervention(s) Social marketing interventions were used to increase referrals, including the promotion of the service through local media and through existing social networks. Main Outcome Measure(s) (i) Severity of depression on entry using Patient Health Questionnaire-9 (PHQ9). (ii) Changes to severity of depression following treatment (ΔPHQ9). (iii) Changes in attainment of a meaningful improvement in condition assessed by a key performance indicator. Results Patients from areas of high deprivation entered the service with more severe depression (M = 15.47, SD = 6.75), compared with patients from areas of low (M = 13.20, SD = 6.75) and medium (M = 14.44, SD = 6.64) deprivation. Patients in low, medium and high deprivation areas attained similar changes in depression score (ΔPHQ9: M = −6.60, SD = 6.41). Similar proportions of patients achieved the key performance indicator across initiative phase and deprivation categories. Conclusions QI methods improved access to mental health services; this paper finds no evidence for differences in clinical outcomes in patients, regardless of level of deprivation, interpreted as no evidence of inequity in the service with respect to this outcome. PMID:24521701

  2. Optimal sensor placement in structural health monitoring using discrete optimization

    NASA Astrophysics Data System (ADS)

    Sun, Hao; Büyüköztürk, Oral

    2015-12-01

    The objective of optimal sensor placement (OSP) is to obtain a sensor layout that gives as much information of the dynamic system as possible in structural health monitoring (SHM). The process of OSP can be formulated as a discrete minimization (or maximization) problem with the sensor locations as the design variables, conditional on the constraint of a given sensor number. In this paper, we propose a discrete optimization scheme based on the artificial bee colony algorithm to solve the OSP problem after first transforming it into an integer optimization problem. A modal assurance criterion-oriented objective function is investigated to measure the utility of a sensor configuration in the optimization process based on the modal characteristics of a reduced order model. The reduced order model is obtained using an iterated improved reduced system technique. The constraint is handled by a penalty term added to the objective function. Three examples, including a 27 bar truss bridge, a 21-storey building at the MIT campus and the 610 m high Canton Tower, are investigated to test the applicability of the proposed algorithm to OSP. In addition, the proposed OSP algorithm is experimentally validated on a physical laboratory structure which is a three-story two-bay steel frame instrumented with triaxial accelerometers. Results indicate that the proposed method is efficient and can be potentially used in OSP in practical SHM.

  3. Optimizing cancer care through mobile health.

    PubMed

    Odeh, Bassel; Kayyali, Reem; Nabhani-Gebara, Shereen; Philip, Nada

    2015-07-01

    The survival rates for patients living with cancer are increasing, due to recent advances in detection, prevention and treatment. It has been estimated that there were 28 million cancer survivors around the world in 2012. In the UK, for patients diagnosed in 2007, it is predicted that more than half of them will survive their cancer for 5 years or more. A large majority of cancer survivors report unmet supportive care needs and distressing symptoms and adverse long-term consequences related to their cancer. Cancer management could be optimized to better meet patients demand through technology, including mobile health (m-Health). m-Health is defined as the use of mobile communications and network technologies for health care. m-Health can help both patients and health-care professionals and play an important part in managing and delivering cancer care including managing side effects, supporting drug adherence, providing cancer information, planning and follow up and detecting and diagnosing cancer. Health authorities have already published guidelines regulating m-Health to insure patient safety and improve the accountability of its applications.

  4. Paths to Success: Optimal and Equitable Health Outcomes for All

    PubMed Central

    Rust, George; Levine, Robert S.; Fry-Johnson, Yvonne; Baltrus, Peter; Ye, Jiali; Mack, Dominic

    2013-01-01

    U.S. health disparities are real, pervasive, and persistent, despite dramatic improvements in civil rights and economic opportunity for racial and ethnic minority and lower socioeconomic groups in the United States. Change is possible, however. Disparities vary widely from one community to another, suggesting that they are not inevitable. Some communities even show paradoxically good outcomes and relative health equity despite significant social inequities. A few communities have even improved from high disparities to more equitable and optimal health outcomes. These positive-deviance communities show that disparities can be overcome and that health equity is achievable. Research must shift from defining the problem (including causes and risk factors) to testing effective interventions, informed by the natural experiments of what has worked in communities that are already moving toward health equity. At the local level, we need multi-dimensional interventions designed in partnership with communities and continuously improved by rapid-cycle surveillance feedback loops of community-level disparities metrics. Similarly coordinated strategies are needed at state and national levels to take success to scale. We propose ten specific steps to follow on a health equity path toward optimal and equitable health outcomes for all Americans. PMID:22643550

  5. Achieving and Sustaining Universal Health Coverage: Fiscal Reform of the National Health Insurance in Taiwan.

    PubMed

    Lan, Jesse Yu-Chen

    2016-10-25

    The paper discusses the expansion of the universal health coverage (UHC) in Taiwan through the establishment of National Health Insurance (NHI), and the fiscal crisis it caused. Two key questions are addressed: How did the NHI gradually achieve universal coverage, and yet cause Taiwanese health spending to escalate to fiscal crisis? What measures have been taken to reform the NHI finance and achieve moderate success to date? The main argument of this paper is that the Taiwanese Government did try to implement various reforms to save costs and had moderate success, but the path-dependent process of reform does not allow increasing contribution rates significantly and thereby makes sustainability challenging.

  6. Optimal Sensor Selection for Health Monitoring Systems

    NASA Technical Reports Server (NTRS)

    Santi, L. Michael; Sowers, T. Shane; Aguilar, Robert B.

    2005-01-01

    Sensor data are the basis for performance and health assessment of most complex systems. Careful selection and implementation of sensors is critical to enable high fidelity system health assessment. A model-based procedure that systematically selects an optimal sensor suite for overall health assessment of a designated host system is described. This procedure, termed the Systematic Sensor Selection Strategy (S4), was developed at NASA John H. Glenn Research Center in order to enhance design phase planning and preparations for in-space propulsion health management systems (HMS). Information and capabilities required to utilize the S4 approach in support of design phase development of robust health diagnostics are outlined. A merit metric that quantifies diagnostic performance and overall risk reduction potential of individual sensor suites is introduced. The conceptual foundation for this merit metric is presented and the algorithmic organization of the S4 optimization process is described. Representative results from S4 analyses of a boost stage rocket engine previously under development as part of NASA's Next Generation Launch Technology (NGLT) program are presented.

  7. The World Health Organization European Health in Prisons Project after 10 years: persistent barriers and achievements.

    PubMed

    Gatherer, Alex; Moller, Lars; Hayton, Paul

    2005-10-01

    The recognition that good prison health is important to general public health has led 28 countries in the European Region of the World Health Organization (WHO) to join a WHO network dedicated to improving health within prisons. Within the 10 years since that time, vital actions have been taken and important policy documents have been produced. A key factor in making progress is breaking down the isolation of prison health services and bringing them into closer collaboration with the country's public health services.However, barriers to progress remain. A continuing challenge is how best to move from policy recommendations to implementation, so that the network's fundamental aim of noticeable improvements in the health and care of prisoners is further achieved.

  8. Knowledge Visualizations: A Tool to Achieve Optimized Operational Decision Making and Data Integration

    DTIC Science & Technology

    2015-06-01

    and pedigree possess additive implications toward the quality of the data utilized within the DSS. F. SUMMARY Decision - making theories such as...VISUALIZATIONS: A TOOL TO ACHIEVE OPTIMIZED OPERATIONAL DECISION MAKING AND DATA INTEGRATION by Paul C. Hudson Jeffrey A. Rzasa June 2015 Thesis...TOOL TO ACHIEVE OPTIMIZED OPERATIONAL DECISION MAKING AND DATA INTEGRATION 5. FUNDING NUMBERS 6. AUTHOR(S) Paul C. Hudson, and Jeffrey A. Rzasa

  9. Optimization of preventive health care facility locations

    PubMed Central

    2010-01-01

    Background Preventive health care programs can save lives and contribute to a better quality of life by diagnosing serious medical conditions early. The Preventive Health Care Facility Location (PHCFL) problem is to identify optimal locations for preventive health care facilities so as to maximize participation. When identifying locations for preventive health care facilities, we need to consider the characteristics of the preventive health care services. First, people should have more flexibility to select service locations. Second, each preventive health care facility needs to have a minimum number of clients in order to retain accreditation. Results This paper presents a new methodology for solving the PHCFL problem. In order to capture the characteristics of preventive health care services, we define a new accessibility measurement that combines the two-step floating catchment area method, distance factor, and the Huff-based competitive model. We assume that the accessibility of preventive health care services is a major determinant for participation in the service. Based on the new accessibility measurement, the PHCFL problem is formalized as a bi-objective model based on efficiency and coverage. The bi-objective model is solved using the Interchange algorithm. In order to accelerate the solving process, we implement the Interchange algorithm by building two new data structures, which captures the spatial structure of the PHCFL problem. In addition, in order to measure the spatial barrier between clients and preventive health care facilities accurately and dynamically, this paper estimates travelling distance and travelling time by calling the Google Maps Application Programming Interface (API). Conclusions Experiments based on a real application for the Alberta breast cancer screening program show that our work can increase the accessibility of breast cancer screening services in the province. PMID:20298608

  10. Optimism and diet quality in the Women's Health Initiative.

    PubMed

    Hingle, Melanie D; Wertheim, Betsy C; Tindle, Hilary A; Tinker, Lesley; Seguin, Rebecca A; Rosal, Milagros C; Thomson, Cynthia A

    2014-07-01

    Diet quality has not been well studied in relation to positive psychological traits. Our purpose was to investigate the relationship between optimism and diet quality in postmenopausal women enrolled in the Women's Health Initiative observational study (OS) and clinical trials (CTs), and to determine whether optimism was associated with diet change after a 1-year dietary intervention. Diet quality was scored with the Alternate Healthy Eating Index (AHEI) and optimism assessed with the Life Orientation Test-Revised. Baseline characteristics were compared across AHEI quintiles or optimism tertiles using regression models with each variable of interest as a function of quintiles or tertiles (OS, n=87,630; CT, n=65,360). Association between optimism and baseline AHEI and change in AHEI over 1 year were tested using multivariate linear regression (CT, n=13,645). Potential interaction between optimism and trial arm and demographic/lifestyle factors on AHEI change was tested using likelihood ratio test (CT intervention, n=13,645; CT control, n=20,242). Women reporting high AHEI were non-Hispanic white, educated, physically active, past or never smokers, hormone therapy users, had lower body mass index and waist circumference, and were less likely to have chronic conditions. In the CT intervention, higher optimism was associated with higher AHEI at baseline and with greater change over 1 year (P=0.001). Effect modification by intervention status was observed (P=0.014), whereas control participants with highest optimism achieved threefold greater AHEI increase compared with those with the lowest optimism. These data support a relationship between optimism and dietary quality score in postmenopausal women at baseline and over 1 year.

  11. The Effects of Academic Optimism on Student Academic Achievement in Alabama

    ERIC Educational Resources Information Center

    Bevel, Raymona King

    2010-01-01

    The purpose of the research was to determine the effects of academic optimism on student academic achievement through measuring the individual and collective effects of academic emphasis, collective efficacy, and faculty trust in clients. Data for this study were obtained from the School Academic Optimism Scale and the reading section of the…

  12. Collective Responsibility, Academic Optimism, and Student Achievement in Taiwan Elementary Schools

    ERIC Educational Resources Information Center

    Wu, Hsin-Chieh

    2012-01-01

    Previous research indicates that collective efficacy, faculty trust in students and parents, and academic emphasis together formed a single latent school construct, called academic optimism. In the U.S., academic optimism has been proven to be a powerful construct that could effectively predict student achievement even after controlling for…

  13. A Family Medicine Health Technology Strategy for Achieving the Triple Aim for US Health Care

    PubMed Central

    Phillips, Robert L.; Bazemore, Andrew W.; DeVoe, Jennifer E.; Weida, Thomas J.; Krist, Alex H.; Dulin, Michael F.; Biagioli, Frances E.

    2016-01-01

    BACKGROUND AND OBJECTIVES Health information technology (health IT) and health technology, more broadly, offer tremendous promise for connecting, synthesizing, and sharing information critical to improving health care delivery, reducing health system costs, and achieving personal and community health. While efforts to spur adoption of electronic health records (EHRs) among US practices and hospitals have been highly successful, aspirations for effective data exchanges and translation of data into measureable improvements in health outcomes remain largely unrealized. There are shining examples of health enhancement through new technologies, and the discipline of family medicine is well poised to take advantage of these innovations to improve patient and population health. The Future of Family Medicine led to important family medicine health IT initiatives over the past decade. For example, the American Academy of Family Physicians (AAFP) Center for Health Information Technology and the Robert Graham Center provided important leadership for informing health IT policy and standard-setting, such as the Centers for Medicare and Medicaid Services EHR incentives programs (often referred to as “meaningful use.”). As we move forward, there is a need for a new and more comprehensive family medicine strategy for technology. To inform the Family Medicine for America’s Health (FMAHealth) initiative, this paper explores strategies and tactics that family medicine could pursue to improve the utility of technology for primary care and to help primary care become a leader in rapid development, testing, and implementation of new technologies. These strategies were also designed with a broader stakeholder audience in mind, intending to reach beyond the work being done by FMAHealth. Specific suggestions include: a shared primary care health IT center, meaningful primary care quality measures and capacity to assess/report them, increased primary care technology research, a

  14. Protein "requirements" beyond the RDA: implications for optimizing health.

    PubMed

    Phillips, Stuart M; Chevalier, Stéphanie; Leidy, Heather J

    2016-05-01

    Substantial evidence supports the increased consumption of high-quality protein to achieve optimal health outcomes. A growing body of research indicates that protein intakes well above the current Recommended Dietary Allowance help to promote healthy aging, appetite regulation, weight management, and goals aligned with athletic performance. Higher protein intakes may help prevent age-related sarcopenia, the loss of muscle mass, and strength that predisposes older adults to frailty, disability, and loss of autonomy. Higher protein diets also improve satiety and lead to greater reductions in body weight and fat mass compared with standard protein diets, and may therefore serve as a successful strategy to help prevent and/or treat obesity. Athletes can also benefit from higher protein intakes to maximize athletic performance given the critical role protein plays in stimulating muscle protein remodelling after exercise. Protein quality, per meal dose, and timing of ingestion are also important considerations. Despite persistent beliefs to the contrary, we can find no evidence-based link between higher protein diets and renal disease or adverse bone health. This brief synopsis highlights recent learnings based on presentations at the 2015 Canadian Nutrition Society conference, Advances in Protein Nutrition across the Lifespan. Current evidence indicates intakes in the range of at least 1.2 to 1.6 g/(kg·day) of high-quality protein is a more ideal target for achieving optimal health outcomes in adults.

  15. The Role of a Provider-Sponsored Health Plan in Achieving Scale and Integration.

    PubMed

    Johnson, Steven P

    2016-01-01

    In pursuit of two primary strategies-to become an integrated delivery network (IDN) on the local level and to achieve additional overall organizational scale to sustain operations-Health First, based in Rockledge, Florida, relies on the success of its provider-sponsored health plan (PSHP) as a critical asset. For Health First, the PSHP serves as an agent for holding and administering financial risk for the health of populations. In addition, we are learning that our PSHP is a critical asset in support of integrating the components of our care delivery system to manage that financial risk effectively, efficiently, and in a manner that creates a unified experience for the customer.Health First is challenged by continuing pressure on reimbursement, as well as by a substantial regulatory burden, as we work to optimize the environments and tools of care and population health management. Even with strong margins and a healthy balance sheet, we simply do not have the resources needed to bring an IDN robustly to life. However, we have discovered that our PSHP can be the vehicle that carries us to additional scale. Many health systems do not own or otherwise have access to a PSHP to hold and manage financial risk. Health First sought and found a not-for-profit health system with complementary goals and a strong brand to partner with, and we now provide private-label health plan products for that system using its strong name while operating the insurance functions under our license and with our capabilities.

  16. Physiological geroscience: targeting function to increase healthspan and achieve optimal longevity.

    PubMed

    Seals, Douglas R; Justice, Jamie N; LaRocca, Thomas J

    2016-04-15

    Most nations of the world are undergoing rapid and dramatic population ageing, which presents great socio-economic challenges, as well as opportunities, for individuals, families, governments and societies. The prevailing biomedical strategy for reducing the healthcare impact of population ageing has been 'compression of morbidity' and, more recently, to increase healthspan, both of which seek to extend the healthy period of life and delay the development of chronic diseases and disability until a brief period at the end of life. Indeed, a recently established field within biological ageing research, 'geroscience', is focused on healthspan extension. Superimposed on this background are new attitudes and demand for 'optimal longevity' - living long, but with good health and quality of life. A key obstacle to achieving optimal longevity is the progressive decline in physiological function that occurs with ageing, which causes functional limitations (e.g. reduced mobility) and increases the risk of chronic diseases, disability and mortality. Current efforts to increase healthspan centre on slowing the fundamental biological processes of ageing such as inflammation/oxidative stress, increased senescence, mitochondrial dysfunction, impaired proteostasis and reduced stress resistance. We propose that optimization of physiological function throughout the lifespan should be a major emphasis of any contemporary biomedical policy addressing global ageing. Effective strategies should delay, reduce in magnitude or abolish reductions in function with ageing (primary prevention) and/or improve function or slow further declines in older adults with already impaired function (secondary prevention). Healthy lifestyle practices featuring regular physical activity and ideal energy intake/diet composition represent first-line function-preserving strategies, with pharmacological agents, including existing and new pharmaceuticals and novel 'nutraceutical' compounds, serving as potential

  17. Financing and funding health care: Optimal policy and political implementability.

    PubMed

    Nuscheler, Robert; Roeder, Kerstin

    2015-07-01

    Health care financing and funding are usually analyzed in isolation. This paper combines the corresponding strands of the literature and thereby advances our understanding of the important interaction between them. We investigate the impact of three modes of health care financing, namely, optimal income taxation, proportional income taxation, and insurance premiums, on optimal provider payment and on the political implementability of optimal policies under majority voting. Considering a standard multi-task agency framework we show that optimal health care policies will generally differ across financing regimes when the health authority has redistributive concerns. We show that health care financing also has a bearing on the political implementability of optimal health care policies. Our results demonstrate that an isolated analysis of (optimal) provider payment rests on very strong assumptions regarding both the financing of health care and the redistributive preferences of the health authority.

  18. Food structure is critical for optimal health.

    PubMed

    Wahlqvist, Mark L

    2016-03-01

    Much nutrition policy is nutrient-based, supported by extensive nutrient science and food nutrient composition tables and recommendations for dietary evaluation. There are no comparable instruments for food structure. This constitutes a policy and practice gap since food is valued for its textural properties and not simply its chemistry. The structurally-important 'dietary fibre' at first proved of greater interest for its chemistry than its physico-chemistry even to health scientists and workers. As food chemistry became evidently complex, especially for phytonutrients, food-based dietary guidelines became an imperative and were launched by FAO and WHO in Cyprus in 1995. Food-health relationships, after weaning, are best articulated in terms of the achievement of dietary diversity, predicated partly on how intact foods are or in what way they are prepared. Cooking itself has health-promoting characteristics. Even with identical chemistry, food structure makes a major difference to biological and health outcomes. With evidence that food structure contributes to the matrix that food provides for nutrient delivery, and also to gut microbiomic profile and integrity, concern has grown about overly-processed food and health outcomes. The definition and categorisation of 'ultra-processed foods' is now a work-in-progress. Future public health nutritional and clinical nutrition developments will take account of food structure. To these ends, food composition tables will need to provide information like particle size and viscosity. Dietary recommendations will need to take account of food structure, as is the case for Brazil whose first step is "Make natural or minimally processed foods the basis of your diet".

  19. Health in All (Foreign) Policy: challenges in achieving coherence.

    PubMed

    Labonté, Ronald

    2014-06-01

    Health in All Policies (HiAP) approach is generally perceived as an intersectoral approach to national or sub-national public policy development, such that health outcomes are given full consideration by non-health sectors. Globalization, however, has created numerous 'inherently global health issues' with cross-border causes and consequences, requiring new forms of global governance for health. Although such governance often includes both state and non-state (private, civil society) actors in agenda setting and influence, different actors have differing degrees of power and authority and, ultimately, it is states that ratify intergovernmental covenants or normative declarations that directly or indirectly affect health. This requires public health and health promotion practitioners working within countries to give increased attention to the foreign policies of their national governments. These foreign policies include those governing national security, foreign aid, trade and investment as well as the traditional forms of diplomacy. A new term has been coined to describe how health is coming to be positioned in governments' foreign policies: global health diplomacy. To become adept at this nuanced diplomatic practice requires familiarity with the different policy frames by which health might be inserted into the foreign policy deliberations, and thence intergovernmental/global governance negotiations. This article discusses six such frames (security, trade, development, global public goods, human rights, ethical/moral reasoning) that have been analytically useful in assessing the potential for greater and more health-promoting foreign policy coherence: a 'Health in All (Foreign) Policies' approach.

  20. What have health care reforms achieved in Turkey? An appraisal of the "Health Transformation Programme".

    PubMed

    Ökem, Zeynep Güldem; Çakar, Mehmet

    2015-09-01

    Poor health status indicators, low quality care, inequity in the access to health services and inefficiency due to fragmented health financing and provision have long been problems in Turkey's health system. To address these problems a radical reform process known as the Health Transformation Programme (HTP) was initiated in 2003. The health sector reforms in Turkey are considered to have been among the most successful of middle-income countries undergoing reform. Numerous articles have been published that review these reforms in terms of, variously, financial sustainability, efficiency, equity and quality. Evidence suggests that Turkey has indeed made significant progress, yet these achievements are uneven among its regions, and their long-term financial sustainability is unresolved due to structural problems in employment. As yet, there is no comprehensive evidence-based analysis of how far the stated reform objectives have been achieved. This article reviews the empirical evidence regarding the outcomes of the HTP during 10 years of its implementation. Strengthening the strategic purchasing function of the Social Security Institution (SSI) should be a priority. Overall performance can be improved by linking resource allocation to provider performance. More emphasis on prevention rather than treatment, with an effective referral chain, can also bring better outcomes, greater efficiency gains and contribute to sustainability.

  1. Costa Rica: achievements of a heterodox health policy.

    PubMed

    Unger, Jean-Pierre; De Paepe, Pierre; Buitrón, René; Soors, Werner

    2008-04-01

    Costa Rica is a middle-income country with a strong governmental emphasis on human development. For more than half a century, its health policies have applied the principles of equity and solidarity to strengthen access to care through public services and universal social health insurance. Costa Rica's population measures of health service coverage, health service use, and health status are excellent, and in the Americas, life expectancy in Costa Rica is second only to that in Canada. Many of these outcomes can be linked to the performance of the public health care system. However, the current emphasis of international aid organizations on privatization of health services threatens the accomplishments and universality of the Costa Rican health care system.

  2. Costa Rica: Achievements of a Heterodox Health Policy

    PubMed Central

    Unger, Jean-Pierre; De Paepe, Pierre; Buitrón, René; Soors, Werner

    2008-01-01

    Costa Rica is a middle-income country with a strong governmental emphasis on human development. For more than half a century, its health policies have applied the principles of equity and solidarity to strengthen access to care through public services and universal social health insurance. Costa Rica’s population measures of health service coverage, health service use, and health status are excellent, and in the Americas, life expectancy in Costa Rica is second only to that in Canada. Many of these outcomes can be linked to the performance of the public health care system. However, the current emphasis of international aid organizations on privatization of health services threatens the accomplishments and universality of the Costa Rican health care system. PMID:17901439

  3. Optimizing Bone Health in Duchenne Muscular Dystrophy

    PubMed Central

    Buckner, Jason L.; Bowden, Sasigarn A.; Mahan, John D.

    2015-01-01

    Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder characterized by progressive muscle weakness, with eventual loss of ambulation and premature death. The approved therapy with corticosteroids improves muscle strength, prolongs ambulation, and maintains pulmonary function. However, the osteoporotic impact of chronic corticosteroid use further impairs the underlying reduced bone mass seen in DMD, leading to increased fragility fractures of long bones and vertebrae. These serious sequelae adversely affect quality of life and can impact survival. The current clinical issues relating to bone health and bone health screening methods in DMD are presented in this review. Diagnostic studies, including biochemical markers of bone turnover and bone mineral density by dual energy X-ray absorptiometry (DXA), as well as spinal imaging using densitometric lateral spinal imaging, and treatment to optimize bone health in patients with DMD are discussed. Treatment with bisphosphonates offers a method to increase bone mass in these children; oral and intravenous bisphosphonates have been used successfully although treatment is typically reserved for children with fractures and/or bone pain with low bone mass by DXA. PMID:26124831

  4. Achieving effective cervical screening coverage in South Africa through human resources and health systems development.

    PubMed

    Kawonga, Mary; Fonn, Sharon

    2008-11-01

    South Africa's cervical screening policy recommends three free Pap smears at ten-year intervals for all women over 30 years of age, aiming to achieve 70% coverage by 2010 by targeting the age group most at risk of developing pre-cancerous cervical lesions. Attaining wide coverage requires an adequate supply of motivated and supported public sector health workers with appropriate training and skills, working in a functional health system. Given the dearth of doctors in South Africa, professional nurses were tasked with performing the bulk of Pap smears at primary care level. Coverage remains sub-optimal and a significant proportion of women with precursor lesions do not receive treatment. Further, health system strengthening - essential for cytology-based screening - has not happened. Research to evaluate alternative screening technologies has proliferated in recent years, but regrettably, strengthening of the health system required to make the new technology work has not received similar attention. Using the South African experience, this article argues that technological interventions and innovations alone are not sufficient to improve cervical screening programmes. Task-shifting is limited unless other human resource concerns (e.g. training, increasing demands on personnel, attrition, and skills mix) are concurrently addressed within a comprehensive workforce development strategy, alongside work to make the health care delivery system functional.

  5. Achieving the American dream: facilitators and barriers to health and mental health for Latino immigrants.

    PubMed

    Shobe, Marcia A; Coffman, Maren J; Dmochowski, Jacek

    2009-01-01

    Latinos are the largest minority group in the U.S. For Latino immigrants, a shift in migration from larger to smaller cities has recently occurred; the Latino immigrant population in Charlotte, North Carolina, has increased by 634% since 1990. The extent to which immigrants can achieve health and well-being is often related to employment, healthcare access, and social support. This study explored the human, social, and financial capital circumstances of Latino immigrants new to Charlotte and examined the effects of different aspects of capital on health outcomes. Findings indicate that capital is significantly associated with functional status and depression. Implications for social work are discussed.

  6. Financing of health systems to achieve the health Millennium Development Goals in low-income countries.

    PubMed

    Fryatt, Robert; Mills, Anne; Nordstrom, Anders

    2010-01-30

    Concern that underfunded and weak health systems are impeding the achievement of the health Millennium Development Goals in low-income countries led to the creation of a High Level Taskforce on Innovative International Financing for Health Systems in September, 2008. This report summarises the key challenges faced by the Taskforce and its Working Groups. Working Group 1 examined the constraints to scaling up and costs. Challenges included: difficulty in generalisation because of scarce and context-specific health-systems knowledge; no consensus for optimum service-delivery approaches, leading to wide cost differences; no consensus for health benefits; difficulty in quantification of likely efficiency gains; and challenges in quantification of the financing gap owing to uncertainties about financial commitments for health. Working Group 2 reviewed the different innovative mechanisms for raising and channelling funds. Challenges included: variable definitions of innovative finance; small evidence base for many innovative finance mechanisms; insufficient experience in harmonisation of global health initiatives; and inadequate experience in use of international investments to improve maternal, newborn, and child health. The various mechanisms reviewed and finally recommended all had different characteristics, some focusing on specific problems and some on raising resources generally. Contentious issues included the potential role of the private sector, the rights-based approach to health, and the move to results-based aid. The challenges and disagreements that arose during the work of the Taskforce draw attention to the many issues facing decision makers in low-income countries. International donors and recipient governments should work together to improve the evidence base for strengthening health systems, increase long-term commitments, and improve accountability through transparent and inclusive national approaches.

  7. Achieving effective universal health coverage with equity: evidence from Chile.

    PubMed

    Frenz, Patricia; Delgado, Iris; Kaufman, Jay S; Harper, Sam

    2014-09-01

    Chile's 'health guarantees' approach to providing universal and equitable coverage for quality healthcare in a dual public-private health system has generated global interest. The programme, called AUGE, defines legally enforceable rights to explicit healthcare benefits for priority health conditions, which incrementally covered 56 problems representing 75% of the disease burden between 2005 and 2009. It was accompanied by other health reform measures to increase public financing and public sector planning to secure the guarantees nationwide, as well as the state's stewardship role. We analysed data from household surveys conducted before and after the AUGE reform to estimate changes in levels of unmet health need, defined as the lack of a healthcare visit for a health problem occurring in the last 30 days, by age, sex, income, education, health insurance, residence and ethnicity; fitting logistic regression models and using predictive margins. The overall prevalence of unmet health need was much lower in 2009 (17.6%, 95% CI: 16.5%, 18.6%) than in 2000 (30.0%, 95% CI: 28.3%, 31.7%). Differences by income and education extremes and rural-urban residence disappeared. In 2009, people who had been in treatment for a condition covered by AUGE in the past year had a lower adjusted prevalence of unmet need for their recent problem (11.7%, 95% CI: 10.5%, 13.2%) than who had not (21.0%, 95% CI: 19.6%, 22.4%). Despite limitations including cross-sectional and self-reported data, our findings suggest that the Chilean health system has become more equitable and responsive to need. While these changes cannot be directly attributed to AUGE, they were coincident with the AUGE reforms. However, healthcare equity concerns are still present, relating to quality of care, health system barriers and differential access for health conditions that are not covered by AUGE.

  8. Achievable Imperative - Baseline Health of the Reserve Component

    DTIC Science & Technology

    2001-03-22

    25 Coleen Weese, "Population Health and Deployed Forces." U.S. Army Medical Department Journal, (October-December 2001): 24. 26 Report to Congress...Synopsis, Atlanta, 1989. Weese, Coleen . "Population Health and Deployed Forces." U.S. Army Medical Department Journal, (October-December 2001): 24-30

  9. Advantages of Coordinated School Health Portfolios: Documenting and Showcasing Achievements

    ERIC Educational Resources Information Center

    Shipley, Meagan; Lohrmann, David; Barnes, Priscilla; O'Neill, Jim

    2013-01-01

    Background: Thirteen school district teams from Michigan and Indiana participated in the Michiana Coordinated School Health Leadership Institute with the intent of Coordinated School Health Program (CSHP) implementation. The purpose of this study was to determine if portfolios served as an effective approach for documenting teams' accomplishments…

  10. Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores among Urban Youth in the United States

    ERIC Educational Resources Information Center

    Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

    2014-01-01

    Background: The Institute of Medicine (2012) concluded that we must "strengthen schools as the heart of health." To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement,…

  11. Restricted and Repetitive Behaviors in Individuals with a History of ASDs Who Have Achieved Optimal Outcomes

    ERIC Educational Resources Information Center

    Troyb, Eva; Orinstein, Alyssa; Tyson, Katherine; Eigsti, Inge-Marie; Naigles, Letitia; Fein, Deborah

    2014-01-01

    Studies of autism spectrum disorders (ASDs) suggest that restricted and repetitive behaviors (RRBs) are particularly difficult to remediate. We examined present and past RRBs in 34 individuals who achieved optimal outcomes (OOs; lost their ASD diagnosis), 45 high-functioning individuals with ASD (HFA) and 34 typically developing (TD) peers. The OO…

  12. Academic Optimism, Organizational Citizenship Behaviors, and Student Achievement at Charter Schools

    ERIC Educational Resources Information Center

    Guvercin, Mustafa

    2013-01-01

    The purpose of this study was to examine the relationship among academic optimism, Organizational Citizenship Behaviors (OCBs), and student achievement in college preparatory charter schools. A purposeful sample of elementary school teachers from college preparatory charter schools (N = 226) in southeast Texas was solicited to complete the…

  13. Using social determinants of health to link health workforce diversity, care quality and access, and health disparities to achieve health equity in nursing.

    PubMed

    Williams, Shanita D; Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

    2014-01-01

    It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators-health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work-both within and outside the nursing field-that is necessary to answer these important but largely unanswered questions.

  14. Using Social Determinants of Health to Link Health Workforce Diversity, Care Quality and Access, and Health Disparities to Achieve Health Equity in Nursing

    PubMed Central

    Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

    2014-01-01

    It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators—health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work—both within and outside the nursing field—that is necessary to answer these important but largely unanswered questions. PMID:24385662

  15. Priority-setting for achieving universal health coverage.

    PubMed

    Chalkidou, Kalipso; Glassman, Amanda; Marten, Robert; Vega, Jeanette; Teerawattananon, Yot; Tritasavit, Nattha; Gyansa-Lutterodt, Martha; Seiter, Andreas; Kieny, Marie Paule; Hofman, Karen; Culyer, Anthony J

    2016-06-01

    Governments in low- and middle-income countries are legitimizing the implementation of universal health coverage (UHC), following a United Nation's resolution on UHC in 2012 and its reinforcement in the sustainable development goals set in 2015. UHC will differ in each country depending on country contexts and needs, as well as demand and supply in health care. Therefore, fundamental issues such as objectives, users and cost-effectiveness of UHC have been raised by policy-makers and stakeholders. While priority-setting is done on a daily basis by health authorities - implicitly or explicitly - it has not been made clear how priority-setting for UHC should be conducted. We provide justification for explicit health priority-setting and guidance to countries on how to set priorities for UHC.

  16. Health in the developing world: achieving the Millennium Development Goals.

    PubMed Central

    Sachs, Jeffrey D.

    2004-01-01

    The Millennium Development Goals depend critically on scaling up public health investments in developing countries. As a matter of urgency, developing-country governments must present detailed investment plans that are sufficiently ambitious to meet the goals, and the plans must be inserted into existing donor processes. Donor countries must keep the promises they have often reiterated of increased assistance, which they can easily afford, to help improve health in the developing countries and ensure stability for the whole world. PMID:15654410

  17. Implications of Student Health Problems on Achievement and Engagement

    ERIC Educational Resources Information Center

    La Salle, Tamika P.; Hagermoser Sanetti, Lisa M.

    2016-01-01

    Healthy students are better learners. Establishing positive school climates where students are healthy, engaged, and prepared to learn is a critical component in increasing student engagement and closing the achievement gap. As such, educators need to be aware of the impact of education-related outcomes on student outcomes and schools' ability to…

  18. Organizational Health and Student Achievement in Tennessee Middle Level Schools

    ERIC Educational Resources Information Center

    Henderson, Christopher L.; Buehler, Alison E.; Stein, William L.; Dalton, John E.; Robinson, Teresa R.; Anfara, Vincent A., Jr.

    2005-01-01

    Although the successful middle level school was designed to address both the affective and cognitive development of young adolescents (NMSA 2003), academic achievement is the outcome of paramount importance in the current political context of accountability, high-stakes testing, and the No Child Left Behind Act of 2001. In their efforts to reform,…

  19. A Review of Literature to Understand the Complexity of Equity, Ethics and Management for Achieving Public Health Goals in India

    PubMed Central

    Garg, Pankaj; Nagpal, Jitender

    2014-01-01

    In the context of inadequate public spending on health care in India (0.9% of the GDP); government liberalized its policies in the form of subsidized lands and tax incentives, resulting in the mushrooming of private hospitals and clinics in India. Paradoxically, a robust framework was not developed for the regulation of these health care providers, resulting in disorganized health sector, inadequate financing models, and lack of prioritization of services, as well as a sub-optimal achievement of the Millennium Development Goals (MDG). We systematically reviewed the evidence base regarding regulation of private hospitals, applicability of private-public mix, state of health insurance and effective policy development for India, while seeking lessons on regulation of private health systems, from South African (a developing country) and Australian (a developed country) health care systems. PMID:24701465

  20. Achieving Workplace Health through Application of Wellness Strategies

    NASA Technical Reports Server (NTRS)

    Robinson, Judith L.

    2008-01-01

    Purpose: 1) Understand and measure JSC workplace health: a) levels, sources, indicators & effects of negative, work-related stress; b) define leading indicators of emerging issues. 2 Provide linkage to outcomes: a) Focus application of wellness strategies & HR tools; b) Increase quality of work life and productivity. 3) Current effort will result in: a) Online assessment tool; b) Assessment of total JSC population (civil service & contractors); c) Application of mitigation tools and strategies. 4) Product of the JSC Employee Wellness Program. 5) Collaboration with Corporate Health Improvement Program/University of Arizona.

  1. Optimism and Physical Health: A Meta-analytic Review

    PubMed Central

    Rasmussen, Heather N.; Greenhouse, Joel B.

    2010-01-01

    Background Prior research links optimism to physical health, but the strength of the association has not been systematically evaluated. Purpose The purpose of this study is to conduct a meta-analytic review to determine the strength of the association between optimism and physical health. Methods The findings from 83 studies, with 108 effect sizes (ESs), were included in the analyses, using random-effects models. Results Overall, the mean ES characterizing the relationship between optimism and physical health outcomes was 0.17, p<.001. ESs were larger for studies using subjective (versus objective) measures of physical health. Subsidiary analyses were also conducted grouping studies into those that focused solely on mortality, survival, cardiovascular outcomes, physiological markers (including immune function), immune function only, cancer outcomes, outcomes related to pregnancy, physical symptoms, or pain. In each case, optimism was a significant predictor of health outcomes or markers, all p<.001. Conclusions Optimism is a significant predictor of positive physical health outcomes. PMID:19711142

  2. Use of a Batch Reactive Distillation with Dynamic Optimization Strategy to Achieve Industrial Grade Ethyl Acetate

    NASA Astrophysics Data System (ADS)

    Konakom, Kwantip; Saengchan, Aritsara; Kittisupakorn, Paisan; Mujtaba, Iqbal M.

    2011-08-01

    Industrial grade ethyl acetate is available with minimum purity of 85.0%. It is mostly produced by an ethanol esterification in a distillation process on both batch and continuous modes. However, researches on high purity production with short operating time are rarely achieved. Therefore, the objective in this work is to study an approach to produce ethyl acetate of 90.0% by 8 hours using a batch reactive distillation column. Based on open-loop simulations, the distillation with constant reflux ratio cannot achieve the product specification. Thus, the dynamic optimization strategy is proposed to handle this problem. For the process safety—preventing the dried column and fractured, a minimum reflux ratio must be determined in advance and then an optimal reflux profile is calculated to achieve optimal product yield. Simulation results show that the industrial grade ethyl acetate can be produced by the dynamic optimization programming with two or more time intervals. Besides, the increasing of time intervals can produce more distillate product.

  3. School Nurse Case Management: Achieving Health and Educational Outcomes

    ERIC Educational Resources Information Center

    Bonaiuto, Maria M.

    2007-01-01

    Educators and health care professionals alike understand that healthy students are likely to be successful learners. The goal of school nurse case management is to support students so that they are ready to learn. This article describes the outcomes of a 4-year process improvement project designed to show the impact of school nurse case management…

  4. Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores Among Urban Youth in the United States*

    PubMed Central

    Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

    2014-01-01

    Background The Institute of Medicine (2012) concluded that we must “strengthen schools as the heart of health.” To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement, and (2) examine cumulative effects of these assets on academic achievement. Methods Participants include 940 students (grades 5 and 6) from 12 schools randomly selected from an urban district. Data include physical assessments, fitness testing, surveys, and district records. Fourteen health indicators were gathered including physical health (eg, body mass index [BMI]), health behaviors (eg, meeting recommendations for fruit/vegetable consumption), family environment (eg, family meals), and psychological well-being (eg, sleep quality). Data were collected 3-6 months prior to standardized testing. Results On average, students reported 7.1 health assets out of 14. Those with more health assets were more likely to be at goal for standardized tests (reading/writing/mathematics), and students with the most health assets were 2.2 times more likely to achieve goal compared with students with the fewest health assets (both p < .001). Conclusions Schools that utilize nontraditional instructional strategies to improve student health may also improve academic achievement, closing equity gaps in both health and academic achievement. PMID:24320151

  5. HIA in Switzerland: strategies for achieving Health in All Policies.

    PubMed

    Mattig, Thomas; Cantoreggi, Nicola; Simos, Jean; Favre Kruit, Catherine; Christie, Derek P T H

    2015-08-27

    The purpose of this article is to review the status of Health Impact Assessment (HIA) in Switzerland and assess whether HIA can be used to implement Health in All Policies (HiAP) in this highly decentralized country. The methods include expert opinion and an extensive literature review, as well as targeted interviews with key informers in the cantons of Geneva, Jura and Ticino. HIA has been implemented successfully since the early 2000s in Switzerland. However, integration has been heterogeneous with only a few cantons taking the lead. Integration of HIA at the federal level was attempted in 2012 but failed due to resistance from a pro-business lobby. HIA in Switzerland has the potential to contribute to HiAP, but success depends on a wider dissemination of HIA and on some form of integration at the national level. In this respect, a 'bottom-up' approach based on inter-cantonal collaborations appears more promising than the 'top-down' federal level approach.

  6. Comparative optimism for severity of negative health outcomes.

    PubMed

    Hevey, D; French, D P

    2012-01-01

    People tend to be comparatively optimistic (i.e., believe that negative outcomes are less likely for themselves than for typical others) regarding their susceptibility to negative health outcomes. The present study investigates the extent to which perceptions of the severity of these health outcomes show similar comparative optimism. A student sample (study 1; N = 200) and a healthy non-student adult sample (study 2; N = 257) completed self-report measures of susceptibility, severity, worry, control and experience in relation to negative health outcomes. Participants in both studies demonstrated significant levels of comparative optimism for both perceived likelihood and severity of health outcomes. Comparative optimism concerning severity was very strongly associated (r = 0.85 to 0.89) with comparative optimism concerning susceptibility. In addition to being comparatively optimistic over their chances of experiencing negative health outcomes, people are also comparatively optimistic regarding how severe the health outcomes will be.

  7. Robust, integrated computational control of NMR experiments to achieve optimal assignment by ADAPT-NMR.

    PubMed

    Bahrami, Arash; Tonelli, Marco; Sahu, Sarata C; Singarapu, Kiran K; Eghbalnia, Hamid R; Markley, John L

    2012-01-01

    ADAPT-NMR (Assignment-directed Data collection Algorithm utilizing a Probabilistic Toolkit in NMR) represents a groundbreaking prototype for automated protein structure determination by nuclear magnetic resonance (NMR) spectroscopy. With a [(13)C,(15)N]-labeled protein sample loaded into the NMR spectrometer, ADAPT-NMR delivers complete backbone resonance assignments and secondary structure in an optimal fashion without human intervention. ADAPT-NMR achieves this by implementing a strategy in which the goal of optimal assignment in each step determines the subsequent step by analyzing the current sum of available data. ADAPT-NMR is the first iterative and fully automated approach designed specifically for the optimal assignment of proteins with fast data collection as a byproduct of this goal. ADAPT-NMR evaluates the current spectral information, and uses a goal-directed objective function to select the optimal next data collection step(s) and then directs the NMR spectrometer to collect the selected data set. ADAPT-NMR extracts peak positions from the newly collected data and uses this information in updating the analysis resonance assignments and secondary structure. The goal-directed objective function then defines the next data collection step. The procedure continues until the collected data support comprehensive peak identification, resonance assignments at the desired level of completeness, and protein secondary structure. We present test cases in which ADAPT-NMR achieved results in two days or less that would have taken two months or more by manual approaches.

  8. Therapeutic recreation: optimal health treatment for orthopaedic disability.

    PubMed

    Wardlaw, F B; McGuire, F A; Overby, Z

    2000-01-01

    Therapeutic recreation is a viable rehabilitation treatment for orthopaedic disabilities. Interdisciplinary treatment teams should consider therapeutic recreation interventions using the Health Prevention/Health Promotion Model in management of orthopaedic disabilities to enhance the client's present level of functioning to optimal health.

  9. Achieving Excellence in Palliative Care: Perspectives of Health Care Professionals

    PubMed Central

    Fitch, Margaret I.; DasGupta, Tracey; Ford, Bill

    2016-01-01

    Caring for individuals at the end of life in the hospital environment is a challenging proposition. Understanding the challenges to provide quality end of life care is an important first step in order to develop appropriate approaches to support and educate staff members and facilitate their capacity remaining “caring.” Four studies were undertaken at our facility to increase our understanding about the challenges health professionals experience in caring for patients at end of life and how staff members could be supported in providing care to patients and families: (1) In-depth interviews were used with cancer nurses (n = 30) to explore the challenges talking about death and dying with patients and families; (2) Surveys were used with nurses (n = 27) and radiation therapists (n = 30) to measure quality of work life; (3) and interprofessional focus groups were used to explore what it means “to care” (five groups held); and (4) interprofessional focus groups were held to understand what “support strategies for staff” ought to look like (six groups held). In all cases, staff members confirmed that interactions concerning death and dying are challenging. Lack of preparation (knowledge and skill in palliative care) and lack of support from managers and colleagues are significant barriers. Key strategies staff members thought would be helpful included: (1) Ensuring all team members were communicating and following the same plan of care, (2) providing skill-based education on palliative care, and (3) facilitating “debriefing” opportunities (either one-on-one or in a group). For staff to be able to continue caring for patients at the end of life with compassion and sensitivity, they need to be adequately prepared and supported appropriately. PMID:27981141

  10. Promoting Student Achievement through Improved Health Policy. Policy Update. Vol. 22, No. 11

    ERIC Educational Resources Information Center

    Fobbs, Erima

    2015-01-01

    "Promoting Student Achievement through Improved Health Policy" is a quick primer of the [Centers for Disease Control and Prevention] CDC's "Whole School, Whole Community, Whole Child" model, which highlights 10 important areas for connecting health and learning: health education; physical education and physical activity;…

  11. Linking Organizational Health in Jeddah Secondary Schools to Students' Academic Achievement

    ERIC Educational Resources Information Center

    Alqarni, Saleh Ali Y.

    2016-01-01

    This study aimed to assess organizational health (OH) in secondary schools in Jeddah district in Saudi Arabia. A second aim of the study was to compare the organizational health of these schools according to their rankings on student achievement tests, school type and the nature of the respondents' work. The Organizational Health Inventory (OHI),…

  12. Translating school health research to policy. School outcomes related to the health environment and changes in mathematics achievement.

    PubMed

    Snelling, Anastasia M; Belson, Sarah Irvine; Watts, Erin; George, Stephanie; Van Dyke, Hugo; Malloy, Elizabeth; Kalicki, Michelle

    2015-10-01

    This paper describes an exploration of the relationship between mathematic achievement and the school health environment relative to policy-driven changes in the school setting, specifically with regard to physical education/physical activity. Using school-level data, the authors seek to understand the relationship between mathematics achievement and the school health environment and physical education minutes. This work provides a description of the aspects of the school health environment, an exploration of the interrelationships between school health and student achievement, and an assessment of the effects of the school health policy and practice on student performance and health status. Based on these findings, we identify additional research necessary to describe the relationship between obesity and learning in children.

  13. Impatience versus achievement strivings in the Type A pattern: Differential effects on students' health and academic achievement

    NASA Technical Reports Server (NTRS)

    Spence, Janet T.; Helmreich, Robert L.; Pred, Robert S.

    1987-01-01

    Psychometric analyses of college students' responses to the Jenkins Activity Survey, a self-report measure of the Type A behavior pattern, revealed the presence of two relatively independent factors. Based on these analyses, two scales, labeled Achievement Strivings (AS) and Impatience and Irritability (II), were developed. In two samples of male and female college students, scores on AS but not on II were found to be significantly correlated with grade point average. Responses to a health survey, on the other hand, indicated that frequency of physical complaints was significantly correlated with II but not with AS. These results suggest that there are two relatively independent factors in the Type A pattern that have differential effects on performance and health. Future research on the personality factors related to coronary heart disease and other disorders might more profitably focus on the syndrome reflected in the II scale than on the Type A pattern.

  14. Achievements and challenges in automated parameter, shape and topology optimization for divertor design

    NASA Astrophysics Data System (ADS)

    Baelmans, M.; Blommaert, M.; Dekeyser, W.; Van Oevelen, T.

    2017-03-01

    Plasma edge transport codes play a key role in the design of future divertor concepts. Their long simulation times in combination with a large number of control parameters turn the design into a challenging task. In aerodynamics and structural mechanics, adjoint-based optimization techniques have proven successful to tackle similar design challenges. This paper provides an overview of achievements and remaining challenges with these techniques for complex divertor design. It is shown how these developments pave the way for fast sensitivity analysis and improved design from different perspectives.

  15. Optimism predicts positive health in repatriated prisoners of war.

    PubMed

    Segovia, Francine; Moore, Jeffrey L; Linnville, Steven E; Hoyt, Robert E

    2015-05-01

    "Positive health," defined as a state beyond the mere absence of disease, was used as a model to examine factors for enhancing health despite extreme trauma. The study examined the United States' longest detained American prisoners of war, those held in Vietnam in the 1960s through early 1970s. Positive health was measured using a physical and a psychological composite score for each individual, based on 9 physical and 9 psychological variables. Physical and psychological health was correlated with optimism obtained postrepatriation (circa 1973). Linear regressions were employed to determine which variables contributed most to health ratings. Optimism was the strongest predictor of physical health (β = -.33, t = -2.73, p = .008), followed by fewer sleep complaints (β = -.29, t = -2.52, p = .01). This model accounted for 25% of the variance. Optimism was also the strongest predictor of psychological health (β = -.41, t = -2.87, p = .006), followed by Minnesota Multiphasic Personality Inventory-Psychopathic Deviate (MMPI-PD; McKinley & Hathaway, 1944) scores (β = -.23, t = -1.88, p = .07). This model strongly suggests that optimism is a significant predictor of positive physical and psychological health, and optimism also provides long-term protective benefits. These findings and the utility of this model suggest a promising area for future research and intervention.

  16. Optimizing Tailored Health Promotion for Older Adults

    PubMed Central

    Marcus-Varwijk, Anne Esther; Koopmans, Marg; Visscher, Tommy L. S.; Seidell, Jacob C.; Slaets, Joris P. J.; Smits, Carolien H. M.

    2016-01-01

    Objective: This study explores older adults’ perspectives on healthy living, and their interactions with professionals regarding healthy living. This perspective is necessary for health professionals when they engage in tailored health promotion in their daily work routines. Method: In a qualitative study, 18 semi-structured interviews were carried out with older adults (aged 55-98) living in the Netherlands. The framework analysis method was used to analyze the transcripts. Results: Three themes emerged from the data—(a) healthy living: daily routines and staying active, (b) enacting healthy living: accepting and adapting, (c) interaction with health professionals with regard to healthy living: autonomy and reciprocity. Discussion: Older adults experience healthy living in a holistic way in which they prefer to live active and independent lives. Health professionals should focus on building an equal relationship of trust and focus on positive health outcomes, such as autonomy and self-sufficiency when communicating about healthy living. PMID:28138485

  17. Level of optimism and health behavior in athletes

    PubMed Central

    Lipowski, Mariusz

    2012-01-01

    Summary Background Persons with an optimistic attitude do not give up despite obstacles and failures. Optimistic athletes compete more out of hope for success than out of fear of defeat. The purpose of my research was to determine if optimism also promotes good health behavior in athletes. Material/Methods In order to measure the role of optimism in shaping the health behavior of athletes, I examined a group of women (N=147) and men (N=385) who were currently in training for athletic competition. The control group consisted of women (N=262) and men (N=435) who were not and had never been competitive athletes. The “O-P” Attitude Questionnaire was used to measure optimism, while health behavior was measured with the Juczynski Health Behavior Inventory, which measures proper nutrition habits, preventive behavior, positive attitude, and healthy practices. Results The level of pessimism in these athletes was average. The female athletes were less pessimistic than the female controls. A similar, highly significant difference occurred between the male athletes and non-athletes. Gender did not differentiate the level of optimism in either group. Among the women, optimism correlated with healthy practices, such as daily sleep and recreation habits, or physical activity. The greater the pessimism increased, positive attitudes declined in the female controls, the female athletes, and the male controls. Conclusions The athletes displayed greater optimism than the controls. Among the women, optimism correlated with good health practices. PMID:22207118

  18. Moving Toward Universal Health Coverage (UHC) to Achieve Inclusive and Sustainable Health Development: Three Essential Strategies Drawn From Asian Experience

    PubMed Central

    Xu, Ye; Huang, Cheng; Colón-Ramos, Uriyoán

    2015-01-01

    Binagwaho and colleagues’ perspective piece provided a timely reflection on the experience of Rwanda in achieving the Millennium Development Goals (MDGs) and a proposal of 5 principles to carry forward in post-2015 health development. This commentary echoes their viewpoints and offers three lessons for health policy reforms consistent with these principles beyond 2015. Specifically, we argue that universal health coverage (UHC) is an integrated solution to advance the global health development agenda, and the three essential strategies drawn from Asian countries’ health reforms toward UHC are: (1) Public financing support and sequencing health insurance expansion by first extending health insurance to the extremely poor, vulnerable, and marginalized population are critical for achieving UHC; (2) Improved quality of delivered care ensures supply-side readiness and effective coverage; (3) Strategic purchasing and results-based financing creates incentives and accountability for positive changes. These strategies were discussed and illustrated with experience from China and other Asian economies. PMID:26673477

  19. Defense Health Care: Applying Key Management Practices Should Help Achieve Efficiencies within the Military Health System

    DTIC Science & Technology

    2012-04-01

    5. Realign the TRICARE Management Activity and establish a Joint Military Health Service Directorate to consolidate shared services and common...Directorate to consolidate shared services and common functions Realign TRICARE Management Activity and establish a TRICARE Health Plan Agency to...Uniformed Services University of the Health Sciences, (2) TRICARE health plan, (3) Health Management Support, and (4) Shared Services division

  20. Ensuring optimal health care for LGBT patients.

    PubMed

    Glasper, Alan

    2016-07-14

    Emeritus Professor Alan Glasper, from the University of Southampton, discusses a Royal College of Nursing policy that highlights the complexities of providing high-quality and non-discriminatory health care.

  1. Practical Approaches for Achieving Integrated Behavioral Health Care in Primary Care Settings

    PubMed Central

    Ratzliff, Anna; Phillips, Kathryn E.; Sugarman, Jonathan R.; Unützer, Jürgen; Wagner, Edward H.

    2016-01-01

    Behavioral health problems are common, yet most patients do not receive effective treatment in primary care settings. Despite availability of effective models for integrating behavioral health care in primary care settings, uptake has been slow. The Behavioral Health Integration Implementation Guide provides practical guidance for adapting and implementing effective integrated behavioral health care into patient-centered medical homes. The authors gathered input from stakeholders involved in behavioral health integration efforts: safety net providers, subject matter experts in primary care and behavioral health, a behavioral health patient and peer specialist, and state and national policy makers. Stakeholder input informed development of the Behavioral Health Integration Implementation Guide and the GROW Pathway Planning Worksheet. The Behavioral Health Integration Implementation Guide is model neutral and allows organizations to take meaningful steps toward providing integrated care that achieves access and accountability. PMID:26698163

  2. Relationships among Stress, Coping, and Mental Health in High-Achieving High School Students

    ERIC Educational Resources Information Center

    Suldo, Shannon M.; Shaunessy, Elizabeth; Hardesty, Robin

    2008-01-01

    This study investigates the relationships among stress, coping, and mental health in 139 students participating in an International Baccalaureate (IB) high school diploma program. Mental health was assessed using both positive indicators (life satisfaction, academic achievement, academic self-efficacy) and negative indicators (psychopathology) of…

  3. Linking the Organizational Health of Middle Grades Schools to Student Achievement

    ERIC Educational Resources Information Center

    Roney, Kathleen; Coleman, Howard; Schlichting, Kathleen A.

    2007-01-01

    The purpose of this study was to examine the relationship between student reading achievement and the organizational health of five middle grades schools in North Carolina. The theoretical framework was based upon Hoy and Feldman's definition of organizational health, which links healthy school climates to improved learning environments and…

  4. Use of indicators in achieving 'Health for All' in South Africa, 1987.

    PubMed

    Yach, D; Klopper, J M; Taylor, S P

    1987-12-05

    This review evaluates South Africa's performance in achieving health when measured against the World Health Organization's global indicators designed to achieve 'Health for All' by the year 2000. As this programme has not been implemented in South Africa, a need exists for this country to announce indicators and targets. South Africa meets the World Health Organization's targets in terms of health expenditure but available information on many of the other indicators suggest that a large segment of the population falls outside the targets set. Lack of immunisation and poor nutrition are reflected in unacceptably high infant mortality rates and relatively low life expectancies. As accurate data are needed for planning at both national and local levels a national health survey should be conducted.

  5. Increasing racial/ethnic diversity in nursing to reduce health disparities and achieve health equity.

    PubMed

    Phillips, Janice M; Malone, Beverly

    2014-01-01

    As nursing continues to advance health care in the 21st century, the current shift in demographics, coupled with the ongoing disparities in health care and health outcomes, will warrant our ongoing attention and action. As within all health professions, concerted efforts are needed to diversify the nation's health-care workforce. The nursing profession in particular will be challenged to recruit and retain a culturally diverse workforce that mirrors the nation's change in demographics. This increased need to enhance diversity in nursing is not new to the profession; however, the need to successfully address this issue has never been greater. This article discusses increasing the diversity in nursing and its importance in reducing health disparities. We highlight characteristics of successful recruitment and retention efforts targeting racial/ethnic minority nurses and conclude with recommendations to strengthen the development and evaluation of their contributions to eliminating health disparities.

  6. Increasing Racial/Ethnic Diversity in Nursing to Reduce Health Disparities and Achieve Health Equity

    PubMed Central

    Malone, Beverly

    2014-01-01

    As nursing continues to advance health care in the 21st century, the current shift in demographics, coupled with the ongoing disparities in health care and health outcomes, will warrant our ongoing attention and action. As within all health professions, concerted efforts are needed to diversify the nation's health-care workforce. The nursing profession in particular will be challenged to recruit and retain a culturally diverse workforce that mirrors the nation's change in demographics. This increased need to enhance diversity in nursing is not new to the profession; however, the need to successfully address this issue has never been greater. This article discusses increasing the diversity in nursing and its importance in reducing health disparities. We highlight characteristics of successful recruitment and retention efforts targeting racial/ethnic minority nurses and conclude with recommendations to strengthen the development and evaluation of their contributions to eliminating health disparities. PMID:24385664

  7. Achieving Effective Universal Health Coverage And Diagonal Approaches To Care For Chronic Illnesses.

    PubMed

    Knaul, Felicia Marie; Bhadelia, Afsan; Atun, Rifat; Frenk, Julio

    2015-09-01

    Health systems in low- and middle-income countries were designed to provide episodic care for acute conditions. However, the burden of disease has shifted to be overwhelmingly dominated by chronic conditions and illnesses that require health systems to function in an integrated manner across a spectrum of disease stages from prevention to palliation. Low- and middle-income countries are also aiming to ensure health care access for all through universal health coverage. This article proposes a framework of effective universal health coverage intended to meet the challenge of chronic illnesses. It outlines strategies to strengthen health systems through a "diagonal approach." We argue that the core challenge to health systems is chronicity of illness that requires ongoing and long-term health care. The example of breast cancer within the broader context of health system reform in Mexico is presented to illustrate effective universal health coverage along the chronic disease continuum and across health systems functions. The article concludes with recommendations to strengthen health systems in order to achieve effective universal health coverage.

  8. The Aboriginal Maternal and Infant Health Service: a decade of achievement in the health of women and babies in NSW.

    PubMed

    Murphy, Elisabeth; Best, Elizabeth

    2012-06-01

    The Aboriginal Maternal and Infant Health Service was established to improve the health of Aboriginal women during pregnancy and decrease perinatal morbidity and mortality for Aboriginal babies. The Service is delivered through a continuity-of-care model, where midwives and Aboriginal Health Workers collaborate to provide a high quality maternity service that is culturally sensitive, women centred, based on primary health-care principles and provided in partnership with Aboriginal people. An evaluation of the Service found that the program is achieving its goals in relation to the provision of antenatal and postnatal care and has demonstrated improvements in perinatal morbidity and mortality rates.

  9. Achievements and future path of Tehran municipality in urban health domain: An Iranian experience

    PubMed Central

    Damari, Behzad; Riazi-Isfahani, Sahand

    2016-01-01

    Background: According to national laws and world experiences; provision, maintenance, and improving citizens’ health are considered to be the essential functions of municipalities as a "social institute". In order to equitably promote health conditions at urban level, particularly in marginal areas, since 2004 targeted efforts have been implemented in the municipality of Tehran metropolis. This study was intended to identify and analyze these targeted measures and tries to analyze health interventions in a conceptual framework and propose a future path. Methods: This is a qualitative study with content analysis approach. Reviewing documents and structured interviews with national health policy making and planning experts and executive managers of 22-region municipalities of Tehran metropolis were used to collect data. The data were analyzed on the basis of conceptual framework prepared for urban health in 4 domains including municipal interventions, goal achievements, drivers and obstacles of success, and the way forward. Results: From the viewpoint of interviewees, these new health actions of Tehran municipality are more based on public participation and the municipality was able to prioritize health issue in the programs and policies of Tehran city council. Tehran municipality has accomplished three types of interventions to improve health, which in orders of magnitude are: facilitative, promotional, and mandatory interventions. Development and institutionalization of public participation is the greatest achievement in health-oriented actions; and expansion of environmental and physical health-oriented facilities and promoting a healthy lifestyle are next in ranks. Conclusion: Since management alterations seriously challenges institutionalization of actions and innovations especially in the developing countries, it is suggested that mayors of metropolitan cities like Tehran document and review municipal health measures as soon as possible and while eliminating

  10. Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health

    PubMed Central

    Bryant-Lukosius, Denise; Valaitis, Ruta; Martin-Misener, Ruth; Donald, Faith; Peña, Laura Morán; Brousseau, Linda

    2017-01-01

    ABSTRACT Objective: to examine advanced practice nursing (APN) roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. Method: we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. Results: given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. Conclusions: given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries. PMID:28146177

  11. Challenges for regulating the private health services in India for achieving universal health care.

    PubMed

    Baru, Rama V

    2013-01-01

    Commercial interests pose a serious challenge for universalizing health-care. This is because "for-profit" health-care privileges individual responsibility and choice over principles of social solidarity. This fundamentally opposing tendency raises ethical dilemmas for designing a health service that is universal and equitable. It is an inadequate to merely state the need for regulating the private sector, the key questions relate to what must be done and how to do it. This paper identifies the challenges to regulating the private health services in India. It argues that regulation has been fragmented and largely driven by the center. Given the diversity of the private sector and health being a state subject, regulating this sector is fraught with the technical and socio-political factors.

  12. Advancing efforts to achieve health equity: equity metrics for health impact assessment practice.

    PubMed

    Heller, Jonathan; Givens, Marjory L; Yuen, Tina K; Gould, Solange; Jandu, Maria Benkhalti; Bourcier, Emily; Choi, Tim

    2014-10-24

    Equity is a core value of Health Impact Assessment (HIA). Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA practice. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the impacts of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communities. There have been several HIA frameworks developed to guide the inclusion of equity considerations. However, the field lacks clear indicators for measuring whether an HIA advanced equity. This article describes the development of a set of equity metrics that aim to guide and evaluate progress toward equity in HIA practice. These metrics also intend to further push the field to deepen its practice and commitment to equity in each phase of an HIA. Over the course of a year, the Society of Practitioners of Health Impact Assessment (SOPHIA) Equity Working Group took part in a consensus process to develop these process and outcome metrics. The metrics were piloted, reviewed, and refined based on feedback from reviewers. The Equity Metrics are comprised of 23 measures of equity organized into four outcomes: (1) the HIA process and products focused on equity; (2) the HIA process built the capacity and ability of communities facing health inequities to engage in future HIAs and in decision-making more generally; (3) the HIA resulted in a shift in power benefiting communities facing inequities; and (4) the HIA contributed to changes that reduced health inequities and inequities in the social and environmental determinants of health. The metrics are comprised of a measurement scale, examples of high scoring activities, potential data sources, and example interview questions to gather data and guide evaluators on scoring each metric.

  13. Millennium Development Goals: how public health professionals perceive the achievement of MDGs

    PubMed Central

    Lomazzi, Marta; Laaser, Ulrich; Theisling, Mareike; Tapia, Leticia; Borisch, Bettina

    2014-01-01

    Background There have been various consultations on the Millennium Development Goals (MDGs) by different groups. However, even if it is clear that the health sector has led the development success of the MDGs, only a few MDG reports consider public health experts’ points of view and these are mainly government driven. Designs The World Federation of Public Health Associations (WFPHA) has executed a global survey to consult public health professionals worldwide concerning the implementation and achievements of the MDGs. The survey was conceived by WFPHA health professionals and promulgated online. Public health professionals and organisations dealing with MDGs responded to the survey. Content analysis was conducted to analyse the data. Results Survey participants attributed the highest importance worldwide to MDGs dealing with women, poverty and hunger reduction, and disease prevention and management. Moreover, they underlined the role of education, referring both to school children and professionals. In high and upper-middle income countries, environmental challenges also received considerable attention. Notably, respondents underlined that weak governance and unstable political situations, as well as the gap between professionals and politicians, were among the main causes that detracted from MDG achievements. Conclusion The public health workforce felt it would be imperative to be included from the outset in the design and implementation of further goals. This implies that those professionals have to take an active part in the political process leading to a new and accountable framework. PMID:25249060

  14. Organizational attributes that assure optimal utilization of public health nurses.

    PubMed

    Meagher-Stewart, Donna; Underwood, Jane; MacDonald, Mary; Schoenfeld, Bonnie; Blythe, Jennifer; Knibbs, Kristin; Munroe, Val; Lavoie-Tremblay, Mélanie; Ehrlich, Anne; Ganann, Rebecca; Crea, Mary

    2010-01-01

    Optimal utilization of public health nurses (PHNs) is important for strengthening public health capacity and sustaining interest in public health nursing in the face of a global nursing shortage. To gain an insight into the organizational attributes that support PHNs to work effectively, 23 focus groups were held with PHNs, managers, and policymakers in diverse regions and urban and rural/remote settings across Canada. Participants identified attributes at all levels of the public health system: government and system-level action, local organizational culture of their employers, and supportive management practices. Effective leadership emerged as a strong message throughout all levels. Other organizational attributes included valuing and promoting public health nursing; having a shared vision, goals, and planning; building partnerships and collaboration; demonstrating flexibility and creativity; and supporting ongoing learning and knowledge sharing. The results of this study highlight opportunities for fostering organizational development and leadership in public health, influencing policies and programs to optimize public health nursing services and resources, and supporting PHNs to realize the full scope of their competencies.

  15. Formative Assessment and Academic Achievement in Pre-Graduate Students of Health Sciences

    ERIC Educational Resources Information Center

    Carrillo-de-la-Pena, Maria T.; Bailles, Eva; Caseras, Xavier; Martinez, Alvar; Ortet, Generos; Perez, Jorge

    2009-01-01

    Although educational experts recommend the use of formative assessment, there is a dearth of empirical studies on its impact on academic achievement. In this research the authors analyse to what extent participation and performance in formative assessment are associated with positive academic outcomes of pre-graduate students of health sciences. A…

  16. Achieving a safer health service: Part 1. Making safety a way of life.

    PubMed

    Woodward, Suzette

    2004-01-01

    Patient safety incidents are a major problem in the health service and it is acknowledged that blaming and reprimanding staff for actual or potential mistakes does not encourage an open and safe culture in which to work. In the first paper in a three-part series the National Patient Safety Agency's seven key to steps to achieving patient safety are discussed.

  17. School Environmental Health Programs and the Challenges of Achieving the Millennium Development Goals

    ERIC Educational Resources Information Center

    Ana, Godson R. E. E.; Shendell, Derek G.

    2011-01-01

    The United Nations (UN) mandate of achieving healthful living for all by the year 2015 through the Millennium Development Goals (MDGs) is facing several challenges. In the school environment, and particularly in less developed countries (LDCs), the situation is further strained by both relatively weak infrastructure and competing governmental…

  18. The Relationship Between Nutrition and Student Achievement, Behavior, and Health: A Review of the Literature.

    ERIC Educational Resources Information Center

    Tseng, Rose Y. L., Comp.; And Others

    The punpose of this report is to review existing research concerned with the relationship of nutrition to student achievement, behavior and health. Information was obtained through searches of computerized data bases, review of journal citations, discussions and correspondence with nutrition personnel as well as reviews of materials available from…

  19. What Is Most Important: Social Factors, Health Selection, and Adolescent Educational Achievement

    ERIC Educational Resources Information Center

    Roos, Leslie L.; Hiebert, Brett; Manivong, Phongsack; Edgerton, Jason; Walld, Randy; MacWilliam, Leonard; de Rocquigny, Janelle

    2013-01-01

    This paper explores the relative importance of social factors and health measures in predicting educational achievement in early and late adolescence using population-based administrative data. The sample was made up of 41,943 children born in Manitoba, Canada between 1982 and 1989 and remaining in the province until age 18. Multilevel modeling…

  20. Physical Health Problems and Barriers to Optimal Health Care Among Children in Foster Care.

    PubMed

    Deutsch, Stephanie Anne; Fortin, Kristine

    2015-10-01

    Children and adolescents in foster care placement represent a unique population with special health care needs, often resulting from pre-placement early adversity and neglected, unaddressed health care needs. High rates of all health problems, including acute and/or chronic physical, mental, and developmental issues prevail. Disparities in health status and access to health care are observed. This article summarizes the physical health problems of children in foster care, who are predisposed to poor health outcomes when complex care needs are unaddressed. Despite recognition of the significant burden of health care need among this unique population, barriers to effective and optimal health care delivery remain. Legislative solutions to overcome obstacles to health care delivery for children in foster care are discussed.

  1. Health benefit modelling and optimization of vehicular pollution control strategies

    NASA Astrophysics Data System (ADS)

    Sonawane, Nayan V.; Patil, Rashmi S.; Sethi, Virendra

    2012-12-01

    This study asserts that the evaluation of pollution reduction strategies should be approached on the basis of health benefits. The framework presented could be used for decision making on the basis of cost effectiveness when the strategies are applied concurrently. Several vehicular pollution control strategies have been proposed in literature for effective management of urban air pollution. The effectiveness of these strategies has been mostly studied as a one at a time approach on the basis of change in pollution concentration. The adequacy and practicality of such an approach is studied in the present work. Also, the assessment of respective benefits of these strategies has been carried out when they are implemented simultaneously. An integrated model has been developed which can be used as a tool for optimal prioritization of various pollution management strategies. The model estimates health benefits associated with specific control strategies. ISC-AERMOD View has been used to provide the cause-effect relation between control options and change in ambient air quality. BenMAP, developed by U.S. EPA, has been applied for estimation of health and economic benefits associated with various management strategies. Valuation of health benefits has been done for impact indicators of premature mortality, hospital admissions and respiratory syndrome. An optimization model has been developed to maximize overall social benefits with determination of optimized percentage implementations for multiple strategies. The model has been applied for sub-urban region of Mumbai city for vehicular sector. Several control scenarios have been considered like revised emission standards, electric, CNG, LPG and hybrid vehicles. Reduction in concentration and resultant health benefits for the pollutants CO, NOx and particulate matter are estimated for different control scenarios. Finally, an optimization model has been applied to determine optimized percentage implementation of specific

  2. Toward a Fourth Generation of Disparities Research to Achieve Health Equity

    PubMed Central

    Thomas, Stephen B.; Quinn, Sandra Crouse; Butler, James; Fryer, Craig S.; Garza, Mary A.

    2011-01-01

    Achieving health equity, driven by the elimination of health disparities, is a goal of Healthy People 2020. In recent decades, the improvement in health status has been remarkable for the U.S. population as a whole. However, racial and ethnic minority populations continue to lag behind whites with a quality of life diminished by illness from preventable chronic diseases and a life span cut short by premature death. We examine a conceptual framework of three generations of health disparities research to understand (a) data trends, (b) factors driving disparities, and (c) solutions for closing the gap. We propose a new, fourth generation of research grounded in public health critical race praxis, utilizing comprehensive interventions to address race, racism, and structural inequalities and advancing evaluation methods to foster our ability to eliminate disparities. This new generation demands that we address the researcher’s own biases as part of the research process. PMID:21219164

  3. A Public Health Achievement Under Adversity: The Eradication of Poliomyelitis From Peru, 1991

    PubMed Central

    Cueto, Marcos

    2014-01-01

    The fight to achieve global eradication of poliomyelitis continues. Although native transmission of poliovirus was halted in the Western Hemisphere by the early 1990s, and only a few cases have been imported in the past few years, much of Latin America’s story remains to be told. Peru conducted a successful flexible, or flattened, vertical campaign in 1991. The initial disease-oriented programs began to collaborate with community-oriented primary health care systems, thus strengthening public–private partnerships and enabling the common goal of poliomyelitis eradication to prevail despite rampant terrorism, economic instability, and political turmoil. Committed leaders in Peru’s Ministry of Health, the Pan American Health Organization, and Rotary International, as well as dedicated health workers who acted with missionary zeal, facilitated acquisition of adequate technologies, coordinated work at the local level, and increased community engagement, despite sometimes being unable to institutionalize public health improvements. PMID:25322297

  4. A public health achievement under adversity: the eradication of poliomyelitis from Peru, 1991.

    PubMed

    Sobti, Deepak; Cueto, Marcos; He, Yuan

    2014-12-01

    The fight to achieve global eradication of poliomyelitis continues. Although native transmission of poliovirus was halted in the Western Hemisphere by the early 1990s, and only a few cases have been imported in the past few years, much of Latin America's story remains to be told. Peru conducted a successful flexible, or flattened, vertical campaign in 1991. The initial disease-oriented programs began to collaborate with community-oriented primary health care systems, thus strengthening public-private partnerships and enabling the common goal of poliomyelitis eradication to prevail despite rampant terrorism, economic instability, and political turmoil. Committed leaders in Peru's Ministry of Health, the Pan American Health Organization, and Rotary International, as well as dedicated health workers who acted with missionary zeal, facilitated acquisition of adequate technologies, coordinated work at the local level, and increased community engagement, despite sometimes being unable to institutionalize public health improvements.

  5. Quantitative Guidance for Stove Usage and Performance to Achieve Health and Environmental Targets

    PubMed Central

    Chiang, Ranyee A.

    2015-01-01

    Background Displacing the use of polluting and inefficient cookstoves in developing countries is necessary to achieve the potential health and environmental benefits sought through clean cooking solutions. Yet little quantitative context has been provided on how much displacement of traditional technologies is needed to achieve targets for household air pollutant concentrations or fuel savings. Objectives This paper provides instructive guidance on the usage of cooking technologies required to achieve health and environmental improvements. Methods We evaluated different scenarios of displacement of traditional stoves with use of higher performing technologies. The air quality and fuel consumption impacts were estimated for these scenarios using a single-zone box model of indoor air quality and ratios of thermal efficiency. Results Stove performance and usage should be considered together, as lower performing stoves can result in similar or greater benefits than a higher performing stove if the lower performing stove has considerably higher displacement of the baseline stove. Based on the indoor air quality model, there are multiple performance–usage scenarios for achieving modest indoor air quality improvements. To meet World Health Organization guidance levels, however, three-stone fire and basic charcoal stove usage must be nearly eliminated to achieve the particulate matter target (< 1–3 hr/week), and substantially limited to meet the carbon monoxide guideline (< 7–9 hr/week). Conclusions Moderate health gains may be achieved with various performance–usage scenarios. The greatest benefits are estimated to be achieved by near-complete displacement of traditional stoves with clean technologies, emphasizing the need to shift in the long term to near exclusive use of clean fuels and stoves. The performance–usage scenarios are also provided as a tool to guide technology selection and prioritize behavior change opportunities to maximize impact. Citation

  6. Strategic Planning as a Tool for Achieving Alignment in Academic Health Centers

    PubMed Central

    Higginbotham, Eve J.; Church, Kathryn C.

    2012-01-01

    After the passage of the Patient Protection and Affordable Care Act in March 2010, there is an urgent need for medical schools, teaching hospitals, and practice plans to work together seamlessly across a common mission. Although there is agreement that there should be greater coordination of initiatives and resources, there is little guidance in the literature to address the method to achieve the necessary transformation. Traditional approaches to strategic planning often engage a few leaders and produce a set of immeasurable initiatives. A nontraditional approach, consisting of a Whole-Scale (Dannemiller Tyson Associates, Ann Arbor, MI) engagement, appreciative inquiry, and a balanced scorecard can, more rapidly transform an academic health center. Using this nontraditional approach to strategic planning, increased organizational awareness was achieved in a single academic health center. Strategic planning can be an effective tool to achieve alignment, enhance accountability, and a first step in meeting the demands of the new landscape of healthcare. PMID:23303997

  7. Strategic planning as a tool for achieving alignment in academic health centers.

    PubMed

    Higginbotham, Eve J; Church, Kathryn C

    2012-01-01

    After the passage of the Patient Protection and Affordable Care Act in March 2010, there is an urgent need for medical schools, teaching hospitals, and practice plans to work together seamlessly across a common mission. Although there is agreement that there should be greater coordination of initiatives and resources, there is little guidance in the literature to address the method to achieve the necessary transformation. Traditional approaches to strategic planning often engage a few leaders and produce a set of immeasurable initiatives. A nontraditional approach, consisting of a Whole-Scale (Dannemiller Tyson Associates, Ann Arbor, MI) engagement, appreciative inquiry, and a balanced scorecard can, more rapidly transform an academic health center. Using this nontraditional approach to strategic planning, increased organizational awareness was achieved in a single academic health center. Strategic planning can be an effective tool to achieve alignment, enhance accountability, and a first step in meeting the demands of the new landscape of healthcare.

  8. Health status and school achievement of children from Head Start and Free School Lunch Programs.

    PubMed

    Gietzen, D; Vermeersch, J A

    1980-01-01

    School health records of 332 children through the eighth grade were examined in a retrospective comparative analysis of physical health status and school achievement of children from Head Start and Free School Lunch Programs. The objective was to determine if nutrition early in the lives of children as a part of a comprehensive health and education program such as Head Start produces greater or different benefits for disadvantaged children than nutrition intervention later through free lunches when the child enters school. Cross-sectional longitudinal, and case-study approaches were used in the analysis. A group of no-food-program disadvantaged children and a group of advantaged children served as comparisons. Results showed that advantaged children performed better on all parameters of school achievement and health status compared with the disadvantaged children, regardless of the form of intervention. Measures of school achievement of Head Start and Free Lunch children did not differ from those of the disadvantaged comparison group, but there were significant differences in measures of health status between the disadvantaged groups. Fewer boys from Project Head Start fell below the 25th percentile for height compared with boys in the Free Lunch Program. Head Start children also scored higher in physical fitness and had fewer reported absences from school due to illness.

  9. The quest for universal health coverage: achieving social protection for all in Mexico.

    PubMed

    Knaul, Felicia Marie; González-Pier, Eduardo; Gómez-Dantés, Octavio; García-Junco, David; Arreola-Ornelas, Héctor; Barraza-Lloréns, Mariana; Sandoval, Rosa; Caballero, Francisco; Hernández-Avila, Mauricio; Juan, Mercedes; Kershenobich, David; Nigenda, Gustavo; Ruelas, Enrique; Sepúlveda, Jaime; Tapia, Roberto; Soberón, Guillermo; Chertorivski, Salomón; Frenk, Julio

    2012-10-06

    Mexico is reaching universal health coverage in 2012. A national health insurance programme called Seguro Popular, introduced in 2003, is providing access to a package of comprehensive health services with financial protection for more than 50 million Mexicans previously excluded from insurance. Universal coverage in Mexico is synonymous with social protection of health. This report analyses the road to universal coverage along three dimensions of protection: against health risks, for patients through quality assurance of health care, and against the financial consequences of disease and injury. We present a conceptual discussion of the transition from labour-based social security to social protection of health, which implies access to effective health care as a universal right based on citizenship, the ethical basis of the Mexican reform. We discuss the conditions that prompted the reform, as well as its design and inception, and we describe the 9-year, evidence-driven implementation process, including updates and improvements to the original programme. The core of the report concentrates on the effects and impacts of the reform, based on analysis of all published and publically available scientific literature and new data. Evidence indicates that Seguro Popular is improving access to health services and reducing the prevalence of catastrophic and impoverishing health expenditures, especially for the poor. Recent studies also show improvement in effective coverage. This research then addresses persistent challenges, including the need to translate financial resources into more effective, equitable and responsive health services. A next generation of reforms will be required and these include systemic measures to complete the reorganisation of the health system by functions. The paper concludes with a discussion of the implications of the Mexican quest to achieve universal health coverage and its relevance for other low-income and middle-income countries.

  10. Achieving large ends with limited means: grand strategy in global health.

    PubMed

    Curry, Leslie A; Luong, Minh A; Krumholz, Harlan M; Gaddis, John; Kennedy, Paul; Rulisa, Stephen; Taylor, Lauren; Bradley, Elizabeth H

    2010-06-01

    Unprecedented attention is focused on global health, with a four-fold increase in development assistance in the last 15 years and the scope of global health expanding beyond infectious disease to include chronic disease and health systems strengthening. As the global impact of health is more widely understood, it has become a crucial element of international relations, economic development, and foreign affairs. At this potential leverage point in the global health movement, the application of grand strategy is of critical importance. Grand strategy, i.e., the development and implementation of comprehensive plans of action to achieve large ends with limited means, has been refined through centuries of international relations and the management of states but has been inadequately applied to global health policy and implementation. We review key principles of grand strategy and demonstrate their applicability to a central global health issue: maternal mortality. The principles include: start with the end in mind, take an ecological approach, recognize that tactics matter, use positive deviance to characterize practical solutions and foster scale-up, and integrate timely intelligence and data into health interventions and improvement efforts. We advocate for the greater use of grand strategy in global health.

  11. Achieving universal health coverage in France: policy reforms and the challenge of inequalities.

    PubMed

    Nay, Olivier; Béjean, Sophie; Benamouzig, Daniel; Bergeron, Henri; Castel, Patrick; Ventelou, Bruno

    2016-05-28

    Since 1945, the provision of health care in France has been grounded in a social conception promoting universalism and equality. The French health-care system is based on compulsory social insurance funded by social contributions, co-administered by workers' and employers' organisations under State control and driven by highly redistributive financial transfers. This system is described frequently as the French model. In this paper, the first in The Lancet's Series on France, we challenge conventional wisdom about health care in France. First, we focus on policy and institutional transformations that have affected deeply the governance of health care over past decades. We argue that the health system rests on a diversity of institutions, policy mechanisms, and health actors, while its governance has been marked by the reinforcement of national regulation under the aegis of the State. Second, we suggest the redistributive mechanisms of the health insurance system are impeded by social inequalities in health, which remain major hindrances to achieving objectives of justice and solidarity associated with the conception of health care in France.

  12. Achieving Millennium Development Goals for Health: Building Understanding, Trust and Capacity to Respond

    PubMed Central

    Larson, Heidi J.

    2007-01-01

    Biomedical interventions promise achievement of health-related Millennium Development Goals provided social-, capacity- and knowledge-based constraints to scaling up and reaching marginalized people at risk, are addressed, and balance between prevention and treatment is struck. We argue for a new approach: multi-stakeholder capacity building and learning for empowerment: MuSCLE. MuSCLE is used as a way to frame three systemic weaknesses in traditional health science and policy approaches: 1) a lack of engagement with people at risk to build a collective understanding of the contexts of health problems; 2) a lack of multi-criteria evaluation of alternative interventions; and 3) a lack of attention paid to integrated capacity building. The MuSCLE framework responds in three ways: 1) Participatory assessment of the ecological, socio-cultural, economic and political contexts of health, identifying priorities using risk and vulnerability science, and modeling drivers; 2) Selection among intervention alternatives that makes ecological, socio-cultural, economic and political tradeoffs transparent; and 3) Integrated capacity building for sustainable and adaptive interventions. Literature and field lessons support the argument, and guidelines are set down. A MuSCLE approach argues for a transformation in health science and policy in order to achieve Millennium Development Goals for health. PMID:17399849

  13. Quality and Health-Optimizing Physical Education: Using Assessment at the Health and Education Nexus

    ERIC Educational Resources Information Center

    Dudley, Dean; Goodyear, Victoria; Baxter, David

    2016-01-01

    Background: The United Nations Educational, Cultural and Scientific Organization (UNESCO) recognizes quality physical education (QPE) must, along with physical, social and affective educative goals, seek to improve the health status of youth (UNESCO, 2015). Health-Optimizing Physical Education (HOPE) is a model of physical education (PE) that…

  14. Optimal microelectromechanical systems (MEMS) device for achieving high pyroelectric response of AlN

    NASA Astrophysics Data System (ADS)

    Kebede, Bemnnet; Coutu, Ronald A.; Starman, LaVern

    2014-03-01

    This paper discusses research being conducted on aluminum nitride (AlN) as a pyroelectric material for use in detecting applications. AlN is being investigated because of its high pyroelectric coefficient, thermal stability, and high Curie temperature. In order to determine suitability of the pyroelectric properties of AlN for use as a detector, testing of several devices was conducted. These devices were fabricated using microelectromechanical systems (MEMS) fabrication processes; the devices were also designed to allow for voltage and current measurements. The deposited AlN films used were 150 nm - 300 nm in thickness. Thin-films were used to rapidly increase the temperature response after the thermal stimulus was applied to the pyroelectric material. This is important because the pyroelectric effect is directly proportional to the rate of temperature change. The design used was a face-electrode bridge that provides thermal isolation which minimizes heat loss to the substrate, thereby increasing operation frequency of the pyroelectric device. A thermal stimulus was applied to the pyroelectric material and the response was measured across the electrodes. A thermal imaging camera was used to monitor the changes in temperature. Throughout the testing process, the annealing temperatures, type of layers, and thicknesses were also varied. These changes resulted in improved MEMS designs, which were fabricated to obtain an optimal design configuration for achieving a high pyroelectric response. A pyroelectric voltage response of 38.9 mVp-p was measured without filtering, 12.45 mVp-p was measured in the infrared (IR) region using a Si filter, and 6.38 mVp-p was measured in the short wavelength IR region using a long pass filter. The results showed that AlN's pyroelectric properties can be used in detecting applications.

  15. Exploration of priority actions for strengthening the role of nurses in achieving universal health coverage

    PubMed Central

    Maaitah, Rowaida Al; AbuAlRub, Raeda Fawzi

    2017-01-01

    ABSTRACT Objective: to explore priority actions for strengthening the role of Advanced Practice Nurses (APNs) towards the achievement of Universal Health Converge (UHC) as perceived by health key informants in Jordan. Methods: an exploratory qualitative design, using a semi-structured survey, was utilized. A purposive sample of seventeen key informants from various nursing and health care sectors was recruited for the purpose of the study. Content analysis utilizing the five-stage framework approach was used for data analysis. Results: the findings revealed that policy and regulation, nursing education, research, and workforce were identified as the main elements that influence the role of APNs in contributing to the achievement of UHC. Priority actions were identified by the participants for the main four elements. Conclusion: study findings confirm the need to strengthen the role of APNs to achieve UHC through a major transformation in nursing education, practice, research, leadership, and regulatory system. Nurses should unite to come up with solid nursing competencies related to APNs, PHC, UHC, leadership and policy making to strengthen their position as main actors in influencing the health care system and evidence creation. PMID:28146176

  16. Robust Airfoil Optimization to Achieve Consistent Drag Reduction Over a Mach Range

    NASA Technical Reports Server (NTRS)

    Li, Wu; Huyse, Luc; Padula, Sharon; Bushnell, Dennis M. (Technical Monitor)

    2001-01-01

    We prove mathematically that in order to avoid point-optimization at the sampled design points for multipoint airfoil optimization, the number of design points must be greater than the number of free-design variables. To overcome point-optimization at the sampled design points, a robust airfoil optimization method (called the profile optimization method) is developed and analyzed. This optimization method aims at a consistent drag reduction over a given Mach range and has three advantages: (a) it prevents severe degradation in the off-design performance by using a smart descent direction in each optimization iteration, (b) there is no random airfoil shape distortion for any iterate it generates, and (c) it allows a designer to make a trade-off between a truly optimized airfoil and the amount of computing time consumed. For illustration purposes, we use the profile optimization method to solve a lift-constrained drag minimization problem for 2-D airfoil in Euler flow with 20 free-design variables. A comparison with other airfoil optimization methods is also included.

  17. Health-financing reforms in southeast Asia: challenges in achieving universal coverage.

    PubMed

    Tangcharoensathien, Viroj; Patcharanarumol, Walaiporn; Ir, Por; Aljunid, Syed Mohamed; Mukti, Ali Ghufron; Akkhavong, Kongsap; Banzon, Eduardo; Huong, Dang Boi; Thabrany, Hasbullah; Mills, Anne

    2011-03-05

    In this sixth paper of the Series, we review health-financing reforms in seven countries in southeast Asia that have sought to reduce dependence on out-of-pocket payments, increase pooled health finance, and expand service use as steps towards universal coverage. Laos and Cambodia, both resource-poor countries, have mostly relied on donor-supported health equity funds to reach the poor, and reliable funding and appropriate identification of the eligible poor are two major challenges for nationwide expansion. For Thailand, the Philippines, Indonesia, and Vietnam, social health insurance financed by payroll tax is commonly used for formal sector employees (excluding Malaysia), with varying outcomes in terms of financial protection. Alternative payment methods have different implications for provider behaviour and financial protection. Two alternative approaches for financial protection of the non-poor outside the formal sector have emerged-contributory arrangements and tax-financed schemes-with different abilities to achieve high population coverage rapidly. Fiscal space and mobilisation of payroll contributions are both important in accelerating financial protection. Expanding coverage of good-quality services and ensuring adequate human resources are also important to achieve universal coverage. As health-financing reform is complex, institutional capacity to generate evidence and inform policy is essential and should be strengthened.

  18. The association between earlier marijuana use and subsequent academic achievement and health problems: a longitudinal study.

    PubMed

    Brook, Judith S; Stimmel, Matthew A; Zhang, Chenshu; Brook, David W

    2008-01-01

    In this prospective longitudinal study, the authors investigated the association between marijuana use over a period of 13 years and subsequent health problems at age 27. A community sample of 749 participants from upstate New York was interviewed at mean ages of 14, 16, 22, and 27 years. Marijuana use over time was significantly associated with increased health problems by the late twenties, including respiratory problems, general malaise, neurocognitive problems, and lower academic achievement and functioning. Effective prevention and intervention programs should consider the wide range of adverse physiological and psychosocial outcomes associated with marijuana use over time.

  19. A Study of the Relationships between Distributed Leadership, Teacher Academic Optimism and Student Achievement in Taiwanese Elementary Schools

    ERIC Educational Resources Information Center

    Chang, I-Hua

    2011-01-01

    The purpose of this study was to explore the relationships between distributed leadership, teachers' academic optimism and student achievement in learning. The study targeted public elementary schools in Taiwan and adopted stratified random sampling to investigate 1500 teachers. Teachers' perceptions were collected by a self-report scale. In…

  20. Should Schools Be Optimistic? An Investigation of the Association between Academic Optimism of Schools and Student Achievement in Primary Education

    ERIC Educational Resources Information Center

    Boonen, Tinneke; Pinxten, Maarten; Van Damme, Jan; Onghena, Patrick

    2014-01-01

    Academic emphasis, collective efficacy, and faculty trust in students and parents (3 school characteristics positively associated with student achievement) are assumed to form a higher order latent construct, "academic optimism" (Hoy, Tarter, & Woolfolk Hoy, 2006a, 2006b). The aim of the present study is to corroborate the latent…

  1. The Relationship of Mental Pressure with Optimism and Academic Achievement Motivation among Second Grade Male High School Students

    ERIC Educational Resources Information Center

    Sarouni, Ali Sedigh; Jenaabadi, Hossein; Pourghaz, Abdulwahab

    2016-01-01

    The present study aimed to examine the relationship of mental pressure with optimism and academic achievement motivation among second grade second period male high school students. This study followed a descriptive-correlational method. The sample included 200 second grade second period male high school students in Sooran. Data collection tools in…

  2. Navy Strategy for Achieving Information Dominance, 2013-2017. Optimizing Navy’s Primacy in the Maritime and Information Domains

    DTIC Science & Technology

    2013-01-01

    and resources to optimize decision making and maximize warfighting effects, Navy Information Dominance has become a leading Service priority. In 2009...This Strategy for Achieving Information Dominance provides the framework through which the Navy s information capabilities will be mainstreamed into...the Navy s culture as a distinct warfighting discipline. The strategy focuses on the three fundamental Information Dominance capabilities of Assured

  3. Leveraging health information technology to achieve the “triple aim” of healthcare reform

    PubMed Central

    Sood, Harpreet S; Bates, David W

    2015-01-01

    Objective To investigate experiences with leveraging health information technology (HIT) to improve patient care and population health, and reduce healthcare expenditures. Materials and methods In-depth qualitative interviews with federal government employees, health policy, HIT and medico-legal experts, health providers, physicians, purchasers, payers, patient advocates, and vendors from across the United States. Results The authors undertook 47 interviews. There was a widely shared belief that Health Information Technology for Economic and Clinical Health (HITECH) had catalyzed the creation of a digital infrastructure, which was being used in innovative ways to improve quality of care and curtail costs. There were however major concerns about the poor usability of electronic health records (EHRs), their limited ability to support multi-disciplinary care, and major difficulties with health information exchange, which undermined efforts to deliver integrated patient-centered care. Proposed strategies for enhancing the benefits of HIT included federal stimulation of competition by mandating vendors to open-up their application program interfaces, incenting development of low-cost consumer informatics tools, and promoting Congressional review of the The Health Insurance Portability and Accountability Act (HIPPA) to optimize the balance between data privacy and reuse. Many underscored the need to “kick the legs from underneath the fee-for-service model” and replace it with a data-driven reimbursement system that rewards high quality care. Conclusions The HITECH Act has stimulated unprecedented, multi-stakeholder interest in HIT. Early experiences indicate that the resulting digital infrastructure is being used to improve quality of care and curtail costs. Reform efforts are however severely limited by problems with usability, limited interoperability and the persistence of the fee-for-service paradigm—addressing these issues therefore needs to be the federal

  4. Academic Optimism and Collective Responsibility: An Organizational Model of the Dynamics of Student Achievement

    ERIC Educational Resources Information Center

    Wu, Jason H.

    2013-01-01

    This study was designed to examine the construct of academic optimism and its relationship with collective responsibility in a sample of Taiwan elementary schools. The construct of academic optimism was tested using confirmatory factor analysis, and the whole structural model was tested with a structural equation modeling analysis. The data were…

  5. Achieving Consistent Near-Optimal Pattern Recognition Accuracy Using Particle Swarm Optimization to Pre-Train Artificial Neural Networks

    ERIC Educational Resources Information Center

    Nikelshpur, Dmitry O.

    2014-01-01

    Similar to mammalian brains, Artificial Neural Networks (ANN) are universal approximators, capable of yielding near-optimal solutions to a wide assortment of problems. ANNs are used in many fields including medicine, internet security, engineering, retail, robotics, warfare, intelligence control, and finance. "ANNs have a tendency to get…

  6. The association between academic engagement and achievement in health sciences students

    PubMed Central

    2013-01-01

    Background Educational institutions play an important role in encouraging student engagement, being necessary to know how engaged are students at university and if this factor is involved in student success point and followed. To explore the association between academic engagement and achievement. Methods Cross-sectional study. The sample consisted of 304 students of Health Sciences. They were asked to fill out an on-line questionnaire. Academic achievements were calculated using three types of measurement. Results Positive correlations were found in all cases. Grade point average was the academic rate most strongly associated with engagement dimensions and this association is different for male and female students. The independent variables could explain between 18.9 and 23.9% of the variance (p < 0.05) in the population of university students being analyzed. Conclusions Engagement has been shown to be one of the many factors, which are positively involved, in the academic achievements of college students. PMID:23446005

  7. Achieving universal health coverage goals in Thailand: the vital role of strategic purchasing.

    PubMed

    Tangcharoensathien, Viroj; Limwattananon, Supon; Patcharanarumol, Walaiporn; Thammatacharee, Jadej; Jongudomsuk, Pongpisut; Sirilak, Supakit

    2015-11-01

    Strategic purchasing is one of the key policy instruments to achieve the universal health coverage (UHC) goals of improved and equitable access and financial risk protection. Given favourable outcomes of Universal Coverage Scheme (UCS), this study synthesized strategic purchasing experiences in the National Health Security Office (NHSO) responsible for the UCS in contributing to achieving UHC goals. The UCS applied the purchaser-provider split concept where NHSO, as a purchaser, is in a good position to enforce accountability by public and private providers to the UCS beneficiaries, through active purchasing. A comprehensive benefit package resulted in high level of financial risk protection as reflected by low incidence of catastrophic health spending and impoverished households. The NHSO contracted the District Health System (DHS) network, to provide outpatient, health promotion and disease prevention services to the whole district population, based on an annual age-adjusted capitation payment. In most cases, the DHS was the only provider in a district without competitors. Geographical monopoly hampered the NHSO to introduce a competitive contractual agreement, but a durable, mutually dependent relationship based on trust was gradually evolved, while accreditation is an important channel for quality improvement. Strategic purchasing services from DHS achieved a pro-poor utilization due to geographical proximity, where travel time and costs were minimal. Inpatient services paid by Diagnostic Related Group within a global budget ceiling, which is estimated based on unit costs, admission rates and admission profiles, contained cost effectively. To prevent potential under-provisions of the services, some high cost interventions were unbundled from closed end payment and paid on an agreed fee schedule. Executing monopsonistic purchasing power by NHSO brought down price of services given assured quality. Cost saving resulted in more patients served within a finite

  8. Optimal vortex formation as an index of cardiac health.

    PubMed

    Gharib, Morteza; Rambod, Edmond; Kheradvar, Arash; Sahn, David J; Dabiri, John O

    2006-04-18

    Heart disease remains a leading cause of death worldwide. Previous research has indicated that the dynamics of the cardiac left ventricle (LV) during diastolic filling may play a critical role in dictating overall cardiac health. Hence, numerous studies have aimed to predict and evaluate global cardiac health based on quantitative parameters describing LV function. However, the inherent complexity of LV diastole, in its electrical, muscular, and hemodynamic processes, has prevented the development of tools to accurately predict and diagnose heart failure at early stages, when corrective measures are most effective. In this work, it is demonstrated that major aspects of cardiac function are reflected uniquely and sensitively in the optimization of vortex formation in the blood flow during early diastole, as measured by a dimensionless numerical index. This index of optimal vortex formation correlates well with existing measures of cardiac health such as the LV ejection fraction. However, unlike existing measures, this previously undescribed index does not require patient-specific information to determine numerical index values corresponding to normal function. A study of normal and pathological cardiac health in human subjects demonstrates the ability of this global index to distinguish disease states by a straightforward analysis of noninvasive LV measurements.

  9. Formative assessment and academic achievement in pre-graduate students of health sciences.

    PubMed

    Carrillo-de-la-Peña, María T; Baillès, Eva; Caseras, Xavier; Martínez, Alvar; Ortet, Generós; Pérez, Jorge

    2009-03-01

    Although educational experts recommend the use of formative assessment, there is a dearth of empirical studies on its impact on academic achievement. In this research the authors analyse to what extent participation and performance in formative assessment are associated with positive academic outcomes of pre-graduate students of health sciences. A total of 548 students from three health science degrees (Medicine, Psychology and Biology) from four Spanish universities were involved in this study. The students who carried out mid-term formative assessment got better marks and had higher success rates in final summative assessment that the students who did not participate. In addition, success in formative assessment tests was associated with better summative marks. Interestingly, participation in formative assessment was a better predictor of final outcome than success in formative assessment, a result that supports the key role of feedback in formative assessment. Students who took the mid-term examination, irrespective of their success, obtained feedback about their achievement and probably this determined their greater involvement in the learning process. Although causal relationships between formative and summative assessment cannot be established from this research, the generalized benefits of formative assessments found here encourage the practice of them in health sciences education.

  10. Schistosomiasis Elimination Strategies and Potential Role of a Vaccine in Achieving Global Health Goals

    PubMed Central

    Mo, Annie X.; Agosti, Jan M.; Walson, Judd L.; Hall, B. Fenton; Gordon, Lance

    2014-01-01

    In March 2013, the National Institute of Allergy and Infectious Diseases and the Bill and Melinda Gates Foundation co-sponsored a meeting entitled “Schistosomiasis Elimination Strategy and Potential Role of a Vaccine in Achieving Global Health Goals” to discuss the potential role of schistosomiasis vaccines and other tools in the context of schistosomiasis control and elimination strategies. It was concluded that although schistosomiasis elimination in some focal areas may be achievable through current mass drug administration programs, global control and elimination will face several significant scientific and operational challenges, and will require an integrated approach with other, additional interventions. These challenges include vector (snail) control; environmental modification; water, sanitation, and hygiene; and other future innovative tools such as vaccines. Defining a clear product development plan that reflects a vaccine strategy as complementary to the existing control programs to combat different forms of schistosomiasis will be important to develop a vaccine effectively. PMID:24402703

  11. Schistosomiasis elimination strategies and potential role of a vaccine in achieving global health goals.

    PubMed

    Mo, Annie X; Agosti, Jan M; Walson, Judd L; Hall, B Fenton; Gordon, Lance

    2014-01-01

    In March 2013, the National Institute of Allergy and Infectious Diseases and the Bill and Melinda Gates Foundation co-sponsored a meeting entitled "Schistosomiasis Elimination Strategy and Potential Role of a Vaccine in Achieving Global Health Goals" to discuss the potential role of schistosomiasis vaccines and other tools in the context of schistosomiasis control and elimination strategies. It was concluded that although schistosomiasis elimination in some focal areas may be achievable through current mass drug administration programs, global control and elimination will face several significant scientific and operational challenges, and will require an integrated approach with other, additional interventions. These challenges include vector (snail) control; environmental modification; water, sanitation, and hygiene; and other future innovative tools such as vaccines. Defining a clear product development plan that reflects a vaccine strategy as complementary to the existing control programs to combat different forms of schistosomiasis will be important to develop a vaccine effectively.

  12. Optimal Experience and Reading Achievement in Virtual Environments among College Level Developmental Readers

    ERIC Educational Resources Information Center

    Burgess, Melissa L.

    2010-01-01

    In this mixed methods study the potential for developmental readers to experience optimal experience (flow) within the multi-user virtual environment, "Second Life," was examined. In an educational context, "Second Life" provided a space for constructivist learning, socialization, exploration, discovery and creativity. The communicative, social…

  13. Study of optimal extraction conditions for achieving high yield and antioxidant activity of tomato seed oil

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Tomato seeds resulting from tomato processing by-product have not been effectively utilized as value-added products. This study investigated the kinetics of oil extraction from tomato seeds and sought to optimize the oil extraction conditions. The oil was extracted by using hexane as solvent for 0 t...

  14. HealthMpowerment.org: Building Community through a Mobile-Optimized, Online Health Promotion Intervention

    ERIC Educational Resources Information Center

    Hightow-Weidman, Lisa B.; Muessig, Kathryn E.; Pike, Emily C.; LeGrand, Sara; Baltierra, Nina; Rucker, Alvin Justin; Wilson, Patrick

    2015-01-01

    Background: Both young Black men who have sex with men as well as young Black transgender women (YBMSM/TW) continue to experience a significant increase in HIV incidence. HealthMpowerment.org (HMP) is a mobile phone-optimized, online intervention for both YBMSM/TW to build community and facilitate supportive relationships. Methods: To assess the…

  15. Achieving cultural appropriateness in health promotion programs: targeted and tailored approaches.

    PubMed

    Kreuter, Matthew W; Lukwago, Susan N; Bucholtz, R D Dawn C; Clark, Eddie M; Sanders-Thompson, Vetta

    2003-04-01

    It is a truism of health education that programs and interventions will be more effective when they are culturally appropriate for the populations they serve. In practice, however, the strategies used to achieve cultural appropriateness vary widely. This article briefly describes five strategies commonly used to target programs to culturally defined groups. It then explains how a sixth approach, cultural tailoring, might extend these strategies and enhance our ability to develop effective programs for cultural groups. The authors illustrate this new approach with an example of cultural tailoring forcancer prevention in a population of lower income urban African American women.

  16. Adolescent Sleep Duration, Variability, and Peak Levels of Achievement and Mental Health.

    PubMed

    Fuligni, Andrew J; Arruda, Erin H; Krull, Jennifer L; Gonzales, Nancy A

    2017-01-27

    To inform public health recommendations for adolescent sleep, the amounts of sleep associated with the highest levels of academic achievement and mental health were examined. The degree to which daily variability in sleep duration represents an underappreciated but functionally significant sleep behavior also was tested. A total of 421 adolescents (Mage  = 15.03 years) with Mexican-American backgrounds reported nightly sleep times for 2 weeks; approximately 80% repeated the same protocol 1 year later. Multilevel modeling indicated that the amount of sleep associated with the lowest levels of internalizing and externalizing symptoms was more than 1 hr greater than the amount associated with the highest levels of academic performance. Greater daily variability in sleep duration predicted greater symptomatology and mixed academic outcomes.

  17. Optimization of Composite Material System and Lay-up to Achieve Minimum Weight Pressure Vessel

    NASA Astrophysics Data System (ADS)

    Mian, Haris Hameed; Wang, Gang; Dar, Uzair Ahmed; Zhang, Weihong

    2013-10-01

    The use of composite pressure vessels particularly in the aerospace industry is escalating rapidly because of their superiority in directional strength and colossal weight advantage. The present work elucidates the procedure to optimize the lay-up for composite pressure vessel using finite element analysis and calculate the relative weight saving compared with the reference metallic pressure vessel. The determination of proper fiber orientation and laminate thickness is very important to decrease manufacturing difficulties and increase structural efficiency. In the present work different lay-up sequences for laminates including, cross-ply [ 0 m /90 n ] s , angle-ply [ ±θ] ns , [ 90/±θ] ns and [ 0/±θ] ns , are analyzed. The lay-up sequence, orientation and laminate thickness (number of layers) are optimized for three candidate composite materials S-glass/epoxy, Kevlar/epoxy and Carbon/epoxy. Finite element analysis of composite pressure vessel is performed by using commercial finite element code ANSYS and utilizing the capabilities of ANSYS Parametric Design Language and Design Optimization module to automate the process of optimization. For verification, a code is developed in MATLAB based on classical lamination theory; incorporating Tsai-Wu failure criterion for first-ply failure (FPF). The results of the MATLAB code shows its effectiveness in theoretical prediction of first-ply failure strengths of laminated composite pressure vessels and close agreement with the FEA results. The optimization results shows that for all the composite material systems considered, the angle-ply [ ±θ] ns is the optimum lay-up. For given fixed ply thickness the total thickness of laminate is obtained resulting in factor of safety slightly higher than two. Both Carbon/epoxy and Kevlar/Epoxy resulted in approximately same laminate thickness and considerable percentage of weight saving, but S-glass/epoxy resulted in weight increment.

  18. Need for optimizing catalyst loading for achieving affordable microbial fuel cells.

    PubMed

    Singh, Inderjeet; Chandra, Amreesh

    2013-08-01

    Microbial fuel cell (MFC) technology is a promising technology for electricity production together with simultaneous water treatment. Catalysts play an important role in deciding the MFC performance. In most reports, effect of catalyst - both type and quantity is not optimized. In this paper, synthesis of nanorods of MnO2-catalyst particles for application in Pt-free MFCs is reported. The effect of catalyst loading i.e., weight ratio, with respect to conducting element and binder has been optimized by employing large number of combinations. Using simple theoretical model, it is shown that too high (or low) concentration of catalysts result in loss of MFC performance. The operation of MFC has been investigated using domestic wastewater as source of bio-waste for obtaining real world situation. Maximum power density of ∼61 mW/m(2) was obtained when weight ratio of catalyst and conducting species was 1:1. Suitable reasons are given to explain the outcomes.

  19. Platform-dependent optimization considerations for mHealth applications

    NASA Astrophysics Data System (ADS)

    Kaghyan, Sahak; Akopian, David; Sarukhanyan, Hakob

    2015-03-01

    Modern mobile devices contain integrated sensors that enable multitude of applications in such fields as mobile health (mHealth), entertainment, sports, etc. Human physical activity monitoring is one of such the emerging applications. There exists a range of challenges that relate to activity monitoring tasks, and, particularly, exploiting optimal solutions and architectures for respective mobile software application development. This work addresses mobile computations related to integrated inertial sensors for activity monitoring, such as accelerometers, gyroscopes, integrated global positioning system (GPS) and WLAN-based positioning, that can be used for activity monitoring. Some of the aspects will be discussed in this paper. Each of the sensing data sources has its own characteristics such as specific data formats, data rates, signal acquisition durations etc., and these specifications affect energy consumption. Energy consumption significantly varies as sensor data acquisition is followed by data analysis including various transformations and signal processing algorithms. This paper will address several aspects of more optimal activity monitoring implementations exploiting state-of-the-art capabilities of modern platforms.

  20. Strategy Developed for Selecting Optimal Sensors for Monitoring Engine Health

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Sensor indications during rocket engine operation are the primary means of assessing engine performance and health. Effective selection and location of sensors in the operating engine environment enables accurate real-time condition monitoring and rapid engine controller response to mitigate critical fault conditions. These capabilities are crucial to ensure crew safety and mission success. Effective sensor selection also facilitates postflight condition assessment, which contributes to efficient engine maintenance and reduced operating costs. Under the Next Generation Launch Technology program, the NASA Glenn Research Center, in partnership with Rocketdyne Propulsion and Power, has developed a model-based procedure for systematically selecting an optimal sensor suite for assessing rocket engine system health. This optimization process is termed the systematic sensor selection strategy. Engine health management (EHM) systems generally employ multiple diagnostic procedures including data validation, anomaly detection, fault-isolation, and information fusion. The effectiveness of each diagnostic component is affected by the quality, availability, and compatibility of sensor data. Therefore systematic sensor selection is an enabling technology for EHM. Information in three categories is required by the systematic sensor selection strategy. The first category consists of targeted engine fault information; including the description and estimated risk-reduction factor for each identified fault. Risk-reduction factors are used to define and rank the potential merit of timely fault diagnoses. The second category is composed of candidate sensor information; including type, location, and estimated variance in normal operation. The final category includes the definition of fault scenarios characteristic of each targeted engine fault. These scenarios are defined in terms of engine model hardware parameters. Values of these parameters define engine simulations that generate

  1. [Optimal fluoride level in drinking water and public health].

    PubMed

    Karsenty, E; Sgan-Cohen, H; Vered, Y; Leventhal, A

    2003-11-01

    Water fluoridation is a safe, efficient, and well-proven way of preventing dental decay in the community. In countries such as Israel, where dental care is not covered by the national insurance law, this has an important role in reducing social inequalities in health care. For toddlers and children, water fluoridation is the only way of promoting dental health without a need for regular visits to dental clinics, and without regard to parent awareness and motivation. The other methods of fluoride supplementation do not succeed in reaching the level of safety and cost-efficiency of water fluoridation, and their use is successful only among upper socio-economic classes. Water fluoridation has been defined by the US CDC as one of the main achievements in health care during the 20th century. In spite of the legal difficulties raised by various activist groups, the use of water fluoridation is growing steadily among developed as well as third world countries. The Israeli bylaw of national water fluoridation that is in effect will enable the safe improvement of the overall dental health status of the population at an extremely low cost.

  2. Achieving universal health care coverage: Current debates in Ghana on covering those outside the formal sector

    PubMed Central

    2012-01-01

    Background Globally, extending financial protection and equitable access to health services to those outside the formal sector employment is a major challenge for achieving universal coverage. While some favour contributory schemes, others have embraced tax-funded health service cover for those outside the formal sector. This paper critically examines the issue of how to cover those outside the formal sector through the lens of stakeholder views on the proposed one-time premium payment (OTPP) policy in Ghana. Discussion Ghana in 2004 implemented a National Health Insurance Scheme, based on a contributory model where service benefits are restricted to those who contribute (with some groups exempted from contributing), as the policy direction for moving towards universal coverage. In 2008, the OTPP system was proposed as an alternative way of ensuring coverage for those outside formal sector employment. There are divergent stakeholder views with regard to the meaning of the one-time premium and how it will be financed and sustained. Our stakeholder interviews indicate that the underlying issue being debated is whether the current contributory NHIS model for those outside the formal employment sector should be maintained or whether services for this group should be tax funded. However, the advantages and disadvantages of these alternatives are not being explored in an explicit or systematic way and are obscured by the considerable confusion about the likely design of the OTPP policy. We attempt to contribute to the broader debate about how best to fund coverage for those outside the formal sector by unpacking some of these issues and pointing to the empirical evidence needed to shed even further light on appropriate funding mechanisms for universal health systems. Summary The Ghanaian debate on OTPP is related to one of the most important challenges facing low- and middle-income countries seeking to achieve a universal health care system. It is critical that there is

  3. Optimized atomistic force fields for aqueous solutions of Magnesium and Calcium Chloride: Analysis, achievements and limitations

    NASA Astrophysics Data System (ADS)

    Elfgen, Roman; Hülsmann, Marco; Krämer, Andreas; Köddermann, Thorsten; Kirschner, Karl N.; Reith, Dirk

    2016-10-01

    Molecular simulations are an important tool in the study of aqueous salt solutions. To predict the physical properties accurately and reliably, the molecular models must be tailored to reproduce experimental data. In this work, a combination of recent global and local optimization tools is used to derive force fields for MgCl2 (aq) and CaCl2 (aq). The molecular models for the ions are based on a Lennard-Jones (LJ) potential with a superimposed point charge. The LJ parameters are adjusted to reproduce the bulk density and shear viscosity of the different solutions at 1 bar and temperatures of 293.15, 303.15, and 318.15 K. It is shown that the σ-value of chloride consistently has the strongest influence on the system properties. The optimized force field for MgCl2 (aq) provides both properties in good agreement with the experimental data over a wide range of salt concentrations. For CaCl2 (aq), a compromise was made between the bulk density and shear viscosity, since reproducing the two properties requires two different choices of the LJ parameters. This is demonstrated by studying metamodels of the simulated data, which are generated to visualize the correlation between the parameters and observables by using projection plots. Consequently, in order to derive a transferable force field, an error of ˜3% on the bulk density has to be tolerated to yield the shear viscosity in satisfactory agreement with experimental data.

  4. Optimism and pessimism in the context of health: bipolar opposites or separate constructs?

    PubMed

    Kubzansky, Laura D; Kubzansky, Philip E; Maselko, Joanna

    2004-08-01

    One difficulty plaguing research on dispositional optimism and health is whether optimism and pessimism are bipolar opposites or constitute distinct constructs. The present study examined the Life Orientation Test to determine whether the two-factor structure is explained by method bias (due to measurement) or substantive differences. The authors compared three measurement models: bipolar, bivariate, and method artifact. Optimism and pessimism emerged as distinct constructs due to substantive differences. The authors also considered the validity of optimism and pessimism, examining their relations with psychological and physical health outcomes. Optimism and pessimism were more similar in relation to psychological health than to other health-related behavior or physical health outcomes. However, a strongly interpretable pattern for the relation of optimism and pessimism to the health outcomes did not emerge. Further research may benefit from considering optimism and pessimism as bivariate and also should consider the conceptual components and behavioral mechanisms specific to each variable.

  5. Metal-binding sites are designed to achieve optimal mechanical and signaling properties

    PubMed Central

    Dutta, Anindita; Bahar, Ivet

    2010-01-01

    Many proteins require bound metals to achieve their function. We take advantage of increasing structural data on metal-binding proteins to elucidate three properties: the involvement of metal-binding sites in the global dynamics of the protein, predicted by elastic network models, their exposure/burial to solvent, and their signal-processing properties indicated by Markovian stochastics analysis. Systematic analysis of a dataset of 145 structures reveals that the residues that coordinate metal ions enjoy remarkably efficient and precise signal transduction properties. These properties are rationalized in terms of their physical properties: participation in hinge sites that control the softest modes collectively accessible to the protein and occupancy of central positions minimally exposed to solvent. Our observations suggest that metal-binding sites may have been evolutionary selected to achieve optimum allosteric communication. They also provide insights into basic principles for designing metal-binding sites, which are verified to be met by recently designed de novo metal-binding proteins. PMID:20826340

  6. Response to health inequity: the role of social protection in reducing poverty and achieving equity.

    PubMed

    Scheil-Adlung, Xenia

    2014-06-01

    Health inequities are determined by multiple factors within the health sector and beyond. While gaps in social health protection coverage and effective access to health care are among the most prominent causes of health inequities, social and economic inequalities existing beyond the health sector contribute greatly to barriers to access affordable and acceptable health care.

  7. Charting the course for home health care quality: action steps for achieving sustainable improvement: conference proceedings.

    PubMed

    Feldman, Penny Hollander; Peterson, Laura E; Reische, Laurie; Bruno, Lori; Clark, Amy

    2004-12-01

    On June 30 and July 1, 2003, the first national meeting Charting the Course for Home Health Care Quality: Action Steps for Achieving Sustainable Improvement convened in New York City. The Center for Home Care Policy & Research of the Visiting Nurse Service of New York (VNSNY) hosted the meeting with support from the Robert Wood Johnson Foundation. Fifty-seven attendees from throughout the United States participated. The participants included senior leaders and managers and nurses working directly in home care today. The meeting's objectives were to: 1. foster dialogue among key constituents influencing patient safety and home care, 2. promote information-sharing across sectors and identify areas where more information is needed, and, 3. develop an agenda and strategy for moving forward. This article reports the meeting's proceedings.

  8. Does parental involvement matter for student achievement and mental health in high school?

    PubMed

    Wang, Ming-Te; Sheikh-Khalil, Salam

    2014-01-01

    Parental involvement in education remains important for facilitating positive youth development. This study conceptualized parental involvement as a multidimensional construct-including school-based involvement, home-based involvement, and academic socialization-and examined the effects of different types of parental involvement in 10th grade on student achievement and depression in 11th grade (approximately ages 15-17 years). In addition, this study tested whether parental involvement influenced adolescent outcomes by increasing their academic engagement in school. A total of 1,056 adolescents participated in the study (51% males; 53% European American, 40% African American, and 7% other). Parental involvement was found to improve academic and emotional functioning among adolescents. In addition, parental involvement predicted adolescent academic success and mental health both directly and indirectly through behavioral and emotional engagement.

  9. Achieving high lipid productivity of a thermotolerant microalga Desmodesmus sp. F2 by optimizing environmental factors and nutrient conditions.

    PubMed

    Ho, Shih-Hsin; Chang, Jo-Shu; Lai, Yen-Ying; Chen, Ching-Nen Nathan

    2014-03-01

    The optimal conditions for cultivating the thermotolerant lipid-rich microalga Desmodesmus sp. F2 to achieve maximal lipid productivity were determined in this study. The conditions were light intensity, 700μmol/m(2)s; temperature, 35°C; cultivation nitrogen source, nitrate; initial nitrogen level, 6.6mM nitrogen. Carbon dioxide (2.5%, 0.2 vvm) was pumped into the cultures continuously. In the pre-optimized conditions, the maximal lipid productivity of this microalga was 113mg/L/d, which was raised to 263mg/L/d in the optimized conditions. This level of lipid productivity of microalgae is the highest ever reported in the literature. Fatty acid composition of the lipid produced by Desmodesmus sp. F2 in the optimal conditions was determined, in which C16 and C18 species accounted for 95% of the fatty acids. Saturated, monounsaturated and polyunsaturated fatty acids accounted for 38.9%, 33.1% and 22.6%, respectively. Based on the analysis, this lipid quality makes it a good feedstock for biodiesel production.

  10. High direct drive illumination uniformity achieved by multi-parameter optimization approach: a case study of Shenguang III laser facility.

    PubMed

    Tian, Chao; Chen, Jia; Zhang, Bo; Shan, Lianqiang; Zhou, Weimin; Liu, Dongxiao; Bi, Bi; Zhang, Feng; Wang, Weiwu; Zhang, Baohan; Gu, Yuqiu

    2015-05-04

    The uniformity of the compression driver is of fundamental importance for inertial confinement fusion (ICF). In this paper, the illumination uniformity on a spherical capsule during the initial imprinting phase directly driven by laser beams has been considered. We aim to explore methods to achieve high direct drive illumination uniformity on laser facilities designed for indirect drive ICF. There are many parameters that would affect the irradiation uniformity, such as Polar Direct Drive displacement quantity, capsule radius, laser spot size and intensity distribution within a laser beam. A novel approach to reduce the root mean square illumination non-uniformity based on multi-parameter optimizing approach (particle swarm optimization) is proposed, which enables us to obtain a set of optimal parameters over a large parameter space. Finally, this method is applied to improve the direct drive illumination uniformity provided by Shenguang III laser facility and the illumination non-uniformity is reduced from 5.62% to 0.23% for perfectly balanced beams. Moreover, beam errors (power imbalance and pointing error) are taken into account to provide a more practical solution and results show that this multi-parameter optimization approach is effective.

  11. Optimization of Oxidation Temperature for Commercially Pure Titanium to Achieve Improved Corrosion Resistance

    NASA Astrophysics Data System (ADS)

    Bansal, Rajesh; Singh, J. K.; Singh, Vakil; Singh, D. D. N.; Das, Parimal

    2017-03-01

    Thermal oxidation of commercially pure titanium (cp-Ti) was carried out at different temperatures, ranging from 200 to 900 °C to achieve optimum corrosion resistance of the thermally treated surface in simulated body fluid. Scanning electron microscopy, x-ray diffraction, Raman spectroscopy and electrochemical impedance spectroscopy techniques were used to characterize the oxides and assess their protective properties exposed in the test electrolyte. Maximum resistance toward corrosion was observed for samples oxidized at 500 °C. This was attributed to the formation of a composite layer of oxides at this temperature comprising Ti2O3 (titanium sesquioxide), anatase and rutile phases of TiO2 on the surface of cp-Ti. Formation of an intact and pore-free oxide-substrate interface also improved its corrosion resistance.

  12. Optimization of Oxidation Temperature for Commercially Pure Titanium to Achieve Improved Corrosion Resistance

    NASA Astrophysics Data System (ADS)

    Bansal, Rajesh; Singh, J. K.; Singh, Vakil; Singh, D. D. N.; Das, Parimal

    2017-02-01

    Thermal oxidation of commercially pure titanium (cp-Ti) was carried out at different temperatures, ranging from 200 to 900 °C to achieve optimum corrosion resistance of the thermally treated surface in simulated body fluid. Scanning electron microscopy, x-ray diffraction, Raman spectroscopy and electrochemical impedance spectroscopy techniques were used to characterize the oxides and assess their protective properties exposed in the test electrolyte. Maximum resistance toward corrosion was observed for samples oxidized at 500 °C. This was attributed to the formation of a composite layer of oxides at this temperature comprising Ti2O3 (titanium sesquioxide), anatase and rutile phases of TiO2 on the surface of cp-Ti. Formation of an intact and pore-free oxide-substrate interface also improved its corrosion resistance.

  13. ABC proteins protect the human body and maintain optimal health.

    PubMed

    Ueda, Kazumitsu

    2011-01-01

    Human MDR1, a multi-drug transporter gene, was isolated as the first of the eukaryote ATP Binding Cassette (ABC) proteins from a multidrug-resistant carcinoma cell line in 1986. To date, over 25 years, many ABC proteins have been found to play important physiological roles by transporting hydrophobic compounds. Defects in their functions cause various diseases, indicating that endogenous hydrophobic compounds, as well as water-soluble compounds, are properly transported by transmembrane proteins. MDR1 transports a large number of structurally unrelated drugs and is involved in their pharmacokinetics, and thus is a key factor in drug interaction. ABCA1, an ABC protein, eliminates excess cholesterol in peripheral cells by generating HDL. Because ABCA1 is a key molecule in cholesterol homeostasis, its function and expression are highly regulated. Eukaryote ABC proteins function on the body surface facing the outside and in organ pathways to adapt to the extracellular environment and protect the body to maintain optimal health.

  14. Optimized Radar Remote Sensing for Levee Health Monitoring

    NASA Technical Reports Server (NTRS)

    Jones, Cathleen E.

    2013-01-01

    Radar remote sensing offers great potential for high resolution monitoring of ground surface changes over large areas at one time to detect movement on and near levees and for location of seepage through levees. Our NASA-funded projects to monitor levees in the Sacramento Delta and the Mississippi River have developed and demonstrated methods to use radar remote sensing to measure quantities relevant to levee health and of great value to emergency response. The DHS-funded project will enable us is to define how to optimally monitor levees in this new way and set the stage for transition to using satellite SAR (synthetic aperture radar) imaging for better temporal and spatial coverage at lower cost to the end users.

  15. Optimism

    PubMed Central

    Carver, Charles S.; Scheier, Michael F.; Segerstrom, Suzanne C.

    2010-01-01

    Optimism is an individual difference variable that reflects the extent to which people hold generalized favorable expectancies for their future. Higher levels of optimism have been related prospectively to better subjective well-being in times of adversity or difficulty (i.e., controlling for previous well-being). Consistent with such findings, optimism has been linked to higher levels of engagement coping and lower levels of avoidance, or disengagement, coping. There is evidence that optimism is associated with taking proactive steps to protect one's health, whereas pessimism is associated with health-damaging behaviors. Consistent with such findings, optimism is also related to indicators of better physical health. The energetic, task-focused approach that optimists take to goals also relates to benefits in the socioeconomic world. Some evidence suggests that optimism relates to more persistence in educational efforts and to higher later income. Optimists also appear to fare better than pessimists in relationships. Although there are instances in which optimism fails to convey an advantage, and instances in which it may convey a disadvantage, those instances are relatively rare. In sum, the behavioral patterns of optimists appear to provide models of living for others to learn from. PMID:20170998

  16. Achieving optimal essential fatty acid status in vegetarians: current knowledge and practical implications.

    PubMed

    Davis, Brenda C; Kris-Etherton, Penny M

    2003-09-01

    Although vegetarian diets are generally lower in total fat, saturated fat, and cholesterol than are nonvegetarian diets, they provide comparable levels of essential fatty acids. Vegetarian, especially vegan, diets are relatively low in alpha-linolenic acid (ALA) compared with linoleic acid (LA) and provide little, if any, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Clinical studies suggest that tissue levels of long-chain n-3 fatty acids are depressed in vegetarians, particularly in vegans. n-3 Fatty acids have numerous physiologic benefits, including potent cardioprotective effects. These effects have been demonstrated for ALA as well as EPA and DHA, although the response is generally less for ALA than for EPA and DHA. Conversion of ALA by the body to the more active longer-chain metabolites is inefficient: < 5-10% for EPA and 2-5% for DHA. Thus, total n-3 requirements may be higher for vegetarians than for nonvegetarians, as vegetarians must rely on conversion of ALA to EPA and DHA. Because of the beneficial effects of n-3 fatty acids, it is recommended that vegetarians make dietary changes to optimize n-3 fatty acid status.

  17. Achievements and challenges on policies for allied health professionals who use telehealth in the Canadian Arctic.

    PubMed

    Hailey, D; Foerster, V; Nakagawa, B; Wapshall, T M; Murtagh, J A; Smitten, J; Steblecki, J A; Wong, G

    2005-01-01

    We formulated policies and procedures for allied health professionals (AHPs) who provide services using telehealth in Nunavut, Canada's newest Arctic territory. These are a supplement to the clinical policies and procedures already established for Nunavut physicians and nurses. The services were in the areas of audiology, dietetics/nutrition, midwifery, occupational therapy, ophthalmic services, pharmacy, physiotherapy, psychology, respiratory therapy, social work and speech therapy. Documents specific to each of the services were developed, drawing on information from Government of Nunavut data, Nunavut healthcare providers and links made through the Internet. Topics included the scope and limitations of telehealth services, staff responsibilities, training and reporting, professional standards and cultural considerations. We also considered generic policies covering common issues such as jurisdiction, licensing and liability. The policies and procedures for AHPs will enhance and expand the successes already achieved with telehealth in Nunavut. The challenges are to balance the preferred approaches to service provision with the realities of health care and communications in an Arctic setting.

  18. Environmental health sciences education--a tool for achieving environmental equity and protecting children.

    PubMed Central

    Claudio, L; Torres, T; Sanjurjo, E; Sherman, L R; Landrigan, P J

    1998-01-01

    Children are highly susceptible to deleterious effects of environmental toxins. Those who live in underserved communities may be particularly at risk because environmental pollution has been found to be disproportionately distributed among communities. Mounting evidence suggests that asthma rates are rising and that this disease can be caused or aggravated by air pollution. Although ambient air quality has generally improved, these improvements have not reached minority communities in equal proportions. This and other data has fueled the concept of environmental justice or environmental equity, which has led to community activism and government actions. One possible example of environmental inequity and its consequences is the Hunt's Point community, in the South Bronx, New York. This community experiences a high pollution burden with the siting of facilities that emit hazardous wastes into the air. Our approach to this problem has been the formation of mechanisms for bidirectional communication between community residents, government entities, and academic institutions such as Mount Sinai Medical Center. As a result of this experience, we believe that the key to achieving environmental health, especially in communities of color where many children are at risk, is to empower residents to take charge of their environment by providing relevant educational opportunities. Strategies for environmental health education include multitiered training approaches that include community residents, parent education, direct children education, and community education through professional counselors and train-the-trainer approaches. We propose that academic researchers must use community residents not just as subjects of our studies, but to increase our mutual understanding of environmental health, resulting in active participation of community members in research design, data collection, analysis, and dissemination of results in order to make intervention strategies more

  19. School Achievement of Children by Demographic and Socioeconomic Factors. Data From the National Health Survey, Series 11, Number 109.

    ERIC Educational Resources Information Center

    Schaie, K. Warner; Roberts, Jean

    This is the second report on the school achievement of children six to eleven years of age in the noninstitutionalized population of the United States, as estimated from the Reading and Arithmetic subtest data of the Wide Range Achievement Test obtained in the Health Examination Survey of 1963-65. It contains findings by selected demographic and…

  20. Isometric Scaling in Developing Long Bones Is Achieved by an Optimal Epiphyseal Growth Balance.

    PubMed

    Stern, Tomer; Aviram, Rona; Rot, Chagai; Galili, Tal; Sharir, Amnon; Kalish Achrai, Noga; Keller, Yosi; Shahar, Ron; Zelzer, Elazar

    2015-08-01

    One of the major challenges that developing organs face is scaling, that is, the adjustment of physical proportions during the massive increase in size. Although organ scaling is fundamental for development and function, little is known about the mechanisms that regulate it. Bone superstructures are projections that typically serve for tendon and ligament insertion or articulation and, therefore, their position along the bone is crucial for musculoskeletal functionality. As bones are rigid structures that elongate only from their ends, it is unclear how superstructure positions are regulated during growth to end up in the right locations. Here, we document the process of longitudinal scaling in developing mouse long bones and uncover the mechanism that regulates it. To that end, we performed a computational analysis of hundreds of three-dimensional micro-CT images, using a newly developed method for recovering the morphogenetic sequence of developing bones. Strikingly, analysis revealed that the relative position of all superstructures along the bone is highly preserved during more than a 5-fold increase in length, indicating isometric scaling. It has been suggested that during development, bone superstructures are continuously reconstructed and relocated along the shaft, a process known as drift. Surprisingly, our results showed that most superstructures did not drift at all. Instead, we identified a novel mechanism for bone scaling, whereby each bone exhibits a specific and unique balance between proximal and distal growth rates, which accurately maintains the relative position of its superstructures. Moreover, we show mathematically that this mechanism minimizes the cumulative drift of all superstructures, thereby optimizing the scaling process. Our study reveals a general mechanism for the scaling of developing bones. More broadly, these findings suggest an evolutionary mechanism that facilitates variability in bone morphology by controlling the activity of

  1. Identification and Treatment of Pathophysiological Comorbidities of Autism Spectrum Disorder to Achieve Optimal Outcomes

    PubMed Central

    Frye, Richard E.; Rossignol, Daniel A.

    2016-01-01

    the optimal treatments for these abnormalities. PMID:27330338

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

    PubMed Central

    2013-01-01

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

  3. Comparative optimism about health and nonhealth events in 8- and 9-year-old children.

    PubMed

    Albery, Ian P; Messer, David

    2005-05-01

    Comparative optimism has been studied extensively in adults and is a significant component of social- cognitive models about health. In contrast, little is known about comparative optimism in children or about the wider social- cognitive processes that underpin their health-related behavior. This study investigated comparative optimism for health- and nonhealth-related topics in 101 children 8 or 9 years of age, the youngest ages that have been investigated so far. Children were shown to be unrealistically optimistic for health and nonhealth events. The implications of these findings for understanding comparative optimism in children are discussed.

  4. Health physics manual of good practices for reducing radiation exposure to levels that are as low as reasonably achievable (ALARA)

    SciTech Connect

    Herrington, W.N.; Higby, D.P.; Kathren,., R.L.; Merwin, S.E.; Stoetzel, G.A.

    1988-06-01

    A primary objective of the US Department of Energy (DOE) health physics and radiation protection program has been to limit radiation exposures to those levels that are as low as reasonably achievable (ALARA). As a result, the ALARA concept developed into a program and a set of operational principles to ensure that the objective was consistently met. Implementation of these principles required that a guide be produced. The original ALARA guide was issued by DOE in 1980 to promote improved understanding of ALARA concepts within the DOE community and to assist those responsible for operational ALARA activities in attaining their goals. Since 1980, additional guidance has been published by national and international organizations to provide further definition and clarification to ALARA concepts. As basic ALARA experience increased, the value and role of the original guide prompted the DOE Office of Nuclear Safety (ONS) to support a current revision. The revised manual of good practices includes six sections: 1.0 Introduction, 2.0 Administration, 3.0 Optimization, 4.0 Setting and Evaluating ALARA Goals, 5.0 Radiological Design, and 6.0 Conduct of Operations. The manual is directed primarily to contractor and DOE staff who are responsible for conduct and overview of radiation protection and ALARA programs at DOE facilities. The intent is to provide sufficient guidance such that the manual, if followed, will ensure that radiation exposures are maintained as low as reasonably achievable and will establish the basis for a formally structured and auditable program. 118 refs., 16 figs., 3 tabs.

  5. Effectiveness of increasing the frequency of posaconazole syrup administration to achieve optimal plasma concentrations in patients with haematological malignancy.

    PubMed

    Park, Wan Beom; Cho, Joo-Youn; Park, Sang-In; Kim, Eun Jung; Yoon, Seonghae; Yoon, Seo Hyun; Lee, Jeong-Ok; Koh, Youngil; Song, Kyoung-Ho; Choe, Pyoeng Gyun; Yu, Kyung-Sang; Kim, Eu Suk; Bang, Su Mi; Kim, Nam Joong; Kim, Inho; Oh, Myoung-Don; Kim, Hong Bin; Song, Sang Hoon

    2016-07-01

    Few data are available on whether adjusting the dose of posaconazole syrup is effective in patients receiving anti-cancer chemotherapy. The aim of this prospective study was to analyse the impact of increasing the frequency of posaconazole administration on optimal plasma concentrations in adult patients with haematological malignancy. A total of 133 adult patients receiving chemotherapy for acute myeloid leukaemia or myelodysplastic syndrome who received posaconazole syrup 200 mg three times daily for fungal prophylaxis were enrolled in this study. Drug trough levels were measured by liquid chromatography-tandem mass spectrometry. In 20.2% of patients (23/114) the steady-state concentration of posaconazole was suboptimal (<500 ng/mL) on Day 8. In these patients, the frequency of posaconazole administration was increased to 200 mg four times daily. On Day 15, the median posaconazole concentration was significantly increased from 368 ng/mL [interquartile range (IQR), 247-403 ng/mL] to 548 ng/mL (IQR, 424-887 ng/mL) (P = 0.0003). The median increase in posaconazole concentration was 251 ng/mL (IQR, 93-517 ng/mL). Among the patients with initially suboptimal levels, 79% achieved the optimal level unless the steady-state level was <200 ng/mL. This study shows that increasing the administration frequency of posaconazole syrup is effective for achieving optimal levels in patients with haematological malignancy undergoing chemotherapy.

  6. Achieving a "Grand Convergence" in Global Health by 2035: Rwanda Shows the Way Comment on "Improving the World's Health Through the Post-2015 Development Agenda: Perspectives From Rwanda".

    PubMed

    Yamey, Gavin; Fewer, Sara; Beyeler, Naomi

    2015-07-29

    Global Health 2035, the report of The Lancet Commission on Investing in Health, laid out a bold, highly ambitious framework for making rapid progress in improving global public health outcomes. It showed that with the right health investments, the international community could achieve a "grand convergence" in global health-a reduction in avertable infectious, maternal, and child deaths down to universally low levels-within a generation. Rwanda's success in rapidly reducing such deaths over the last 20 years shows that convergence is feasible. Binagwaho and Scott have argued that 5 lessons from this success are the importance of equity, quality health services, evidence-informed policy, intersectoral collaboration, and effective collaboration between countries and multilateral agencies. This article re-examines these lessons through the lens of the Global Health 2035 report to analyze how the experience in Rwanda might be generalized for other countries to making progress towards achieving a grand convergence.

  7. Addressing the Human Resources for Health crisis in countries: How far have we gone? What can we expect to achieve by 2015?

    PubMed

    Dayrit, Manuel M; Dolea, Carmen; Dreesch, Norbert

    2011-06-01

    The World Health Report 2006 identified 57 countries world-wide whose health worker to population density fell below a critical threshold of 2.3 per 1,000 population. This meant that below this critical threshold, a country could not provide the basic health services to its population, defined here as 80% immunization coverage and 80% skilled birth attendance at delivery. Of the 57 countries, 36 are located in Africa. This article reviews the progress countries have made in addressing their health workforce crisis. It cites 3 of the most recent global studies and the indicators used to measure progress. It also features the experiences of 8 countries, namely Malawi, Peru, Ethiopia, Brazil, Thailand, Philippines, Zambia, Mali. Their situations provide a diverse picture of country efforts, challenges, and successes. The article asks the question of whether the target of 25% reduction in the number of crisis countries can be achieved by 2015. This was a goal set by the World Health Assembly in 2008. While the authors wish to remain optimistic about the striving towards this target, their optimism must be matched by an adequate level of investment in countries on HRH development. The next four years will show how much will really be achieved.

  8. Learning styles, academic achievement, and mental health problems among medical students in Thailand

    PubMed Central

    2016-01-01

    Purpose This study aimed to investigate the prevalence of various learning styles among medical students and their correlations with academic achievement and mental health problems in these students. Methods This study was conducted among 140 first-year medical students of Chiang Mai University, Thailand in 2014. The participants completed the visual-aural-read/write-kinesthetic (VARK) questionnaire, the results of which can be categorized into 4 modes, corresponding to how many of the 4 types are preferred by a respondent. The 10-item Perceived Stress Scale (PSS-10) and the 21-item Outcome Inventory (OI-21) were also used. The participants’ demographic data, grade point average (GPA), and scores of all measurements are presented using simple statistics. Correlation and regression analysis were employed to analyze differences in the scores and to determine the associations among them. Results Sixty percent of the participants were female. The mean age was 18.86±0.74 years old. Quadmodal was found to be the most preferred VARK mode (43.6%). Unimodal, bimodal, and trimodal modes were preferred by 35%, 12.9%, and 18.6% of the participants, respectively. Among the strong unimodal learners, visual, aural, read/write, and kinesthetic preferences were reported by 4.3%, 7.1%, 11.4%, and 12.1% of participants, respectively. No difference was observed in the PSS-10, OI-anxiety, OI-depression, and OI-somatization scores according to the VARK modes, although a significant effect was found for OI-interpersonal (F=2.788, P=0.043). Moreover, neither VARK modes nor VARK types were correlated with GPA. Conclusion The most preferred VARK learning style among medical students was quadmodal. Learning styles were not associated with GPA or mental health problems, except for interpersonal problems. PMID:27804284

  9. Workplace wellness recognition for optimizing workplace health: a presidential advisory from the American Heart Association.

    PubMed

    Fonarow, Gregg C; Calitz, Chris; Arena, Ross; Baase, Catherine; Isaac, Fikry W; Lloyd-Jones, Donald; Peterson, Eric D; Pronk, Nico; Sanchez, Eduardo; Terry, Paul E; Volpp, Kevin G; Antman, Elliott M

    2015-05-19

    The workplace is an important setting for promoting cardiovascular health and cardiovascular disease and stroke prevention in the United States. Well-designed, comprehensive workplace wellness programs have the potential to improve cardiovascular health and to reduce mortality, morbidity, and disability resulting from cardiovascular disease and stroke. Nevertheless, widespread implementation of comprehensive workplace wellness programs is lacking, and program composition and quality vary. Several organizations provide worksite wellness recognition programs; however, there is variation in recognition criteria, and they do not specifically focus on cardiovascular disease and stroke prevention. Although there is limited evidence to suggest that company performance on employer health management scorecards is associated with favorable healthcare cost trends, these data are not currently robust, and further evaluation is needed. As a recognized national leader in evidence-based guidelines, care systems, and quality programs, the American Heart Association/American Stroke Association is uniquely positioned and committed to promoting the adoption of comprehensive workplace wellness programs, as well as improving program quality and workforce health outcomes. As part of its commitment to improve the cardiovascular health of all Americans, the American Heart Association/American Stroke Association will promote science-based best practices for comprehensive workplace wellness programs and establish benchmarks for a national workplace wellness recognition program to assist employers in applying the best systems and strategies for optimal programming. The recognition program will integrate identification of a workplace culture of health and achievement of rigorous standards for cardiovascular health based on Life's Simple 7 metrics. In addition, the American Heart Association/American Stroke Association will develop resources that assist employers in meeting these rigorous

  10. Policy actions to achieve integrated community-based mental health services.

    PubMed

    DeSilva, Mary; Samele, Chiara; Saxena, Shekhar; Patel, Vikram; Darzi, Ara

    2014-09-01

    Globally, the majority of people with mental health problems do not receive evidence-based interventions that can transform their lives. We describe six mental health policy actions adopted at the World Innovation Summit for Health in 2013. For each policy action, we offer real-world examples of mental health innovations that governments and health care providers can implement to move toward universal health coverage for mental health. The six policy actions are empowering people with mental health problems and their families, building a diverse mental health workforce, developing collaborative and multidisciplinary mental health teams, using technology to increase access to mental health care, identifying and treating mental health problems early, and reducing premature mortality in people with mental health problems. Challenges to implementing these policy actions include the lack of recognition of mental health as a global health priority and the resulting lack of investment in mental health, the difficulties of integrating mental health into primary care health services because of a scarcity of human and financial resources, and the lack of evidence on the effectiveness and costs of taking innovations to a national scale.

  11. Utilizing a Positive Behavior Support Approach to Achieve Integrated Mental Health Services

    ERIC Educational Resources Information Center

    Frey, Andy; Young, Scott; Gold, Allene; Trevor, Earl

    2008-01-01

    Although experts in early childhood mental health services make clear the need to infuse mental health services into all program components, many have suggested that the mental health services in the majority of Head Start programs are narrowly focused and that mental health consultants are often used in limited ways (see D. J. Cohen, Solnit, &…

  12. Achieving recognition that mental health is part of the mission of CDC.

    PubMed

    Safran, Marc A

    2009-11-01

    For much of its history the U.S. Centers for Disease Control and Prevention (CDC) considered mental health to be outside of its mission. That assumption persisted even after CDC became a leading public health agency and began to face important mental health issues. This narrative describes how the organizational paradigm indicating that mental health was not mission related was challenged and superseded by a new paradigm recognizing mental health as part of CDC's public health mission. Even after the CDC Mental Health Work Group's establishment in 2000, CDC took eight more years to overcome powerful remnants of the old paradigm that had for so long excluded, minimized, or discouraged attention to mental health. The CDC Mental Health Work Group led the agency's mental health efforts without funding or dedicated staffing but with more than 100 CDC professionals from multiple disciplines and centers serving as voluntary members, in addition to their other CDC responsibilities.

  13. Making It Local: Beacon Communities Use Health Information Technology to Optimize Care Management

    PubMed Central

    Allen, Amy; Des Jardins, Terrisca R.; Heider, Arvela; Kanger, Chatrian R.; Lobach, David F.; McWilliams, Lee; Polello, Jennifer M.; Schachter, Abigail A.; Singh, Ranjit; Sorondo, Barbara; Tulikangas, Megan C.; Turske, Scott A.

    2014-01-01

    Abstract Care management aims to provide cost-effective, coordinated, non-duplicative care to improve care quality, population health, and reduce costs. The 17 communities receiving funding from the Office of the National Coordinator for Health Information Technology through the Beacon Community Cooperative Agreement Program are leaders in building and strengthening their health information technology (health IT) infrastructure to provide more effective and efficient care management. This article profiles 6 Beacon Communities' health IT-enabled care management programs, highlighting the influence of local context on program strategy and design, and describing challenges, lessons learned, and policy implications for care delivery and payment reform. The unique needs (eg, disease burden, demographics), community partnerships, and existing resources and infrastructure all exerted significant influence on the overall priorities and design of each community's care management program. Though each Beacon Community needed to engage in a similar set of care management tasks—including patient identification, stratification, and prioritization; intervention; patient engagement; and evaluation—the contextual factors helped shape the specific strategies and tools used to carry out these tasks and achieve their objectives. Although providers across the country are striving to deliver standardized, high-quality care, the diverse contexts in which this care is delivered significantly influence the priorities, strategies, and design of community-based care management interventions. Gaps and challenges in implementing effective community-based care management programs include: optimizing allocation of care management services; lack of available technology tailored to care management needs; lack of standards and interoperability; integrating care management into care settings; evaluating impact; and funding and sustainability. (Population Health Management 2014;17:149–158) PMID

  14. In place of fear: aligning health care planning with system objectives to achieve financial sustainability.

    PubMed

    Birch, Stephen; Murphy, Gail Tomblin; MacKenzie, Adrian; Cumming, Jackie

    2015-04-01

    The financial sustainability of publicly funded health care systems is a challenge to policymakers in many countries as health care absorbs an ever increasing share of both national wealth and government spending. New technology, aging populations and increasing public expectations of the health care system are often cited as reasons why health care systems need ever increasing funding as well as reasons why universal and comprehensive public systems are unsustainable. However, increases in health care spending are not usually linked to corresponding increases in need for care within populations. Attempts to promote financial sustainability of systems such as limiting the range of services is covered or the groups of population covered may compromise their political sustainability as some groups are left to seek private cover for some or all services. In this paper, an alternative view of financial sustainability is presented which identifies the failure of planning and management of health care to reflect needs for care in populations and to integrate planning and management functions for health care expenditure, health care services and the health care workforce. We present a Health Care Sustainability Framework based on disaggregating the health care expenditure into separate planning components. Unlike other approaches to planning health care expenditure, this framework explicitly incorporates population health needs as a determinant of health care requirements, and provides a diagnostic tool for understanding the sources of expenditure increase.

  15. Using portfolios to evaluate achievement of population-based public health nursing competencies in baccalaureate nursing students.

    PubMed

    Schaffer, Marjorie A; Nelson, Pamela; Litt, Emily

    2005-01-01

    Public health nurses from 13 local public health agencies and nurse educators from five schools of nursing developed population-based public health nursing competencies for new graduates and novice public health nurses. Educators in one nursing program used a portfolio assignment to measure achievement of the competencies by traditional and RN to BSN students in a community health nursing course. Data were collected from surveys and focus groups to determine students' responses to the portfolio and their use of population-based public health nursing concepts. The assignment enhanced students' critical thinking skills; however, concerns about the structure and evaluation of the portfolio decreased student satisfaction. Recommendations are made for improving the portfolio format, increasing students' valuing of the portfolio, managing the tension between assessment and learning, and orienting clinical agency staff and nursing instructors.

  16. Health-care delivery in Cuba: nursing's role in achievement of the goal of 'Health for All'.

    PubMed

    Swanson, J M

    1988-01-01

    The findings of a study of the delivery of nursing care in noninstitutionalized settings in Cuba are presented. The study investigated factors associated with change in health status and the role of nursing in the community to bring about that change since the time of the 1959 revolution. Recommendations of the World Health Organization's 'Goal of Health For All by the Year 2000' provided guidelines for the study. In the pursuit of Health for All, the World Health Organization specifically called for universal coverage with primary health care to include the following essential elements: education covering the prevention and control of major health problems; adequate food, safe water and nutrition; maternal and child health including family planning; immunization against infectious disease; prevention and control of endemic diseases; and treatment of diseases and injuries. Findings of the study suggest that nursing can play an important role in the delivery of health care that meets the World Health Organization's goal of Health for All through universal coverage of primary health care to the defined population.

  17. Compounded Testosterone Troches TO OPTIMIZE HEALTH AND THE TESTOSTERONE CONTROVERSY.

    PubMed

    Guth, Michael A S

    2015-01-01

    As men age, testosterone levels progressively fall and inflammatory biomarkers increase. The gradual decline in testosterone production with aging, known as andropause, is common and may have deleterious effects on men including decreased overall well-being, increased sarcopenia, increased risk of cardiovascular disease, reduced sexual function, and bone loss. Therefore, it comes as no surprise that an increasing number of men worldwide have begun requesting testosterone replacement therapy from their physicians. Occasionally, physicians discourage male patients from getting testosterone replacement therapy based on a few recent studies indicating the therapy causes cardiovascular events, including myocardial infarctions. Yet, an extensive review of the testosterone replacement therapy literature reveals that the majority of clinical studies show that properly administered testosterone replacement therapy, in which estradiol and dihydrotestosterone levels are also controlled, has no adverse effects on myocardial infarction risk. The current state-of-the-art in testosterone replacement therapy comprises compounded testosterone troches; an aromatase inhibitor, such as generic Anastrazole, to control estradiol levels; and a 5α-reductase inhibitor, such as beneric Dutasteride or Finasteride, to control dihydrotestosterone. Compounded testosterone troches easily raise serum testosterone levels to the optimal range, are highly cost effective at $82 for a 180-day supply, and provide affordable access to testosterone replacement therapy to millions of men requesting it. Yet, the Blue Cross Blue Shield-associated firms have largely denied requests for coverage of compounded medications, including testosterone troches. Despite data demonstrating strong links between testosterone deficiency and significant comorbid conditions (including Type 2 diabetes and other metabolic syndrome diseases) as well as the health benefits of testosterone replacement therapy, some physian have

  18. Minimalist Medical Diplomacy - Do Engagements Achieve US National Strategy Global Health Security Objectives?

    DTIC Science & Technology

    2015-04-01

    Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time...ABSTRACT unclassified c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 i    Disclaimer The views...Health Initiatives GHS Global Health Security HA Humanitarian Assistance HE Health Engagement HN Host Nation HSS Health Services Support

  19. What is Health and What is Important for its Achievement? A Qualitative Study on Adolescent Boys’ Perceptions and Experiences of Health

    PubMed Central

    Randell, Eva; Jerdén, Lars; Öhman, Ann; Flacking, Renée

    2016-01-01

    Few qualitative studies have explored adolescent boys’ perceptions of health. Aim: The aim of this study was therefore to explore how adolescent boys understand the concept of health and what they find important for its achievement Methods: Grounded theory was used as a method to analyse interviews with 33 adolescent boys aged 16 to 17 years attending three upper secondary schools in a relatively small town in Sweden. Results: There was a complexity in how health was perceived, experienced, dealt with, and valued. Although health on a conceptual level was described as ‘holistic’, health was experienced and dealt with in a more dualistic manner, one in which the boys were prone to differentiate between mind and body. Health was experienced as mainly emotional and relational, whereas the body had a subordinate value. The presence of positive emotions, experiencing self-esteem, balance in life, trustful relationships, and having a sense of belonging were important factors for health while the body was experienced as a tool to achieve health, as energy, and as a condition. Conclusion: Our findings indicate that young, masculine health is largely experienced through emotions and relationships and thus support theories on health as a social construction of interconnected processes. PMID:27347252

  20. Discussing Women's Reproductive Health, Religion, Roles and Rights: Achieving Women's Empowerment.

    ERIC Educational Resources Information Center

    Sousa, Isabela Cabral Felix de

    1995-01-01

    A health education program in Brazil trained 26 women as community health educators. Only four used their roles to foster social change. Discussing women's reproductive health in the context of religion and social values contributed to successful training; economic and political empowerment was hampered by perpetuation of traditional role…

  1. Latin America and the Caribbean: Assessment of the Advances in Public Health for the Achievement of the Millennium Development Goals

    PubMed Central

    Mitra, Amal K.; Rodriguez-Fernandez, Gisela

    2010-01-01

    To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC). The paper also identifies areas of deficits for the achievement of MDGs in LAC. PMID:20623022

  2. Latin America and the Caribbean: assessment of the advances in public health for the achievement of the Millennium Development Goals.

    PubMed

    Mitra, Amal K; Rodriguez-Fernandez, Gisela

    2010-05-01

    To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC). The paper also identifies areas of deficits for the achievement of MDGs in LAC.

  3. Income redistribution is not enough: income inequality, social welfare programs, and achieving equity in health.

    PubMed

    Starfield, Barbara; Birn, Anne-Emanuelle

    2007-12-01

    Income inequality is widely assumed to be a major contributor to poorer health at national and subnational levels. According to this assumption, the most appropriate policy strategy to improve equity in health is income redistribution. This paper considers reasons why tackling income inequality alone could be an inadequate approach to reducing differences in health across social classes and other population subgroups, and makes the case that universal social programs are critical to reducing inequities in health. A health system oriented around a strong primary care base is an example of such a strategy.

  4. Debiasing comparative optimism and increasing worry for health outcomes.

    PubMed

    Rose, Jason P

    2012-11-01

    Comparative optimism - feeling at less personal risk for negative outcomes than one's peers - has been linked to reduced prevention efforts. This study examined a novel debiasing technique aimed at simultaneously reducing both indirectly and directly measured comparative optimism. Before providing direct comparative estimates, participants provided absolute self and peer estimates in a joint format (same computer screen) or a separate format (different computer screens). Relative to the separate format condition, participants in the joint format condition showed (1) lower comparative optimism in absolute/indirect measures, (2) lower direct comparative optimism, and (3) heightened worry. Implications for risk perception screening are discussed.

  5. Making it local: Beacon Communities use health information technology to optimize care management.

    PubMed

    Allen, Amy; Des Jardins, Terrisca R; Heider, Arvela; Kanger, Chatrian R; Lobach, David F; McWilliams, Lee; Polello, Jennifer M; Rein, Alison L; Schachter, Abigail A; Singh, Ranjit; Sorondo, Barbara; Tulikangas, Megan C; Turske, Scott A

    2014-06-01

    Care management aims to provide cost-effective, coordinated, non-duplicative care to improve care quality, population health, and reduce costs. The 17 communities receiving funding from the Office of the National Coordinator for Health Information Technology through the Beacon Community Cooperative Agreement Program are leaders in building and strengthening their health information technology (health IT) infrastructure to provide more effective and efficient care management. This article profiles 6 Beacon Communities' health IT-enabled care management programs, highlighting the influence of local context on program strategy and design, and describing challenges, lessons learned, and policy implications for care delivery and payment reform. The unique needs (eg, disease burden, demographics), community partnerships, and existing resources and infrastructure all exerted significant influence on the overall priorities and design of each community's care management program. Though each Beacon Community needed to engage in a similar set of care management tasks--including patient identification, stratification, and prioritization; intervention; patient engagement; and evaluation--the contextual factors helped shape the specific strategies and tools used to carry out these tasks and achieve their objectives. Although providers across the country are striving to deliver standardized, high-quality care, the diverse contexts in which this care is delivered significantly influence the priorities, strategies, and design of community-based care management interventions. Gaps and challenges in implementing effective community-based care management programs include: optimizing allocation of care management services; lack of available technology tailored to care management needs; lack of standards and interoperability; integrating care management into care settings; evaluating impact; and funding and sustainability.

  6. What it will take to achieve the as-yet-unfulfilled promises of health information technology.

    PubMed

    Kellermann, Arthur L; Jones, Spencer S

    2013-01-01

    A team of RAND Corporation researchers projected in 2005 that rapid adoption of health information technology (IT) could save the United States more than $81 billion annually. Seven years later the empirical data on the technology's impact on health care efficiency and safety are mixed, and annual health care expenditures in the United States have grown by $800 billion. In our view, the disappointing performance of health IT to date can be largely attributed to several factors: sluggish adoption of health IT systems, coupled with the choice of systems that are neither interoperable nor easy to use; and the failure of health care providers and institutions to reengineer care processes to reap the full benefits of health IT. We believe that the original promise of health IT can be met if the systems are redesigned to address these flaws by creating more-standardized systems that are easier to use, are truly interoperable, and afford patients more access to and control over their health data. Providers must do their part by reengineering care processes to take full advantage of efficiencies offered by health IT, in the context of redesigned payment models that favor value over volume.

  7. Dispositional and comparative optimism interact to predict avoidance of a looming health threat.

    PubMed

    Fowler, Stephanie L; Geers, Andrew L

    2015-01-01

    Research indicates that when confronted with a health threat, individuals high in both dispositional and comparative optimism employ a more avoidant style of coping than individuals high in dispositional but low in comparative optimism. We examined the hypothesis that threat distance moderates this interactive optimism association. In two studies, participants were randomly assigned to a looming or distant threat condition. Study 1 revealed that in the looming threat condition, participants high in both forms of optimism were more likely to minimise the threat and less inclined to seek additional health information relative to participants high in dispositional but low in comparative optimism. In Study 2, the same interaction pattern emerged on a measure of psychological abstraction suggesting these variables combine to alter broad information processing strategies. Implications for considering multiple forms of optimism when delivering health status information are discussed.

  8. The Ha Noi Expert Statement: recognition of maternal mental health in resource-constrained settings is essential for achieving the Millennium Development Goals.

    PubMed

    Fisher, Jane Rw; de Mello, Meena Cabral; Izutsu, Takashi; Tran, Tuan

    2011-01-07

    Mental health problems in women during pregnancy and after childbirth and their adverse consequences for child health and development have received sustained detailed attention in high-income countries. In contrast, evidence has only been generated more recently in resource-constrained settings.In June 2007 the United Nations Population Fund, the World Health Organization, the Key Centre for Women's Health in Society, a WHO Collaborating Centre for Women's Health and the Research and Training Centre for Community Development in Vietnam convened the first international expert meeting on maternal mental health and child health and development in resource-constrained settings. It aimed to appraise the evidence about the nature, prevalence and risks for common perinatal mental disorders in women; the consequences of these for child health and development and ameliorative strategies in these contexts.The substantial disparity in rates of perinatal mental disorders between women living in high- and low-income settings, suggests social rather than biological determinants. Risks in resource-constrained contexts include: poverty; crowded living situations; limited reproductive autonomy; unintended pregnancy; lack of empathy from the intimate partner; rigid gender stereotypes about responsibility for household work and infant care; family violence; poor physical health and discrimination. Development is adversely affected if infants lack day-to-day interactions with a caregiver who can interpret their cues, and respond effectively. Women with compromised mental health are less able to provide sensitive, responsive infant care. In resource-constrained settings infants whose mothers are depressed are less likely to thrive and to receive optimal care than those whose mothers are well.The meeting outcome is the Hanoi Expert Statement (Additional file 1). It argues that the Millennium Development Goals to improve maternal health, reduce child mortality, promote gender equality

  9. The Perceptions of Principals and Teachers Regarding Mental Health Providers' Impact on Student Achievement in High Poverty Schools

    ERIC Educational Resources Information Center

    Perry, Teresa

    2012-01-01

    This study examined the perceptions of principals and teachers regarding mental health provider's impact on student achievement and behavior in high poverty schools using descriptive statistics, t-test, and two-way ANOVA. Respondents in this study shared similar views concerning principal and teacher satisfaction and levels of support for the…

  10. Predicting Early Adolescents' Academic Achievement, Social Competence, and Physical Health from Parenting, Ego Resilience, and Engagement Coping

    ERIC Educational Resources Information Center

    Swanson, Jodi; Valiente, Carlos; Lemery-Chalfant, Kathryn; O'Brien, T. Caitlin

    2011-01-01

    This study examined ego resilience and engagement coping as mediators of the relationships between supportive and controlling parenting practices and early adolescents' academic achievement, social competence, and physical health. Participants were 240 predominantly Mexican American early adolescents, their parents, and their teachers. There were…

  11. The Effects of Work Intensity on Adolescent Mental Health, Achievement, and Behavioral Adjustment: New Evidence from a Prospective Study.

    ERIC Educational Resources Information Center

    Mortimer, Jeylan T.; And Others

    1996-01-01

    Examined effects of work intensity on 1,000 employed adolescents. Found that students who worked at higher intensity engaged in more alcohol use. Negative effects on mental health, academic achievement, and 2 other indicators of behavioral adjustment were not found, but seniors working at moderate intensity (fewer than 20 hours per week) had…

  12. The Relationship between Health (Malnutrition) and Educational Achievements (Maths and English) in the Rural Children of South Africa

    ERIC Educational Resources Information Center

    Themane, M. J.; Monyeki, K. D.; Nthangeni, M. E.; Kemper, H. C. G.; Twisk, J. W. R.

    2003-01-01

    The purpose of this paper is to report the cross-sectional relationship between educational achievements and the "health status" of the rural South African children in the Ellisras Longitudinal Study (ELS). The study followed a cohort design where 1033 children (569 boys and 464 girls) aged 7-14 were randomly sampled from 11 primary…

  13. Public Health Analysis Transport Optimization Model v. 1.0

    SciTech Connect

    Beyeler, Walt; Finley, Patrick; Walser, Alex; Frazier, Chris; Mitchell, Michael

    2016-10-05

    PHANTOM models logistic functions of national public health systems. The system enables public health officials to visualize and coordinate options for public health surveillance, diagnosis, response and administration in an integrated analytical environment. Users may simulate and analyze system performance applying scenarios that represent current conditions or future contingencies what-if analyses of potential systemic improvements. Public health networks are visualized as interactive maps, with graphical displays of relevant system performance metrics as calculated by the simulation modeling components.

  14. College Students' Physical Activity and Health-Related Quality of Life: An Achievement Goal Perspective

    ERIC Educational Resources Information Center

    Zhang, Tao; Xiang, Ping; Gu, Xiangli; Rose, Melanie

    2016-01-01

    Purpose: The 2 × 2 achievement goal model, including the mastery-approach, mastery-avoidance, performance-approach, and performance-avoidance goal orientations, has recently been used to explain motivational outcomes in physical activity. This study attempted to examine the relationships among 2 × 2 achievement goal orientations, physical…

  15. Achievable Steps Toward Building a National Health Information Infrastructure in the United States

    PubMed Central

    Stead, William W.; Kelly, Brian J.; Kolodner, Robert M.

    2005-01-01

    Consensus is growing that a health care information and communication infrastructure is one key to fixing the crisis in the United States in health care quality, cost, and access. The National Health Information Infrastructure (NHII) is an initiative of the Department of Health and Human Services receiving bipartisan support. There are many possible courses toward its objective. Decision makers need to reflect carefully on which approaches are likely to work on a large enough scale to have the intended beneficial national impacts and which are better left to smaller projects within the boundaries of health care organizations. This report provides a primer for use by informatics professionals as they explain aspects of that dividing line to policy makers and to health care leaders and front-line providers. It then identifies short-term, intermediate, and long-term steps that might be taken by the NHII initiative. PMID:15561783

  16. Achievable steps toward building a National Health Information infrastructure in the United States.

    PubMed

    Stead, William W; Kelly, Brian J; Kolodner, Robert M

    2005-01-01

    Consensus is growing that a health care information and communication infrastructure is one key to fixing the crisis in the United States in health care quality, cost, and access. The National Health Information Infrastructure (NHII) is an initiative of the Department of Health and Human Services receiving bipartisan support. There are many possible courses toward its objective. Decision makers need to reflect carefully on which approaches are likely to work on a large enough scale to have the intended beneficial national impacts and which are better left to smaller projects within the boundaries of health care organizations. This report provides a primer for use by informatics professionals as they explain aspects of that dividing line to policy makers and to health care leaders and front-line providers. It then identifies short-term, intermediate, and long-term steps that might be taken by the NHII initiative.

  17. The Relationship between Academic Achievement and School-Based Mental Health Services for Middle School Students

    ERIC Educational Resources Information Center

    Williams, Lisa O.

    2012-01-01

    Mental health issues among American adolescents and children can negatively impact their potential for school success. As many as 10% of students among the general education population suffer from psychiatric disorders, yet only between 1% and 5% of those students are being served. The effects of mental health difficulties are problematic for…

  18. New York State School Facilities and Student Health, Achievement, and Attendance: A Data Analysis Report

    ERIC Educational Resources Information Center

    Boese, Stephen; Shaw, John

    2005-01-01

    Students who attend schools with environmental hazards that impact indoor air quality are more likely to miss class, and therefore lose learning opportunities. Yet school environmental health and safety remains largely unregulated and there is no state or federal agency in charge of protecting children's environmental health in schools. This…

  19. Lipid Encapsulation Provides Insufficient Total-Tract Digestibility to Achieve an Optimal Transfer Efficiency of Fatty Acids to Milk Fat

    PubMed Central

    Bainbridge, Melissa; Kraft, Jana

    2016-01-01

    Transfer efficiencies of rumen-protected n-3 fatty acids (FA) to milk are low, thus we hypothesized that rumen-protection technologies allow for biohydrogenation and excretion of n-3 FA. The objectives of this study were to i) investigate the ruminal protection and post-ruminal release of the FA derived from the lipid-encapsulated echium oil (EEO), and ii) assess the bioavailability and metabolism of the EEO-derived FA through measuring the FA content in plasma lipid fractions, feces, and milk. The EEO was tested for rumen stability using the in situ nylon bag technique, then the apparent total-tract digestibility was assessed in vivo using six Holstein dairy cattle. Diets consisted of a control (no EEO); 1.5% of dry matter (DM) as EEO and 1.5% DM as encapsulation matrix; and 3% DM as EEO. The EEO was rumen-stable and had no effect on animal production. EEO-derived FA were incorporated into all plasma lipid fractions, with the highest proportion of n-3 FA observed in cholesterol esters. Fecal excretion of EEO-derived FA ranged from 7–14%. Biohydrogenation products increased in milk, plasma, and feces with EEO supplementation. In conclusion, lipid-encapsulation provides inadequate digestibility to achieve an optimal transfer efficiency of n-3 FA to milk. PMID:27741299

  20. Achieving Health Equity Through Community Engagement in Translating Evidence to Policy: The San Francisco Health Improvement Partnership, 2010–2016

    PubMed Central

    Vargas, Roberto A.; Fleisher, Paula; Aragón, Tomás J.; Chung, Lisa; Chawla, Colleen; Yant, Abbie; Garcia, Estela R.; Santiago, Amor; Lang, Perry L.; Jones, Paula; Liu, Wylie; Schmidt, Laura A.

    2017-01-01

    Background The San Francisco Health Improvement Partnership (SFHIP) promotes health equity by using a novel collective impact model that blends community engagement with evidence-to-policy translational science. The model involves diverse stakeholders, including ethnic-based community health equity coalitions, the local public health department, hospitals and health systems, a health sciences university, a school district, the faith community, and others sectors. Community Context We report on 3 SFHIP prevention initiatives: reducing consumption of sugar sweetened beverages (SSBs), regulating retail alcohol sales, and eliminating disparities in children’s oral health. Methods SFHIP is governed by a steering committee. Partnership working groups for each initiative collaborate to 1) develop and implement action plans emphasizing feasible, scalable, translational-science–informed interventions and 2) consider sustainability early in the planning process by including policy and structural interventions. Outcome Through SFHIP’s efforts, San Francisco enacted ordinances regulating sale and advertising of SSBs and a ballot measure establishing a soda tax. Most San Francisco hospitals implemented or committed to implementing healthy-beverage policies that prohibited serving or selling SSBs. SFHIP helped prevent Starbucks and Taco Bell from receiving alcohol licenses in San Francisco and helped prevent state authorization of sale of powdered alcohol. SFHIP increased the number of primary care clinics providing fluoride varnish at routine well-child visits from 3 to 14 and acquired a state waiver to allow dental clinics to be paid for dental services delivered in schools. Interpretation The SFHIP model of collective impact emphasizing community engagement and policy change accomplished many of its intermediate goals to create an environment promoting health and health equity. PMID:28333598

  1. Essential strategies for achieving durable population-based maternal and child health services.

    PubMed

    Akukwe, C; Nowell, A H

    1999-03-01

    Increased competition for dwindling financial resources places funding and provision of public health services at risk in all countries of the world. Maternal and Child Health (MCH) clients--often poor, mostly women, their children, and families--are at extraordinary risk of receiving poor or no health care. Not considered a voting constituency, and therefore exercising little leverage over elected officials, specific assurances are necessary to ensure that essential health services are available to MCH target population. Therefore, it is critical that all MCH stakeholders leverage their capacity by networking and by developing common strategies for survival and relevance within the health care system in their jurisdiction. Identifying and working with every segment of the population at risk is a crucial first step. Becoming familiar with the history of the population at risk, and defining their geographic boundaries are essential secondary steps. Developing baseline information on their general health and MCH risk status according to available demographic, socioeconomic and environmental data are important next steps. Then, working with the target population, we propose that MCH advocates adopt the 18 MCH strategies discussed in this article. These strategies will strengthen the ability of programs and initiatives that deal with women, their children and families, to survive the current financial and management struggles of the public health services in developed and developing countries.

  2. Integrating Systems Science and Community-Based Participatory Research to Achieve Health Equity.

    PubMed

    Frerichs, Leah; Lich, Kristen Hassmiller; Dave, Gaurav; Corbie-Smith, Giselle

    2016-02-01

    Unanswered questions about racial and socioeconomic health disparities may be addressed using community-based participatory research and systems science. Community-based participatory research is an orientation to research that prioritizes developing capacity, improving trust, and translating knowledge to action. Systems science provides research methods to study dynamic and interrelated forces that shape health disparities. Community-based participatory research and systems science are complementary, but their integration requires more research. We discuss paradigmatic, socioecological, capacity-building, colearning, and translational synergies that help advance progress toward health equity.

  3. Integrating Systems Science and Community-Based Participatory Research to Achieve Health Equity

    PubMed Central

    Lich, Kristen Hassmiller; Dave, Gaurav; Corbie-Smith, Giselle

    2016-01-01

    Unanswered questions about racial and socioeconomic health disparities may be addressed using community-based participatory research and systems science. Community-based participatory research is an orientation to research that prioritizes developing capacity, improving trust, and translating knowledge to action. Systems science provides research methods to study dynamic and interrelated forces that shape health disparities. Community-based participatory research and systems science are complementary, but their integration requires more research. We discuss paradigmatic, socioecological, capacity-building, colearning, and translational synergies that help advance progress toward health equity. PMID:26691110

  4. Achieving U.S. Health information technology adoption: the need for a third hand.

    PubMed

    Middleton, Blackford

    2005-01-01

    The U.S. health care information technology (HIT) market is broken; broad-scale adoption of HIT is not occurring despite considerable evidence of its impact on the quality of care and patient safety. Although adoption of HIT will not cure all that ails health care, it is an important step toward transformation of the U.S. health care delivery system. In this commentary I describe several critical issues pertaining to the HIT market failure and several ways in which the federal government may act as a deft and gentle "Third Hand" to assist the Invisible Hand of Adam Smith.

  5. Tackling NCD in LMIC: Achievements and Lessons Learned From the NHLBI-UnitedHealth Global Health Centers of Excellence Program.

    PubMed

    Engelgau, Michael M; Sampson, Uchechukwu K; Rabadan-Diehl, Cristina; Smith, Richard; Miranda, Jaime; Bloomfield, Gerald S; Belis, Deshiree; Narayan, K M Venkat

    2016-03-01

    Effectively tackling the growing noncommunicable disease (NCD) burden in low- and middle-income countries (LMIC) is a major challenge. To address research needs in this setting for NCDs, in 2009, National Heart, Lung, and Blood Institute (NHLBI) and UnitedHealth Group (UHG) engaged in a public-private partnership that supported a network of 11 LMIC-based research centers and created the NHLBI-UnitedHealth Global Health Centers of Excellence (COE) Program. The Program's overall goal was to contribute to reducing the cardiovascular and lung disease burdens by catalyzing in-country research institutions to develop a global network of biomedical research centers. Key elements of the Program included team science and collaborative approaches, developing research and training platforms for future investigators, and creating a data commons. This Program embraced a strategic approach for tackling NCDs in LMICs and will provide capacity for locally driven research efforts that can identify and address priority health issues in specific countries' settings.

  6. [Inequality in access to health care services. Policy recommendations aimed at achieving equity].

    PubMed

    Urbanos-Garrido, Rosa

    2016-11-01

    This article reveals the presence of inequalities in access to health care that may be considered unfair and avoidable. These inequalities are related to coverage of clinical needs, to the financial problems faced by families in completing medical treatments, or to disparities in waiting times and the use of services for equal need. A substantial proportion of inequalities appears to have increased as a result of the measures adopted to face the economic crisis. The recommendations aimed at improving equity affect different pillars of the taxpayer-funded health system, including, among others, the definition of the right to public health care coverage, the formulas of cost-sharing, the distribution of powers between primary and specialty care, the reforms of clinical management, and the production and dissemination of information to facilitate the decision-making processes of health authorities, professionals and citizens. Moreover, it is recommended to focus on particularly vulnerable population groups.

  7. International Conference on Population and Development at 15 Years: Achieving Sexual and Reproductive Health and Rights for All?

    PubMed Central

    Roseman, Mindy Jane

    2010-01-01

    Sexual and reproductive health remains the contentious concept it was at the 1994 United Nations International Conference on Population and Development (ICPD), held in Cairo, Egypt. In light of the recent 15-year review of ICPD, we suggest several areas where advocates, practitioners, and researchers can inform future progress for sexual and reproductive health. These include the following: improving measurement and accountability related to the evidence base for sexual and reproductive health, indicators of program success, and the tracking of resource flows; creating and renewing alliances to strengthen advocacy; and employing new resource mobilization strategies. Given the 20-year goals established at ICPD, now is the time to move toward finally achieving the sexual and reproductive health and rights agenda. PMID:20075310

  8. Future's Learning Environments in Health Education: The Effects of Smart Classrooms on the Academic Achievements of the Students at Health College

    ERIC Educational Resources Information Center

    Sevindik, Tuncay

    2010-01-01

    The aim of this study is to determine the effectiveness of smart classrooms on the academic achievement of the nursing students. The sample of the research included 66 Health College students in Elazig. The sampling group was randomly chosen from second year students of Nursing and Midwife Education. The research was carried out with experimental…

  9. Can developing countries achieve adequate improvements in child health outcomes without engaging the private sector?

    PubMed Central

    Bustreo, Flavia; Harding, April; Axelsson, Henrik

    2003-01-01

    The private sector exerts a significant and critical influence on child health outcomes in developing countries, including the health of poor children. This article reviews the available evidence on private sector utilization and quality of care. It provides a framework for analysing the private sector's influence on child health outcomes. This influence goes beyond service provision by private providers and nongovernmental organizations (NGOs). Pharmacies, drug sellers, private suppliers, and food producers also have an impact on the health of children. Many governments are experimenting with strategies to engage the private sector to improve child health. The article analyses some of the most promising strategies, and suggests that a number of constraints make it hard for policy-makers to emulate these approaches. Few experiences are clearly described, monitored, and evaluated. The article suggests that improving the impact of child health programmes in developing countries requires a more systematic analysis of how to engage the private sector most effectively. The starting point should include the evaluation of the presence and potential of the private sector, including actors such as professional associations, producer organizations, community groups, and patients' organizations. PMID:14997241

  10. mHealth interventions for weight loss: a guide for achieving treatment fidelity

    PubMed Central

    Shaw, Ryan J; Steinberg, Dori M; Zullig, Leah L; Bosworth, Hayden B; Johnson, Constance M; Davis, Linda L

    2014-01-01

    mHealth interventions have shown promise for helping people sustain healthy behaviors such as weight loss. However, few have assessed treatment fidelity, that is, the accurate delivery, receipt, and enactment of the intervention. Treatment fidelity is critical because the valid interpretation and translation of intervention studies depend on treatment fidelity assessments. We describe strategies used to assess treatment fidelity in mobile health (mHealth) interventions aimed at sustaining healthy behaviors in weight loss. We reviewed treatment fidelity recommendations for mHealth-based behavioral interventions and described how these recommendations were applied in three recent weight loss studies. We illustrate how treatment fidelity can be supported during study design, training of providers, treatment delivery, receipt of treatment, and enactment of treatment skills. Pre-planned strategies to ensure the treatment fidelity of mHealth interventions will help counter doubts concerning valid conclusions about their effectiveness and allow investigators and clinicians to implement robustly efficacious mobile health programs. Trial registration number 1F31 NR012599. PMID:24853065

  11. Optimism, mental health, and quality of life: a study among breast cancer patients.

    PubMed

    Colby, Deborah A; Shifren, Kim

    2013-01-01

    Fifty one breast cancer patients participated in a cross-sectional study developed to assess the relation between their level of optimism, positive and negative mental health, and their quality of life. Patients were measured with the Life Orientation Test (LOT), the Center for Epidemiological Studies Depression Scale (CES-D), and the Functional Living Index-Cancer (FLIC). T-tests revealed that these breast cancer patients reported more optimism than pessimism, more positive than negative mental health, and the majority of the sample reported doing well on each qualify life domain of the FLIC. As expected, individuals who reported more depressive symptoms also reported less qualify of life. Breast cancer patients who scored lower on pessimism showed more positive mental health, but they showed no relation to negative mental health. Women who scored higher on optimism reported better social and mental functioning on the FLIC than women who scored low on optimism.

  12. Optimal savings and health spending over the life cycle.

    PubMed

    Fioroni, Tamara

    2010-08-01

    This paper investigates the relationship between saving and health spending in a two-period overlapping generations economy. Individuals work in the first period of life and live in retirement in old age. Health spending is an activity that increases quality of life and longevity. Empirical evidence shows that both health spending and saving behave as luxury goods but their behaviour differs markedly according to the level of per capita GDP. The share of saving on GDP has a concave shape with respect to per capita GDP, whereas the share of health spending on GDP increases more than proportionally with respect to per capita GDP. The ratio of saving to spending is nonlinear with respect to income, i.e. first increasing and then decreasing. This ratio, in the proposed model, is equal to the ratio between the elasticity of the utility function with respect to saving and the elasticity of the utility function with respect to health.

  13. Optimal Allocation of Restoration Practices Using Indexes for Stream Health

    EPA Science Inventory

    Methodologies that allocate the placement of agricultural and urban green infrastructure management practices with the intent to achieve both economic and environmental objectives typically use objectives related to individual intermediary environmental outputs, yet guidance is n...

  14. Stochastic multi-objective auto-optimization for resource allocation decision-making in fixed-input health systems.

    PubMed

    Bastian, Nathaniel D; Ekin, Tahir; Kang, Hyojung; Griffin, Paul M; Fulton, Lawrence V; Grannan, Benjamin C

    2016-01-07

    The management of hospitals within fixed-input health systems such as the U.S. Military Health System (MHS) can be challenging due to the large number of hospitals, as well as the uncertainty in input resources and achievable outputs. This paper introduces a stochastic multi-objective auto-optimization model (SMAOM) for resource allocation decision-making in fixed-input health systems. The model can automatically identify where to re-allocate system input resources at the hospital level in order to optimize overall system performance, while considering uncertainty in the model parameters. The model is applied to 128 hospitals in the three services (Air Force, Army, and Navy) in the MHS using hospital-level data from 2009 - 2013. The results are compared to the traditional input-oriented variable returns-to-scale Data Envelopment Analysis (DEA) model. The application of SMAOM to the MHS increases the expected system-wide technical efficiency by 18 % over the DEA model while also accounting for uncertainty of health system inputs and outputs. The developed method is useful for decision-makers in the Defense Health Agency (DHA), who have a strategic level objective of integrating clinical and business processes through better sharing of resources across the MHS and through system-wide standardization across the services. It is also less sensitive to data outliers or sampling errors than traditional DEA methods.

  15. Achieving Mental Health Care Parity Might Require Changes In Payments And Competition

    PubMed Central

    McGuire, Thomas G.

    2016-01-01

    One of the most prominent features of the Affordable Care Act has been the promotion of individual health plans chosen by consumers in the Marketplaces. These plans are subject to regulation and paid by risk-adjusted capitation, a set of policies known as managed competition. Individual health insurance markets, however, are vulnerable to what economists describe as efficiency problems stemming from adverse selection, and Marketplaces are no exception. Health plans have incentives to discriminate against services used by people with certain chronic illnesses, including mental health conditions. Parity regulations, which dictate coverage for mental health benefits on par with medical and surgical benefits, can eliminate discrimination in coverage but redirect discrimination toward hard-to-regulate tactics from managed care such as restrictive network design and provider payment. This article reviews policy options to contend with ongoing selection issues. “Better enforcement” of parity has less chance of success than more fundamental but feasible changes in the way plans are paid or in the way competition among plans is structured. PMID:27269019

  16. Achieving smoke-free mental health services: lessons from the past decade of implementation research.

    PubMed

    Lawn, Sharon; Campion, Jonathan

    2013-09-10

    The culture of smoking by patients and staff within mental health systems of care has a long and entrenched history. Cigarettes have been used as currency between patients and as a patient management tool by staff. These settings have traditionally been exempt from smoke-free policy because of complex held views about the capacity of people with mental disorder to tolerate such policy whilst they are acutely unwell, with stakeholders' continuing fierce debate about rights, choice and duty of care. This culture has played a significant role in perpetuating physical, social and economic smoking associated impacts experienced by people with mental disorder who receive care within mental health care settings. The past decade has seen a clear policy shift towards smoke-free mental health settings in several countries. While many services have been successful in implementing this change, many issues remain to be resolved for genuine smoke-free policy in mental health settings to be realized. This literature review draws on evidence from the international published research, including national audits of smoke-free policy implementation in mental health units in Australia and England, in order to synthesise what we know works, why it works, and the remaining barriers to smoke-free policy and how appropriate interventions are provided to people with mental disorder.

  17. Achieving Smoke-Free Mental Health Services: Lessons from the Past Decade of Implementation Research

    PubMed Central

    Lawn, Sharon; Campion, Jonathan

    2013-01-01

    The culture of smoking by patients and staff within mental health systems of care has a long and entrenched history. Cigarettes have been used as currency between patients and as a patient management tool by staff. These settings have traditionally been exempt from smoke-free policy because of complex held views about the capacity of people with mental disorder to tolerate such policy whilst they are acutely unwell, with stakeholders’ continuing fierce debate about rights, choice and duty of care. This culture has played a significant role in perpetuating physical, social and economic smoking associated impacts experienced by people with mental disorder who receive care within mental health care settings. The past decade has seen a clear policy shift towards smoke-free mental health settings in several countries. While many services have been successful in implementing this change, many issues remain to be resolved for genuine smoke-free policy in mental health settings to be realized. This literature review draws on evidence from the international published research, including national audits of smoke-free policy implementation in mental health units in Australia and England, in order to synthesise what we know works, why it works, and the remaining barriers to smoke-free policy and how appropriate interventions are provided to people with mental disorder. PMID:24025397

  18. Prediction of the optimum surface orientation angles to achieve maximum solar radiation using Particle Swarm Optimization in Sabha City Libya

    NASA Astrophysics Data System (ADS)

    Mansour, F. A.; Nizam, M.; Anwar, M.

    2017-02-01

    This research aims to predict the optimum surface orientation angles in solar panel installation to achieve maximum solar radiation. Incident solar radiation is calculated using koronakis mathematical model. Particle Swarm Optimization (PSO) is used as computational method to find optimum angle orientation for solar panel installation in order to get maximum solar radiation. A series of simulation has been carried out to calculate solar radiation based on monthly, seasonally, semi-yearly and yearly period. South-facing was calculated also as comparison of proposed method. South-facing considers azimuth of 0°. Proposed method attains higher incident predictions than South-facing that recorded 2511.03 kWh/m2for monthly. It were about 2486.49 kWh/m2, 2482.13 kWh/m2and 2367.68 kWh/m2 for seasonally, semi-yearly and yearly. South-facing predicted approximately 2496.89 kWh/m2, 2472.40 kWh/m2, 2468.96 kWh/m2, 2356.09 kWh/m2for monthly, seasonally, semi-yearly and yearly periods respectively. Semi-yearly is the best choice because it needs twice adjustments of solar panel in a year. Yet it considers inefficient to adjust solar panel position in every season or monthly with no significant solar radiation increase than semi-yearly and solar tracking device still considers costly in solar energy system. PSO was able to predict accurately with simple concept, easy and computationally efficient. It has been proven by finding the best fitness faster.

  19. Impact of Health on Education Access and Achievement. Policy Brief Number 3

    ERIC Educational Resources Information Center

    Pridmore, P.

    2008-01-01

    Access to education is recognized as a basic human right and yet projections based on current trends show that more than 50 countries will not achieve universal primary education by 2015. This briefing paper looks at the role of malnutrition and diseases in the failure of countries to meet EFA targets. It is based on the CREATE Pathways to Access…

  20. Food for Thought, Health for Success: Pursuing Policy that Supports Student Wellness and Achievement

    ERIC Educational Resources Information Center

    Groginsky, Scott; Trujillo, Tara

    2009-01-01

    As schools work to ensure that all students have the skills and competencies to succeed in work and life, and with growing expectations for success on standardized assessments at the federal, state and local levels, education leaders increasingly understand the importance of student wellness to achieving these goals. This report outlines why…

  1. Transdisciplinarity as an Inference Technique to Achieve a Better Understanding in the Health and Environmental Sciences

    PubMed Central

    Annerstedt, Matilda

    2010-01-01

    The problems of the world are not categorised into disciplines. They are far more complex, a reality that the tradition of transdisciplinary research has recognised. When faced with questions in public health and sustainability, the traditional scientific paradigm often seems inadequate, and, at least in medicine, transdisciplinary research has not yet been fully appreciated or acknowledged. This lack of recognition may be partly caused by a lack of cooperation between disciplines and between science and society. In this paper, I discuss some of the challenges that scientists and policymakers face in public health and environment within a methodological context. I present transdisciplinarity as a modern research tool that should be applied in research in health and the environment and argue that these topics can be approached beyond the inherent obstacle of incommensurability between disciplines. Thus, a small step might be taken in this immense research arena. PMID:20644696

  2. Transdisciplinarity as an inference technique to achieve a better understanding in the health and environmental sciences.

    PubMed

    Annerstedt, Matilda

    2010-06-01

    The problems of the world are not categorised into disciplines. They are far more complex, a reality that the tradition of transdisciplinary research has recognised. When faced with questions in public health and sustainability, the traditional scientific paradigm often seems inadequate, and, at least in medicine, transdisciplinary research has not yet been fully appreciated or acknowledged. This lack of recognition may be partly caused by a lack of cooperation between disciplines and between science and society. In this paper, I discuss some of the challenges that scientists and policymakers face in public health and environment within a methodological context. I present transdisciplinarity as a modern research tool that should be applied in research in health and the environment and argue that these topics can be approached beyond the inherent obstacle of incommensurability between disciplines. Thus, a small step might be taken in this immense research arena.

  3. Optimizing health care for children with spina bifida.

    PubMed

    Liptak, Gregory S; El Samra, Ahmad

    2010-01-01

    The health care needs of children with spina bifida are complex. They need specialists, generalists, and an integrated system to deliver this complex care and to align and inform all the providers. Most research in spina bifida has been focused on narrow medical outcomes; it has been noncollaborative, based on small samples of convenience, with no comparison groups, and without consistent standards of measurement. Models of health, like the World Health Organization International Classification of Functioning, Disability, and Health Model can help to broaden the scope of future research. Using methods from other pediatric conditions like the patient registry (cystic fibrosis), gene bank (autism), and collaborative research (leukemia), researchers can improve the quality of future studies. Research questions related to the process of care and to specific nonsurgical conditions associated with spina bifida are reviewed in this article.

  4. The EQUATOR Network and reporting guidelines: Helping to achieve high standards in reporting health research studies.

    PubMed

    Simera, Iveta; Moher, David; Hoey, John; Schulz, Kenneth F; Altman, Douglas G

    2009-05-20

    Poorly reported research seriously undermines the usability of reported findings and misleads clinicians, researchers, policy makers and, ultimately, patients. Guidelines for reporting health research are available but they are not widely used. The EQUATOR Network is an international initiative that aims to systematically tackle the problems of poor reporting. The main goals of the EQUATOR Network are to improve the clarity, completeness and transparency of scientific publications by providing resources and education relating to the reporting of health research and assisting in the development, dissemination and implementation of robust reporting guidelines.

  5. Zika Virus -10 Public Health Achievements in 2016 and Future Priorities.

    PubMed

    Oussayef, Nadia L; Pillai, Satish K; Honein, Margaret A; Ben Beard, C; Bell, Beth; Boyle, Coleen A; Eisen, Lars M; Kohl, Katrin; Kuehnert, Matthew J; Lathrop, Eva; Martin, Stacey W; Martin, Rebecca; McAllister, Janet C; McClune, Elizabeth Pantino; Mead, Paul; Meaney-Delman, Dana; Petersen, Brett; Petersen, Lyle R; Polen, Kara N D; Powers, Ann M; Redd, Stephen C; Sejvar, James J; Sharp, Tyler; Villanueva, Julie; Jamieson, Denise J

    2017-01-06

    The introduction of Zika virus into the Region of the Americas (Americas) and the subsequent increase in cases of congenital microcephaly resulted in activation of CDC's Emergency Operations Center on January 22, 2016, to ensure a coordinated response and timely dissemination of information, and led the World Health Organization to declare a Public Health Emergency of International Concern on February 1, 2016. During the past year, public health agencies and researchers worldwide have collaborated to protect pregnant women, inform clinicians and the public, and advance knowledge about Zika virus (Figure 1). This report summarizes 10 important contributions toward addressing the threat posed by Zika virus in 2016. To protect pregnant women and their fetuses and infants from the effects of Zika virus infection during pregnancy, public health activities must focus on preventing mosquito-borne transmission through vector control and personal protective practices, preventing sexual transmission by advising abstention from sex or consistent and correct use of condoms, and preventing unintended pregnancies by reducing barriers to access to highly effective reversible contraception.

  6. Military Health System: Sustained Senior Leadership Needed to Fully Develop Plans for Achieving Cost Savings

    DTIC Science & Technology

    2014-02-26

    left its existing structure in place, approving instead a shared - services directorate to consolidate common MHS functions (e.g., shared information...has seven main goals: (1) consolidate functions ( shared services ) common to DoD, (2) deliver more-integrated health care in areas with more than one

  7. Barriers Experienced by Mexican Immigrants: Implications for Educational Achievement and Mental Health

    ERIC Educational Resources Information Center

    Consoli, Melissa L. Morgan; Consoli, Andres J.; Orozco, Graciela Leon; Gonzales, Rufus R.; Vera, Elizabeth M.

    2012-01-01

    The adversities faced by Latina/o individuals and their families in the U.S. negatively impact educational outcomes as well as their mental and physical health. These adversities are often related to immigration status and acculturation and include difficulties with immigration, language barriers, and discrimination. Given that recent immigrants…

  8. Leveraging HIV-related human rights achievements through a Framework Convention on Global Health.

    PubMed

    Buse, Kent; Eba, Patrick; Sigurdson, Jason; Thomson, Kate; Timberlake, Susan

    2013-06-14

    Although AIDS remains a leading cause of death, especially in low- and middle-income countries, the movement to address it has greatly contributed to changing the world's response to health challenges. By fusing activism, political leadership, domestic and international investment, and accountability for results, the course of the epidemic has been radically shifted. People living with HIV and others directly affected by the epidemic have exerted immense leadership since the first days of the response: they have fought to end discrimination on the basis of sero-status, gender, sexual orientation, disability, migration status, drug use, or participation in sex work. Some of this mobilization has taken the form of strategic litigation, drawing human rights down into concrete demands and defining social, health, legal, and economic policy. The global AIDS response has shown that at the core of health lie considerations of social justice, human rights, and accountability. As momentum builds for a Framework Convention on Global Health (FCGH), we believe there is an opportunity to take stock of lessons learned from the response to HIV and ensure that they are replicated and institutionalized in an eventual Convention. We argue that the most critical aspect to the success of the HIV response has been the leadership and activism of civil society. Conventions do not lead to results on their own, and there should be every expectation that the FCGH will be no different. Success requires active monitoring of progress and shortcomings, combined with political and social mobilization to expand investment and access to the services and underlying conditions that protect and advance health. While the FCGH must make civil society support and engagement an indispensable principle, the AIDS movement can contribute substantive content and mobilization for its adoption. A broad international legal framework for health can help address some of the key legal, policy, regulatory, and

  9. Revenue cycle optimization in health care institutions. A conceptual framework for change management.

    PubMed

    Mugdh, Mrinal; Pilla, Satya

    2012-01-01

    Health care providers in the United States are constantly faced with the enormous challenge of optimizing their revenue cycle to improve their overall financial performance. These challenges keep evolving in both scope and complexity owing to a host of internal and external factors. Furthermore, given the lack of control that health care providers have over external factors, any attempt to successfully optimize the revenue cycle hinges on several critical improvements aimed at realigning the internal factors. This study provides an integrated change management model that aims to reengineer and realign the people-process-technology framework by using the principles of lean and Six Sigma for revenue cycle optimization.

  10. Organizational health and the achievement level of students in science at the secondary-level schools in Sri Lanka

    NASA Astrophysics Data System (ADS)

    Pakkeer-Jaufar, Pakkeer Cadermohideen

    This study sought to identify those organizational health factors that might have overriding influence on the achievement level of students in science in Sri Lankan secondary schools. This study involved 752 students, 33 science teachers, and 10 principals from two different districts, Ampara and Colombo, in Sri Lanka. Ten Tamil medium, secondary level, public schools were selected to participate in this study. Data were collected using four types of instruments: a questionnaire for pupils; interview schedules for science teachers and principals; checklists for classroom/school facilities, science laboratory facilities, and science practicals; and a science achievement test. The analysis focused on the collective perceptions of students, science teachers, and principals. Regression and path analyses were used as major analysis techniques, and the qualitative data provided by science teachers and principals were considered for a crosschecking of the quantitative inferences. The researcher found teacher affiliation, academic emphasis, and instructional leadership of the principal, in descending order, were the overriding influential factors on the achievement level of students in science in Sri Lankan secondary schools. At the same time a similar descending order was found in their mean values and qualities. The researcher concluded that increasing the quality of the organizational health factors in Sri Lankan secondary schools would result in improved better achievement in science. The findings further indicate that instructional leadership of the principal had both direct and indirect effects on students' achievement in science when academic emphasis and teacher affiliation were taken into account. In addition, the resource support of the principal did not make any difference in students' science achievement and the findings stress the availability of the resources for individual students instead of assuming the general facilities of the school are available to all

  11. New Grandparents' Mental Health: The Protective Role of Optimism, Self-Mastery, and Social Support

    ERIC Educational Resources Information Center

    Ben Shlomo, Shirley; Taubman - Ben-Ari, Orit

    2012-01-01

    The current study examines the contribution of optimism, self-mastery, perceived social support, and background variables (age, physical health, economic status) to mental health following the transition to grandparenthood. The sample consisted of 257 first-time Israeli grandparents (grandmothers and grandfathers, maternal and paternal) who were…

  12. HealthMpowerment.org: Building Community Though a Mobile-Optimized, Online Health Promotion Intervention

    PubMed Central

    Hightow-Weidman, Lisa B.; Muessig, Kathryn E.; Pike, Emily C.; LeGrand, Sara; Baltierra, Nina; Rucker, Alvin Justin; Wilson, Patrick

    2015-01-01

    Background Both young Black men who have sex with men as well as young Black transgender women (YBMSM/TW) continue to experience a significant increase in HIV incidence. HealthMpowerment.org (HMP) is a mobile phone-optimized, online intervention for both YBMSM/TW to build community and facilitate supportive relationships. Methods To assess the feasibility, acceptability, and preliminary outcomes, a 1-month pilot trial of HMP among 15 YBMSM/TW was conducted. Results Retention was 100%. Mean age was 26 years, 60% were HIV-infected, 87% earned <$21,000, and 67% were uninsured. Despite the small sample size and limited intervention length, statistically significant improvements were seen in social support (p = .012), social isolation (p = .050), and depressive symptoms (p = .045). Conclusion The HMP pilot trial demonstrated feasibility and acceptability. Given the burden of the epidemic among YBMSM/TW, there is an imperative to develop, test, and scale up culturally appropriate interventions to both prevent HIV acquisition and limit onward transmission. PMID:25588932

  13. Achieving Continuity of Care: Facilitators and Barriers in Community Mental Health Teams

    PubMed Central

    2011-01-01

    Background The integration of mental health and social services for people diagnosed with severe mental illness (SMI) has been a key aspect of attempts to reform mental health services in the UK and aims to minimise user and carer distress and confusion arising from service discontinuities. Community mental health teams (CMHTs) are a key component of UK policy for integrated service delivery, but implementing this policy has raised considerable organisational challenges. The aim of this study was to identify and explore facilitators and barriers perceived to influence continuity of care by health and social care professionals working in and closely associated with CMHTs. Methods This study employed a survey design utilising in-depth, semi-structured interviews with a proportionate, random sample of 113 health and social care professionals and representatives of voluntary organisations. Participants worked in two NHS Mental Health Trusts in greater London within eight adult CMHTs and their associated acute in-patient wards, six local general practices, and two voluntary organisations. Results Team leadership, decision making, and experiences of teamwork support were facilitators for cross boundary and team continuity; face-to-face communication between teams, managers, general practitioners, and the voluntary sector were facilitators for information continuity. Relational, personal, and longitudinal continuity were facilitated in some local areas by workforce stability. Barriers for cross boundary and team continuity were specific leadership styles and models of decision making, blurred professional role boundaries, generic working, and lack of training for role development. Barriers for relational, personal, and longitudinal continuity were created by inadequate staffing levels, high caseloads, and administrative duties that could limit time spent with users. Incompatibility of information technology systems hindered information continuity. Flexible continuity was

  14. Achieving Healthy School Siting and Planning Policies: Understanding Shared Concerns of Environmental Planners, Public Health Professionals, and Educators

    PubMed Central

    Cohen, Alison

    2013-01-01

    Policy decisions regarding the quality of the physical school environment—both, school siting and school facility planning policies—are often considered through the lens of environmental planning, public health, or education policy, but rarely through all three. Environmental planners consider environmental justice issues on a local level and/or consider the regional impact of a school. Public health professionals focus on toxic exposures and populations particularly vulnerable to negative health outcomes. Educators and education policymakers emphasize investing in human capital of both students and staff. By understanding these respective angles and combining these efforts around the common goals of achieving adequacy and excellence, we can work towards a regulatory system for school facilities that recognizes children as a uniquely vulnerable population and seeks to create healthier school environments in which children can learn and adults can work. PMID:20359991

  15. Achieving healthy school siting and planning policies: understanding shared concerns of environmental planners, public health professionals, and educators.

    PubMed

    Cohen, Alison

    2010-01-01

    Policy decisions regarding the quality of the physical school environment-both, school siting and school facility planning policies-are often considered through the lens of environmental planning, public health, or education policy, but rarely through all three. Environmental planners consider environmental justice issues on a local level and/or consider the regional impact of a school. Public health professionals focus on toxic exposures and populations particularly vulnerable to negative health outcomes. Educators and education policymakers emphasize investing in human capital of both students and staff. By understanding these respective angles and combining these efforts around the common goals of achieving adequacy and excellence, we can work toward a regulatory system for school facilities that recognizes children as a uniquely vulnerable population and seeks to create healthier school environments in which children can learn and adults can work.

  16. Optimize patient health by treating literacy and language barriers.

    PubMed

    Dreger, Vicki; Tremback, Tom

    2002-02-01

    More than 90 million Americans have limited literacy skills. Almost two million US residents cannot speak English, and millions more speak it poorly. The stigma of illiteracy or the inability to speak a country's predominant language keep patients from disclosing their limitations. Recognizing these facts is an important first step in improving health education for this vulnerable population. By adapting teaching techniques to patients' special needs, nurses can ensure that patients understand their health problems and plan of care. Statistics dramatically demonstrate the high cost of neglecting these needs. Patients who do not understand their plan of care do not comply with instructions and, therefore, suffer unnecessary complications. Health care providers who can communicate with their patients through multilingual, low literacy patient education materials and with the use of qualified interpreters markedly improve the quality of care for their patients and the resulting outcomes.

  17. Constraining National Health Care Expenditures. Achieving Quality Care at an Affordable Cost.

    DTIC Science & Technology

    1985-09-30

    and future * generations. Advances in orthopedic surgery and the development of laser surgery have also improved the patient’s health status and reduced...disabling bone and joint " ailments. Similarly, the development of laser surgery has . reduced the pain and suffering from many procedures and enabled...more surgery to be performed on an outpatient basis. For example, laser surgery to remove cataracts can frequently be performed on an outpatient basis

  18. Defense Health: Actions Needed to Help Ensure Combat Casualty Care Research Achieves Goals

    DTIC Science & Technology

    2013-02-01

    Department of Health and Human Services JPC -6 Joint Program Committee for Combat Casualty Care MRMC Army Medical Research and...and development.) Note: The JPC -6 includes representatives from each military service (Army, Navy, Air Force, and Marine Corps) and is chartered...care, which is managed by the Joint Program Committee for Combat Casualty Care ( JPC -6). The JPC -6 includes representatives from the DOD biomedical

  19. Use of allopurinol with low-dose 6-mercaptopurine in inflammatory bowel disease to achieve optimal active metabolite levels: A review of four cases and the literature

    PubMed Central

    Witte, Todd N; Ginsberg, Allen L

    2008-01-01

    BACKGROUND: At least one-third of patients with inflammatory bowel disease do not respond or are intolerant to therapy with 6-mercaptopurine (6-MP). A subgroup fails to attain optimal levels of 6-thioguanine nucleotide (6-TGN) and instead shunts to 6-methylmercaptopurine nucleotide (6-MMPN). PATIENTS AND METHODS: A retrospective chart review was conducted, and four patients are described who had been previously unable to achieve optimal 6-TGN metabolite levels until allopurinol was added to their treatment. RESULTS: All four patients achieved optimal 6-TGN levels and undetectable 6-MMPN with a mean 6-MP dose of 0.49 mg/kg. Three achieved steroid-free clinical remission. Two of those three patients had normalization of liver enzymes; one patient had baseline normal liver enzymes despite an initial 6-MMPN level of 27,369 pmol/8×108 red blood cells. Two patients experienced reversible leukopenia. CONCLUSIONS: Combination allopurinol and low-dose 6-MP is an effective means to achieve optimal metabolite levels and steroid-free clinical remission in previously refractory patients. Caution is advised. PMID:18299738

  20. Optimizing Health Care for Children with Spina Bifida

    ERIC Educational Resources Information Center

    Liptak, Gregory S.; El Samra, Ahmad

    2010-01-01

    The health care needs of children with spina bifida are complex. They need specialists, generalists, and an integrated system to deliver this complex care and to align and inform all the providers. Most research in spina bifida has been focused on narrow medical outcomes; it has been noncollaborative, based on small samples of convenience, with no…

  1. Achieving organizational change: findings from a case study of health promoting hospitals in Taiwan.

    PubMed

    Lee, Chiachi Bonnie; Chen, Michael S; Powell, Michael; Chu, Cordia Ming-Yeuk

    2014-06-01

    The Taiwanese Network of Health Promoting Hospitals (HPH) has been in place since 2006 and developing rapidly. The criticism of inadequate evaluation of the HPH approach taken elsewhere also holds true for the Taiwan HPH Network. Organizational change is a key to sustainable and effective health promotion, and it is also an important aspect in the European HPH movement. Therefore, this study aims to evaluate changes in organizational capacity for the implementation of HPH in Taiwan. All 55 HPH coordinators were invited to participate in the study, and 52 of them completed the questionnaires. The survey covered seven dimensions of HPH organizational capacity, and a total score of each dimension was calculated and converted to a figure on a scale of 10. This study has shown that HPH made a positive impact on HP hospitals in Taiwan regarding organizational change in capacity building for HPH. Leadership, organization culture and mission and strategy received the top three highest mean scores (8.19 ± 1.25, 8.08 ± 1.39, 7.99 ± 1.42), while staff participation received the lowest score (7.62 ± 1.26). The high level of organizational change was associated with the high satisfaction levels of organizational support from the viewpoint of the HPH coordinators. Based on a cluster analysis, a majority of the HP hospitals in Taiwan seemed to have adopted the addition model in putting the HPH initiative into practice; a few hospitals appeared to have accepted HPH initiative well through the integration model. These results presented evidence that HPH contributed to organizational capacity building of hospitals for health promotion.

  2. Moving Toward Universal Health Coverage (UHC) to Achieve Inclusive and Sustainable Health Development: Three Essential Strategies Drawn From Asian Experience Comment on "Improving the World's Health Through the Post-2015 Development Agenda: Perspectives from Rwanda".

    PubMed

    Xu, Ye; Huang, Cheng; Colón-Ramos, Uriyoán

    2015-08-26

    Binagwaho and colleagues' perspective piece provided a timely reflection on the experience of Rwanda in achieving the Millennium Development Goals (MDGs) and a proposal of 5 principles to carry forward in post-2015 health development. This commentary echoes their viewpoints and offers three lessons for health policy reforms consistent with these principles beyond 2015. Specifically, we argue that universal health coverage (UHC) is an integrated solution to advance the global health development agenda, and the three essential strategies drawn from Asian countries' health reforms toward UHC are: (1) Public financing support and sequencing health insurance expansion by first extending health insurance to the extremely poor, vulnerable, and marginalized population are critical for achieving UHC; (2) Improved quality of delivered care ensures supply-side readiness and effective coverage; (3) Strategic purchasing and results-based financing creates incentives and accountability for positive changes. These strategies were discussed and illustrated with experience from China and other Asian economies.

  3. [Health system sustainability from a network perspective: a proposal to optimize healthy habits and social support].

    PubMed

    Marqués Sánchez, Pilar; Fernández Peña, Rosario; Cabrera León, Andrés; Muñoz Doyague, María F; Llopis Cañameras, Jaime; Arias Ramos, Natalia

    2013-01-01

    The search of new health management formulas focused to give wide services is one of the priorities of our present health policies. Those formulas examine the optimization of the links between the main actors involved in public health, ie, users, professionals, local socio-political and corporate agents. This paper is aimed to introduce the Social Network Analysis as a method for analyzing, measuring and interpreting those connections. The knowledge of people's relationships (what is called social networks) in the field of public health is becoming increasingly important at an international level. In fact, countries such as UK, Netherlands, Italy, Australia and U.S. are looking formulas to apply this knowledge to their health departments. With this work we show the utility of the ARS on topics related to sustainability of the health system, particularly those related with health habits and social support, topics included in the 2020 health strategies that underline the importance of the collaborative aspects in networks.

  4. The PILI 'Ohana Project: a community-academic partnership to achieve metabolic health equity in Hawai'i.

    PubMed

    Kaholokula, Joseph Keawe'aimoku; Kekauoha, Puni; Dillard, Adrienne; Yoshimura, Sheryl; Palakiko, Donna-Marie; Hughes, Claire; Townsend, Claire Km

    2014-12-01

    Native Hawaiians and Pacific Islanders (NHPI) have higher rates of excess body weight and related medical disorders, such as diabetes and cardiovascular disease, compared to other ethnic groups in Hawai'i. To address this metabolic health inequity, the Partnership for Improving Lifestyle Intervention (PILI) 'Ohana Project, a community-academic partnership, was formed over eight years ago and developed two community-placed health promotion programs: the PILI Lifestyle Program (PLP) to address overweight/obesity and the Partners in Care (PIC) to address diabetes self-care. This article describes and reviews the innovations, scientific discoveries, and community capacity built over the last eight years by the PILI 'Ohana Project's (POP) partnership in working toward metabolic health equity. It also briefly describes the plans to disseminate and implement the PLP and PIC in other NHPI communities. Highlighted in this article is how scientific discoveries can have a real-world impact on health disparate populations by integrating community wisdom and academic expertise to achieve social and health equity through research.

  5. The PILI ‘Ohana Project: A Community-Academic Partnership to Achieve Metabolic Health Equity in Hawai‘i

    PubMed Central

    Kekauoha, Puni; Dillard, Adrienne; Yoshimura, Sheryl; Palakiko, Donna-Marie; Hughes, Claire; Townsend, Claire KM

    2014-01-01

    Native Hawaiians and Pacific Islanders (NHPI) have higher rates of excess body weight and related medical disorders, such as diabetes and cardiovascular disease, compared to other ethnic groups in Hawai‘i. To address this metabolic health inequity, the Partnership for Improving Lifestyle Intervention (PILI) ‘Ohana Project, a community-academic partnership, was formed over eight years ago and developed two community-placed health promotion programs: the PILI Lifestyle Program (PLP) to address overweight/obesity and the Partners in Care (PIC) to address diabetes self-care. This article describes and reviews the innovations, scientific discoveries, and community capacity built over the last eight years by the PILI ‘Ohana Project's (POP) partnership in working toward metabolic health equity. It also briefly describes the plans to disseminate and implement the PLP and PIC in other NHPI communities. Highlighted in this article is how scientific discoveries can have a real-world impact on health disparate populations by integrating community wisdom and academic expertise to achieve social and health equity through research. PMID:25535599

  6. Heart failure management: optimal health care delivery programs.

    PubMed

    Moser, D K

    2000-01-01

    Heart failure is the single most costly health care expenditure in the United States. The major proportion of these costs is attributable to rehospitalizations, and by many estimates the majority of rehospitalizations might be preventable with better health care delivery. The past 5 years have seen an explosion in the number of heart failure disease management programs put in place across the country to try to decrease the economic burden of heart failure and improve patient outcomes. Yet few of these are based on programs tested by researchers, let alone tested in randomized, controlled trials. This chapter summarizes findings from studies of heart failure disease management programs from 1980 to the present, critiques those studies, and offers suggestions for future research in this area.

  7. Which New Health Technologies Do We Need to Achieve an End to HIV/AIDS?

    PubMed Central

    Gray, Glenda E.; Laher, Fatima; Doherty, Tanya; Abdool Karim, Salim; Hammer, Scott; Mascola, John; Beyrer, Chris; Corey, Larry

    2016-01-01

    In the last 15 years, antiretroviral therapy (ART) has been the most globally impactful life-saving development of medical research. Antiretrovirals (ARVs) are used with great success for both the treatment and prevention of HIV infection. Despite these remarkable advances, this epidemic grows relentlessly worldwide. Over 2.1 million new infections occur each year, two-thirds in women and 240,000 in children. The widespread elimination of HIV will require the development of new, more potent prevention tools. Such efforts are imperative on a global scale. However, it must also be recognised that true containment of the epidemic requires the development and widespread implementation of a scientific advancement that has eluded us to date—a highly effective vaccine. Striving for such medical advances is what is required to achieve the end of AIDS. PMID:26933962

  8. Achieving health care cost containment through provider payment reform that engages patients and providers.

    PubMed

    Ginsburg, Paul B

    2013-05-01

    The best opportunity to pursue cost containment in the next five to ten years is through reforming provider payment to gradually diminish the role of fee-for-service reimbursement. Public and private payers have launched many promising payment reform pilots aimed at blending fee-for-service with payment approaches based on broader units of care, such as an episode or patients' total needs over a period of time, a crucial first step. But meaningful cost containment from payment reform will not be achieved until Medicare and Medicaid establish stronger incentives for providers to contract in this way, with discouragement of nonparticipation increasing over time. In addition, the models need to evolve to engage beneficiaries, perhaps through incentives for patients to enroll in an accountable care organization and to seek care within that organization's network of providers.

  9. Optimism and Resources: Effects on Each Other and on Health over 10 Years

    PubMed Central

    Segerstrom, Suzanne C.

    2007-01-01

    Dispositional optimism may be associated with growth of social and status resources by virtue of optimists' greater persistence and better performance. Conversely, resource growth may give people a more positive view of their future and increase optimism. Changes in dispositional optimism and resources over 10 years were examined in former law students (N = 61). More optimistic first-year law students made more money 10 years later, but income did not predict later optimism. More optimistic students did not have larger social networks 10 years later, but increases in social network size predicted increased optimism. These changes predicted mental and physical health. Dispositional optimism was less stable than many personality traits (r = .35), potentially because it is responsive to resource change. PMID:24347739

  10. An integrated framework to achieve interoperability in person-centric health management.

    PubMed

    Vergari, Fabio; Salmon Cinotti, Tullio; D'Elia, Alfredo; Roffia, Luca; Zamagni, Guido; Lamberti, Claudio

    2011-01-01

    The need for high-quality out-of-hospital healthcare is a known socioeconomic problem. Exploiting ICT's evolution, ad-hoc telemedicine solutions have been proposed in the past. Integrating such ad-hoc solutions in order to cost-effectively support the entire healthcare cycle is still a research challenge. In order to handle the heterogeneity of relevant information and to overcome the fragmentation of out-of-hospital instrumentation in person-centric healthcare systems, a shared and open source interoperability component can be adopted, which is ontology driven and based on the semantic web data model. The feasibility and the advantages of the proposed approach are demonstrated by presenting the use case of real-time monitoring of patients' health and their environmental context.

  11. An Integrated Framework to Achieve Interoperability in Person-Centric Health Management

    PubMed Central

    Vergari, Fabio; Salmon Cinotti, Tullio; D'Elia, Alfredo; Roffia, Luca; Zamagni, Guido; Lamberti, Claudio

    2011-01-01

    The need for high-quality out-of-hospital healthcare is a known socioeconomic problem. Exploiting ICT's evolution, ad-hoc telemedicine solutions have been proposed in the past. Integrating such ad-hoc solutions in order to cost-effectively support the entire healthcare cycle is still a research challenge. In order to handle the heterogeneity of relevant information and to overcome the fragmentation of out-of-hospital instrumentation in person-centric healthcare systems, a shared and open source interoperability component can be adopted, which is ontology driven and based on the semantic web data model. The feasibility and the advantages of the proposed approach are demonstrated by presenting the use case of real-time monitoring of patients' health and their environmental context. PMID:21811499

  12. Quality of Vegetable Oil Prior to Fortification Is an Important Criteria to Achieve a Health Impact

    PubMed Central

    Andarwulan, Nuri; Gitapratiwi, Desty; Laillou, Arnaud; Fitriani, Dwi; Hariyadi, Purwiyatno; Moench-Pfanner, Regina; Martianto, Drajat

    2014-01-01

    Unbranded palm cooking oil has been fortified for several years and can be found in the market with different oxidation levels. This study aimed to investigate the stability and shelf life of unbranded, bulk, vitamin A-fortified palm oils with the most commonly observed oxidation levels in Indonesia. Three types of cooking oils were tested: (i) cooking oil with a peroxide value (PV) below 2 mEq O2/kg (PO1); (ii) cooking oil with a PV around 4 mEq O2/kg (PO2); and (iii) cooking oil with a PV around 9 mEq O2/kg (PO3). The oil shelf life was determined by using accelerated shelf life testing (ASLT), where the product was stored at 60, 75 and 90 °C, and then PV, free fatty acid and vitamin A concentration in the oil samples were measured. The results showed that PO1 had a shelf life of between 2–3 months, while PO2’s shelf life was a few weeks and PO3’s only a few days. Even given those varying shelf lives, the vitamin A loss in the oils was still acceptable, at around 10%. However, the short shelf life of highly oxidized cooking oil, such as PO3, might negatively impact health, due to the potential increase of free radicals of the lipid peroxidation in the oil. Based on the results, the Indonesian government should prohibit the sale of highly-oxidized cooking oil. In addition, government authorities should promote and endorse the fortification of only cooking oil with low peroxide levels to ensure that fortification is not associated with any health issues associated with high oxidation levels of the cooking oil. PMID:25393689

  13. Optimal electrocardiographic lead systems: practical scenarios in smart clothing and wearable health systems.

    PubMed

    Finlay, Dewar D; Nugent, Chris D; Donnelly, Mark P; McCullagh, Paul J; Black, Norman D

    2008-07-01

    Advances in wearable health systems, from a smart textile, signal processing, and wireless communications perspective, have resulted in the recent deployment of such systems in real clinical and healthcare settings. Nevertheless, the problem of identifying the most appropriate sites from which biological parameters can be recorded still remains unsolved. This paper aims to asses the effects of various practical constraints that may be encountered when choosing electrocardiographic recording sites for wearable health systems falling within the category of smart shirts for cardiac monitoring and analysis. We apply a lead selection algorithm to a set of 192 lead body surface potential maps (BSPM) and simulate a number of practical constraints by only allowing selection of recording sites from specific regions available in the 192 lead array. Of the various scenarios that were investigated, we achieved the best results when the selection process to identify the recording sites was constrained to an area around the precordial region. The top ten recording sites chosen in this region exhibited an rms voltage error of 25.8 mu V when they were used to estimate total ECG information. The poorest performing scenario was that which constrained the selection to two vertical strips on the posterior surface. The top ten recording sites chosen in this scenario exhibited an rms voltage error of 41.1 muV. In general, it was observed that out of all the scenarios investigated, those which constrained available regions to the posterior and lateral surfaces performed less favorably than those where electrodes could also be chosen on the anterior surface. The overall results from our approach have validated the proposed algorithm and its ability to select optimal recording sites taking into consideration the practical constraints that may exist with smart shirts.

  14. Sensor Selection and Optimization for Health Assessment of Aerospace Systems

    NASA Technical Reports Server (NTRS)

    Maul, William A.; Kopasakis, George; Santi, Louis M.; Sowers, Thomas S.; Chicatelli, Amy

    2008-01-01

    Aerospace systems are developed similarly to other large-scale systems through a series of reviews, where designs are modified as system requirements are refined. For space-based systems few are built and placed into service these research vehicles have limited historical experience to draw from and formidable reliability and safety requirements, due to the remote and severe environment of space. Aeronautical systems have similar reliability and safety requirements, and while these systems may have historical information to access, commercial and military systems require longevity under a range of operational conditions and applied loads. Historically, the design of aerospace systems, particularly the selection of sensors, is based on the requirements for control and performance rather than on health assessment needs. Furthermore, the safety and reliability requirements are met through sensor suite augmentation in an ad hoc, heuristic manner, rather than any systematic approach. A review of the current sensor selection practice within and outside of the aerospace community was conducted and a sensor selection architecture is proposed that will provide a justifiable, defendable sensor suite to address system health assessment requirements.

  15. Sensor Selection and Optimization for Health Assessment of Aerospace Systems

    NASA Technical Reports Server (NTRS)

    Maul, William A.; Kopasakis, George; Santi, Louis M.; Sowers, Thomas S.; Chicatelli, Amy

    2007-01-01

    Aerospace systems are developed similarly to other large-scale systems through a series of reviews, where designs are modified as system requirements are refined. For space-based systems few are built and placed into service. These research vehicles have limited historical experience to draw from and formidable reliability and safety requirements, due to the remote and severe environment of space. Aeronautical systems have similar reliability and safety requirements, and while these systems may have historical information to access, commercial and military systems require longevity under a range of operational conditions and applied loads. Historically, the design of aerospace systems, particularly the selection of sensors, is based on the requirements for control and performance rather than on health assessment needs. Furthermore, the safety and reliability requirements are met through sensor suite augmentation in an ad hoc, heuristic manner, rather than any systematic approach. A review of the current sensor selection practice within and outside of the aerospace community was conducted and a sensor selection architecture is proposed that will provide a justifiable, dependable sensor suite to address system health assessment requirements.

  16. Mother-child health research (IRN-MCH): achievements and prospects of an international network.

    PubMed

    de Thé, Guy; Zetterström, Rolf

    2005-07-01

    The Inter-Academy Panel (IAP) is critical about the scarce support to mother-child health (MCH) research in developing countries. At the request of the IAP, a group of members of the French and Swedish Academies of Science have arrived at the conclusion that an efficient network between scientists in resource-poor and industrialized countries will facilitate MCH research in developing countries. The priorities for such a network have been listed as follows: The present organization for the MCH website at the Pasteur Institute in Paris should be adapted to better promote collaboration between scientists from industrialized and developing countries. To provide short-term courses for young scientists from developing countries in the design of research protocols, and in the writing of scientific reports and manuscripts. To organize workshops on various topics of relevance for MCH in developing countries in order to create new research networks for scientific collaboration between industrialized and resource-poor countries. To establish collaboration between non-governmental organizations (NGOs) that support MCH research in developing countries. Topics for such collaborative studies and the way in which they may be performed are summarized.

  17. Achieving health, safety, and performance improvements through enhanced cost visibility and workplace partnerships.

    PubMed

    Grant, Katharyn A; Garland, John G; Joachim, Todd C; Wallen, Andrew; Vital, Twyla

    2003-01-01

    Reduction in the environment, safety, and occupational health (ESOH) component of operational costs requires not only a better understanding of ESOH costs and requirements, but also the formation of effective partnerships between ESOH professionals, financial analysts, and shop workers to identify viable improvements to current practices. This article presents two case studies of efforts to enhance productivity and ESOH in corrosion control facilities at Randolph Air Force Base (AFB), Texas, and Robins AFB, Ga. At each site, activity-based cost models were created to increase the visibility of ESOH-related costs and target improvement opportunities. Analysis of the strip-and-paint processes for the T-38 aircraft at Randolph and the F-15 radome and C-141 aft cowl at Robins revealed that a large proportion of operating costs were tied to ESOH requirements and practices (22 and 39%, respectively). In each case ESOH professionals teamed with shop personnel to identify potential improvements in personal protective equipment use, waste disposal, tool selection, and work methods. This approach yielded alternatives projected to reduce total shop costs by 5 to 7%. This case study demonstrates how workplaces can identify cost-saving and efficiency-enhancing practices by partnering with ESOH professionals in planning and decision-making activities.

  18. Occupational health nurses’ achievement of competence and comfort in respiratory protection and preferred learning methods results of a nationwide survey.

    PubMed

    Burgel, Barbara J; Novak, Debra A; Carpenter, Holly Elizabeth; Gruden, MaryAnn; Lachat, Ann M; Taormina, Deborah

    2014-02-01

    Additional findings are presented from a 2012 nationwide survey of 2,072 occupational health nurses regarding how they achieved competence in respiratory protection, their preferred methods of learning, and how they motivated employees to use respiratory protection. On-the-job training, taking a National Institute for Occupational Safety and Health spirometry course, or attending professional conferences were the primary ways occupational health nurses gained respiratory protection knowledge. Attending professional conferences was the preferred method of learning, varying by type of industry and years of occupational health nurse experience. Employee motivational strategies were not widely used; the most common strategy was to tailor respiratory protection training to workplace culture. Designing training methods that match learning preferences, within the context of the organization's safety and quality improvement culture, is a key recommendation supported by the literature and these findings. Including respiratory protection content and competencies in all levels of academic nursing education is an additional recommendation. Additional research is needed to link training strategies with consistent and correct use of respiratory protection by employees.

  19. Achieving compliance with the International Health Regulations by overseas territories of the United Kingdom of Great Britain and Northern Ireland.

    PubMed

    Hamblion, Esther L; Salter, Mark; Jones, Jane

    2014-11-01

    The 2005 International Health Regulations (IHR) came into force for all Member States of the World Health Organization (WHO) in June 2007 and the deadline for achieving compliance was June 2012. The purpose of the IHR is to prevent, protect against, control - and provide a public health response to - international spread of disease. The territory of the United Kingdom of Great Britain and Northern Ireland and that of several other Member States, such as China, Denmark, France, the Netherlands and the United States of America, include overseas territories, which cover a total population of approximately 15 million people. Member States have a responsibility to ensure that all parts of their territory comply with the IHR. Since WHO has not provided specific guidance on compliance in the special circumstances of the overseas territories of Member States, compliance by these territories is an issue for self-assessment by Member States themselves. To date, no reports have been published on the assessment of IHR compliance in countries with overseas territories. We describe a gap analysis done in the United Kingdom to assess IHR compliance of its overseas territories. The findings and conclusions are broadly applicable to other countries with overseas territories which may have yet to assess their compliance with the IHR. Such assessments are needed to ensure compliance across all parts of a Member States' territory and to increase global health security.

  20. The role of the organizational champion in achieving health system change.

    PubMed

    Hendy, Jane; Barlow, James

    2012-02-01

    In healthcare there is a long held wisdom that 'champions' are a key aspect of organizational change. Drawing on organizational management theory, we examine the role of champions in three health and social care organizations in England as they attempt to move services to a remote model of delivery, 'telecare'. The delivery of remote care is a significant policy in the U.K. and elsewhere, but its introduction has been challenging. Over three years ethnographic methods (observations, informed discussions and interviews) were used to analyze the role of organizational champions in implementing remote care. Cases were local authorities and associated primary care trusts. Participants were champions and organizational members involved in implementation. Our study shows that organizational champions are highly effective in the first phase of adoption, when change is contained within distinct sub-sets of practice. Moving beyond local contexts the effectiveness of the champions varied. Identification centered on the remote care work. This identification enabled the champions to motivate others and move beyond their normally prescribed roles, contributing to innovation ideas, processes and practices. When required to shift their work organization-wide, and share ideas outside their professional culture, some champions responded with resistance, resulting in a lack of innovation spread. These results caution against allowing change to become positioned within the remit of a few individuals. Whilst this strategy may be initially beneficial, the role of champion may be less useful, even detrimental to progress, in the later stages of implementation, particularly if identification with the new circumstances is not established.

  1. Positive futures? The impact of HIV infection on achieving health, wealth and future planning.

    PubMed

    Harding, Richard; Molloy, Tim

    2008-05-01

    Although HIV is now cast as a chronic condition with favourable clinical outcomes under new treatments, it is unclear how living with HIV affects expectations and planning for the future. This mixed-methods study aimed to investigate UK gay men's expectations of their own future when living with HIV, and to identify the heath and social interventions required to enhance roles, participation and personal fulfilment. A preliminary focus group identified relevant domains of enquiry for a subsequent online cross-sectional survey. A total of 347 gay men living in the UK with HIV participated in the survey, and 56.6% were currently on treatment. However, high 7-day prevalence of psychological and physical symptoms was identified (42.6% in pain, 80.2% worrying); 57.8% perceived reduced career options due to their infection and 71.8% reduced life expectancy. Being on treatment was not significantly associated with perceived life expectancy. Coded open-ended survey data identified eight principle themes related to goal planning and attainment. The integrated open and closed data items offer an understanding of barriers and challenges that focus on poor mental health due to clinical inattention, discrimination and stigma, poor career and job opportunities due to benefit and workplace inflexibility and lack of understanding, a lack of personal goals and associated skills deficit related to confidence and self esteem. Gay men living with HIV require an integrated holistic approach to wellbeing that incorporates clinical, social and individual intervention in order to lead productive lives with maximum benefit from treatment gains.

  2. Optimal Indicators of Socioeconomic Status for Health Research

    PubMed Central

    Duncan, Greg J.; Daly, Mary C.; McDonough, Peggy; Williams, David R.

    2002-01-01

    Objectives. In this study we examined the relationship between indicators of socioeconomic status (SES) and mortality for a representative sample of individuals. Methods. The sample included 3734 individuals aged 45 and older interviewed in 1984 in the Panel Study of Income Dynamics. In the current study, mortality was tracked between 1984 and 1994 and is related to SES indicators of education, occupation, income, and wealth. Results. Wealth and recent family income were the indicators that were most strongly associated with subsequent mortality. These associations persisted after we controlled for the other SES indicators and were stronger for women than for men and for nonelderly than for elderly individuals. Conclusions. We found that the economic indicators of SES were usually as strongly associated with mortality as, if not more strongly associated with mortality than, the more conventional indicators of completed schooling and occupation. (Am J Public Health. 2002;92:1151–1157) PMID:12084700

  3. Language and Verbal Memory in Individuals with a History of Autism Spectrum Disorders Who Have Achieved Optimal Outcomes

    ERIC Educational Resources Information Center

    Tyson, Katherine; Kelley, Elizabeth; Fein, Deborah; Orinstein, Alyssa; Troyb, Eva; Barton, Marianne; Eigsti, Inge-Marie; Naigles, Letitia; Schultz, Robert T.; Stevens, Michael; Helt, Molly; Rosenthal, Michael

    2014-01-01

    Some individuals who lose their autism spectrum disorder diagnosis may continue to display subtle weaknesses in language. We examined language and verbal memory in 44 individuals with high-functioning autism (HFA), 34 individuals with "optimal outcomes" (OO) and 34 individuals with typical development (TD). The OO group scored in the…

  4. Exquisite Moments: Achieving Optimal Flow in Three Activity-Based Groups Regardless of Early-Childhood Adversity

    ERIC Educational Resources Information Center

    Thomson, Paula; Jaque, S. Victoria

    2016-01-01

    Flow experiences (also known as optimal performance) occur when people engage in activities they enjoy. The authors discuss such events in their study that examined a number of healthy, active individuals (performing artists, athletes, and others engaged in a range of recreational activities) and divided these into three groups based on adverse…

  5. Evaluation of skill achievement levels and practical experiences of public health nursing students before and after the introduction of the public health nursing course as an elective.

    PubMed

    Suzuki, Yoshimi; Saito, Emiko; Sawai, Minako; Kishi, Emiko; Kakemoto, Satori; Nakada, Harumi; Igarashi, Chiyo; Asahara, Kiyomi

    2016-01-01

    Objective To equip public health nurses (PHNs) with higher qualifications, PHN education is shifting from an integrated curriculum for PHNs and registered nurses to a specific elective system of undergraduate or postgraduate programs. Most colleges in the special wards of Tokyo introduced the elective system in 2014 before the remaining areas. The outcomes of this must be evaluated. This study aimed to evaluate the achievement levels and practical experiences of PHN students at seven colleges in the special wards before and after introduction of the PHN course as an elective.Method Self-administered, anonymous questionnaires were completed by senior PHN students at seven colleges in the special wards who underwent training in 2013, the last year of an integrated curriculum, and in 2014, the first year of the elective system. The target numbers of participants were 663 in 2013 and 136 in 2014 with 20 students from each school exposed to the elective system. Our study focused on whether they achieved the 98 "technical items of PHN training and achievement levels at the time of graduation" required by the Ministry of Health, Labour and Welfare. The study also determined whether participants obtained practical experience in 15 items developed by the special wards based on the standards set for training.Results In 2013, there were 348 total responses (52.5%) and 310 valid responses. In 2014, there were 136 total responses (88.2%) and 120 valid responses. The average achievement rate at which the student answered, "I was able to arrive at it," at an arrival degree level for the 98 technical items was 72.6% in 2014, an increase compared to the 67.9% obtained in 2013. Moreover, the average practical experience rate at which the student answered, "I was able to have an experience," regarding the 15 items was 85.7% in 2014, which constituted an increase compared to 70.5% attained in 2013. However, the number of items with an achievement rate of more than 80% remained

  6. Tibetan medicine: a complementary science of optimal health.

    PubMed

    Loizzo, Joseph J; Blackhall, Leslie J; Rapgay, Lobsang

    2009-08-01

    Traditional medical systems are challenging because their theories and practices strike many conventionally trained physicians and researchers as incomprehensible. Should modern medicine dismiss them as unscientific, view them as sources of alternatives hidden in a matrix of superstition, or regard them as complementary sciences of medicine? We make the latter argument using the example of Tibetan medicine. Tibetan medicine is based on analytic models and methods that are rationally defined, internally coherent, and make testable predictions, meeting current definitions of "science." A ninth century synthesis of Indian, Chinese, Himalayan, and Greco-Persian traditions, Tibetan medicine is the most comprehensive form of Eurasian healthcare and the world's first integrative medicine. Incorporating rigorous systems of meditative self-healing and ascetic self-care from India, it includes a world-class paradigm of mind/body and preventive medicine. Adapting the therapeutic philosophy and contemplative science of Indian Buddhism to the quality of secular life and death, it features the world's most effective systems of positive and palliative healthcare. Based on qualitative theories and intersubjective methods, it involves predictions and therapies shown to be more accurate and effective than those of modern medicine in fields from physiology and pharmacology to neuroscience, mind/body medicine, and positive health. The possibility of complementary sciences follows from the latest view of science as a set of tools--instruments of social activity based on learned agreement in aims and methods--rather than as a monolith of absolute truth. Implications of this pluralistic outlook for medical research and practice are discussed.

  7. [Prioritizing prescriptions in a ambulatory care setting: a tool to achieve appropriateness of care in public health management].

    PubMed

    Semeraro, V; Zantedeschi, E; Pasquarella, A; Guerrera, C; Guasticchi, G

    2012-01-01

    Waiting lists are one of the main Public Health issues within developed countries. To promote appropriateness about General Practitioners' (GPs) prescriptions, during 2009 the project "Priority setting in outpatient prescriptions" in Latium Region has been approved. Regional referees, Latium Public Health Agency managers and advisors, managers and advisors of three Local Public Health Units (LPHUs) within the Latium region and some voluntarily recruited General Practitioners (each one with more than 800 patients enrolled) were included in a team work with the duty to develop the project. During two selected months of 2010, 46 GPs have forwarded overall 2.229 medical prescriptions. The six most numerous prescriptions were picked out and analyzed by the team work. 42% of these prescriptions were identified as belonging to category D of the priority level--"standard", while 42% and 41% of prescriptions bore the expressions of "control" and "diagnostic purpose" respectively. Among these ones, 75% were represented by bilateral mammography, prescribed to women aged between 50 and 69 years: but for those people bilateral mammography is already provided free of charge within the regional program of breast cancer screening, making the routine prescription by their physician a useless duplication, unacceptable in a healthcare system of good quality. Therefore at the conclusion of the project, the team work suggests proper standards be applied by healthcare professionals and GPs to achieve a significant objective: mammography appropriateness prescriptions.

  8. Academic Abilities in Children and Adolescents with a History of Autism Spectrum Disorders Who Have Achieved Optimal Outcomes

    ERIC Educational Resources Information Center

    Troyb, Eva; Orinstein, Alyssa; Tyson, Katherine; Helt, Molly; Eigsti, Inge-Marie; Stevens, Michael; Fein, Deborah

    2014-01-01

    This study examines the academic abilities of children and adolescents who were once diagnosed with an autism spectrum disorder, but who no longer meet diagnostic criteria for this disorder. These individuals have achieved social and language skills within the average range for their ages, receive little or no school support, and are referred to…

  9. Perceived Academic Control: Mediating the Effects of Optimism and Social Support on College Students' Psychological Health

    ERIC Educational Resources Information Center

    Ruthig, Joelle C.; Haynes, Tara L.; Stupnisky, Robert H.; Perry, Raymond P.

    2009-01-01

    The first year of college presents numerous challenges experienced as overwhelming by some freshmen who may become overly stressed and depressed. This longitudinal study examined perceived academic control (PAC) as a mediator of optimism and social support's buffering effects on freshman students' psychological health. Multiple regressions…

  10. The Contributions of Physical Activity and Fitness to Optimal Health and Wellness

    ERIC Educational Resources Information Center

    Ohuruogu, Ben

    2016-01-01

    The paper examined the role of physical activity and fitness more especially in the area of disease prevention and control by looking at the major ways by which regular physical activity and fitness contributes to optimal health and wellness. The Surgeor General's Report (1996), stressed that physical inactivity is a national problem which…

  11. SU-E-T-387: Achieving Optimal Patient Setup Imaging and Treatment Workflow Configurations in Multi-Room Proton Centers

    SciTech Connect

    Zhang, H; Prado, K; Langen, K; Yi, B; Mehta, M; Regine, W; D'Souza, W

    2014-06-01

    Purpose: To simulate patient flow in proton treatment center under uncertainty and to explore the feasibility of treatment preparation rooms to improve patient throughput and cyclotron utilization. Methods: Three center layout scenarios were modeled: (S1: In-Tx room imaging) patient setup and imaging (planar/volumetric) performed in treatment room, (S2: Patient setup in preparation room) each treatment room was assigned with preparation room(s) that was equipped with lasers only for patient setup and gross patient alignment, and (S3: Patient setup and imaging in preparation room) preparation room(s) was equipped with laser and volumetric imaging for patient setup, gross and fine patient alignment. A 'snap' imaging was performed in treatment room. For each scenario, the number of treatment rooms and the number of preparation rooms serving each treatment room were varied. We examined our results (average of 100 16-hour (two shifts) working days) by evaluating patient throughput and cyclotron utilization. Results: When the number of treatment rooms increased ([from, to]) [1, 5], daily patient throughput increased [32, 161], [29, 184] and [27, 184] and cyclotron utilization increased [13%, 85%], [12%, 98%], and [11%, 98%] for scenarios S1, S2 and S3 respectively. However, both measures plateaued after 4 rooms. With the preparation rooms, the throughput and the cyclotron utilization increased by 14% and 15%, respectively. Three preparation rooms were optimal to serve 1-3 treatment rooms and two preparation rooms were optimal to serve 4 or 5 treatment rooms. Conclusion: Patient preparation rooms for patient setup may increase throughput and decrease the need for additional treatment rooms (cost effective). Optimal number of preparation rooms serving each gantry room varies as a function of treatment rooms and patient setup scenarios. A 5th treatment room may not be justified by throughput or utilization.

  12. Gap Analysis for Chinese Drug Control Institutes to Achieve the Standards of World Health Organization Medicine Prequalification.

    PubMed

    Mao, Xin; Yang, Yue

    2017-02-01

    The study aims to explore the challenges and the gaps faced by Chinese Drug Control Institutes in achieving the standards of World Health Organization (WHO) Medicine Prequalification. The study was undertaken with 6 Provincial Drug Control Institutes in China from November 2012 to November 2013. The study assessed key elements required to comply with WHO Good Practices for Pharmaceutical Quality Control Laboratories (GPPQCL). For GPPQCL, the study found gaps in quality management system, control of documentation, data-processing equipment, premises and equipment, contracts, reagents (water), reference substances and reference materials, calibration, verification of performance and qualification of equipment, instruments and other devices, analytical worksheet, evaluation of test results, personnel, and validation of analytical procedures. The study indicates that gaps are attributed to differences between the standards of Chinese Accreditation Standards and WHO-GPPQCL.

  13. Utilizing Electronic Health Record Information to Optimize Medication Infusion Devices: A Manual Data Integration Approach.

    PubMed

    Chuk, Amanda; Maloney, Robert; Gawron, Joyce; Skinner, Colin

    Health information technology is increasingly utilized within healthcare delivery systems today. Two examples of this type of technology include the capture of patient-specific information within an electronic health record and intravenous medication infusion devices equipped with dose error reduction software known as drug libraries. Automatic integration of these systems, termed intravenous (IV) interoperability, should serve as the goal toward which all healthcare systems work to maximize patient safety. For institutions lacking IV interoperability, we describe a manual approach of querying the electronic health record to incorporate medication administration information with data from infusion device software to optimize drug library settings. This approach serves to maximize utilization of available information to optimize medication safety provided by drug library software.

  14. Utilizing Electronic Health Record Information to Optimize Medication Infusion Devices: A Manual Data Integration Approach.

    PubMed

    Chuk, Amanda; Maloney, Robert; Gawron, Joyce; Skinner, Colin

    2015-05-23

    Health information technology is increasingly utilized within healthcare delivery systems today. Two examples of this type of technology include the capture of patient-specific information within an electronic health record and intravenous medication infusion devices equipped with dose error reduction software known as drug libraries. Automatic integration of these systems, termed intravenous (IV) interoperability, should serve as the goal toward which all healthcare systems work to maximize patient safety. For institutions lacking IV interoperability, we describe a manual approach of querying the electronic health record to incorporate medication administration information with data from infusion device software to optimize drug library settings. This approach serves to maximize utilization of available information to optimize medication safety provided by drug library software.

  15. Ultrasonic Sensor Placement Optimization in Structural Health Monitoring Using Evolutionary Strategy

    NASA Astrophysics Data System (ADS)

    Gao, H.; Rose, J. L.

    2006-03-01

    In structural health monitoring (SHM), sensor network scale and sensor distribution decisions are critical since sensor network performance and system cost are greatly affected. A quantitative sensor placement optimization method with covariance matrix adaptation evolutionary strategy (CMAES) is presented in this paper. A damage detection probability model is developed for ultrasonic guided wave sensor networks. Two sample problems are presented in this paper. One is for structure with irregular damage distribution probability, and the other is for an E2 aircraft wing section. The reliability of this genetic and evolutionary optimization method is proved in this study. Sensor network configurations with minimum missed-detection probability are obtained from the results of evolutionary optimization. The tradeoff relationship between optimized sensor network performance and the number of sensors is also presented in this paper.

  16. Out-of-School-Time Academic Programs to Improve School Achievement: A Community Guide Health Equity Systematic Review

    PubMed Central

    Knopf, John A.; Hahn, Robert A.; Proia, Krista K.; Truman, Benedict I.; Johnson, Robert L.; Muntaner, Carles; Fielding, Jonathan E.; Jones, Camara Phyllis; Fullilove, Mindy T.; Hunt, Pete C.; Qu, Shuli; Chattopadhyay, Sajal K.; Milstein, Bobby

    2015-01-01

    Context Low-income and minority status in the United States are associated with poor educational outcomes, which, in turn, reduce the long-term health benefits of education. Objective This systematic review assessed the extent to which out-of-school-time academic (OSTA) programs for at-risk students, most of whom are from low-income and racial/ethnic minority families, can improve academic achievement. Because most OSTA programs serve low-income and ethnic/racial minority students, programs may improve health equity. Design Methods of the Guide to Community Preventive Services were used. An existing systematic review assessing the effects of OSTA programs on academic outcomes (Lauer et al 2006; search period 1985–2003) was supplemented with a Community Guide update (search period 2003–2011). Main Outcome Measure Standardized mean difference. Results Thirty-two studies from the existing review and 25 studies from the update were combined and stratified by program focus (ie, reading-focused, math-focused, general academic programs, and programs with minimal academic focus). Focused programs were more effective than general or minimal academic programs. Reading-focused programs were effective only for students in grades K-3. There was insufficient evidence to determine effectiveness on behavioral outcomes and longer-term academic outcomes. Conclusions OSTA programs, particularly focused programs, are effective in increasing academic achievement for at-risk students. Ongoing school and social environments that support learning and development may be essential to ensure the longer-term benefits of OSTA programs. PMID:26062096

  17. Optimal placement of sensors for structural system identification and health monitoring using a hybrid swarm intelligence technique

    NASA Astrophysics Data System (ADS)

    Rama Mohan Rao, A.; Anandakumar, Ganesh

    2007-12-01

    Setting up a health monitoring system for large-scale civil engineering structures requires a large number of sensors and the placement of these sensors is of great significance for such spatially separated large structures. In this paper, we present an optimal sensor placement (OSP) algorithm by treating OSP as a combinatorial optimization problem which is solved using a swarm intelligence technique called particle swarm optimization (PSO). We propose a new hybrid PSO algorithm by combining a self-configurable PSO with the Nelder-Mead algorithm to solve this rather difficult combinatorial problem of OSP. The proposed algorithm aims precisely to achieve the best identification of modal frequencies and mode shapes. Numerical experiments have been carried out by considering civil engineering structures to evaluate the performance of the proposed swarm-intelligence-based OSP algorithm. Numerical studies indicate that the proposed hybrid PSO algorithm generates sensor configurations superior to the conventional iterative information-based approaches which have been popularly used for large structures. Further, the proposed hybrid PSO algorithm exhibits superior convergence characteristics when compared to other PSO counterparts.

  18. Using ant colony optimization on the quadratic assignment problem to achieve low energy cost in geo-distributed data centers

    NASA Astrophysics Data System (ADS)

    Osei, Richard

    There are many problems associated with operating a data center. Some of these problems include data security, system performance, increasing infrastructure complexity, increasing storage utilization, keeping up with data growth, and increasing energy costs. Energy cost differs by location, and at most locations fluctuates over time. The rising cost of energy makes it harder for data centers to function properly and provide a good quality of service. With reduced energy cost, data centers will have longer lasting servers/equipment, higher availability of resources, better quality of service, a greener environment, and reduced service and software costs for consumers. Some of the ways that data centers have tried to using to reduce energy costs include dynamically switching on and off servers based on the number of users and some predefined conditions, the use of environmental monitoring sensors, and the use of dynamic voltage and frequency scaling (DVFS), which enables processors to run at different combinations of frequencies with voltages to reduce energy cost. This thesis presents another method by which energy cost at data centers could be reduced. This method involves the use of Ant Colony Optimization (ACO) on a Quadratic Assignment Problem (QAP) in assigning user request to servers in geo-distributed data centers. In this paper, an effort to reduce data center energy cost involves the use of front portals, which handle users' requests, were used as ants to find cost effective ways to assign users requests to a server in heterogeneous geo-distributed data centers. The simulation results indicate that the ACO for Optimal Server Activation and Task Placement algorithm reduces energy cost on a small and large number of users' requests in a geo-distributed data center and its performance increases as the input data grows. In a simulation with 3 geo-distributed data centers, and user's resource request ranging from 25,000 to 25,000,000, the ACO algorithm was able

  19. The Progress of Nations: The Nations of the World Ranked According to Their Achievements in Child Health, Nutrition, Education, Family Planning, and Progress for Women, 1995.

    ERIC Educational Resources Information Center

    Progress of Nations, 1995

    1995-01-01

    This report brings together the latest available statistics on national achievements in child survival, health, nutrition, education, family planning, and progress for women. Each section contains a commentary, a presentation of related statistics, and a discussion on achievement and disparity. The sections are: (1) Introduction, "Social…

  20. Indigenous Children in Australia: Health, Education and Optimism for the Future

    ERIC Educational Resources Information Center

    Lyons, Zaza; Janca, Aleksandar

    2012-01-01

    In Australia, Indigenous children are disproportionately affected by poor health. The combined consequences of illness and social factors in this population have an adverse affect on educational outcomes for Indigenous children, resulting in lower levels of achievement and attainment compared with non-Indigenous children. From early childhood,…

  1. The study of optimal nursing position in health care delivery system in Iran

    PubMed Central

    Shahshahani, Maryam Sadat; Salehi, Shayesteh; Rastegari, Mohammad; Rezayi, Abdollah

    2010-01-01

    BACKGROUND: In the recent decade, due to the overwhelming importance of health and prevention of diseases, nurses, the greatest part of the health care system, are acting in any position of the health care delivery system; because nursing have a key role in promotion of health and health care everywhere. The objective of this research was to study the desired positions of nursing in the health care delivery system in Iran. METHODS: This was a triangulation study done on three steps during 2005-2007. At the first step, the positions of nurses were elicited out of library and internet sources. At the second step, the comments of 15 participants were collected using an open questionnaire. Thereafter, at the third step, using the collected data, a questionnaire was made for a poll (all over the country) on the optimal positions of nursing in Iran, and 64 participants answered it. The results were analyzed using descriptive statistics. RESULTS: Derived positions were categorized in two groups: hospital, and community positions. The results showed that all positions were accepted more than 70%. CONCLUSIONS: Considering positions of nursing and in order to promote the nursing itself and community health, it is suggested that proper planning should be implemented for nurses’ activities in these positions by health planners. PMID:21589788

  2. ACHIEVING NEW SOURCE PERFORMANCE STANDARDS (NSPS) EMISSION STANDARDS THROUGH INTEGRATION OF LOW-NOx BURNERS WITH AN OPTIMIZATION PLAN FOR BOILER COMBUSTION

    SciTech Connect

    Wayne Penrod; David Moyeda

    2003-07-01

    The objective of this project is to demonstrate the use of an Integrated Combustion Optimization System to achieve NO{sub x} emissions levels in the range of 0.15 to 0.22 lb/MMBtu while simultaneously enabling increased power output. The project consists of the integration of low-NO{sub x} burners and advanced overfire air technology with various process measurement and control devices on the Holcomb Station Unit 1 boiler. The project includes the use of sophisticated neural networks or other artificial intelligence technologies and complex software that can optimize several operating parameters, including NO{sub x} emissions, boiler efficiency, and CO emissions. The program is being performed in three phases. In Phase I, the boiler is being equipped with sensors that can be used to monitor furnace conditions and coal flow to permit improvements in boiler operation. In Phase II, the boiler will be equipped with burner modifications designed to reduce NO{sub x} emissions and automated coal flow dampers to permit on-line fuel balancing. In Phase III, the boiler will be equipped with an overfire air system to permit deep reductions in NO{sub x} emissions to be achieved. Integration of the overfire air system with the improvements made in Phases I and II will permit optimization of the boiler performance, output, and emissions. During this reporting period, efforts were focused on completion of Phase I and Phase II activities. The low-NO{sub x} burner modifications, the coal flow dampers, and the coal flow monitoring system were procured and installed during a boiler outage in March 2003. During this reporting period, optimization tests were performed to evaluate system performance and identify optimum operating conditions for the installed equipment. The overfire air system process design activities and preliminary engineering design were completed.

  3. Supporting Immigrant Family Strengths: Promoting Optimal Health, Health Care, and Development

    ERIC Educational Resources Information Center

    Brotanek, Jane M.; Rocha, Lisa Oglesby; Flores, Glenn

    2008-01-01

    An extensive literature documents that a lower level of acculturation is associated with better health outcomes among U.S. immigrants, despite the many hardships these families face. It is likely that cultural practices and strong family networks contribute to this phenomenon, which has been termed the "healthy immigrant effect". This article…

  4. Technology for monitoring shot-level light source performance data to achieve high-optimization of lithography processes

    NASA Astrophysics Data System (ADS)

    Moriya, Masato; Ochiai, Hideyuki; Watabe, Yoshinobu; Ishida, Keisuke; Masuda, Hiroyuki; Sasaki, Youichi; Kumazaki, Takahito; Kurosu, Akihiko; Ohta, Takeshi; Kakizaki, Kouji; Matsunaga, Takashi; Mizoguchi, Hakaru

    2014-03-01

    Gigaphoton has developed a new monitoring system that provides shot-level light source performance data to FDC systems during exposure time. The system provides basic monitoring data (e.g. Energy, Wavelength, Bandwidth, etc.) and beam performance data, such as Beam Profile, Pointing, Divergence, Polarization can also be monitored using a new metrology tool called the Beam Performance Monitor (BPM) module. During exposure time the system automatically identifies the start and end timing of the wafer and each shot based on the burst of firing signals from the scanner, and stores the measured data in sequence. The stored data is sorted by wafer or by shot, and sent to REDeeM Piece which in turn converts the data to the user's protocol and send it to the FDC system. The user also has the option to directly view or download the stored data using a GUI. Through this monitoring system, users can manage light sources data at the shot or reticle level to facilitate optimization of performance and running cost of the light source for each process. This monitoring system can be easily retrofitted to Gigaphoton's current ArF laser light sources. The beam splitter of the BPM was specially designed to bend only a small fraction of the source beam, so we are able to simply install the BPM without the need for special optical alignment.

  5. Imaging Live Cells at the Nanometer-Scale with Single-Molecule Microscopy: Obstacles and Achievements in Experiment Optimization for Microbiology

    PubMed Central

    Haas, Beth L.; Matson, Jyl S.; DiRita, Victor J.; Biteen, Julie S.

    2015-01-01

    Single-molecule fluorescence microscopy enables biological investigations inside living cells to achieve millisecond- and nanometer-scale resolution. Although single-molecule-based methods are becoming increasingly accessible to non-experts, optimizing new single-molecule experiments can be challenging, in particular when super-resolution imaging and tracking are applied to live cells. In this review, we summarize common obstacles to live-cell single-molecule microscopy and describe the methods we have developed and applied to overcome these challenges in live bacteria. We examine the choice of fluorophore and labeling scheme, approaches to achieving single-molecule levels of fluorescence, considerations for maintaining cell viability, and strategies for detecting single-molecule signals in the presence of noise and sample drift. We also discuss methods for analyzing single-molecule trajectories and the challenges presented by the finite size of a bacterial cell and the curvature of the bacterial membrane. PMID:25123183

  6. Phenotypic flexibility as a measure of health: the optimal nutritional stress response test.

    PubMed

    Stroeve, Johanna H M; van Wietmarschen, Herman; Kremer, Bas H A; van Ommen, Ben; Wopereis, Suzan

    2015-05-01

    Nutrition research is struggling to demonstrate beneficial health effects, since nutritional effects are often subtle and long term. Health has been redefined as the ability of our body to cope with daily-life challenges. Physiology acts as a well-orchestrated machinery to adapt to the continuously changing environment. We term this adaptive capacity "phenotypic flexibility." The phenotypic flexibility concept implies that health can be measured by the ability to adapt to conditions of temporary stress, such as physical exercise, infections or mental stress, in a healthy manner. This may offer a more sensitive way to assess changes in health status of healthy subjects. Here, we performed a systematic review of 61 studies applying different nutritional stress tests to quantify health and nutritional health effects, with the objective to define an optimal nutritional stress test that has the potential to be adopted as the golden standard in nutrition research. To acknowledge the multi-target role of nutrition, a relevant subset of 50 processes that govern optimal health, with high relevance to diet, was used to define phenotypic flexibility. Subsequently, we assessed the response of biomarkers related to this subset of processes to the different challenge tests. Based on the obtained insights, we propose a nutritional stress test composed of a high-fat, high-caloric drink, containing 60 g palm olein, 75 g glucose and 20 g dairy protein in a total volume of 400 ml. The use of such a standardized nutritional challenge test in intervention studies is expected to demonstrate subtle improvements of phenotypic flexibility, thereby enabling substantiation of nutritional health effects.

  7. Optimizing Patient Preparation and Surgical Experience Using eHealth Technology

    PubMed Central

    Forshaw, Kristy; Carey, Mariko; Robinson, Sancha; Kerridge, Ross; Proietto, Anthony; Sanson-Fisher, Rob

    2015-01-01

    With population growth and aging, it is expected that the demand for surgical services will increase. However, increased complexity of procedures, time pressures on staff, and the demand for a patient-centered approach continue to challenge a system characterized by finite health care resources. Suboptimal care is reported in each phase of surgical care, from the time of consent to discharge and long-term follow-up. Novel strategies are thus needed to address these challenges to produce effective and sustainable improvements in surgical care across the care pathway. The eHealth programs represent a potential strategy for improving the quality of care delivered across various phases of care, thereby improving patient outcomes. This discussion paper describes (1) the key functions of eHealth programs including information gathering, transfer, and exchange; (2) examples of eHealth programs in overcoming challenges to optimal surgical care across the care pathway; and (3) the potential challenges and future directions for implementing eHealth programs in this setting. The eHealth programs are a promising alternative for collecting patient-reported outcome data, providing access to credible health information and strategies to enable patients to take an active role in their own health care, and promote efficient communication between patients and health care providers. However, additional rigorous intervention studies examining the needs of potential role of eHealth programs in augmenting patients’ preparation and recovery from surgery, and subsequent impact on patient outcomes and processes of care are needed to advance the field. Furthermore, evidence for the benefits of eHealth programs in supporting carers and strategies to maximize engagement from end users are needed. PMID:26330206

  8. Optimizing bone health and minimizing skeletal morbidity in men with prostate cancer.

    PubMed

    McKay, Rana R; Taplin, Mary-Ellen; Choueiri, Toni K

    2013-12-01

    Maintaining bone health is important in the management of men with prostate cancer. Patients receiving androgen deprivation therapy are at increased risk for treatment-related osteoporosis, and patients with bone metastases are at increased risk for skeletal morbidity related to debilitating skeletal-related events (SREs). Optimizing bone health in these patients includes lifestyle modifications, calcium/vitamin D supplementation, and osteoclast-targeted agents in select high-risk patients. No agent is approved for the prevention of bone metastases. Novel systemic agents have shown a beneficial effect bone by directly affecting tumor growth. Integration of these anticancer agents with osteoclast-targeted agents warrants further investigation.

  9. Achieving the Dream: Health Care...Healthy Kids. Forum on Children's Issues (Century City, California, April 15, 1994). Source Book.

    ERIC Educational Resources Information Center

    Norton Family Foundation, Santa Monica, CA.

    This collection contains materials from various sources on the status of children's health, successful children's health programs, and advocacy for children's health. Section 1 contains: (1) the statement by the Children's Defense Fund (CDF) on maternal and child health needs under national health reform; (2) information on uninsured children,…

  10. Achieving universal health coverage through voluntary insurance: what can we learn from the experience of Lao PDR?

    PubMed Central

    2013-01-01

    Background The Government of Lao Peoples’ Democratic Republic (Lao PDR) has embarked on a path to achieve universal health coverage (UHC) through implementation of four risk-protection schemes. One of these schemes is community-based health insurance (CBHI) – a voluntary scheme that targets roughly half the population. However, after 12 years of implementation, coverage through CBHI remains very low. Increasing coverage of the scheme would require expansion to households in both villages where CBHI is currently operating, and new geographic areas. In this study we explore the prospects of both types of expansion by examining household and district level data. Methods Using a household survey based on a case-comparison design of 3000 households, we examine the determinants of enrolment at the household level in areas where the scheme is currently operating. We model the determinants of enrolment using a probit model and predicted probabilities. Findings from focus group discussions are used to explain the quantitative findings. To examine the prospects for geographic scale-up, we use secondary data to compare characteristics of districts with and without insurance, using a combination of univariate and multivariate analyses. The multivariate analysis is a probit model, which models the factors associated with roll-out of CBHI to the districts. Results The household findings show that enrolment is concentrated among the better off and that adverse selection is present in the scheme. The district level findings show that to date, the scheme has been implemented in the most affluent areas, in closest proximity to the district hospitals, and in areas where quality of care is relatively good. Conclusions The household-level findings indicate that the scheme suffers from poor risk-pooling, which threatens financial sustainability. The district-level findings call into question whether or not the Government of Laos can successfully expand to more remote, less affluent

  11. Near-optimal sensor placement for health monitoring of civil structures

    NASA Astrophysics Data System (ADS)

    van der Linden, Gwendolyn W.; Emami-Naeini, Abbas; Kosut, Robert L.; Sederat, Hassan; Lynch, Jerome P.

    2010-04-01

    In this paper we focus on the optimal placement of sensors for state estimation-based continuous health monitoring of structures using three approaches. The first aims to minimize the static estimation error of the structure deflections, using the linear stiffness matrix derived from a finite element model. The second approach aims to maximize the observability of the derived linear state space model. The third approach aims to minimize the dynamic estimation error of the deflections using a Linear Quadratic Estimator. Both nonlinear mixed-integer and relaxed convex optimization formulations are presented. A simple search-based optimization implementation for each of the three approaches is demonstrated on a model of the long-span New Carquinez Bridge in California.

  12. A Structural Health Monitoring Software Tool for Optimization, Diagnostics and Prognostics

    DTIC Science & Technology

    2011-01-01

    A Structural Health Monitoring Software Tool for Optimization, Diagnostics and Prognostics Seth S . Kessler1, Eric B. Flynn2, Christopher T...technology more accessible, and commercially practical. 1. INTRODUCTION Currently successful laboratory non- destructive testing and monitoring...PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES

  13. Ophthalmologists' practice patterns and challenges in achieving optimal management for glaucoma in Nigeria: results from a nationwide survey

    PubMed Central

    Kyari, Fatima; Nolan, Winifred; Gilbert, Clare

    2016-01-01

    Purpose of the study Glaucoma, a chronic non-communicable disease, and leading cause of irreversible blindness worldwide is a public health problem in Nigeria, with a prevalence of 5.02% in people aged ≥40 years. The purpose of this nationwide survey was to assess Nigerian ophthalmologists’ practice patterns and their constraints in managing glaucoma. Study design Ophthalmologists were sent a semistructured questionnaire on how they manage glaucoma, their training in glaucoma care, where they practice, their access to equipment for diagnosis and treatment, whether they use protocols and the challenges they face in managing patients with glaucoma. Results 153/250 ophthalmologists in 80 centres completed questionnaires. Although 79% felt their training was excellent or good, 46% needed more training in glaucoma diagnosis and surgery. All had ophthalmoscopes, 93% had access to applanation tonometers, 81% to visual field analysers and 29% to laser machines (in 19 centres). 3 ophthalmologists had only ophthalmoscopes and schiøtz tonometers. For 85%, a glaucomatous optic disc was the most important feature that would prompt glaucoma work-up. Only 56% routinely performed gonioscopy and 61% used slit-lamp stereoscopic biomicroscopy for disc assessment. Trabeculectomy (with/without antimetabolites) was the only glaucoma surgery performed with one mention of canaloplasty. Poor compliance with medical treatment (78%) and low acceptance of surgery (71%) were their greatest challenges. Conclusions This study indicates that a systems-oriented approach is required to enhance ophthalmologist's capability for glaucoma care. Strategies to improve glaucoma management include strengthening poorly equipped centres including provision of lasers and training, and improving patients’ awareness and education on glaucoma. PMID:27729348

  14. Are People Healthier If Their Partners Are More Optimistic? The Dyadic Effect of Optimism On Health Among Older Adults

    PubMed Central

    Kim, Eric S.; Chopik, William J.; Smith, Jacqui

    2015-01-01

    Objective Optimism has been linked with an array of positive health outcomes at the individual level. However, researchers have not examined how a spouse's optimism might impact an individual's health. We hypothesized that being optimistic (and having an optimistic spouse) would both be associated with better health. Methods Participants were 3,940 adults (1,970 couples) from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50. Participants were tracked for four years and outcomes included: physical functioning, self-rated health, and number of chronic illnesses. We analyzed the dyadic data using the actor partner interdependence model. Results After controlling for several psychological and demographic factors, a person's own optimism and their spouse's optimism predicted better self-rated health and physical functioning (b's = .08-.25, p's < .01). More optimistic people also reported better physical functioning (b = −.11, p < .01) and fewer chronic illnesses (b = −.01, p < .05) over time. Further, having an optimistic spouse uniquely predicted better physical functioning (b = −.09, p < .01) and fewer chronic illnesses (b = −.01, p < .05) over time. The strength of the relationship between optimism and health did not diminish over time. Conclusions Being optimistic and having an optimistic spouse were both associated with better health. Examining partner effects is important because such analyses reveal the unique role that spouses play in promoting health. These findings may have important implications for future health interventions. PMID:24840138

  15. Achieving Adherence to Evidence-Based Practices: Are Health IT and Hospital-Physician Integration Complementary or Substitutive Strategies?

    PubMed

    Everson, Jordan; Lee, Shoou-Yih Daniel; Adler-Milstein, Julia

    2016-12-01

    In response to evolving policies and conditions, hospitals have increased health information technology (HIT) adoption and strived to improve hospital-physician integration. While evidence suggests that both HIT and integration confer independent benefits, when combined, they may provide complementary means to achieve high performance or overlap to offset each other's contribution. We explore this relationship in the context of hospital adherence to evidence-based practices (EBPs). Using the American Hospital Association's Annual and IT Supplement surveys, and Centers for Medicare and Medicaid Services's Hospital Compare, we estimate the independent relationships and interactions between HIT and hospital-physician integration with respect to EBP adherence. HIT adoption and tight (but not loose) integration are independently associated with greater adherence to EBPs. The interaction between HIT adoption and tight integration is negative, consistent with an offsetting association between HIT adoption and integration in their relationship to EBP adherence. This finding reveals the need to be aware of potential substitutive effects from simultaneous pursuit of multiple approaches to performance improvement.

  16. ACHIEVING NEW SOURCE PERFORMANCE STANDARDS (NSPS) EMISSION STANDARDS THROUGH INTEGRATION OF LOW-NOx BURNERS WITH AN OPTIMIZATION PLAN FOR BOILER COMBUSTION

    SciTech Connect

    Wayne Penrod; David Moyeda

    2003-04-01

    The objective of this project is to demonstrate the use of an Integrated Combustion Optimization System to achieve NO{sub x} emissions levels in the range of 0.15 to 0.22 lb/MMBtu while simultaneously enabling increased power output. The project consists of the integration of low-NO{sub x} burners and advanced overfire air technology with various process measurement and control devices on the Holcomb Station Unit 1 boiler. The project includes the use of sophisticated neural networks or other artificial intelligence technologies and complex software that can optimize several operating parameters, including NO{sub x} emissions, boiler efficiency, and CO emissions. The program is being performed in three phases. In Phase I, the boiler is being equipped with sensors that can be used to monitor furnace conditions and coal flow to permit improvements in boiler operation. In Phase II, the boiler will be equipped with burner modifications designed to reduce NO{sub x} emissions and automated coal flow dampers to permit on-line fuel balancing. In Phase III, the boiler will be equipped with an overfire air system to permit deep reductions in NO{sub x} emissions to be achieved. Integration of the overfire air system with the improvements made in Phases I and II will permit optimization of the boiler performance, output, and emissions. During this reporting period, efforts were focused on Phase I and Phase II activities. The furnace sensors were procured and installed in February 2003. Baseline testing was performed following the sensor installation. The low-NO{sub x} burner modifications, the coal flow dampers, and the coal flow monitoring system were procured and installed during a boiler outage in March 2003. Process design activities were performed to support design of the equipment installed and to develop specifications for the overfire air system. The overfire air system preliminary engineering design was initiated.

  17. The Contextualized Technology Adaptation Process (CTAP): Optimizing Health Information Technology to Improve Mental Health Systems.

    PubMed

    Lyon, Aaron R; Wasse, Jessica Knaster; Ludwig, Kristy; Zachry, Mark; Bruns, Eric J; Unützer, Jürgen; McCauley, Elizabeth

    2016-05-01

    Health information technologies have become a central fixture in the mental healthcare landscape, but few frameworks exist to guide their adaptation to novel settings. This paper introduces the contextualized technology adaptation process (CTAP) and presents data collected during Phase 1 of its application to measurement feedback system development in school mental health. The CTAP is built on models of human-centered design and implementation science and incorporates repeated mixed methods assessments to guide the design of technologies to ensure high compatibility with a destination setting. CTAP phases include: (1) Contextual evaluation, (2) Evaluation of the unadapted technology, (3) Trialing and evaluation of the adapted technology, (4) Refinement and larger-scale implementation, and (5) Sustainment through ongoing evaluation and system revision. Qualitative findings from school-based practitioner focus groups are presented, which provided information for CTAP Phase 1, contextual evaluation, surrounding education sector clinicians' workflows, types of technologies currently available, and influences on technology use. Discussion focuses on how findings will inform subsequent CTAP phases, as well as their implications for future technology adaptation across content domains and service sectors.

  18. Twentieth anniversary of the European Union health mandate: taking stock of perceived achievements, failures and missed opportunities – a qualitative study

    PubMed Central

    2013-01-01

    Background The European Union (EU) health mandate was initially defined in the Maastricht Treaty in 1992. The twentieth anniversary of the Treaty offers a unique opportunity to take stock of EU health actions by giving an overview of influential public health related EU-level policy outputs and a summary of policy outputs or actions perceived as an achievement, a failure or a missed opportunity. Methods Semi-structured expert interviews (N = 20) were conducted focusing on EU-level actions that were relevant for health. Respondents were asked to name EU policies or actions that they perceived as an achievement, a failure or a missed opportunity. A directed content analysis approach was used to identify expert perceptions on achievements, failures and missed opportunities in the interviews. Additionally, a nominal group technique was applied to identify influential and public health relevant EU-level policy outputs. Results The ranking of influential policy outputs resulted in top positions of adjudications and legislations, agencies, European Commission (EC) programmes and strategies, official networks, cooperative structures and exchange efforts, the work on health determinants and uptake of scientific knowledge. The assessment of EU health policies as being an achievement, a failure or a missed opportunity was often characterized by diverging respondent views. Recurring topics that emerged were the Directorate General for Health and Consumers (DG SANCO), EU agencies, life style factors, internal market provisions as well as the EU Directive on patients’ rights in cross-border healthcare. Among these recurring topics, expert perceptions on the establishment of DG SANCO, EU public health agencies, and successes in tobacco control were dominated by aspects of achievements. The implementation status of the Health in All Policy approach was perceived as a missed opportunity. Conclusions When comparing the emerging themes from the interviews conducted with the

  19. Relationship of optimism-pessimism and health-related quality of life in breast cancer survivors.

    PubMed

    Petersen, Larra R; Clark, Matthew M; Novotny, Paul; Kung, Simon; Sloan, Jeff A; Patten, Christi A; Vickers, Kristin S; Rummans, Teresa A; Frost, Marlene H; Colligan, Robert C

    2008-01-01

    Few studies have investigated the influence of optimism-pessimism in breast cancer survivors. This study used a retrospective design with 268 adult women who completed the Minnesota Multiphasic Personality Inventory (MMPI) as part of their medical care approximately 10 years prior to their breast cancer diagnosis and Medical Outcome Study Short-Form General Health Survey (SF-36 or SF-12), on average, 8 years after diagnosis. MMPI pessimism scores were divided into quartiles, and t tests were used to determine differences between those highest and lowest in pessimism on health-related quality-of-life (QOL) measures, demographics, and disease status. The mean age at diagnosis of breast cancer was 63 years, and 74% had early-stage breast cancer. Patients age 65 years and older were significantly lower on physical health related QOL scales. There were no significant differences in health-related QOL scores by stage of disease. Patients with a pessimistic explanatory style were significantly lower on all of the health-related QOL scores, compared to those with a nonpessimistic style. Breast cancer survivors who exhibit a pessimistic explanatory style report lower health-related QOL for years after receiving a cancer diagnosis, compared to nonpessimistic women.

  20. Optimal distribution of medical backpacks and health surveillance assistants in Malawi.

    PubMed

    Kunkel, Amber G; Van Itallie, Elizabeth S; Wu, Duo

    2014-09-01

    Despite recent progress, Malawi continues to perform poorly on key health indicators such as child mortality and life expectancy. These problems are exacerbated by a severe lack of access to health care. Health Surveillance Assistants (HSAs) help bridge this gap by providing community-level access to basic health care services. However, the success of these HSAs is limited by a lack of supplies and long distances between HSAs and patients. To address this issue, we used large-scale weighted p-median and capacitated facility location problems to create a scalable, three-tiered plan for optimal allocation of HSAs, HSA designated medical backpacks, and backpack resupply centers. Our analysis uses real data on the location and characteristics of hospitals, health centers, and the general population. In addition to offering specific recommendations for HSA, backpack, and resupply center locations, it provides general insights into the scope of the proposed HSA backpack program scale-up. In particular, it demonstrates the importance of local health centers to the resupply network. The proposed assignments are robust to changes in the underlying population structure, and could significantly improve access to medical supplies for both HSAs and patients.

  1. Achieving the integrated and smart health and wellbeing paradigm: a call for policy research and action on governance and business models.

    PubMed

    Stroetmann, Karl A

    2013-04-01

    To assure sustainability of our health systems and improve quality, implementing integrated wellness, health and social care service models have been proposed. They will need the enabling power of Health ICT facilitated systems and applications. Such solutions support the efficient coordination of service provision across provider and jurisdictional boundaries, the sharing of data, information and knowledge, and the streamlining as well as individualisation of care. Achieving such change in health systems with limited resources requires refocusing the trend of medico-technical progress. Health ICT innovations must be scrutinised for their potential to indeed contribute not only to decreasing costs, but - at the same time - improving the quality of life and ability to cope with challenges like the increasing prevalence of certain chronic diseases or new expectations from healthy people and patients alike. This paper argues that decision-oriented governance models leading to focused policy interventions are needed at several levels: Governments should provide for comprehensive Health ICT infrastructures to enable provider market success. At the individual actor level, sustainable business models reflecting in their value propositions the expectations of their clients (patients and funders) need to be developed. Health policy should design intelligent reimbursement systems providing incentives to indeed optimise services. Smart health innovations should only be implemented where they help achieve the goal of increasing the productivity of health value chains and the quality of overall service delivery value systems. To assure allocational efficiency, regulatory impact analyses (RIA) can support evidence based policy making.

  2. Spatio-temporal optimization of agricultural practices to achieve a sustainable development at basin level; framework of a case study in Colombia

    NASA Astrophysics Data System (ADS)

    Uribe, Natalia; corzo, Gerald; Solomatine, Dimitri

    2016-04-01

    The flood events present during the last years in different basins of the Colombian territory have raised questions on the sensitivity of the regions and if this regions have common features. From previous studies it seems important features in the sensitivity of the flood process were: land cover change, precipitation anomalies and these related to impacts of agriculture management and water management deficiencies, among others. A significant government investment in the outreach activities for adopting and promoting the Colombia National Action Plan on Climate Change (NAPCC) is being carried out in different sectors and regions, having as a priority the agriculture sector. However, more information is still needed in the local environment in order to assess were the regions have this sensitivity. Also the continuous change in one region with seasonal agricultural practices have been pointed out as a critical information for optimal sustainable development. This combined spatio-temporal dynamics of crops cycle in relation to climate change (or variations) has an important impact on flooding events at basin areas. This research will develop on the assessment and optimization of the aggregated impact of flood events due to determinate the spatio-temporal dynamic of changes in agricultural management practices. A number of common best agricultural practices have been identified to explore their effect in a spatial hydrological model that will evaluate overall changes. The optimization process consists on the evaluation of best performance in the agricultural production, without having to change crops activities or move to other regions. To achieve this objectives a deep analysis of different models combined with current and future climate scenarios have been planned. An algorithm have been formulated to cover the parametric updates such that the optimal temporal identification will be evaluated in different region on the case study area. Different hydroinformatics

  3. Strengthening Health Systems to Accelerate Achievement of Millennium Development Goals 4 and 5: A Case Study of Ketu South and Keta Municipalities in Ghana.

    PubMed

    Iddrisu, Farouk Adam; Dhakal, Sarita; Nam, Eun Woo

    2015-06-01

    This study aims to determine means of strengthening the health system to accelerate achievement of MDGs 4 and 5 in the Volta Region of Ghana, with a particular emphasis in the Ketu South and Keta municipalities. Secondary data have been used in this study. High maternal and infant mortality is a crucial issue in Ghana. Maternal and infant mortality is high in rural area compared to urban area due to unavailability of the service facilities. A community based health planning and services programs have been established to improve access and quality of health care in Ghana. Our study suggests that health system strengthening with community health care programs improved access to quality health care and resulted in a decrease of maternal and child mortality in Ketu South and Keta Municipalities in Ghana.

  4. Specialty Task Force: A Strategic Component to Electronic Health Record (EHR) Optimization.

    PubMed

    Romero, Mary Rachel; Staub, Allison

    2016-01-01

    Post-implementation stage comes after an electronic health record (EHR) deployment. Analyst and end users deal with the reality that some of the concepts and designs initially planned and created may not be complementary to the workflow; creating anxiety, dissatisfaction, and failure with early adoption of system. Problems encountered during deployment are numerous and can vary from simple to complex. Redundant ticket submission creates backlog for Information Technology personnel resulting in delays in resolving concerns with EHR system. The process of optimization allows for evaluation of system and reassessment of users' needs. A solid and well executed optimization infrastructure can help minimize unexpected end-user disruptions and help tailor the system to meet regulatory agency goals and practice standards. A well device plan to resolve problems during post implementation is necessary for cost containment and to streamline communication efforts. Creating a specialty specific collaborative task force is efficacious and expedites resolution of users' concerns through a more structured process.

  5. Strategy to Achieve Highly Porous/Biocompatible Macroscale Cell Blocks, Using a Collagen/Genipin-bioink and an Optimal 3D Printing Process.

    PubMed

    Kim, Yong Bok; Lee, Hyeongjin; Kim, Geun Hyung

    2016-11-30

    Recently, a three-dimensional (3D) bioprinting process for obtaining a cell-laden structure has been widely applied because of its ability to fabricate biomimetic complex structures embedded with and without cells. To successfully obtain a cell-laden porous block, the cell-delivering vehicle, bioink, is one of the significant factors. Until now, various biocompatible hydrogels (synthetic and natural biopolymers) have been utilized in the cell-printing process, but a bioink satisfying both biocompatibility and print-ability requirements to achieve a porous structure with reasonable mechanical strength has not been issued. Here, we propose a printing strategy with optimal conditions including a safe cross-linking procedure for obtaining a 3D porous cell block composed of a biocompatible collagen-bioink and genipin, a cross-linking agent. To obtain the optimal processing conditions, we modified the 3D printing machine and selected an optimal cross-linking condition (∼1 mM and 1 h) of genipin solution. To show the feasibility of the process, 3D pore-interconnected cell-laden constructs were manufactured using osteoblast-like cells (MG63) and human adipose stem cells (hASCs). Under these processing conditions, a macroscale 3D collagen-based cell block of 21 × 21 × 12 mm(3) and over 95% cell viability was obtained. In vitro biological testing of the cell-laden 3D porous structure showed that the embedded cells were sufficiently viable, and their proliferation was significantly higher; the cells also exhibited increased osteogenic activities compared to the conventional alginate-based bioink (control). The results indicated the fabrication process using the collagen-bioink would be an innovative platform to design highly biocompatible and mechanically stable cell blocks.

  6. Achieving New Source Performance Standards (NSPS) Emission Standards Through Integration of Low-NOx Burners with an Optimization Plan for Boiler Combustion

    SciTech Connect

    Wayne Penrod

    2006-12-31

    The objective of this project was to demonstrate the use of an Integrated Combustion Optimization System to achieve NO{sub X} emission levels in the range of 0.15 to 0.22 lb/MMBtu while simultaneously enabling increased power output. The project plan consisted of the integration of low-NO{sub X} burners and advanced overfire air technology with various process measurement and control devices on the Holcomb Station Unit 1 boiler. The plan included the use of sophisticated neural networks or other artificial intelligence technologies and complex software to optimize several operating parameters, including NO{sub X} emissions, boiler efficiency, and CO emissions. The program was set up in three phases. In Phase I, the boiler was equipped with sensors that can be used to monitor furnace conditions and coal flow to permit improvements in boiler operation. In Phase II, the boiler was equipped with burner modifications designed to reduce NO{sub X} emissions and automated coal flow dampers to permit on-line fuel balancing. In Phase III, the boiler was to be equipped with an overfire air system to permit deep reductions in NO{sub X} emissions. Integration of the overfire air system with the improvements made in Phases I and II would permit optimization of boiler performance, output, and emissions. This report summarizes the overall results from Phases I and II of the project. A significant amount of data was collected from the combustion sensors, coal flow monitoring equipment, and other existing boiler instrumentation to monitor performance of the burner modifications and the coal flow balancing equipment.

  7. Optimal and safe standard doses of midazolam and propofol to achieve patient and doctor satisfaction with dental treatment: A prospective cohort study

    PubMed Central

    Nonaka, Mutsumi; Nishimura, Akiko; Gotoh, Kinuko; Oka, Shuichirou; Iijima, Takehiko

    2017-01-01

    Background The incidences of morbidity and mortality caused by pharmacosedation for dental treatment have not yet reached zero. Adverse events are related to inappropriate respiratory management, mostly originating from an overdose of sedatives. Since sedation is utilized for the satisfaction of both the dentist and the patient, the optimal dose should be minimized to prevent adverse events. We attempted to define the optimal doses of midazolam and propofol required to achieve high levels of patient and dentist satisfaction. Methods One thousand dental patients, including those undergoing third molar extractions, were enrolled in this study. A dose of 1 mg of midazolam was administered at 1-minute intervals until adequate sedation was achieved. Propofol was then infused continuously to maintain the sedation level. Both the patients and the dentists were subsequently interviewed and asked to complete a questionnaire. A multivariate logistic regression analysis was used to examine the factors that contributed to patient and dentist satisfaction. Results The peak midazolam dose resulting in the highest percentage of patient satisfaction was 3 mg. Both a lower dose and a higher dose reduced patient satisfaction. Patient satisfaction increased with an increasing dosage of propofol up until 4 mg/kg/hr, reaching a peak of 78.6%. The peak midazolam dose resulting in the highest percentage of dentist satisfaction (78.8%) was 2 mg. Incremental propofol doses reduced dentist satisfaction, in contrast to their effect on patient satisfaction. The strongest independent predictors of patient satisfaction and dentist satisfaction were no intraoperative memory (OR, 5.073; 95% CI, 3.532–7.287; P<0.001) and unintentional movements by the patient (OR, 0.035; 95% CI, 0.012–0.104; P<0.001), respectively. No serious adverse events were reported. Conclusion We found that 3 mg of midazolam and 3 mg/kg/hr of propofol may be the optimal doses for maximizing both patient and dentist

  8. To Evaluate the Effectiveness of Achievement Motivation Training for Mental Patients Being Rehabilitated to the Community: Goal Planning in Mental Health Rehabilitation.

    ERIC Educational Resources Information Center

    Houts, Peter S.; Scott, Robert A.

    A project sought to identify how the strategies used in training programs for the development of achievement motivation could be applied to the field of mental health. In addition to using goal planning in all its aspects, if focused on the patients' strengths rather than their problems. It also trained the staff who worked with the patients…

  9. Assessing the Impact of School-Based Health Centers on Academic Achievement and College Preparation Efforts: Using Propensity Score Matching to Assess School-Level Data in California

    ERIC Educational Resources Information Center

    Bersamin, Melina; Garbers, Samantha; Gaarde, Jenna; Santelli, John

    2016-01-01

    This study examines the association between school-based health center (SBHC) presence and school-wide measures of academic achievement and college preparation efforts. Publicly available educational and demographic data from 810 California public high schools were linked to a list of schools with an SBHC. Propensity score matching, a method to…

  10. The Progress of Nations: The Nations of the World Ranked According to Their Achievements in Child Health, Nutrition, Education, Family Planning, and Progress for Women, 1994.

    ERIC Educational Resources Information Center

    Adamson, Peter, Ed.

    1994-01-01

    This report brings together the latest available statistics to record national achievements in child survival, health, nutrition, education, family planning, and progress for women. Each section contains a commentary and a presentation of related statistics. The commentaries of the report are: (1) Introduction, "One Small Step for a…

  11. The Progress of Nations: The Nations of the World Ranked According to Their Achievements in Child Health, Nutrition, Education, Water and Sanitation, and Progress for Women, 1997.

    ERIC Educational Resources Information Center

    United Nations Children's Fund, New York, NY.

    This report summarizes the latest available statistics on international achievements in child survival, health, nutrition, education, water and sanitation, and the plight of women. Each section contains a commentary, related statistics, and a discussion on progress and disparity in the section's particular area. Following a foreword by United…

  12. The Progress of Nations, 1996: The Nations of the World Ranked According to Their Achievements in Child Health, Nutrition, Education, Family Planning, and Progress for Women.

    ERIC Educational Resources Information Center

    Adamson, Peter, Ed.

    This report brings together the latest available statistics to record national achievements in child survival, health, nutrition, education, family planning, and progress for women. Each section contains a commentary and a presentation of related statistics. Following an introduction by UNICEF executive director Carol Bellamy, the commentaries…

  13. Health Behavior and Academic Achievement among Adolescents: The Relative Contribution of Dietary Habits, Physical Activity, Body Mass Index, and Self-Esteem

    ERIC Educational Resources Information Center

    Kristjansson, Alfgeir Logi; Sigfusdottir, Inga Dora; Allegrante, John P.

    2010-01-01

    This study tested a structural equation model to estimate the relationship between health behaviors, body mass index (BMI), and self-esteem and the academic achievement of adolescents. The authors analyzed survey data from the 2000 study of "Youth in Iceland", a population-based, cross-sectional sample of 6,346 adolescents in Iceland.…

  14. Perceptions of high-achieving African American/Black tenth graders from a low socioeconomic community regarding health scientists and desired careers.

    PubMed

    Boekeloo, Bradley; Randolph, Suzanne; Timmons-Brown, Stephanie; Wang, Min Qi

    2014-08-01

    Measures are needed to assess youth perceptions about health science careers to facilitate research aimed at increasing youth pursuit of health science. Although the Indiana Instrument provides an established measure of perceptions regarding nursing and ideal careers, we were interested in learning how high-achieving 10th graders from relatively low socioeconomic areas who identify as black/African American (black) perceive health science and ideal careers. The Indiana Instrument was modified, administered to 90 youth of interest, and psychometrically analyzed. Reliable subscales were identified that may facilitate parsimonious, theoretical, and reliable study of youth decision-making regarding health science careers. Such research may help to develop and evaluate strategies for increasing the number of minority health scientists.

  15. Perceptions of High Achieving African American/Black 10th Graders from a Low Socioeconomic Community Regarding Health Scientists and Desired Careers

    PubMed Central

    Boekeloo, Bradley; Randolph, Suzanne; Timmons-Brown, Stephanie; Wang, Min Qi

    2014-01-01

    Measures are needed to assess youth perceptions about health science careers to facilitate research aimed at facilitating youth pursuit of health science. Although the Indiana Instrument provides an established measure of perceptions regarding nursing and ideal careers, we were interested in learning how high achieving 10th graders from relatively low socioeconomic areas who identify as Black/African American (Black) perceive health science and ideal careers. The Indiana Instrument was modified, administered to 90 youth of interest, and psychometrically analyzed. Reliable subscales were identified that may facilitate parsimonious, theoretical, and reliable study of youth decision-making regarding health science careers. Such research may help to develop and evaluate strategies for increasing the number of minority health scientists. PMID:25194058

  16. The Department of Defense Plan to Achieve the Vision of the DoD Task Force on Mental Health

    DTIC Science & Technology

    2007-09-01

    that in the world of psychological health, as with physical health, “an ounce of prevention is worth a pound of cure .” In that vein, we will conduct a...acute psychosis , and substance use disorders readily available across DoD and VA. • Emphasize use of existing DoD/VA Clinical Practice Guidelines on...PTSD, major depressive disorder, psychosis , and substance use disorders through policy memo. ü Continue VA/DoD partnership to train mental health

  17. PLAN or get SLAM'ed: Optimal management of invasive species in the presence of indirect health externalities.

    PubMed

    Jones, Benjamin A; McDermott, Shana M; Chermak, Janie M

    2016-09-15

    This paper examines invasive species management when invasive species impact health outcomes indirectly through changes to environmental quality. For example, the emerald ash borer (EAB) has destroyed millions of ash trees throughout North America and has the potential to impact rates of cardiorespiratory mortality and morbidity through ash trees' ability to capture airborne pollutants. Optimal management inclusive of indirect health externalities may be different than status quo plans because the links between nature and health are complex, dynamic, and spatially heterogeneous. We produce a novel dynamic bioeconomic-health model to determine optimal EAB management in the face of such health effects. Our results show that including health increases net benefits of management substantially and that a "one size fits all" management approach is suboptimal given forest cover and demographic spatial heterogeneity. Net benefits to society are 873% higher and air pollution related mortality incidence is 82% lower when health externalities are included in management profiles using insecticide treatments and non-ash tree preemptive plantings without removal. Additionally, constrained managers optimally substitute toward preemptive tree plantings and away from insecticide use in the presence of indirect health externalities as a way to minimize disruptions to air quality. This paper has policy implications for the optimal management of environmental amenities.

  18. Framework for Smart Electronic Health Record-Linked Predictive Models to Optimize Care for Complex Digestive Diseases

    DTIC Science & Technology

    2013-06-01

    AD_________________ Award Number: W81XWH-11-2-0133 TITLE: Framework for Smart Electronic Health...NUMBER Framework for Smart Electronic Health Record-Linked Predictive Models to Optimize Care for Complex Digestive Diseases 5b. GRANT NUMBER...an intelligent workspace , by displaying annotation forms and de-identified reports with the same view, automatic report queuing and providing easy

  19. The public health implications of United Kingdom offender healthcare policy: a holistic approach to achieve individual and societal gains.

    PubMed

    Senior, Jane; Shaw, Jenny

    2011-01-01

    In 2009, two seminal documents were published by the United Kingdom (UK) government concerning healthcare services for offenders. The Bradley review into diversion for people with mental health problems and learning disabilities emphasised a need to improve offender health, not least because of the high economic costs to society as a whole resulting from unresolved mental illness, physical ill-health and substance abuse problems commonly experienced by offenders. The Bradley review made wide-reaching recommendations for change, requiring strong partnership between health and justice agencies at both central government and local levels. A framework for the delivery of Bradley's recommendations has been set out in Improving health, supporting justice, the Department of Health's offender health strategy which sets out the direction of travel for the next 10 years. This paper discusses the reality of working toward improving health services for this marginalised group in the context of the influence of the current straitened financial climate on the allocation of resources to publically funded healthcare in the UK; it examines the historically based, and widely held, belief in the principle of "less eligibility" within our society, whereby there is much public and media resistance to allocating resources to improving care for offenders when other, more "deserving", groups are perceived to be in continuing need.

  20. The Effects of Health and Wellness on Academic Achievement and Cognitive Ability in Students Attending Seventh-Day Adventist Schools

    ERIC Educational Resources Information Center

    Williams, Patricia C.

    2011-01-01

    Healthful living has been a cornerstone of Seventh-day Adventist belief and practice almost from the very beginning of the church's history. The problem was that no one had studied the role healthful practices play in Seventh-day Adventist education using the entire Seventh-day Adventist student population. The correlations between four aspects of…

  1. A triaxial accelerometer monkey algorithm for optimal sensor placement in structural health monitoring

    NASA Astrophysics Data System (ADS)

    Jia, Jingqing; Feng, Shuo; Liu, Wei

    2015-06-01

    Optimal sensor placement (OSP) technique is a vital part of the field of structural health monitoring (SHM). Triaxial accelerometers have been widely used in the SHM of large-scale structures in recent years. Triaxial accelerometers must be placed in such a way that all of the important dynamic information is obtained. At the same time, the sensor configuration must be optimal, so that the test resources are conserved. The recommended practice is to select proper degrees of freedom (DOF) based upon several criteria and the triaxial accelerometers are placed at the nodes corresponding to these DOFs. This results in non-optimal placement of many accelerometers. A ‘triaxial accelerometer monkey algorithm’ (TAMA) is presented in this paper to solve OSP problems of triaxial accelerometers. The EFI3 measurement theory is modified and involved in the objective function to make it more adaptable in the OSP technique of triaxial accelerometers. A method of calculating the threshold value based on probability theory is proposed to improve the healthy rate of monkeys in a troop generation process. Meanwhile, the processes of harmony ladder climb and scanning watch jump are proposed and given in detail. Finally, Xinghai NO.1 Bridge in Dalian is implemented to demonstrate the effectiveness of TAMA. The final results obtained by TAMA are compared with those of the original monkey algorithm and EFI3 measurement, which show that TAMA can improve computational efficiency and get a better sensor configuration.

  2. Pharmacodynamic effects of cangrelor and clopidogrel: the platelet function substudy from the cangrelor versus standard therapy to achieve optimal management of platelet inhibition (CHAMPION) trials.

    PubMed

    Angiolillo, Dominick J; Schneider, David J; Bhatt, Deepak L; French, William J; Price, Matthew J; Saucedo, Jorge F; Shaburishvili, Tamaz; Huber, Kurt; Prats, Jayne; Liu, Tiepu; Harrington, Robert A; Becker, Richard C

    2012-07-01

    Cangrelor is an intravenous antagonist of the P2Y(12) receptor characterized by rapid, potent, predictable, and reversible platelet inhibition. However, cangrelor was not superior to clopidogrel in reducing the incidence of ischemic events in the cangrelor versus standard therapy to achieve optimal management of platelet inhibition (CHAMPION) trials. A prospectively designed platelet function substudy was performed in a selected cohort of patients to provide insight into the pharmacodynamic effects of cangrelor, particularly in regard to whether cangrelor therapy may interfere with the inhibitory effects of clopidogrel. This pre-defined substudy was conducted in a subset of patients from the CHAMPION-PCI trial (n = 230) comparing cangrelor with 600 mg of clopidogrel administered before percutaneous coronary intervention (PCI) and from the CHAMPION-PLATFORM trial (n = 4) comparing cangrelor at the time of PCI and 600 mg clopidogrel given after the PCI. Pharmacodynamic measures included P2Y12 reaction units (PRU) assessed by VerifyNow P2Y12 testing (primary endpoint marker), platelet aggregation by light transmittance aggregometry following 5 and 20 μmol/L adenosine diphosphate stimuli, and markers of platelet activation determined by flow cytometry. The primary endpoint was the percentage of patients who achieved <20 % change in PRU between baseline and >10 h after PCI. The main trial was stopped early limiting enrollment in the platelet substudy. A total of 167 patients had valid pharmacodynamic assessments for the primary endpoint. The percent of individuals achieving <20 % change in PRU between baseline and >10 h after PCI was higher with cangrelor + clopidogrel (32/84, 38.1 %) compared with placebo + clopidogrel (21/83, 25.3 %), but this was not statistically significant (difference:12.79 %, 95 % CI: -1.18 %, 26.77 %;p = 0.076). All pharmacodynamic markers as well as the prevalence of patients with high on-treatment platelet reactivity were significantly lower

  3. The special programme of research in human reproduction: forty years of activities to achieve reproductive health for all.

    PubMed

    Benagiano, Giuseppe; d'Arcangues, Catherine; Harris Requejo, Jennifer; Schafer, Alessandra; Say, Lale; Merialdi, Mario

    2012-01-01

    The Special Programme of Research in Human Reproduction (HRP), co-sponsored by the UNDP, UNFPA, WHO, and the World Bank, is celebrating 40 years of activities with an expansion of its mandate and new co-sponsors. When it began, in 1972, the main focus was on evaluating the acceptability, effectiveness, and safety of existing fertility-regulating methods, as well as developing new, improved modalities for family planning. In 1994, HRP not only made major contributions to the Plan of Action of the International Conference on Population and Development (ICPD); it also broadened its scope of work to include other aspects of health dealing with sexuality and reproduction, adding a specific perspective on gender issues and human rights. In 2002, HRP's mandate was once again broadened to include sexually transmitted infections and HIV/AIDS and in 2003 it was further expanded to research activities on preventing violence against women and its many dire health consequences. Today, the work of the Programme includes research on: the sexual and reproductive health of adolescents, women, and men; maternal and perinatal health; reproductive tract and sexually transmitted infections (including HIV/AIDS); family planning; infertility; unsafe abortion; sexual health; screening for cancer of the cervix in developing countries, and gender and reproductive rights. Additional activities by the Programme have included: fostering international cooperation in the field of human reproduction; the elaboration of WHO's first Global Reproductive Health Strategy; work leading to the inclusion of ICPD's goal 'reproductive health for all by 2015' into the Millennium Development Goal framework; the promotion of critical interagency statements on the public health, legal, and human rights implications of female genital mutilation and gender-biased sex selection. Finally, HRP has been involved in the creation of guidelines and tools, such as the 'Medical eligibility criteria for contraceptive use

  4. A simulation modeling framework to optimize programs using financial incentives to motivate health behavior change

    PubMed Central

    Basu, Sanjay; Kiernan, Michaela

    2015-01-01

    Introduction While increasingly popular among mid- to large-size employers, using financial incentives to induce health behavior change among employees has been controversial, in part due to poor quality and generalizability of studies to date. Thus, fundamental questions have been left unanswered: to generate positive economic returns on investment, what level of incentive should be offered for any given type of incentive program and among which employees? Methods We constructed a novel modeling framework that systematically identifies how to optimize marginal return on investment from programs incentivizing behavior change by integrating commonly-collected data on health behaviors and associated costs. We integrated “demand curves” capturing individual differences in response to any given incentive with employee demographic and risk factor data. We also estimated the degree of self-selection that could be tolerated, i.e., the maximum percentage of already-healthy employees who could enroll in a wellness program while still maintaining positive absolute return on investment. In a demonstration analysis, the modeling framework was applied to data from 3,000 worksite physical activity programs across the nation. Results For physical activity programs, the incentive levels that would optimize marginal return on investment ($367/employee/year) were higher than average incentive levels currently offered ($143/employee/year). Yet a high degree of self-selection could undermine the economic benefits of the program; if more than 17% of participants came from the top 10% of the physical activity distribution, the cost of the program would be expected to always be greater than its benefits. Discussion Our generalizable framework integrates individual differences in behavior and risk to systematically estimate the incentive level that optimizes marginal return on investment. PMID:25977362

  5. An Efficient Taguchi Approach for the Performance Optimization of Health, Safety, Environment and Ergonomics in Generation Companies

    PubMed Central

    Azadeh, Ali; Sheikhalishahi, Mohammad

    2014-01-01

    Background A unique framework for performance optimization of generation companies (GENCOs) based on health, safety, environment, and ergonomics (HSEE) indicators is presented. Methods To rank this sector of industry, the combination of data envelopment analysis (DEA), principal component analysis (PCA), and Taguchi are used for all branches of GENCOs. These methods are applied in an integrated manner to measure the performance of GENCO. The preferred model between DEA, PCA, and Taguchi is selected based on sensitivity analysis and maximum correlation between rankings. To achieve the stated objectives, noise is introduced into input data. Results The results show that Taguchi outperforms other methods. Moreover, a comprehensive experiment is carried out to identify the most influential factor for ranking GENCOs. Conclusion The approach developed in this study could be used for continuous assessment and improvement of GENCO's performance in supplying energy with respect to HSEE factors. The results of such studies would help managers to have better understanding of weak and strong points in terms of HSEE factors. PMID:26106505

  6. Closing the health and nutrition gap in Odisha, India: A case study of how transforming the health system is achieving greater equity.

    PubMed

    Thomas, Deborah; Sarangi, Biraj Laxmi; Garg, Anu; Ahuja, Arti; Meherda, Pramod; Karthikeyan, Sujata R; Joddar, Pinaki; Kar, Rajendra; Pattnaik, Jeetendra; Druvasula, Ramesh; Dembo Rath, Alison

    2015-11-01

    Health equity is high on the international agenda. This study provides evidence of how health systems can be strengthened to improve health equity in a low-income state. The paper presents a case study of how the Government of Odisha in eastern India is transforming the health system for more equitable health and nutrition outcomes. Odisha has a population of over 42 million, high levels of poverty, and poor maternal and child health concentrated in its Southern districts and among Scheduled Tribe and Scheduled Caste communities. Conducted between 2008 and 2012 with the Departments of Health and Family Welfare, and Women and Child Development, the study reviewed a wide range of literature including policy and programme documents, evaluations and studies, published and grey material, and undertook secondary analysis of state level household surveys. It identifies innovative and expanded provision of health services, reforms to the management and development of human resources for health, and the introduction of a number of cash transfer and entitlement schemes as contributing to closing the gap between maternal and child health and nutrition outcomes of Scheduled Tribes, and the Southern districts, compared to the state average. The institutional delivery rate for Scheduled Tribes has risen from 11.7% in 2005-06 to 67.3% in 2011, and from 35.6% to 79.8% for all women. The social gradient has also closed for antenatal and postnatal care and immunisation. Nutrition indicators though improving are proving slower to budge. The paper identifies how political will, committed policy makers and fiscal space energised the health system to promote equity. Sustained political commitment will be required to continue to address the more challenging human resource, health financing and gender issues.

  7. Minimizing the health and climate impacts of emissions from heavy-duty public transportation bus fleets through operational optimization.

    PubMed

    Gouge, Brian; Dowlatabadi, Hadi; Ries, Francis J

    2013-04-16

    In contrast to capital control strategies (i.e., investments in new technology), the potential of operational control strategies (e.g., vehicle scheduling optimization) to reduce the health and climate impacts of the emissions from public transportation bus fleets has not been widely considered. This case study demonstrates that heterogeneity in the emission levels of different bus technologies and the exposure potential of bus routes can be exploited though optimization (e.g., how vehicles are assigned to routes) to minimize these impacts as well as operating costs. The magnitude of the benefits of the optimization depend on the specific transit system and region. Health impacts were found to be particularly sensitive to different vehicle assignments and ranged from worst to best case assignment by more than a factor of 2, suggesting there is significant potential to reduce health impacts. Trade-offs between climate, health, and cost objectives were also found. Transit agencies that do not consider these objectives in an integrated framework and, for example, optimize for costs and/or climate impacts alone, risk inadvertently increasing health impacts by as much as 49%. Cost-benefit analysis was used to evaluate trade-offs between objectives, but large uncertainties make identifying an optimal solution challenging.

  8. Operational research in primary health care planning: a theoretical model for estimating the coverage achieved by different distributions of staff and facilities

    PubMed Central

    Kemball-Cook, D.; Vaughan, J. P.

    1983-01-01

    This report outlines a basic operational research model for estimating the coverage achieved by different distributions of primary health care staff and facilities, using antenatal home visiting as an illustrative example. Coverage is estimated in terms of the average number of patient contacts achieved per annum. The model takes into account such features as number of facilities and health workers per 10 000 population, the radius of the health facility area, the overall population density in the region, the number of working days in the year, and the health worker's travelling time and work rate. A theoretical planning situation is also presented, showing the application of the model in defining various possible strategies, using certain planning norms for new levels of staff and facilities. This theoretical model is presented as an example of the use of operational research in primary health care, but it requires to be tested and validated in known situations before its usefulness can be assessed. Some indications are given of the ways in which the model could be adapted and improved for application to a real planning situation. PMID:6602666

  9. Outcomes achieved by and police and clinician perspectives on a joint police officer and mental health clinician mobile response unit.

    PubMed

    Lee, Stuart J; Thomas, Phillipa; Doulis, Chantelle; Bowles, Doug; Henderson, Kathryn; Keppich-Arnold, Sandra; Perez, Eva; Stafrace, Simon

    2015-12-01

    Despite their limited mental health expertise, police are often first to respond to people experiencing a mental health crisis. Often the person in crisis is then transported to hospital for care, instead of receiving more immediate assessment and treatment in the community. The current study conducted an evaluation of an Australian joint police-mental health mobile response unit that aimed to improve the delivery of a community-based crisis response. Activity data were audited to demonstrate utilization and outcomes for referred people. Police officers and mental health clinicians in the catchment area were also surveyed to measure the unit's perceived impact. During the 6-month pilot, 296 contacts involving the unit occurred. Threatened suicide (33%), welfare concerns (22%) and psychotic episodes (18%) were the most common reasons for referral. The responses comprised direct admission to a psychiatric unit for 11% of contacts, transportation to a hospital emergency department for 32% of contacts, and community management for the remainder (57%). Police officers were highly supportive of the model and reported having observed benefits of the unit for consumers and police and improved collaboration between services. The joint police-mental health clinician unit enabled rapid delivery of a multi-skilled crisis response in the community.

  10. An international comparative public health analysis of sex trafficking of women and girls in eight cities: achieving a more effective health sector response.

    PubMed

    Macias Konstantopoulos, Wendy; Ahn, Roy; Alpert, Elaine J; Cafferty, Elizabeth; McGahan, Anita; Williams, Timothy P; Castor, Judith Palmer; Wolferstan, Nadya; Purcell, Genevieve; Burke, Thomas F

    2013-12-01

    Sex trafficking, trafficking for the purpose of forced sexual exploitation, is a widespread form of human trafficking that occurs in all regions of the world, affects mostly women and girls, and has far-reaching health implications. Studies suggest that up to 50 % of sex trafficking victims in the USA seek medical attention while in their trafficking situation, yet it is unclear how the healthcare system responds to the needs of victims of sex trafficking. To understand the intersection of sex trafficking and public health, we performed in-depth qualitative interviews among 277 antitrafficking stakeholders across eight metropolitan areas in five countries to examine the local context of sex trafficking. We sought to gain a new perspective on this form of gender-based violence from those who have a unique vantage point and intimate knowledge of push-and-pull factors, victim health needs, current available resources and practices in the health system, and barriers to care. Through comparative analysis across these contexts, we found that multiple sociocultural and economic factors facilitate sex trafficking, including child sexual abuse, the objectification of women and girls, and lack of income. Although there are numerous physical and psychological health problems associated with sex trafficking, health services for victims are patchy and poorly coordinated, particularly in the realm of mental health. Various factors function as barriers to a greater health response, including low awareness of sex trafficking and attitudinal biases among health workers. A more comprehensive and coordinated health system response to sex trafficking may help alleviate its devastating effects on vulnerable women and girls. There are numerous opportunities for local health systems to engage in antitrafficking efforts while partnering across sectors with relevant stakeholders.

  11. Benefits and requirements of vitamin D for optimal health: a review.

    PubMed

    Grant, William B; Holick, Micael F

    2005-06-01

    Vitamin D sufficiency is required for optimal health. The conditions with strong evidence for a protective effect of vitamin D include several bone diseases, muscle weakness, more than a dozen types of internal cancers, multiple sclerosis, and type 1 diabetes mellitus. There is also weaker evidence for several other diseases and conditions. There are good reasons that vitamin D sufficiency be maintained during all stages of life, from fetal development to old age. Adequate calcium intake is also recommended. The current vitamin D requirements in the United States are based on protection against bone diseases. These guidelines are being revised upward in light of new findings, especially for soft-tissue health. The consensus of scientific understanding appears to be that vitamin D deficiency is reached for serum 25-hydroxyvitamin D (25OHD) levels less than 20 ng/mL (50 nmol/L), insufficiency in the range from 20-32 ng/mL, and sufficiency in the range from 33-80 ng/mL, with normal in sunny countries 54-90 ng/mL, and excess greater than 100 ng/mL. Solar ultraviolet-B (UVB) irradiation is the primary source of vitamin D for most people. In general, the health benefits accruing from moderate UV irradiation, without erythema or excess tanning, greatly outweigh the health risks, with skin pigmentation (melanin) providing much of the protection. In the absence of adequate solar UVB irradiation due to season, latitude, or lifestyle, vitamin D can be obtained from fortified food, oily fish, vitamin D supplements, and artificial sources of UVB radiation.

  12. Health Instruction Packages: Test-Taking Strategies for the N. L. N. (National League of Nursing) Achievement Tests.

    ERIC Educational Resources Information Center

    Bateman, Leslie Miller

    As an informational aid for students who are planning to take NLN (National League of Nursing) Achievement Tests, the text and accompanying exercises in this module describe NLN testing procedures and fundamental test-taking skills. After introductory material discussing the importance of mastering test-taking skills, the module describes how to…

  13. The Effects of Learning Styles and Meaningful Learning on the Learning Achievement of Gamification Health Education Curriculum

    ERIC Educational Resources Information Center

    Fan, Kuo-Kuang; Xiao, Peng-wei; Su, Chung-Ho

    2015-01-01

    This study aims to discuss the correlations among learning styles, meaningful learning, and learning achievement. Directed at the rather difficult to comprehend human blood circulation unit in the biology materials for junior high school students, a Mobile Meaningful Blood Circulation Learning System, called MMBCLS gamification learning, was…

  14. Maternal Perinatal Mental Health and Offspring Academic Achievement at Age 16: The Mediating Role of Childhood Executive Function

    ERIC Educational Resources Information Center

    Pearson, Rebecca M.; Bornstein, Marc H.; Cordero, Miguel; Scerif, Gaia; Mahedy, Liam; Evans, Jonathan; Abioye, Abu; Stein, Alan

    2016-01-01

    Background: Elucidating risk pathways for under-achieving at school can inform strategies to reduce the number of adolescents leaving school without passing grades in core subjects. Maternal depression can compromise the quality of parental care and is associated with multiple negative child outcomes. However, only a few small studies have…

  15. Achieving appropriate design for developing world heath care: the case of a low-cost autoclave for primary health clinics.

    PubMed

    Cho, Hallie S; Tao, Gregory D; Winter, Amos

    2012-01-01

    In developing world health clinics, incidence of surgical site infection is 2 to 10 times higher than in developed world hospitals. This paper identifies lack of availability of appropriately designed, low-cost autoclaves in developing world health clinics as a major contributing factor to the dramatic gap in surgical site infection rates. The paper describes the process of developing a low-cost autoclave that addresses the unique challenges faced by developing world primary health clinics and discusses how appropriateness of design was determined. The resulting pressure cooker-based autoclave design was fabricated and tested against the CDC specifications. Twelve partnering clinics in Nepal trialed these autoclaves from July until December 2012.

  16. Wearable and micro and nano technologies for pHealth: R&D achievements to enable future innovation.

    PubMed

    Lymberis, Andreas

    2013-01-01

    The fast developments in information and communication technology as well as R&D work on micro and nano systems in biology and biomedical engineering are stimulating the explosive growth in life sciences, which is leading to an ever increasing understanding of life at sub-cellular and molecular level and so revolutionizing and personalizing diagnosis and therapy. By bringing these parallel developments to biomedicine and health, ultrafast and sensitive systems can be developed to prevention & lifestyle support, to early diagnose or treat diseases with high accuracy and less invasiveness, and to support body functions or to replace lost functionality. Such pHealth systems will enable the delivery of individualized health services with better access & outcomes at lower costs than previously deemed possible, making a substantial contribution to bring healthcare expenditures under control and increase its productivity.

  17. The role of vaccines and vaccine decision-making to achieve the goals of the Grand Convergence in public health.

    PubMed

    Kaslow, David C; Kalil, Jorge; Bloom, David; Breghi, Gianluca; Colucci, Anna Maria; De Gregorio, Ennio; Madhavan, Guru; Meier, Genevieve; Seabrook, Richard; Xu, Xiaoning

    2017-01-20

    On 17 and 18 July 2015, a meeting in Siena jointly sponsored by ADITEC and GlaxoSmithKline (GSK) was held to review the goals of the Global Health 2035 Grand Convergence, to discuss current vaccine evaluation methods, and to determine the feasibility of reaching consensus on an assessment framework for comprehensively and accurately capturing the full benefits of vaccines. Through lectures and workshops, participants reached a consensus that Multi-Criteria-Decision-Analysis is a method suited to systematically account for the many variables needed to evaluate the broad benefits of vaccination, which include not only health system savings, but also societal benefits, including benefits to the family and increased productivity. Participants also agreed on a set of "core values" to be used in future assessments of vaccines for development and introduction. These values include measures of vaccine efficacy and safety, incident cases prevented per year, the results of cost-benefit analyses, preventable mortality, and the severity of the target disease. Agreement on this set of core assessment parameters has the potential to increase alignment between manufacturers, public health agencies, non-governmental organizations (NGOs), and policy makers (see Global Health 2035 Mission Grand Convergence [1]). The following sections capture the deliberations of a workshop (Working Group 4) chartered to: (1) review the list of 24 parameters selected from SMART vaccines (see the companion papers by Timmis et al. and Madhavan et al., respectively) to determine which represent factors (see Table 1) that should be taken into account when evaluating the role of vaccines in maximizing the success of the Global Health 2035 Grand Convergence; (2) develop 3-5 "core values" that should be taken into account when evaluating vaccines at various stages of development; and (3) determine how vaccines can best contribute to the Global Health 2035 Grand Convergence effort.

  18. Achieving a “Grand Convergence” in Global Health: Modeling the Technical Inputs, Costs, and Impacts from 2016 to 2030

    PubMed Central

    Boyle, Colin F.; Levin, Carol; Hatefi, Arian; Madriz, Solange; Santos, Nicole

    2015-01-01

    Background The Commission on Investing in Health published its report, GlobalHealth2035, in 2013, estimating an investment case for a grand convergence in health outcomes globally. In support of the drafting of the Sustainable Development Goals (SDGs), we estimate what the grand convergence investment case might achieve—and what investment would be required—by 2030. Methods and Findings Our projection focuses on a sub-set of low-income (LIC) or lower-middle-income countries (LMIC). We start with a country-based (bottom-up) analysis of the costs and impact of scaling up reproductive, maternal, and child health tools, and select HIV and malaria interventions. We then incorporate global (top-down) analyses of the costs and impacts of scaling up existing tools for tuberculosis, additional HIV interventions, the costs to strengthen health systems, and the costs and benefits from scaling up new health interventions over the time horizon of this forecast. These data are then allocated to individual countries to provide an aggregate projection of potential cost and impact at the country level. Finally, incremental costs of R&D for low-income economies and the costs of addressing NTDs are added to provide a global total cost estimate of the investment scenario. Results Compared with a constant coverage scenario, there would be more than 60 million deaths averted in LIC and 70 million deaths averted in LMIC between 2016 and 2030. For the years 2015, 2020, 2025, and 2030, the incremental costs of convergence in LIC would be (US billion) $24.3, $21.8, $24.7, and $27, respectively; in LMIC, the incremental costs would be (US billion) $34.75, $38.9, $48.7, and $56.3, respectively. Conclusion Key health outcomes in low- and low-middle income countries can significantly converge with those of wealthier countries by 2030, and the notion of a “grand convergence” may serve as a unifying theme for health indicators in the SDGs. PMID:26452263

  19. Prediction in Health Domain Using Bayesian Networks Optimization Based on Induction Learning Techniques

    NASA Astrophysics Data System (ADS)

    Felgaer, Pablo; Britos, Paola; García-Martínez, Ramón

    A Bayesian network is a directed acyclic graph in which each node represents a variable and each arc a probabilistic dependency; they are used to provide: a compact form to represent the knowledge and flexible methods of reasoning. Obtaining it from data is a learning process that is divided in two steps: structural learning and parametric learning. In this paper we define an automatic learning method that optimizes the Bayesian networks applied to classification, using a hybrid method of learning that combines the advantages of the induction techniques of the decision trees (TDIDT-C4.5) with those of the Bayesian networks. The resulting method is applied to prediction in health domain.

  20. Using information Theory in Optimal Test Point Selection for Health Management in NASA's Exploration Vehicles

    NASA Technical Reports Server (NTRS)

    Mehr, Ali Farhang; Tumer, Irem

    2005-01-01

    In this paper, we will present a new methodology that measures the "worth" of deploying an additional testing instrument (sensor) in terms of the amount of information that can be retrieved from such measurement. This quantity is obtained using a probabilistic model of RLV's that has been partially developed in the NASA Ames Research Center. A number of correlated attributes are identified and used to obtain the worth of deploying a sensor in a given test point from an information-theoretic viewpoint. Once the information-theoretic worth of sensors is formulated and incorporated into our general model for IHM performance, the problem can be formulated as a constrained optimization problem where reliability and operational safety of the system as a whole is considered. Although this research is conducted specifically for RLV's, the proposed methodology in its generic form can be easily extended to other domains of systems health monitoring.

  1. Factors Influencing Persistence/Achievement in the Sciences and Health Professions by Black High School and College Women. Final Report.

    ERIC Educational Resources Information Center

    Turner, Henrie M.; And Others

    This paper reports on a study which investigated socioeconomic, academic, and psychosocial factors that might affect enrollment and persistence rates of black women in science and health careers. An overview is presented of women in science, black women's status in science, role models and support groups, other factors affecting persistence, and…

  2. Achieving Equity through Critical Science Agency: An Ethnographic Study of African American Students in a Health Science Career Academy

    ERIC Educational Resources Information Center

    Haun-Frank, Julie

    2010-01-01

    The purpose of this study was to examine the potential of a High School Health Science Career Academy to support African American students' science career trajectories. I used three key theoretical tools---critical science agency (Basu, 2007; Calabrese Barton & Tan, 2008), power (Nespor, 1994), and cultural production (Carlone, 2004; Eisenhart &…

  3. Comparison of patient evaluations of health care quality in relation to WHO measures of achievement in 12 European countries.

    PubMed Central

    Kerssens, Jan J.; Groenewegen, Peter P.; Sixma, Herman J.; Boerma, Wienke G. W.; van der Eijk, Ingrid

    2004-01-01

    OBJECTIVES: To gain insight into similarities and differences in patient evaluations of quality of primary care across 12 European countries and to correlate patient evaluations with WHO health system performance measures (for example, responsiveness) of these countries. METHODS: Patient evaluations were derived from a series of Quote (QUality of care Through patients' Eyes) instruments designed to measure the quality of primary care. Various research groups provided a total sample of 5133 patients from 12 countries: Belarus, Denmark, Finland, Greece, Ireland, Israel, Italy, the Netherlands, Norway, Portugal, United Kingdom, and Ukraine. Intraclass correlations of 10 Quote items were calculated to measure differences between countries. The world health report 2000 - Health systems: improving performance performance measures in the same countries were correlated with mean Quote scores. FINDINGS: Intra-class correlation coefficients ranged from low to very high, which indicated little variation between countries in some respects (for example, primary care providers have a good understanding of patients' problems in all countries) and large variation in other respects (for example, with respect to prescription of medication and communication between primary care providers). Most correlations between mean Quote scores per country and WHO performance measures were positive. The highest correlation (0.86) was between the primary care provider's understanding of patients' problems and responsiveness according to WHO. CONCLUSIONS: Patient evaluations of the quality of primary care showed large differences across countries and related positively to WHO's performance measures of health care systems. PMID:15042232

  4. Academic Achievement and Behavioral Health among Asian American and African American Adolescents: Testing the Model Minority and Inferior Minority Assumptions

    ERIC Educational Resources Information Center

    Whaley, Arthur L.; Noel, La Tonya

    2013-01-01

    The present study tested the model minority and inferior minority assumptions by examining the relationship between academic performance and measures of behavioral health in a subsample of 3,008 (22%) participants in a nationally representative, multicultural sample of 13,601 students in the 2001 Youth Risk Behavioral Survey, comparing Asian…

  5. Helping Students Achieve Their Goals: The Experience of Working with Students with Mental Health Concerns in a Residence Hall

    ERIC Educational Resources Information Center

    Schafer, Kevin P.

    2016-01-01

    Individuals living with a mental health issue and attending college may experience significant opportunities for growth and also personal challenges in their development into young adulthood. Residence hall directors may be instrumental in assisting this population during their college years. The purpose of this qualitative study was to examine…

  6. Framework for Smart Electronic Health Record-Linked Predictive Models to Optimize Care for Complex Digestive Diseases

    DTIC Science & Technology

    2012-06-01

    Regueiro MD, Krasinskas AM, Saul M, Sapienza D, Binion DG, Hartman D. Mucosal IgG4 Cell Infiltration in Ulcerative Colitis (UC) is Linked to Disease ...Record-Linked Predictive Models to Optimize Care for Complex Digestive Diseases PRINCIPAL INVESTIGATOR: Michael A. Dunn, MD CONTRACTING...Framework for Smart Electronic Health Record-Linked Predictive Models to Optimize Care for Complex Digestive Diseases 5b. GRANT NUMBER W81XWH11-2

  7. Use of focus group interviews with public health nurses to identify the efforts of and challenges faced by branches of the Japan Health Insurance Association to achieve good performance of the Specific Health Guidance initiatives.

    PubMed

    Hayashi, Fumi; Ozawa, Keiko; Kawabata, Teruko; Takemi, Yukari

    2016-01-01

    Objectives Aiming at improvement of the Japan Health Insurance Association's Specific Health Guidance initiatives and human resource development, we conducted a qualitative study to clarify the features necessary for and the challenges hindering the achievement of good performance of the initiatives.Methods From November 2014 to January 2015, we conducted 10 focus group interviews, each 90 minutes long, with 64 public health nurses from 10 Japan Health Insurance Association branches. In addition, self-administered questionnaires were administered to obtain the participants' basic characteristics. After we excluded one group for failing to meet our performance targets, we divided the remaining nine focus groups according to two patterns: Maintenance and Progress. The four focus groups fitting the Maintenance pattern had a well-established track record, and the five focus groups fitting the Progress pattern had a track record of good growth. Using open coding of the interview transcripts, we extracted efforts or needs in two domains, individual and branch, Then, we placed codes in eight main categories: [quality], [general practice], [dietary guidance practice], [success factor], [branch system], [training and skill development], [approach to the member office], and [past efforts]. We further extracted important subcategories based on their rates of appearance within branches.Results Data from 56 female public health nurses working at nine branches were included in the analysis. With respect to the individual domain, subcategories such as "building rapport," "creating the physical environment," and "taking the initiative in evaluating one's own lifestyle" in the 〈high emphasis〉 segment of the [general practice] category were common to both patterns. In addition, "increasing opportunities for training" and "enhancement of training program content" were found for both patterns in relation to the 〈demand〉 segment of the [training and skill development

  8. Rapid Process Optimization: A Novel Process Improvement Methodology to Innovate Health Care Delivery.

    PubMed

    Wiler, Jennifer L; Bookman, Kelly; Birznieks, Derek B; Leeret, Robert; Koehler, April; Planck, Shauna; Zane, Richard

    2016-03-26

    Health care systems have utilized various process redesign methodologies to improve care delivery. This article describes the creation of a novel process improvement methodology, Rapid Process Optimization (RPO). This system was used to redesign emergency care delivery within a large academic health care system, which resulted in a decrease: (1) door-to-physician time (Department A: 54 minutes pre vs 12 minutes 1 year post; Department B: 20 minutes pre vs 8 minutes 3 months post), (2) overall length of stay (Department A: 228 vs 184; Department B: 202 vs 192), (3) discharge length of stay (Department A: 216 vs 140; Department B: 179 vs 169), and (4) left without being seen rates (Department A: 5.5% vs 0.0%; Department B: 4.1% vs 0.5%) despite a 47% increased census at Department A (34 391 vs 50 691) and a 4% increase at Department B (8404 vs 8753). The novel RPO process improvement methodology can inform and guide successful care redesign.

  9. Optimal approaches to the health economics of palliative care: report of an international think tank.

    PubMed

    Gomes, Barbara; Harding, Richard; Foley, Kathleen M; Higginson, Irene J

    2009-07-01

    More people will need palliative care in aging societies with stretched health budgets and less ability to provide informal care. The future will bring new and tougher challenges to sustain, optimize, and expand the 8000 dedicated palliative care services that currently exist in the world. The full breakdown of the costs of palliative care is yet to be unveiled, and this has left huge unresolved questions for funding, costing, evaluating, and modeling palliative care. At an international meeting in London in November 2007, a group of 40 researchers, health economists, policy makers, and advocates exchanged their experiences, concerns, and recommendations in five main areas: shared definitions, strengths and weaknesses of different payment systems, international and country-specific research challenges, appropriate economic evaluation methods, and the varied perspectives to the costs of palliative care. This article reports the discussions that took place and the views of this international group of experts on the best research approaches to capture, analyze, and interpret data on both costs and outcomes for families and patients toward the end of life.

  10. Closing the gaps in child health in the Pacific: An achievable goal in the next 20 years

    PubMed Central

    Duke, Trevor; Kado, Joseph H; Auto, James; Amini, James; Gilbert, Katherine

    2015-01-01

    It is not inconceivable that by 2035 the substantial gaps in child health across the Pacific can close significantly. Currently, Australia and New Zealand have child mortality rates of 5 and 6 per 1000 live births, respectively, while Pacific island developing nations have under 5 mortality rates ranging from 13 to 16 (Vanuatu, Fiji and Tonga) to 47 and 58 per 1000 live births (Kiribati and Papua New Guinea, respectively). However, these Pacific child mortality rates are falling, by an average of 1.4% per year since 1990, and more rapidly (1.9% per year) since 2000. Based on progress elsewhere, there is a need to (i) define the specific things needed to close the gaps in child health; (ii) be far more ambitious and hopeful than ever before; and (iii) form a new regional compact based on solidarity and interdependence. PMID:25586845

  11. Closing the gaps in child health in the Pacific: an achievable goal in the next 20 years.

    PubMed

    Duke, Trevor; Kado, Joseph H; Auto, James; Amini, James; Gilbert, Katherine

    2015-01-01

    It is not inconceivable that by 2035 the substantial gaps in child health across the Pacific can close significantly. Currently, Australia and New Zealand have child mortality rates of 5 and 6 per 1000 live births, respectively, while Pacific island developing nations have under 5 mortality rates ranging from 13 to 16 (Vanuatu, Fiji and Tonga) to 47 and 58 per 1000 live births (Kiribati and Papua New Guinea, respectively). However, these Pacific child mortality rates are falling, by an average of 1.4% per year since 1990, and more rapidly (1.9% per year) since 2000. Based on progress elsewhere, there is a need to (i) define the specific things needed to close the gaps in child health; (ii) be far more ambitious and hopeful than ever before; and (iii) form a new regional compact based on solidarity and interdependence.

  12. Achieving equity through critical science agency: An ethnographic study of African American students in a health science career academy

    NASA Astrophysics Data System (ADS)

    Haun-Frank, Julie

    The purpose of this study was to examine the potential of a High School Health Science Career Academy to support African American students' science career trajectories. I used three key theoretical tools---critical science agency (Basu, 2007; Calabrese Barton & Tan, 2008), power (Nespor, 1994), and cultural production (Carlone, 2004; Eisenhart & Finkel, 1998) to highlight the intersections between the career trajectory implied by the Academy (its curriculum, classroom activities, and clinical experiences) and the students' pursued career trajectories. Data was collected over five months and included individual student interviews, group interviews, parent and administrator interviews, field notes from a culminating medical course and clinical internship, and Academy recruitment documents. The results of this study suggest that participants pursued a health science career for altruistic purposes and the Academy was a resource they drew upon to do so. However, the meanings of science and science person implied by the Academy hindered the possibility for many participants' to advance their science career trajectories. While the Academy promised to expose students to a variety of high-status health care roles, they were funneled into feminine, entry-level positions. This study adds to previous underrepresentation literature by contextualizing how identity-related factors influence African American students' career attainment.

  13. Of jugglers, mechanics, communities, and the thyroid gland: how do we achieve good quality data to improve public health?

    PubMed Central

    Karmaus, W

    2001-01-01

    Our knowledge about the distribution of exposures to toxic chemicals in various communities is limited. Only about 6% of approximately 1,400 toxic chemicals have been identified in surveys. Even for those chemicals that are measured, information is often insufficient to identify smaller populations at high risk. The question is whether information about the distribution of diseases in communities can help identify environmental risks, indicate areas of concern, and thus substitute exposure information. Thyroid disorders represent a large group of diseases that cannot be recorded into registries because of the lack of clear caseness; community-based monitoring of subtle health effects is needed. Thus, to identify potential health risks in communities, epidemiologic studies including effect and human exposure monitoring are necessary. However, to overcome the limitation of nonsystematic case studies, the development of a network of exposed communities concerned about exposures is proposed. A network would provide assessments of exposures and health outcomes, with different communities mutually serving as exposed and control groups. Such a network would foster communication and prevention measures within communities often left out of the dissemination of information about risks identified in studies conducted with residents of these communities. PMID:11744504

  14. Case study of how successful coordination was achieved between a mental health and social care service in Sweden.

    PubMed

    Hansson, Johan; Øvretveit, John; Brommels, Mats

    2012-01-01

    This paper summarises the findings from an empirical longitudinal study of a health and social care consortium for people with mental health problems in one area in Stockholm. The aim was to describe the formation and structure of coordination within the consortium, and to assess the intermediate impact on care processes and client outcomes. A multiple-method case study design, theoretically informed by the Pettigrew and Whipp model of strategic change (1993) was applied. Data was gathered from interviews with informants from different organisations at different times in the development of the consortium, and from administrative documents, plans and service statistics showing some of the intermediate changes and client outcomes. The findings revealed activities and factors both helping and hindering the formation of coordination arrangements. One of the most significant hindering factors was the central county purchasing organisation focusing more on volume and costs, with payments for specific units and services, and with less emphasis on quality of the services. Few studies have described implementation of changes to improve coordination with reference to context over a long period of time, as well as assessing different results. This study contributes to knowledge about improved methods for this type of research, as well as knowledge about developing coordination between public health and welfare services. One lesson for the current policy is that, where full structural integration is not possible, then client-level coordination roles in each sector are useful to connect sector services for shared clients.

  15. Pups of dams fed low-fat diet during pregnancy and lactation showed strong preference for high-fat diet to achieve optimal growth.

    PubMed

    Nakashima, Yoko; Sato, Akie

    2011-01-01

    To investigate the causes why pups of dams fed a low-fat high-carbohydrate diet (LFD) showed a strong preference for fat, three groups of dams were fed one of three diets during pregnancy and lactation: the LFD, a control diet (CTD) or a high-fat low-carbohydrate diet (HFD). After weaning, pups of each of the three groups were divided into two equal subgroups (Pair 1 and Pair 2), for a total of six pup subgroups. Each subgroup was placed on a two-choice diet program of the LFD and the HFD (Pair 1), or the LFD and a HFDLE (with cellulose added to maintain the same energy concentration as the LFD) (Pair 2), for 3 wk. Although the energy intake of dams fed the LFD during the nursing period was lower than that of the HFD group, no significant difference in body weight was observed among the three groups. At weaning, the body weight of pups nursed by dams fed the LFD was lower than that of the other groups. In Pair 1, the HFD intake ratio of the LFD and the HFD groups during the self-selection period was higher than that of the CTD group. In Pair 2, the HFDLE intake ratio of the LFD and the CTD groups was lower than that of the HFD group. At the end of the self-selection period, no significant difference in body weight was observed among the three groups of Pair 1. However, in Pair 2, the body weight of the LFD group was lower than that of the other groups. Therefore, it was supposed that pups of dams fed the LFD showed strong preference for the HFD containing high energy in order to achieve optimal growth.

  16. Genetic and environmental influences on optimism and its relationship to mental and self-rated health: a study of aging twins.

    PubMed

    Mosing, Miriam A; Zietsch, Brendan P; Shekar, Sri N; Wright, Margaret J; Martin, Nicholas G

    2009-11-01

    Optimism has been shown to be important in maintaining wellbeing into old age, but little is known about the sources of variation in optimism and its links to mental and somatic health. Optimism, mental, and self-rated health were measured in 3,053 twin individuals (501 MZF, 153 MZM, 274 DZF, 77 DZM, and 242 DZ opposite-sex twin pairs and 561 single twins) over 50 years using the life orientation test, the General Health Questionnaire and a single-item question for self-rated health. Additive genetic factors explained 36, 34, and 46% of the variation in optimism, mental, and self-rated health, respectively, with the remainder being due to non-shared environmental influences. Genetic influences accounted for most of the covariance between the variables (14-20% of the genetic variance) indicating that in older adults genes predisposing to high optimism also predispose to good mental health and self-rated health.

  17. The role of childhood neglect and childhood poverty in predicting mental health, academic achievement and crime in adulthood.

    PubMed

    Nikulina, Valentina; Widom, Cathy Spatz; Czaja, Sally

    2011-12-01

    This study examines the roles of childhood neglect and childhood poverty (family and neighborhood) in predicting Posttraumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD), academic achievement, and crime in young adulthood. Using existing data from a prospective cohort design study, 1,005 children with documented histories of neglect (N = 507) and matched controls (N = 497) were interviewed in young adulthood (mean age 29). Official criminal histories were also used to assess outcomes. Data were analyzed using logistic and ordinary least squares regressions and hierarchical linear modeling (HLM) to control for neighborhood clustering. Results from HLM revealed that childhood neglect and childhood family poverty uniquely predicted PTSD and adult arrest, MDD was predicted only by childhood family poverty, and a significant interaction between childhood family poverty and childhood neighborhood poverty predicted academic achievement for the control group only. Childhood neglect, childhood family poverty, and childhood neighborhood poverty each contribute to poor outcomes later in life. While interventions should be developed for neglected children to prevent negative outcomes, the current findings suggest that it is also important to consider the ecological context in which these children are growing up.

  18. The role of public health advocacy in achieving an outright ban on commercial tanning beds in Australia.

    PubMed

    Sinclair, Craig A; Makin, Jennifer Kay; Tang, Anita; Brozek, Irena; Rock, Vanessa

    2014-02-01

    Although many countries still face opposition to the legislation of artificial tanning beds, all Australian states and territories have announced a total ban on commercial tanning beds. A combination of epidemiological and policy-centered research, powerful personal stories, and the active advocacy of prominent academics, cancer organizations, and grassroots community campaigners contributed to the decisions to first legislate standards and then ban all commercial tanning beds. We have illustrated that incremental change can be an effective pathway to securing substantial public health reforms.

  19. The environmental and public health benefits of achieving high penetrations of solar energy in the United States

    SciTech Connect

    Wiser, Ryan; Millstein, Dev; Mai, Trieu; Macknick, Jordan; Carpenter, Alberta; Cohen, Stuart; Cole, Wesley; Frew, Bethany; Heath, Garvin

    2016-10-01

    We estimate the environmental and public health benefits that may be realized if solar energy cost reductions continue until solar power is competitive across the U.S. without subsidies. Specifically, we model, from 2015 to 2050, solar power-induced reductions to greenhouse gas (GHG) emissions, air pollutant emissions, and water usage. To find the incremental benefits of new solar deployment, we compare the difference between two scenarios, one where solar costs have fallen such that solar supplies 14% of the nation's electricity by 2030 and 27% by 2050, and a baseline scenario in which no solar is added after 2014. We monetize benefits, where credible methods exist to do so. We find that under these scenarios, solar power reduces GHG and air pollutants by ~10%, from 2015 to 2050, providing a discounted present value of $56-$789 billion (central value of ~$250 billion, equivalent to ~2 cents/kWh-solar) in climate benefits and $77-$298 billion (central value of $167 billion, or ~1.4 cents/kWh-solar) in air quality and public health benefits. The ranges reflect uncertainty within the literature about the marginal impact of emissions of GHG and air pollutants. Solar power is also found to reduce water withdrawals and consumption by 4% and 9%, respectively, including in many drought-prone states.

  20. Cross-country analysis of strategies for achieving progress towards global goals for women’s and children’s health

    PubMed Central

    Ahmed, Syed Masud; Rawal, Lal B; Chowdhury, Sadia A; Murray, John; Arscott-Mills, Sharon; Jack, Susan; Hinton, Rachael; Alam, Prima M

    2016-01-01

    Abstract Objective To identify how 10 low- and middle-income countries achieved accelerated progress, ahead of comparable countries, towards meeting millennium development goals 4 and 5A to reduce child and maternal mortality. Methods We synthesized findings from multistakeholder dialogues and country policy reports conducted previously for the Success Factors studies in 10 countries: Bangladesh, Cambodia, China, Egypt, Ethiopia, the Lao People's Democratic Republic, Nepal, Peru, Rwanda and Viet Nam. A framework approach was used to analyse and synthesize the data from the country reports, resulting in descriptive or explanatory conclusions by theme. Findings Successful policy and programme approaches were categorized in four strategic areas: leadership and multistakeholder partnerships; health sector; sectors outside health; and accountability for resources and results. Consistent and coordinated inputs across sectors, based on high-impact interventions, were assessed. Within the health sector, key policy and programme strategies included defining standards, collecting and using data, improving financial protection, and improving the availability and quality of services. Outside the health sector, strategies included investing in girls’ education, water, sanitation and hygiene, poverty reduction, nutrition and food security, and infrastructure development. Countries improved accountability by strengthening and using data systems for planning and evaluating progress. Conclusion Reducing maternal and child mortality in the 10 fast-track countries can be linked to consistent and coordinated policy and programme inputs across health and other sectors. The approaches used by successful countries have relevance to other countries looking to scale-up or accelerate progress towards the sustainable development goals. PMID:27147765

  1. The economics of optimal health and productivity in smallholder livestock systems in developing countries.

    PubMed

    McDermott, J J; Randolph, T F; Staal, S J

    1999-08-01

    where epidemic disease are still important and infrastructure is poor, disease control primarily involves managing communal natural resources, requiring a different analytical approach. Finally, in crop farming systems using draught cattle, the livestock activity is an integrated component of crop production and this must be reflected in the approach used to evaluate draught animal health management. Continued development of analytical approaches and decision-support tools for disease control strategies adapted to the special characteristics of these systems will be needed as smallholder systems continue to intensify in areas with good market access, and those in marginal areas face increasing pressures to optimally manage the natural resource base.

  2. Health Optimizing Physical Education (HOPE): A New Curriculum for School Programs--Part 2: Teacher Knowledge and Collaboration

    ERIC Educational Resources Information Center

    Metzler, Michael W.; McKenzie, Thomas L.; van der Mars, Hans; Barrett-Williams, Shannon L.; Ellis, Rebecca

    2013-01-01

    Part 1 of this article, which appeared in the April 2013 of JOPERD, presented the theoretical foundation and evidence-based needs for a main-theme curriculum model called Health Optimizing Physical Education (HOPE) for schools. It also described eight strands that could be used to plan, implement, and assess this version of a comprehensive school…

  3. Health from Space to Ground- A Centre to Foster Italy Impressive Achievements in Space Medicine and Biotechnology

    NASA Astrophysics Data System (ADS)

    Benassai, Mario; Ambesi-Impimbato, Francesco Saverio

    2013-02-01

    The paper describes the project for a new strategic asset currently emerging within the Italian scientific community in the field of Space Medicine and Biotechnology: an Italian Centre for Health from Space to Ground, dedicated to transferring biomedical methodologies from Space to Earth applications (for rehabilitation, prevention, degenerative diseases treatment), to co-operate with existing similar centers to gather and disseminate data, resources and facilities. This need originates by the convergence between a very active science community, (fostered by the Italian space Agency and the recently founded the Italian Society for Space Biomedicine and Biotechnology - ISSBB) and ALTEC SpA, a public/private company incorporated in Turin by Thales Alenia Space Italy, ASI, a local consortium among local authorities and Finmeccanica, which is very active in supporting Science in Space.

  4. Achieving compliance with environmental health-related land use planning conditions in Hong Kong: perspectives from traditional motivation theories.

    PubMed

    Man, Rita Li Yi

    2009-11-01

    Environmental health-related land use planning conditions can enhance the environment in Hong Kong. Previous research by others has shown, however, that a lack of compliance with planning conditions often occurs. And as no direct enforcement of planning conditions exists in Hong Kong, it is of interest to understand possible ways in which to increase the motivation of land developers and property owners to comply with planning conditions. The author looked at motivation from the perspective of three traditional motivation theories: Theory X, Theory Y, and incentive theory. While the majority of this article focuses on the enforcement and the legal tests in land use planning conditions, it also presents the results of the first study of the motivations behind Hong Kong land developers to comply with land use planning conditions.

  5. Main achievements of the World Organisation for Animal Health/United Nations Food and Agriculture Organization network on animal influenza.

    PubMed

    Dauphin, Gwenaelle; Hamilton, Keith; Kim, L Mia; Choudhury, Bhudipa; Capua, Ilaria; Edwards, Steve

    2010-03-01

    The World Organisation for Animal Health (OIE)/United Nations Food and Agriculture Organization (FAO) joint network of expertise on animal influenza (OFFLU) includes all ten OIE/FAO reference laboratories and collaborating centers for avian influenza, other diagnostic laboratories, research and academic institutions, and experts in the fields of virology, epidemiology, vaccinology, and molecular biology. OFFLU has made significant progress in improving its infrastructure, in identifying and addressing technical gaps, and in establishing associations among leading veterinary institutions. Interaction with the World Health Organization (WHO) Global Influenza Program is also critical, and mechanisms for permanent interaction are being developed. OFFLU played a key role in the WHO/OIE/FAO Joint Technical Consultation held in Verona (October 7-9, 2008), which provided an opportunity to highlight and share knowledge and identify potential gaps regarding issues at the human-animal interface for avian influenza. OFFLU experts also contributed to the working group for the Unified Nomenclature System for H5N1 influenza viruses based on hemagglutinin gene phylogeny (WHO/OIE/FAO, H5N1 Evolution Working Group, Towards a unified nomenclature system for highly pathogenic avian influenza virus (H5N1) in Emerging Infectious Diseases 14:el, 2008). OFFLU technical activities, led by expert scientists from OIE/FAO reference institutions and coordinated by OIE and FAO focal points, have been prioritized to include commercial diagnostic kit evaluation, applied epidemiology, biosafety, vaccination, proficiency testing, development of standardized reference materials for sera and RNA, and issues at the human-animal interface. The progress to date and future plans for these groups will be presented. OFFLU is also involved in two national projects implemented by FAO in Indonesia and Egypt that seek to establish sustainable mechanisms for monitoring virus circulation, including viral

  6. Aerosol exposure versus aerosol cooling of climate: what is the optimal emission reduction strategy for human health?

    NASA Astrophysics Data System (ADS)

    Löndahl, J.; Swietlicki, E.; Lindgren, E.; Loft, S.

    2010-10-01

    Particles, climate change, and health have thought-provoking interactions. Air pollution is one of the largest environmental problems concerning human health. On the other hand, aerosol particles can have a cooling effect on climate and a reduction of those emissions may result in an increased temperature globally, which in turn may have negative health effects. The objective of this work was to investigate the "total health effects" of aerosol emissions, which include both exposure to particles and consequences for climate change initiated by particles. As a case study the "total health effect" from ship emissions was derived by subtracting the number of deaths caused by exposure with the estimated number of lives saved from the cooling effect of the emissions. The analysis showed that, with current level of scientific understanding, it could not be determined whether ship emissions are negative or positive for human health on a short time scale. This first attempt to approximate the combined effect of particle emissions on health shows that reductions of particulate air pollution will in some cases (black carbon) have win-win effects on health and climate, but sometimes also cause a shift from particle exposure-related health effects towards an increasing risk of health consequences from climate change. Thus, measures to reduce aerosol emissions have to be coupled with climate change mitigation actions to achieve a full health benefit on a global level.

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

    ERIC Educational Resources Information Center

    Gallaway, Patrick J.; Hongu, Nobuko

    2016-01-01

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

  8. Views from the global south: exploring how student volunteers from the global north can achieve sustainable impact in global health

    PubMed Central

    2013-01-01

    Background The body of research and practice regarding student volunteer abroad experiences largely focuses on ensuring the optimal learning experience for the student from the Global North, without equivalent attention to the benefits, if any, to the host institution in the Global South. In this debate article, we examine an often overlooked component of global student volunteer programs: the views of the local partner on what makes for a mutually beneficial partnership between volunteers from the Global North and institutions in the Global South. Discussion To guide our discussion, we drew upon the experiences of a Kenyan NGO with a Canadian student volunteer in the summer of 2012, organized via a formalized partnership with a Canadian university. We found that the approach of the NGO to hosting the student mirrored the organizational behaviour theories of Margaret J. Wheatley, who emphasized a disorderly or ‘chaotic’ approach to acquiring impactful change, coupled with a focus on building solid human relationships. Rather than following a set of rigid goals or tasks, the student was encouraged to critically engage and participate in all aspects of the culture of the organization and country, to naturally discover an area where his priorities aligned with the needs of the NGO. Solid networks and interpersonal connections resulted in a process useful for the organization long after the student’s short-term placement ended. Summary Our discussion reveals key features of successful academic volunteer abroad placements: equal partnership in the design phase between organizations in the Global North and Global South; the absence of rigid structures or preplanned tasks during the student’s placement; participatory observation and critical engagement of the student volunteer; and a willingness of the partners to measure impact by the resultant process instead of tangible outcomes. PMID:23889908

  9. Achieving Research Impact Through Co‐creation in Community‐Based Health Services: Literature Review and Case Study

    PubMed Central

    JACKSON, CLAIRE; SHAW, SARA; JANAMIAN, TINA

    2016-01-01

    Policy Points: Co‐creation—collaborative knowledge generation by academics working alongside other stakeholders—is an increasingly popular approach to aligning research and service development.It has potential for “moving beyond the ivory towers” to deliver significant societal impact via dynamic, locally adaptive community‐academic partnerships.Principles of successful co‐creation include a systems perspective, a creative approach to research focused on improving human experience, and careful attention to governance and process.If these principles are not followed, co‐creation efforts may fail. Context Co‐creation—collaborative knowledge generation by academics working alongside other stakeholders—reflects a “Mode 2” relationship (knowledge production rather than knowledge translation) between universities and society. Co‐creation is widely believed to increase research impact. Methods We undertook a narrative review of different models of co‐creation relevant to community‐based health services. We contrasted their diverse disciplinary roots and highlighted their common philosophical assumptions, principles of success, and explanations for failures. We applied these to an empirical case study of a community‐based research‐service partnership led by the Centre of Research Excellence in Quality and Safety in Integrated Primary‐Secondary Care at the University of Queensland, Australia. Findings Co‐creation emerged independently in several fields, including business studies (“value co‐creation”), design science (“experience‐based co‐design”), computer science (“technology co‐design”), and community development (“participatory research”). These diverse models share some common features, which were also evident in the case study. Key success principles included (1) a systems perspective (assuming emergence, local adaptation, and nonlinearity); (2) the framing of research as a creative enterprise with human

  10. Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: implications for achievement of MDG-5 targets

    PubMed Central

    Mpembeni, Rose NM; Killewo, Japhet Z; Leshabari, Melkzedeck T; Massawe, Siriel N; Jahn, Albrecht; Mushi, Declare; Mwakipa, Hassan

    2007-01-01

    Background Almost two decades since the initiation of the Safe motherhood Initiative, Maternal Mortality is still soaring high in most developing countries. In 2000 WHO estimated a life time risk of a maternal death of 1 in 16 in Sub- Saharan Africa while it was only 1 in 2800 in developed countries. This huge discrepancy in the rate of maternal deaths is due to differences in access and use of maternal health care services. It is known that having a skilled attendant at every delivery can lead to marked reductions in maternal mortality. For this reason, the proportion of births attended by skilled health personnel is one of the indicators used to monitor progress towards the achievement of the MDG-5 of improving maternal health. Methods Cross sectional study which employed quantitative research methods. Results We interviewed 974 women who gave birth within one year prior to the survey. Although almost all (99.8%) attended ANC at least once during their last pregnancy, only 46.7% reported to deliver in a health facility and only 44.5% were assisted during delivery by a skilled attendant. Distance to the health facility (OR = 4.09 (2.72–6.16)), discussion with the male partner on place of delivery (OR = 2.37(1.75–3.22)), advise to deliver in a health facility during ANC (OR = 1.43 (1.25–2.63)) and knowledge of pregnancy risk factors (OR 2.95 (1.65–5.25)) showed significant association with use of skilled care at delivery even after controlling for confounding factors. Conclusion Use of skilled care during delivery in this district is below the target set by ICPD + of attaining 80% of deliveries attended by skilled personnel by 2005. We recommend the following in order to increase the pace towards achieving the MDG targets: to improve coverage of health facilities, raising awareness for both men and women on danger signs during pregnancy/delivery and strengthening counseling on facility delivery and individual birth preparedness. PMID:18053268

  11. "Is there an optimal diet for weight management and metabolic health?"

    PubMed

    Thom, George; Lean, Mike

    2017-02-15

    Individuals can lose body weight and improve health status on a wide range of energy (calorie) restricted dietary interventions. In this paper, we have reviewed the effectiveness of the most commonly utilized diets, including low-fat, low-carbohydrate and Mediterranean approaches in addition to commercial slimming programmes, meal replacements and newly-popularized intermittent fasting diets. We also consider the role of artificial sweeteners in weight management. Low-fat diets tend to improve LDL-cholesterol most, whilst lower-carbohydrate diets may preferentially improve triglycerides and HDL-cholesterol, however differences between diets are marginal. Weight loss improves almost all obesity related co-morbidities and metabolic markers, regardless of the macronutrient composition of the diet, but individuals do vary in preferences and ability to adhere to different diets. Optimizing adherence is the most important factor for weight loss success, and this is enhanced by regular professional contact and supportive behavioral change programs. Maintaining weight losses in the long-term remains the biggest challenge, and is undermined by an 'obesogenic' environment and biological adaptations that accompany weight loss.

  12. Design and performance of optimal detectors for guided wave structural health monitoring

    SciTech Connect

    Dib, G.; Udpa, L.

    2016-01-01

    Ultrasonic guided wave measurements in a long term structural health monitoring system are affected by measurement noise, environmental conditions, transducer aging and malfunction. This results in measurement variability which affects detection performance, especially in complex structures where baseline data comparison is required. This paper derives the optimal detector structure, within the framework of detection theory, where a guided wave signal at the sensor is represented by a single feature value that can be used for comparison with a threshold. Three different types of detectors are derived depending on the underlying structure’s complexity: (i) Simple structures where defect reflections can be identified without the need for baseline data; (ii) Simple structures that require baseline data due to overlap of defect scatter with scatter from structural features; (iii) Complex structure with dense structural features that require baseline data. The detectors are derived by modeling the effects of variabilities and uncertainties as random processes. Analytical solutions for the performance of detectors in terms of the probability of detection and false alarm are derived. A finite element model is used to generate guided wave signals and the performance results of a Monte-Carlo simulation are compared with the theoretical performance. initial results demonstrate that the problems of signal complexity and environmental variability can in fact be exploited to improve detection performance.

  13. Human ergology that promotes participatory approach to improving safety, health and working conditions at grassroots workplaces: achievements and actions.

    PubMed

    Kawakami, Tsuyoshi

    2011-12-01

    Participatory approaches are increasingly applied to improve safety, health and working conditions of grassroots workplaces in Asia. The core concepts and methods in human ergology research such as promoting real work life studies, relying on positive efforts of local people (daily life-technology), promoting active participation of local people to identify practical solutions, and learning from local human networks to reach grassroots workplaces, have provided useful viewpoints to devise such participatory training programmes. This study was aimed to study and analyze how human ergology approaches were applied in the actual development and application of three typical participatory training programmes: WISH (Work Improvement for Safe Home) with home workers in Cambodia, WISCON (Work Improvement in Small Construction Sites) with construction workers in Thailand, and WARM (Work Adjustment for Recycling and Managing Waste) with waste collectors in Fiji. The results revealed that all the three programmes, in the course of their developments, commonly applied direct observation methods of the work of target workers before devising the training programmes, learned from existing local good examples and efforts, and emphasized local human networks for cooperation. These methods and approaches were repeatedly applied in grassroots workplaces by taking advantage of their the sustainability and impacts. It was concluded that human ergology approaches largely contributed to the developments and expansion of participatory training programmes and could continue to support the self-help initiatives of local people for promoting human-centred work.

  14. Identifying Factors for Optimal Development of Health-Related Websites: A Delphi Study Among Experts and Potential Future Users

    PubMed Central

    van Osch, Liesbeth; de Vries, Hein

    2012-01-01

    Background The Internet has become a popular medium for offering tailored and targeted health promotion programs to the general public. However, suboptimal levels of program use in the target population limit the public health impact of these programs. Optimizing program development is considered as one of the main processes to increase usage rates. Objective To distinguish factors potentially related to optimal development of health-related websites by involving both experts and potential users. By considering and incorporating the opinions of experts and potential users in the development process, involvement in the program is expected to increase, consequently resulting in increased appreciation, lower levels of attrition, and higher levels of sustained use. Methods We conducted a systematic three-round Delphi study through the Internet. Both national and international experts (from the fields of health promotion, health psychology, e-communication, and technical Web design) and potential users were invited via email to participate. During this study an extensive list of factors potentially related to optimal development of health-related websites was identified, by focusing on factors related to layout, general and risk information provision, questionnaire use, additional services, and ease of use. Furthermore, we assessed the extent to which experts and potential users agreed on the importance of these factors. Differences as well as similarities among experts and potentials users were deduced. Results In total, 20 of 62 contacted experts participated in the first round (32% response rate); 60 of 200 contacted experts (30% response rate) and 210 potential users (95% response rate) completed the second-round questionnaire, and 32 of 60 contacted experts completed the third round (53% response rate). Results revealed important factors consented upon by experts and potential users (eg, ease of use, clear structure, and detailed health information provision), as

  15. Optimal Sensor Fusion for Structural Health Monitoring of Aircraft Composite Components

    DTIC Science & Technology

    2011-09-01

    Advanced Materials. Vol 3. #2., 2002. 16. COCONUT Project. 2001. Algorithms for Solving Nonlinear Constrained Optimization Problems: The State of the Art...http://www.mat.univie.ac.at/~neum/glopt/ coconut /2001 17. Pinter J. (Ed). 2006. Global Optimization: Scientific and Engineering Case Studies (Nonconvex Optimization and Its Applications). Springer, 2006

  16. The far-reaching effects of believing people can change: implicit theories of personality shape stress, health, and achievement during adolescence.

    PubMed

    Yeager, David Scott; Johnson, Rebecca; Spitzer, Brian James; Trzesniewski, Kali H; Powers, Joseph; Dweck, Carol S

    2014-06-01

    The belief that personality is fixed (an entity theory of personality) can give rise to negative reactions to social adversities. Three studies showed that when social adversity is common-at the transition to high school--an entity theory can affect overall stress, health, and achievement. Study 1 showed that an entity theory of personality, measured during the 1st month of 9th grade, predicted more negative immediate reactions to social adversity and, at the end of the year, greater stress, poorer health, and lower grades in school. Studies 2 and 3, both experiments, tested a brief intervention that taught a malleable (incremental) theory of personality--the belief that people can change. The incremental theory group showed less negative reactions to an immediate experience of social adversity and, 8 months later, reported lower overall stress and physical illness. They also achieved better academic performance over the year. Discussion centers on the power of targeted psychological interventions to effect far-reaching and long-term change by shifting interpretations of recurring adversities during developmental transitions.

  17. Trends and implications for achieving VISION 2020 human resources for eye health targets in 16 countries of sub-Saharan Africa by the year 2020

    PubMed Central

    2014-01-01

    Background Development of human resources for eye health (HReH) is a major global eye health strategy to reduce the prevalence of avoidable visual impairment by the year 2020. Building on our previous analysis of current progress towards key HReH indicators and cataract surgery rates (CSRs), we predicted future indicator achievement among 16 countries of sub-Saharan Africa by 2020. Methods Surgical and HReH data were collected from national eye care programme coordinators on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and ‘mid-level refractionists’ and combined them with publicly available population data to calculate practitioner-to-population ratios and CSRs. Data on workforce entry and exit (2008 to 2010) was used to project practitioner population and CSR growth between 2011 and 2020 in relation to projected growth in the general population. Associations between indicator progress and the presence of a non-physician cataract surgeon cadre were also explored using Wilcoxon rank sum tests and Spearman rank correlations. Results In our 16-country sample, practitioner per million population ratios are predicted to increase slightly for surgeons (ophthalmologists/cataract surgeons, from 3.1 in 2011 to 3.4 in 2020) and ophthalmic nurses/clinical officers (5.8 to 6.8) but remain low for refractionists (including optometrists, at 3.6 in 2011 and 2020). Among countries that have not already achieved target indicators, however, practitioner growth will be insufficient for any additional countries to reach the surgeon and refractionist targets by year 2020. Without further strategy change and investment, even after 2020, surgeon growth is only expected to sufficiently outpace general population growth to reach the target in one country. For nurses, two additional countries will achieve the target while one will fall below it. In 2011, high surgeon practitioner ratios were associated with

  18. Changes in Optimal Childcare Practices in Kenya: Insights from the 2003, 2008-9 and 2014 Demographic and Health Surveys

    PubMed Central

    Matanda, Dennis Juma; Urke, Helga Bjørnøy; Mittelmark, Maurice B.

    2016-01-01

    Objective(s) Using nationally representative surveys conducted in Kenya, this study examined optimal health promoting childcare practices in 2003, 2008–9 and 2014. This was undertaken in the context of continuous child health promotion activities conducted by government and non-government organizations throughout Kenya. It was the aim of such activities to increase the prevalence of health promoting childcare practices; to what extent have there been changes in optimal childcare practices in Kenya during the 11-year period under study? Methods Cross-sectional data were obtained from the Kenya Demographic and Health Surveys conducted in 2003, 2008–9 and 2014. Women 15–49 years old with children 0–59 months were interviewed about a range of childcare practices. Logistic regression analysis was used to examine changes in, and correlates of, optimal childcare practices using the 2003, 2008–9 and 2014 data. Samples of 5949, 6079 and 20964 women interviewed in 2003, 2008–9 and 2014 respectively were used in the analysis. Results Between 2003 and 2014, there were increases in all health facility-based childcare practices with major increases observed in seeking medical treatment for diarrhoea and complete child vaccination. Mixed results were observed in home-based care where increases were noted in the use of insecticide treated bed nets, sanitary stool disposal and use of oral rehydration solutions, while decreases were observed in the prevalence of urging more fluid/food during diarrhoea and consumption of a minimum acceptable diet. Logit models showed that area of residence (region), household wealth, maternal education, parity, mother's age, child’s age and pregnancy history were significant determinants of optimal childcare practices across the three surveys. Conclusions The study observed variation in the uptake of the recommended optimal childcare practices in Kenya. National, regional and local child health promotion activities, coupled with changes

  19. Mental health care delivery system reform in Belgium: the challenge of achieving deinstitutionalisation whilst addressing fragmentation of care at the same time.

    PubMed

    Nicaise, Pablo; Dubois, Vincent; Lorant, Vincent

    2014-04-01

    Most mental health care delivery systems in welfare states currently face two major issues: deinstitutionalisation and fragmentation of care. Belgium is in the process of reforming its mental health care delivery system with the aim of simultaneously strengthening community care and improving integration of care. The new policy model attempts to strike a balance between hospitals and community services, and is based on networks of services. We carried out a content analysis of the policy blueprint for the reform and performed an ex-ante evaluation of its plan of operation, based on the current knowledge of mental health service networks. When we examined the policy's multiple aims, intermediate goals, suggested tools, and their articulation, we found that it was unclear how the new policy could achieve its goals. Indeed, deinstitutionalisation and integration of care require different network structures, and different modes of governance. Furthermore, most of the mechanisms contained within the new policy were not sufficiently detailed. Consequently, three major threats to the effectiveness of the reform were identified. These were: issues concerning the relationship between network structure and purpose, the continued influence of hospitals despite the goal of deinstitutionalisation, and the heterogeneity in the actual implementation of the new policy.

  20. Optimism, Social Support, and Mental Health Outcomes in Patients with Advanced Cancer

    PubMed Central

    Applebaum, Allison J.; Stein, Emma M.; Lord-Bessen, Jennifer; Pessin, Hayley; Rosenfeld, Barry; Breitbart, William

    2014-01-01

    Objective Optimism and social support serve as protective factors against distress in medically ill patients. Very few studies have specifically explored the ways in which these variables interact to impact quality of life (QOL), particularly among patients with advanced cancer. The present study examined the role of optimism as a moderator of the relationship between social support and anxiety, depression, hopelessness, and QOL among patients with advanced cancer. Methods Participants (N = 168) completed self-report assessments of psychosocial, spiritual, and physical well-being, including social support, optimism, hopelessness, depressive and anxious symptoms, and QOL. Hierarchical multiple regression analyses were conducted to determine the extent to which social support and optimism were associated with depressive and anxious symptomatology, hopelessness and QOL, and the potential role of optimism as a moderator of the relationship between social support and these variables. Results Higher levels of optimism were significantly associated with fewer anxious and depressive symptoms, less hopelessness and better QOL. Higher levels of perceived social support were also significantly associated with better QOL. Additionally, optimism moderated the relationship between social support and anxiety, such that there was a strong negative association between social support and anxiety for participants with low optimism. Conclusions This study highlights the importance of optimism and social support in the QOL of patients with advanced cancer. As such, interventions that attend to patients’ expectations for positive experiences and the expansion of social support should be the focus of future clinical and research endeavors. PMID:24123339

  1. Optimal conditions for identifying 80Br and 128I in health food Angelica keiskei using rapid epithermal neutron activation analysis.

    PubMed

    Chen, Chien-Yi

    2003-04-01

    This study presents an optimal rapid epithermal neutron activation analysis (ENAA) technique, using a 1mm Cd filter in reactor neutron flux, to analyze 80Br and 128I in the roots, stems, and leaves of health food Angelica keiskei (AK). Various sample weights of lichen (IAEA-336) for each portion of AK, under various periods of irradiation and counting, were used to optimize the elemental analysis. Selecting the analytical conditions depends on the minimum detectable concentration (MDC), required sensitivities and the quantitative accuracy of Br and I elements. These findings imply that the MDCs of Br and I, measured under 10min activation and 5min counting followed by 10min decaying, using 350mg of lichen are ideal for elemental analysis. Moreover, each portions of AK were analyzed under optimal conditions. The elemental concentrations of Br, Cl, I, Mg, Mn and Na and their implications are discussed.

  2. On the Path to SunShot - The Environmental and Public Health Benefits of Achieving High Penetrations of Solar Energy in the United States

    SciTech Connect

    Wiser, Ryan; Mai, Trieu; Millstein, Dev; Macknick, Jordan; Carpenter, Alberta; Cohen, Stuart; Cole, Wesley; Frew, Bethany; Heath, Garvin

    2016-05-01

    Monetizing the environmental health benefits of solar could add ~3.5¢/kWh to the value of solar energy (see Wiser et al. 2016). The monetary impacts due to environmental degradation and public health impacts seem far removed from the apparent “sticker price” of electricity. Yet quantifying these impacts is essential to understanding the true costs and benefits of solar and conventional generating technologies. Compared with fossil fuel generators, PV and CSP produce far lower lifecycle levels of greenhouse gas (GHG) emissions and harmful pollutants including fine particular matter (PM2.5), sulfur dioxide (SO2), and nitrogen oxides (NOx). Achieving the SunShot-level solar deployment targets—14% of U.S. electricity demand met by solar in 2030 and 27% in 2050—could reduce cumulative power-sector GHG emissions by 10% between 2015 and 2050, resulting in savings of $238–$252 billion. This is equivalent to 2.0–2.2 cents per kilowatt-hour of solar installed (¢/kWh-solar). Similarly, realizing these levels of solar deployment could reduce cumulative power-sector emissions of PM2.5 by 8%, SO2 by 9%, and NOx by 11% between 2015 and 2050. This could produce $167 billion in savings from lower future health and environmental damages, or 1.4¢/kWh-solar—while also preventing 25,000–59,000 premature deaths. To put this in perspective, the estimated 3.5¢/kWh-solar in benefits due to SunShot-level solar deployment is approximately equal to the additional LCOE reduction needed to make unsubsidized utility-scale solar competitive with conventional generators today. In addition, water savings from achieving the SunShot goals, could result in the 2015–2050 cumulative savings of 4% of total power-sector withdrawals and 9% of total power-sector consumption—a particularly important consideration for arid states where substantial solar will be deployed. Improving public health and the environment is but one aspect of solar’s many costs and benefits. Clearly, however

  3. Optimizing the Uptake of Health Checks for People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    McConkey, Roy; Taggart, Laurence; Kane, Molly

    2015-01-01

    The provision of an annual health check for adult persons with an intellectual disability is intended to counter the health inequalities experienced by this population. This study documents the uptake of checks across general practitioner (GP) practices in Northern Ireland over a 3-year period. In all, 84% of GP practices provided health checks…

  4. Helping people make well-informed decisions about health care: old and new challenges to achieving the aim of the Cochrane Collaboration.

    PubMed

    Oxman, Andrew D

    2013-09-20

    The aim of the Cochrane Collaboration is to help people make well-informed decisions about health care by preparing, maintaining and promoting the accessibility of systematic reviews of the effects of health care interventions. This aim is as relevant now as it was 20 years ago, when the Cochrane Collaboration was established. Substantial progress has been made toward addressing challenges to achieving the Collaboration's aim. At the same time, a huge amount of work remains to be done. Current challenges include improving the quality of reviews, methodological challenges, meeting the needs of contributors and users and taking on new challenges while staying focused on the Collaboration's aim. Radical thinking and substantial change may be needed to identify and implement pragmatic strategies to ensure that reviews are up-to-date and informative. Methodological challenges include the development and application of better methods for addressing explanatory factors, incorporating non-randomized evidence and making comparisons across multiple interventions. Innovations in editorial processes and strategies to meet the needs of low- and middle-income countries and diverse users of Cochrane reviews are needed. Finally, although it is important to consider broadening the aims of the Collaboration to include types of questions other than the effects of interventions and types of products other than the Cochrane Library, we should not lose sight of the aim of the Cochrane Collaboration. Addressing that aim is still a major challenge that requires the collaboration of thousands of people around the world and continuing improvements in the methods used to achieve that aim.

  5. Low high-density lipoprotein cholesterol is a residual risk factor associated with long-term clinical outcomes in diabetic patients with stable coronary artery disease who achieve optimal control of low-density lipoprotein cholesterol.

    PubMed

    Ogita, Manabu; Miyauchi, Katsumi; Miyazaki, Tadashi; Naito, Ryo; Konishi, Hirokazu; Tsuboi, Shuta; Dohi, Tomotaka; Kasai, Takatoshi; Yokoyama, Takayuki; Okazaki, Shinya; Kurata, Takeshi; Daida, Hiroyuki

    2014-01-01

    Diabetes mellitus is recognized an independent risk factor for coronary artery disease (CAD) and mortality. Clinical trials have shown that statins significantly reduce cardiovascular events in diabetic patients. However, residual cardiovascular risk persists despite the achievement of target low-density lipoprotein cholesterol (LDL-C) levels with statin. High-density lipoprotein cholesterol (HDL-C) is an established coronary risk factor that is independent of LDL-C levels. We evaluated the impact of HDL-C on long-term mortality in diabetic patients with stable CAD who achieved optimal LDL-C. We enrolled 438 consecutive diabetic patients who were scheduled for percutaneous coronary intervention between 2004 and 2007 at our institution. We identified 165 patients who achieved target LDL-C <100 mg/dl. Patients were stratified into two groups according to HDL-C levels (low HDL-C group, baseline HDL-C <40 mg/dl; high HDL-C group, ≥40 mg/dl). Major adverse cardiac events (MACE) that included all-cause death, acute coronary syndrome, and target lesion revascularization were evaluated between the two groups. The median follow-up period was 946 days. The rate of MACE was significantly higher in diabetic patients with low-HDL-C who achieved optimal LDL-C (6.9 vs 17.9 %, log-rank P = 0.030). Multivariate Cox regression analysis showed that HDL-C is significantly associated with clinical outcomes (adjusted hazard ratio for MACE 1.33, 95 % confidence interval 1.01-1.75, P = 0.042). Low HDL-C is a residual risk factor that is significantly associated with long-term clinical outcomes among diabetic patients with stable CAD who achieve optimal LDL-C levels.

  6. Appraising Reading Achievement.

    ERIC Educational Resources Information Center

    Ediger, Marlow

    To determine quality sequence in pupil progress, evaluation approaches need to be used which guide the teacher to assist learners to attain optimally. Teachers must use a variety of procedures to appraise student achievement in reading, because no one approach is adequate. Appraisal approaches might include: (1) observation and subsequent…

  7. On the Path to SunShot. The Environmental and Public Health Benefits of Achieving High Solar Penetrations in the United States

    SciTech Connect

    Wiser, Ryan; Mai, Trieu; Millstein, Dev; Macknick, Jordan; Carpenter, Alberta; Cohen, Stuart; Cole, Wesley; Frew, Bethany; Heath, Garvin

    2016-05-01

    Compared with fossil fuel generators, photovoltaics (PV) and concentrating solar power (CSP) produce far lower lifecycle levels of greenhouse gas (GHG) emissions and harmful pollutants including fine particular matter (PM2.5), sulfur dioxide (SO2), and nitrogen oxides (NOx). In this report, we monetize the emission reductions from achieving the U.S. Department of Energy's SunShot deployment goals: 14% of U.S. electricity demand met by solar in 2030 and 27% in 2050. We estimate that achieving these goals could reduce cumulative power-sector GHG emissions by 10% between 2015 and 2050, resulting in savings of $238-$252 billion. This is equivalent to 2.0-2.2 cents per kilowatt-hour of solar installed (cents/kWh-solar). Similarly, realizing these levels of solar deployment could reduce cumulative power-sector emissions of PM2.5 by 8%, SO2 by 9%, and NOx by 11% between 2015 and 2050. This could produce $167 billion in savings from lower future health and environmental damages, or 1.4 cents/kWh-solar--while also preventing 25,000-59,000 premature deaths. To put this in perspective, this estimated combined benefit of 3.5 cents/kWh-solar due to SunShot-level solar deployment is approximately equal to the additional levelized cost of electricity reduction needed to make unsubsidized utility-scale solar competitive with conventional generators today. In addition, the analysis shows that achieving the SunShot goals could save 4% of total power-sector water withdrawals and 9% of total power-sector water consumption over the 2015-2050 period--a particularly important consideration for arid states where substantial solar will be deployed. These results have potential implications for policy innovation and the economic competitiveness of solar and other generation technologies.

  8. High-performance n-type organic semiconductors: incorporating specific electron-withdrawing motifs to achieve tight molecular stacking and optimized energy levels.

    PubMed

    Yun, Sun Woo; Kim, Jong H; Shin, Seunghoon; Yang, Hoichang; An, Byeong-Kwan; Yang, Lin; Park, Soo Young

    2012-02-14

    Novel π–conjugated cyanostilbene-based semiconductors (Hex-3,5-TFPTA and Hex-4-TFPTA) with tight molecular stacking and optimized energy levels are synthesized. Hex-4-TFPTA exhibits high-performance n-type organic field-effect transistor (OFET) properties with electron mobilities as high as 2.14 cm2 V−1s−1 and on-off current ratios

  9. The McMaster Optimal Aging Portal: Usability Evaluation of a Unique Evidence-Based Health Information Website

    PubMed Central

    Dobbins, Maureen; Haynes, R. Brian; Iorio, Alfonso; Lavis, John N; Raina, Parminder

    2016-01-01

    Background Increasingly, older adults and their informal caregivers are using the Internet to search for health-related information. There is a proliferation of health information online, but the quality of this information varies, often based on exaggerated or dramatic findings, and not easily comprehended by consumers. The McMaster Optimal Aging Portal (Portal) was developed to provide Internet users with high-quality evidence about aging and address some of these current limitations of health information posted online. The Portal includes content for health professionals coming from three best-in-class resources (MacPLUS, Health Evidence, and Health Systems Evidence) and four types of content specifically prepared for the general public (Evidence Summaries, Web Resource Ratings, Blog Posts, and Twitter messages). Objective Our objectives were to share the findings of the usability evaluation of the Portal with particular focus on the content features for the general public and to inform designers of health information websites and online resources for older adults about key usability themes. Methods Data analysis included task performance during usability testing and qualitative content analyses of both the usability sessions and interviews to identify core themes. Results A total of 37 participants took part in 33 usability testing sessions and 21 focused interviews. Qualitative analysis revealed common themes regarding the Portal’s strengths and challenges to usability. The strengths of the website were related to credibility, applicability, browsing function, design, and accessibility. The usability challenges included reluctance to register, process of registering, searching, terminology, and technical features. Conclusions The study reinforced the importance of including end users during the development of this unique, dynamic, evidence-based health information website. The feedback was applied to iteratively improve website usability. Our findings can be

  10. Unravelling the concept of consumer preference: implications for health policy and optimal planning in primary care.

    PubMed

    Foster, Michele M; Earl, Peter E; Haines, Terry P; Mitchell, Geoffrey K

    2010-10-01

    Accounting for consumer preference in health policy and delivery system design makes good economic sense since this is linked to outcomes, quality of care and cost control. Probability trade-off methods are commonly used in policy evaluation, marketing and economics. Increasingly applied to health matters, the trade-off preference model has indicated that consumers of health care discriminate between different attributes of care. However, the complexities of the health decision-making environment raise questions about the inherent assumptions concerning choice and decision-making behavior which frame this view of consumer preference. In this article, we use the example of primary care in Australia as a vehicle to examine the concept of 'consumer preference' from different perspectives within economics and discuss the significance of how we model preferences for health policy makers. In doing so, we question whether mainstream thinking, namely that consumers are capable of deliberating between rival strategies and are willing to make trade-offs, is a reliable way of thinking about preferences given the complexities of the health decision-making environment. Alternative perspectives on preference can assist health policy makers and health providers by generating more precise information about the important attributes of care that are likely to enhance consumer engagement and optimise acceptability of health care.

  11. UK Food Standards Agency Optimal Nutrition Status Workshop: environmental factors that affect bone health throughout life.

    PubMed

    Burns, Lynn; Ashwell, Margaret; Berry, Jacqueline; Bolton-Smith, Caroline; Cassidy, Aedin; Dunnigan, Matthew; Khaw, Kay Tee; Macdonald, Helen; New, Susan; Prentice, Ann; Powell, Jonathan; Reeve, Jonathan; Robins, Simon; Teucher, Birgit

    2003-06-01

    The UK Food Standards Agency (FSA) convened a group of expert scientists to discuss and review UK FSA- and Department of Health-funded research on diet and bone health. This research focused on the lifestyle factors that are amenable to change and may significantly affect bone health and the risk of osteoporotic fracture. The potential benefits of fruits and vegetables, meat, Ca, vitamins D and K and phyto-oestrogens were presented and discussed. Other lifestyle factors were also discussed, particularly the effect of physical activity and possible gene-nutrient interactions affecting bone health.

  12. Ultralong, small-diameter TiOTiO₂ nanotubes achieved by an optimized two-step anodization for efficient dye-sensitized solar cells.

    PubMed

    Wang, Xiaoyan; Sun, Lidong; Zhang, Sam; Wang, Xiu

    2014-02-12

    An optimized two-step anodization is developed to fabricate ultralong, small-diameter TiO2 nanotubes, that is, with tube length of up to 31 μm and pore diameter of about 35 nm in this work. This overcomes the length limitation of small diameter tubes that usually presents in conventional one-step anodization. The small tubes with lengths of 23 μm yield a conversion efficiency of 5.02% in dye-sensitized solar cells under nonoptimized conditions.

  13. Multilayer-strategy to enhance optimal safety of the blood supply: The role of pathogen inactivation for optimizing recipient safety and helping health care cost containment: Moderator views.

    PubMed

    Seghatchian, Jerard

    2015-04-01

    This brief paper is based on the Coimbra 'conference presentation by the moderator', prior to the two main lectures on pathogen reduction treatment [PRT] of plasma. Being an educationist and teacher in core and having a great interest to simplify the message convey to conference' participants and readers I decided to maintain the slide format of the presentation. To highlight most effectively the role played by pathogen reduction to supplement the multilayer-strategy already in place, emphasizes were placed by going back to basic focusing on: where we were, where we are now and where we are going!. The unresolved problems of viral safety of blood components and criteria of universal acceptability of PRT are highlighted so is the need for further DDR strategies both in incremental and innovative ways. Finally the issue of who would benefit from implementation of PRT is described based on published data and also providing some visionary foresights for the long term benefits of PRT in both optimizing the safety of blood supply and helping at least in health care containment. I hope this new approach will be useful to readers, providing at least some conceptual and technical supports in understanding the role of PRT in optimizing the safety of blood supply.

  14. Optimizing Health Care for Foreign Students in the United States and American Students Abroad.

    ERIC Educational Resources Information Center

    American Coll. Health Association, Evanston, IL.

    This workbook is organized around 15 guidelines for improving health care for foreign students in the United States and U.S. students abroad. Each guideline is described in a chapter followed by self-assessment questions enabling the evaluation of the adequacy of campus health programs. Each chapter concludes with an invitation to outline goals…

  15. Health Belief Factors and Dispositional Optimism as Predictors of STD and HIV Preventive Behavior

    ERIC Educational Resources Information Center

    Zak-Place, Jennifer; Stern, Marilyn

    2004-01-01

    Identifying factors predictive of youth's engaging in preventive behaviors related to sexually transmitted diseases (STDs) and HIV remains a prominent public health concern. The utility of the Health Belief Model (HBM) continues to be suggested in identifying preventive behaviors. This study sought to examine the full HBM, including self-efficacy,…

  16. Can functional magnetic resonance imaging studies help with the optimization of health messaging for lifestyle behavior change? A systematic review.

    PubMed

    Whelan, Maxine E; Morgan, Paul S; Sherar, Lauren B; Orme, Mark W; Esliger, Dale W

    2017-02-15

    Unhealthy behaviors, including smoking, poor nutrition, excessive alcohol consumption, physical inactivity and sedentary lifestyles, are global risk factors for non-communicable diseases and premature death. Functional magnetic resonance imaging (fMRI) offers a unique approach to optimize health messages by examining how the brain responds to information relating to health. Our aim was to systematically review fMRI studies that have investigated variations in brain activation in response to health messages relating to (i) smoking; (ii) alcohol consumption; (iii) physical activity; (iv) diet; and (v) sedentary behavior. The electronic databases used were Medline/PubMed, Web of Science (Core Collection), PsychINFO, SPORTDiscuss, Cochrane Library and Open Grey. Studies were included if they investigated subjects aged ≥10years and were published before January 2017. Of the 13,836 studies identified in the database search, 18 studies (smoking k=15; diet k=2; physical activity/sedentary behavior k=1) were included in the review. The prefrontal cortex was activated in seven (47%) of the smoking-related studies and the physical activity study. Results suggest that activation of the ventromedial, dorsolateral and medial prefrontal cortex regions were predictive of subsequent behavior change following exposure to aversive anti-smoking stimuli. Studies investigating the neurological responses to anti-smoking material were most abundant. Of note, the prefrontal cortex and amygdala were most commonly activated in response to health messages across lifestyle behaviors. The review highlights an important disparity between research focusing on different lifestyle behaviors. Insights from smoking literature suggest fMRI may help to optimize health messaging in relation to other lifestyle behaviors.

  17. Optimizing the Presentation of Mental Health Information in Social Media: The Effects of Health Testimonials and Platform on Source Perceptions, Message Processing, and Health Outcomes.

    PubMed

    Quintero Johnson, Jessie M; Yilmaz, Gamze; Najarian, Kristy

    2016-08-30

    Using social media for the purpose of disseminating mental health information is a critical area of scientific inquiry for health communication professionals. The purpose of this study was to investigate whether the presence of a first-person testimonial in educational mental health information placed in Facebook and Twitter messages influenced college students' (N = 257) source perceptions, information processing, cognitive elaboration, health information recall, beliefs, and behavioral intentions. Results show that exposure to social media messages that featured mental health information embedded with a testimonial predicted less source homophily and more critical thoughts about the social media source, less systematic message processing, and less cognitive elaboration. Health information recall was significantly impacted by both the social media platform and message content such that participants in the testimonial condition on Facebook were more likely to recall the health facts in those messages whereas participants who viewed the testimonial in Twitter were less likely to recall the facts in those tweets. Compared to those who read Facebook messages, participants who read Twitter messages reported higher levels of systematic message processing. These findings suggest that the integration of health testimonials into social media messages might inadvertently provoke psychological resistance to mental health information, thereby reducing the persuasive impact of those messages.

  18. Helping the decision maker effectively promote various experts’ views into various optimal solutions to China’s institutional problem of health care provider selection through the organization of a pilot health care provider research system

    PubMed Central

    2013-01-01

    Background The main aim of China’s Health Care System Reform was to help the decision maker find the optimal solution to China’s institutional problem of health care provider selection. A pilot health care provider research system was recently organized in China’s health care system, and it could efficiently collect the data for determining the optimal solution to China’s institutional problem of health care provider selection from various experts, then the purpose of this study was to apply the optimal implementation methodology to help the decision maker effectively promote various experts’ views into various optimal solutions to this problem under the support of this pilot system. Methods After the general framework of China’s institutional problem of health care provider selection was established, this study collaborated with the National Bureau of Statistics of China to commission a large-scale 2009 to 2010 national expert survey (n = 3,914) through the organization of a pilot health care provider research system for the first time in China, and the analytic network process (ANP) implementation methodology was adopted to analyze the dataset from this survey. Results The market-oriented health care provider approach was the optimal solution to China’s institutional problem of health care provider selection from the doctors’ point of view; the traditional government’s regulation-oriented health care provider approach was the optimal solution to China’s institutional problem of health care provider selection from the pharmacists’ point of view, the hospital administrators’ point of view, and the point of view of health officials in health administration departments; the public private partnership (PPP) approach was the optimal solution to China’s institutional problem of health care provider selection from the nurses’ point of view, the point of view of officials in medical insurance agencies, and the health care researchers’ point

  19. Patient safety is not enough: targeting quality improvements to optimize the health of the population.

    PubMed

    Woolf, Steven H

    2004-01-06

    Ensuring patient safety is essential for better health care, but preoccupation with niches of medicine, such as patient safety, can inadvertently compromise outcomes if it distracts from other problems that pose a greater threat to health. The greatest benefit for the population comes from a comprehensive view of population needs and making improvements in proportion with their potential effect on public health; anything less subjects an excess of people to morbidity and death. Patient safety, in context, is a subset of health problems affecting Americans. Safety is a subcategory of medical errors, which also includes mistakes in health promotion and chronic disease management that cost lives but do not affect "safety." These errors are a subset of lapses in quality, which result not only from errors but also from systemic problems, such as lack of access, inequity, and flawed system designs. Lapses in quality are a subset of deficient caring, which encompasses gaps in therapeutics, respect, and compassion that are undetected by normative quality indicators. These larger problems arguably cost hundreds of thousands more lives than do lapses in safety, and the system redesigns to correct them should receive proportionately greater emphasis. Ensuring such rational prioritization requires policy and medical leaders to eschew parochialism and take a global perspective in gauging health problems. The public's well-being requires policymakers to view the system as a whole and consider the potential effect on overall population health when prioritizing care improvements and system redesigns.

  20. Optimization of bioenergy crop selection and placement based on a stream health indicator using an evolutionary algorithm.

    PubMed

    Herman, Matthew R; Nejadhashemi, A Pouyan; Daneshvar, Fariborz; Abouali, Mohammad; Ross, Dennis M; Woznicki, Sean A; Zhang, Zhen

    2016-10-01

    The emission of greenhouse gases continues to amplify the impacts of global climate change. This has led to the increased focus on using renewable energy sources, such as biofuels, due to their lower impact on the environment. However, the production of biofuels can still have negative impacts on water resources. This study introduces a new strategy to optimize bioenergy landscapes while improving stream health for the region. To accomplish this, several hydrological models including the Soil and Water Assessment Tool, Hydrologic Integrity Tool, and Adaptive Neruro Fuzzy Inference System, were linked to develop stream health predictor models. These models are capable of estimating stream health scores based on the Index of Biological Integrity. The coupling of the aforementioned models was used to guide a genetic algorithm to design watershed-scale bioenergy landscapes. Thirteen bioenergy managements were considered based on the high probability of adaptation by farmers in the study area. Results from two thousand runs identified an optimum bioenergy crops placement that maximized the stream health for the Flint River Watershed in Michigan. The final overall stream health score was 50.93, which was improved from the current stream health score of 48.19. This was shown to be a significant improvement at the 1% significant level. For this final bioenergy landscape the most often used management was miscanthus (27.07%), followed by corn-soybean-rye (19.00%), corn stover-soybean (18.09%), and corn-soybean (16.43%). The technique introduced in this study can be successfully modified for use in different regions and can be used by stakeholders and decision makers to develop bioenergy landscapes that maximize stream health in the area of interest.

  1. Gaps between Knowing and Doing: Understanding and Assessing the Barriers to Optimal Health Care

    ERIC Educational Resources Information Center

    Cochrane, Lorna J.; Olson, Curtis A.; Murray, Suzanne; Dupuis, Martin; Tooman, Tricia; Hayes, Sean

    2007-01-01

    Introduction: A significant gap exists between science and clinical practice guidelines, on the one hand, and actual clinical practice, on the other. An in-depth understanding of the barriers and incentives contributing to the gap can lead to interventions that effect change toward optimal practice and thus to better care. Methods: A systematic…

  2. The AWHONN Near-Term Infant Initiative: a conceptual framework for optimizing health for near-term infants.

    PubMed

    Medoff-Cooper, Barbara; Bakewell-Sachs, Susan; Buus-Frank, Madge E; Santa-Donato, Anne

    2005-01-01

    In June 2005, the Association of Women's Health, Obstetric and Neonatal Nurses launched a multiyear initiative to address the unique physiologic and developmental needs of near-term infants (NTIs) defined as those born between 34 and 37 weeks post-menstrual age. The Optimizing Care for the Near-Term Infant Conceptual Model integrates the concepts of neonatal physiologic functional status, nursing care practices, care environment, and the essential role of the family both in the hospital and beyond. The elements of the model will serve to guide program and resource development within the Near-Term Infant Initiative. Goals of the initiative are to raise awareness of the NTI population's unique needs, emphasize the need for research, encourage development and adoption of evidence-based guidelines to promote safe care, and provide resources that assist nurses and other health care professionals in risk-based assessment of NTIs.

  3. Health-related quality of life, optimism, and coping strategies in persons suffering from localized scleroderma.

    PubMed

    Szramka-Pawlak, B; Dańczak-Pazdrowska, A; Rzepa, T; Szewczyk, A; Sadowska-Przytocka, A; Żaba, R

    2013-01-01

    The clinical course of localized scleroderma may consist of bodily deformations, and bodily functions may also be affected. Additionally, the secondary lesions, such as discoloration, contractures, and atrophy, are unlikely to regress. The aforementioned symptoms and functional disturbances may decrease one's quality of life (QoL). Although much has been mentioned in the medical literature regarding QoL in persons suffering from dermatologic diseases, no data specifically describing patients with localized scleroderma exist. The aim of the study was to explore QoL in localized scleroderma patients and to examine their coping strategies in regard to optimism and QoL. The study included 41 patients with localized scleroderma. QoL was evaluated using the SKINDEX questionnaire, and levels of dispositional optimism were assessed using the Life Orientation Test-Revised. In addition, individual coping strategy was determined using the Mini-MAC scale and physical condition was assessed using the Localized Scleroderma Severity Index. The mean QoL score amounted to 51.10 points, with mean scores for individual components as follows: symptoms = 13.49 points, emotions = 21.29 points, and functioning = 16.32 points. A relationship was detected between QoL and the level of dispositional optimism as well as with coping strategies known as anxious preoccupation and helplessness-hopelessness. Higher levels of optimism predicted a higher general QoL. In turn, greater intensity of anxious preoccupied and helpless-hopeless behaviors predicted a lower QoL. Based on these results, it may be stated that localized scleroderma patients have a relatively high QoL, which is accompanied by optimism as well as a lower frequency of behaviors typical of emotion-focused coping strategies.

  4. [What can and cannot be achieved by registries : Perspective of the registry working group of the German Network of Health Services Research].

    PubMed

    Neugebauer, E A M; Stausberg, J

    2016-06-01

    In addition to clinical trials, registries and cohort studies are the fundamental basis of patient-orientated research. The importance of registries is increasing because more questions involving patient care under routine conditions (real world data) need to be answered. This article supplies answers to the questions: what can be achieved with registries and what are the limitations? Starting with a consensus definition of a registry from the German Network of Health Services Research (DNVF), the question of existing registries was examined and it was concluded that there was a lack of transparency. Consequently, a registry of registries similar to clinical trials registries is urgently needed as well as an evaluation of the quality of existing registries. Criteria are deduced that allow an assessment of the quality of a registry and which comprehensive possibilities registries can provide are discussed in eight different areas of interest to clinicians. The limitations of registries compared to randomized clinical trials and cohort studies are emphasized and discussed in this article. In the future, the use of registry-based randomized clinical trials (RRCT) will allow data related to efficacy as well as to effectiveness to be collated.

  5. Optimizing influenza vaccine distribution.

    PubMed

    Medlock, Jan; Galvani, Alison P

    2009-09-25

    The criteria to assess public health policies are fundamental to policy optimization. Using a model parametrized with survey-based contact data and mortality data from influenza pandemics, we determined optimal vaccine allocation for five outcome measures: deaths, infections, years of life lost, contingent valuation, and economic costs. We find that optimal vaccination is achieved by prioritization of schoolchildren and adults aged 30 to 39 years. Schoolchildren are most responsible for transmission, and their parents serve as bridges to the rest of the population. Our results indicate that consideration of age-specific transmission dynamics is paramount to the optimal allocation of influenza vaccines. We also found that previous and new recommendations from the U.S. Centers for Disease Control and Prevention both for the novel swine-origin influenza and, particularly, for seasonal influenza, are suboptimal for all outcome measures.

  6. New approach for optimal electricity planning and dispatching with hourly time-scale air quality and health considerations

    PubMed Central

    Kerl, Paul Y.; Zhang, Wenxian; Moreno-Cruz, Juan B.; Nenes, Athanasios; Realff, Matthew J.; Russell, Armistead G.; Sokol, Joel; Thomas, Valerie M.

    2015-01-01

    Integrating accurate air quality modeling with decision making is hampered by complex atmospheric physics and chemistry and its coupling with atmospheric transport. Existing approaches to model the physics and chemistry accurately lead to significant computational burdens in computing the response of atmospheric concentrations to changes in emissions profiles. By integrating a reduced form of a fully coupled atmospheric model within a unit commitment optimization model, we allow, for the first time to our knowledge, a fully dynamical approach toward electricity planning that accurately and rapidly minimizes both cost and health impacts. The reduced-form model captures the response of spatially resolved air pollutant concentrations to changes in electricity-generating plant emissions on an hourly basis with accuracy comparable to a comprehensive air quality model. The integrated model allows for the inclusion of human health impacts into cost-based decisions for power plant operation. We use the new capability in a case study of the state of Georgia over the years of 2004–2011, and show that a shift in utilization among existing power plants during selected hourly periods could have provided a health cost savings of $175.9 million dollars for an additional electricity generation cost of $83.6 million in 2007 US dollars (USD2007). The case study illustrates how air pollutant health impacts can be cost-effectively minimized by intelligently modulating power plant operations over multihour periods, without implementing additional emissions control technologies. PMID:26283358

  7. New approach for optimal electricity planning and dispatching with hourly time-scale air quality and health considerations.

    PubMed

    Kerl, Paul Y; Zhang, Wenxian; Moreno-Cruz, Juan B; Nenes, Athanasios; Realff, Matthew J; Russell, Armistead G; Sokol, Joel; Thomas, Valerie M

    2015-09-01

    Integrating accurate air quality modeling with decision making is hampered by complex atmospheric physics and chemistry and its coupling with atmospheric transport. Existing approaches to model the physics and chemistry accurately lead to significant computational burdens in computing the response of atmospheric concentrations to changes in emissions profiles. By integrating a reduced form of a fully coupled atmospheric model within a unit commitment optimization model, we allow, for the first time to our knowledge, a fully dynamical approach toward electricity planning that accurately and rapidly minimizes both cost and health impacts. The reduced-form model captures the response of spatially resolved air pollutant concentrations to changes in electricity-generating plant emissions on an hourly basis with accuracy comparable to a comprehensive air quality model. The integrated model allows for the inclusion of human health impacts into cost-based decisions for power plant operation. We use the new capability in a case study of the state of Georgia over the years of 2004-2011, and show that a shift in utilization among existing power plants during selected hourly periods could have provided a health cost savings of $175.9 million dollars for an additional electricity generation cost of $83.6 million in 2007 US dollars (USD2007). The case study illustrates how air pollutant health impacts can be cost-effectively minimized by intelligently modulating power plant operations over multihour periods, without implementing additional emissions control technologies.

  8. Intergenerational photovoice projects: optimizing this mechanism for influencing health promotion policies and strengthening relationships.

    PubMed

    Garcia, Carolyn M; Aguilera-Guzman, Rosa Maria; Lindgren, Sandi; Gutierrez, Rodolfo; Raniolo, Blanca; Genis, Therese; Vazquez-Benitez, Gabriela; Clausen, Lisa

    2013-09-01

    Intergenerational photovoice groups are promising for promoting health through the topic that is explored and through group dynamics that can foster healthy relationships and communication. To investigate the potential benefits of intergenerational photovoice projects, photovoice groups were conducted in urban Minnesota, United States, and in rural Morelos, Mexico, between 2009 and 2012 with Mexican-origin adults and their adolescent relatives. Seven photovoice groups of adult-adolescent dyads met for eight sessions and developed exhibits highlighting their views on health and migration and made policy recommendations, using messages conveyed through their words and photographs. Informal process evaluation and focus groups were used to elicit feedback about photovoice project participation. Photovoice project themes were descriptively analyzed. Focus group evaluation data were thematically summarized, and facilitator reflections were descriptively summarized to identify factors associated with intergenerational photovoice groups. Seventy-five participants were recruited. Photovoice themes represented effects of migration on health, family, and well-being. The following two evaluative themes were identified: (a) participant sentiments about the benefits of photovoice participation and (b) facilitator observations of intergenerational photovoice group benefits and challenges. Participants described opportunities to learn new things and barriers to healthy relationships that the project was eliminating by providing them with time to work together. Used in health promotion, photovoice is a valuable tool that contributes to understanding the complex underlying factors influencing behaviors and health.

  9. Importance of Ecological Factors and Colony Handling for Optimizing Health Status of Apiaries in Mediterranean Ecosystems

    PubMed Central

    Asensio, Irene; Muñoz, María Jesús; Fernández-Carrión, Eduardo; Sánchez-Vizcaíno, José Manuel; Carballo, Matilde

    2016-01-01

    We analyzed six apiaries in several natural environments with a Mediterranean ecosystem in Madrid, central Spain, in order to understand how landscape and management characteristics may influence apiary health and bee production in the long term. We focused on five criteria (habitat quality, landscape heterogeneity, climate, management and health), as well as 30 subcriteria, and we used the analytic hierarchy process (AHP) to rank them according to relevance. Habitat quality proved to have the highest relevance, followed by beehive management. Within habitat quality, the following subcriteria proved to be most relevant: orographic diversity, elevation range and important plant species located 1.5 km from the apiary. The most important subcriteria under beehive management were honey production, movement of the apiary to a location with a higher altitude and wax renewal. Temperature was the most important subcriterion under climate, while pathogen and Varroa loads were the most significant under health. Two of the six apiaries showed the best values in the AHP analysis and showed annual honey production of 70 and 28 kg/colony. This high productivity was due primarily to high elevation range and high orographic diversity, which favored high habitat quality. In addition, one of these apiaries showed the best value for beehive management, while the other showed the best value for health, reflected in the low pathogen load and low average number of viruses. These results highlight the importance of environmental factors and good sanitary practices to maximize apiary health and honey productivity. PMID:27727312

  10. What is the optimal type of physical activity to enhance health?

    PubMed Central

    Shephard, R J

    1997-01-01

    This review examines the potential of active daily living as a means of gaining the cardiovascular and health rewards previously sought through vigorous aerobic fitness programmes. Cross-sectional studies of occupational and leisure activity show encouraging associations between such activity and good health; in workers, the gross intensity of effort needed for health benefits has seemed to be 20 kJ/min. There has been less unanimity on the threshold intensity needed in leisure activities, but various recent "position statements" have decreased the recommendation to 50% of an individual's maximal oxygen intake, sustained for one hour three to five times per week. Life-style activities such as walking seem likely to reach this intensity in older individuals, but are unlikely to do so in young adults. A growing number of controlled longitudinal studies of walking programmes have demonstrated gains in aerobic fitness, modest reductions in blood pressure, improvements in lipid profile, increased bone density, and enhanced mood state, with less consistent reductions of body fat. However, gains have been greatest in the elderly, sedentary, and obese populations. The main component of active living, fast walking, seems likely to enhance health in such populations, but it is unlikely to be effective in young adults who are in good initial health. PMID:9429004

  11. Importance of Ecological Factors and Colony Handling for Optimizing Health Status of Apiaries in Mediterranean Ecosystems.

    PubMed

    Asensio, Irene; Vicente-Rubiano, Marina; Muñoz, María Jesús; Fernández-Carrión, Eduardo; Sánchez-Vizcaíno, José Manuel; Carballo, Matilde

    2016-01-01

    We analyzed six apiaries in several natural environments with a Mediterranean ecosystem in Madrid, central Spain, in order to understand how landscape and management characteristics may influence apiary health and bee production in the long term. We focused on five criteria (habitat quality, landscape heterogeneity, climate, management and health), as well as 30 subcriteria, and we used the analytic hierarchy process (AHP) to rank them according to relevance. Habitat quality proved to have the highest relevance, followed by beehive management. Within habitat quality, the following subcriteria proved to be most relevant: orographic diversity, elevation range and important plant species located 1.5 km from the apiary. The most important subcriteria under beehive management were honey production, movement of the apiary to a location with a higher altitude and wax renewal. Temperature was the most important subcriterion under climate, while pathogen and Varroa loads were the most significant under health. Two of the six apiaries showed the best values in the AHP analysis and showed annual honey production of 70 and 28 kg/colony. This high productivity was due primarily to high elevation range and high orographic diversity, which favored high habitat quality. In addition, one of these apiaries showed the best value for beehive management, while the other showed the best value for health, reflected in the low pathogen load and low average number of viruses. These results highlight the importance of environmental factors and good sanitary practices to maximize apiary health and honey productivity.

  12. A conceptual framework for economic optimization of an animal health surveillance portfolio.

    PubMed

    Guo, X; Claassen, G D H; Oude Lansink, A G J M; Saatkamp, H W

    2016-04-01

    Decision making on hazard surveillance in livestock product chains is a multi-hazard, multi-stakeholder, and multi-criteria process that includes a variety of decision alternatives. The multi-hazard aspect means that the allocation of the scarce resource for surveillance should be optimized from the point of view of a surveillance portfolio (SP) rather than a single hazard. In this paper, we present a novel conceptual approach for economic optimization of a SP to address the resource allocation problem for a surveillance organization from a theoretical perspective. This approach uses multi-criteria techniques to evaluate the performances of different settings of a SP, taking cost-benefit aspects of surveillance and stakeholders' preferences into account. The credibility of the approach has also been checked for conceptual validity, data needs and operational validity; the application potentials of the approach are also discussed.

  13. Dynamic optimization and conformity in health behavior and life enjoyment over the life cycle.

    PubMed

    Bejarano, Hernán D; Kaplan, Hillard; Rassenti, Stephen

    2015-01-01

    This article examines individual and social influences on investments in health and enjoyment from immediate consumption. Our lab experiment mimics the problem of health investment over a lifetime (Grossman, 1972a,b). Incentives to find the appropriate expenditures on life enjoyment and health are given by making in each period come period a function of previous health investments. In order to model social effects in the experiment, we randomly assigned individuals to chat/observation groups. Groups were permitted to freely chat between repeated lifetimes. Two treatments were employed: In the Independent-rewards treatment, an individual's rewards from investments in life enjoyment depend only on his choice and in the Interdependent-rewards treatment; rewards not only depend on an individual's choices but also on their similarity to the choices of the others in their group, generating a premium on conformity. The principal hypothesis is that gains from conformity increase variance in health behavior among groups and can lead to suboptimal performance. We tested three predictions and each was supported by the data: the Interdependent-rewards treatment (1) decreased within-group variance, (2) increased between-group variance, and (3) increased the likelihood of behavior far from the optimum with respect to the dynamic problem. We also test and find support for a series of subsidiary hypotheses. We found: (4) Subjects engaged in helpful chat in both treatments; (5) there was significant heterogeneity among both subjects and groups in chat frequencies; and (6) chat was most common early in the experiment, and (7) the interdependent rewards treatment increased strategic chat frequency. Incentives for conformity appear to promote prosocial behavior, but also increase variance among groups, leading to convergence on suboptimal strategies for some groups. We discuss these results in light of the growing literature focusing on social networks and health outcomes.

  14. Dynamic optimization and conformity in health behavior and life enjoyment over the life cycle

    PubMed Central

    Bejarano, Hernán D.; Kaplan, Hillard; Rassenti, Stephen

    2015-01-01

    This article examines individual and social influences on investments in health and enjoyment from immediate consumption. Our lab experiment mimics the problem of health investment over a lifetime (Grossman, 1972a,b). Incentives to find the appropriate expenditures on life enjoyment and health are given by making in each period come period a function of previous health investments. In order to model social effects in the experiment, we randomly assigned individuals to chat/observation groups. Groups were permitted to freely chat between repeated lifetimes. Two treatments were employed: In the Independent-rewards treatment, an individual's rewards from investments in life enjoyment depend only on his choice and in the Interdependent-rewards treatment; rewards not only depend on an individual's choices but also on their similarity to the choices of the others in their group, generating a premium on conformity. The principal hypothesis is that gains from conformity increase variance in health behavior among groups and can lead to suboptimal performance. We tested three predictions and each was supported by the data: the Interdependent-rewards treatment (1) decreased within-group variance, (2) increased between-group variance, and (3) increased the likelihood of behavior far from the optimum with respect to the dynamic problem. We also test and find support for a series of subsidiary hypotheses. We found: (4) Subjects engaged in helpful chat in both treatments; (5) there was significant heterogeneity among both subjects and groups in chat frequencies; and (6) chat was most common early in the experiment, and (7) the interdependent rewards treatment increased strategic chat frequency. Incentives for conformity appear to promote prosocial behavior, but also increase variance among groups, leading to convergence on suboptimal strategies for some groups. We discuss these results in light of the growing literature focusing on social networks and health outcomes. PMID

  15. Optimization of piezoelectric energy harvester for wireless smart sensors in railway health monitoring

    NASA Astrophysics Data System (ADS)

    Li, Jingcheng; Jang, Shinae; Tang, Jiong

    2013-04-01

    Wireless sensor network is one of the prospective methods for railway monitoring due to the long-term operation and low-maintenance performances. How to supply power to the wireless sensor nodes has drawn much attention recently. In railway monitoring, the idea of converting ambient vibration energy from vibration of railway track induced by passing trains to electric energy has made it a potential way for powering the wireless sensor nodes. Nowadays, most of vibration based energy harvesters are designed at resonance. However, as railway vibration frequency is a wide band range, how to design an energy harvester working at that range is critical. In this paper, the energy consumption of the wireless smart sensor platform, Imote2, at different working states were investigated. Based on the energy consumption, a design of a bimorph cantilever piezoelectric energy harvester has been optimized to generate maximum average power between a wide-band frequency range. Significant power and current outputs have been increased after optimal design. Finally, the rechargeable battery life for supplying the Imote2 for railway monitoring is predicted by using the optimized piezoelectric energy harvesting system.

  16. Optimizing the Care and Health of Women with Inflammatory Bowel Disease

    PubMed Central

    Nee, Judy; Feuerstein, Joseph D.

    2015-01-01

    Inflammatory bowel disease (IBD) including both ulcerative colitis and Crohn's disease is increasing worldwide. Although diagnosis is equally found in men and women, the chronicity of IBD poses a unique impact on the milestones of a woman's life. As the gastroenterologist becomes increasingly important in the health maintenance of patients with IBD, this review stresses the unique gender issues in women with IBD related to menstruation, cervical cancer, sexual health, contraception, and menopause that may affect the course of disease, treatment decisions, and quality of life. PMID:26089868

  17. Integrating Hospital-Acquired Lessons into Community Health Practice: Optimizing Antimicrobial Use in Bangalore

    ERIC Educational Resources Information Center

    Biswas, Rakesh; Dineshan, Vineeth; Narasimhamurthy, N. S.; Kasthuri, A. S.

    2007-01-01

    Introduction: Even as antimicrobial resistance is a serious public health concern worldwide, the uncertainties of diagnosis and treatment of fever strongly influence community practitioners toward prescribing antibiotics. To help community practitioners resolve their diagnostic questions and reduce the unnecessary use of antibiotics for viral…

  18. Barriers to, Efforts in, and Optimization of Integrated One Health Surveillance: A Review and Synthesis.

    PubMed

    Uchtmann, Nathaniel; Herrmann, John Arthur; Hahn, Edwin C; Beasley, Val Richard

    2015-06-01

    Insufficient data from existing surveillance systems underlie societal tolerance of acute and slow-onset health disasters that threaten, harm, and kill vast numbers of humans, animals, and plants. Here we describe barriers to integrated "One Health" surveillance, including those related to a lack of medical services, professional divisions, incompatible vocabularies, isolated data sets, and territorial borders. We draw from publications of experts who justify broader and more integrated surveillance, education, and stewardship focused on preventing and mitigating disease emergence and re-emergence. In addition, we highlight efforts from Illinois, the United States and the broader world, pointing to examples of relevant education; ways to acquire, compile, and analyze diagnostic and syndromic data; mapping of diseases of humans and animals; and rapid communication of findings and recommendations. For the future, we propose using needed outcomes for health and sustainability to set priorities for One Health programs of education, surveillance, and stewardship. Professionals and paraprofessionals should gather, interpret, and widely communicate the implications of data, not only on infectious diseases, but also on toxic agents, malnutrition, ecological damage, the grave impacts of warfare, societal drivers underlying these problems, and the effectiveness of specific countermeasures.

  19. Optimal Interventions in Host-Nation Health Systems During Counterinsurgency Operations

    DTIC Science & Technology

    2014-12-12

    the unique nature of an insurgency, and the how the United States Army can make suitable interventions that support both public health goals and...assistance in areas that may have undergone a natural disaster or are chronically economically disadvantaged, to burgeoning or established insurgencies and...

  20. Optimizing information technology to improve sexual health-care delivery: public and patient preferences.

    PubMed

    Ross, J D C; Copas, A; Stephenson, J; Fellows, L; Gilleran, G

    2007-07-01

    Information and communication technology (ICT) has the potential to improve the quality of care and efficiency in sexual health clinics, but its introduction requires input not only from health-care professionals and ICT specialists but also from service users and potential future users. In this study, views on ICT in relation to the delivery of sexual health services were assessed using a structured interview in two groups - a community sample of young people and a clinic sample of existing patients. In all, 542 community interviewees and 202 clinic patients participated. About 75% of respondents had access to the Internet and overall 60% reported that the self-collection of a sexual history on an electronic form was acceptable. Black Caribbean individuals had significantly less access to the Internet and a lower acceptance of electronic data collection. For booking an appointment, the majority of patients reported the telephone (community sample 93%, clinic sample 96%) or attending in person (community sample 77%, clinic sample 54%) to be acceptable, with a smaller proportion choosing email (community sample 10%, clinic sample 27%) or the Internet (community sample 7%, clinic sample 11%). Electronic booking was significantly less acceptable to Black Caribbean respondents. Although new technologies offer the opportunity to improve the quality of sexual health services, patient preferences and differences between groups in access to technology also need to be considered when services are reconfigured.

  1. Obstacles in the optimization of bone health outcomes in the female athlete triad.

    PubMed

    Ducher, Gaele; Turner, Anne I; Kukuljan, Sonja; Pantano, Kathleen J; Carlson, Jennifer L; Williams, Nancy I; De Souza, Mary Jane

    2011-07-01

    Maintaining low body weight for the sake of performance and aesthetic purposes is a common feature among young girls and women who exercise on a regular basis, including elite, college and high-school athletes, members of fitness centres, and recreational exercisers. High energy expenditure without adequate compensation in energy intake leads to an energy deficiency, which may ultimately affect reproductive function and bone health. The combination of low energy availability, menstrual disturbances and low bone mineral density is referred to as the 'female athlete triad'. Not all athletes seek medical assistance in response to the absence of menstruation for 3 or more months as some believe that long-term amenorrhoea is not harmful. Indeed, many women may not seek medical attention until they sustain a stress fracture. This review investigates current issues, controversies and strategies in the clinical management of bone health concerns related to the female athlete triad. Current recommendations focus on either increasing energy intake or decreasing energy expenditure, as this approach remains the most efficient strategy to prevent further bone health complications. However, convincing the athlete to increase energy availability can be extremely challenging. Oral contraceptive therapy seems to be a common strategy chosen by many physicians to address bone health issues in young women with amenorrhoea, although there is little evidence that this strategy improves bone mineral density in this population. Assessment of bone health itself is difficult due to the limitations of dual-energy X-ray absorptiometry (DXA) to estimate bone strength. Understanding how bone strength is affected by low energy availability, weight gain and resumption of menses requires further investigations using 3-dimensional bone imaging techniques in order to improve the clinical management of the female athlete triad.

  2. Framework for Smart Electronic Health Record- Linked Predictive Models to Optimize Care for Complex Digestive Diseases

    DTIC Science & Technology

    2013-08-01

    etc, disease location descriptors, Lupus , Thyroid disease, Rheumatoid arthritis, history of Appendectomy, psoriasis. The Crohn’s work is also...of a patient’s clinical history . This information is usually not rich enough to develop predictive models. To construct a useful patient profile...collaboration to achieve this goal given their history of successful development of informatics applications and our clinical research in complex GI

  3. The Effect of Dispositional Optimism on Health Outcomes in Patient with Heart Failure

    DTIC Science & Technology

    2013-03-08

    0.57- 0.90) for non-fatal MI, 0.70 (95%CI: 0.55-0.90) for angina pectoris , and 0.75 (95%CI: 0.62-0.91) for total incident CHD after adjusting for age...Non-fatal MI, angina pectoris , incident CHD Non-fatal MI=0.72 (95%CI: 0.57-0.90), angina = 0.70 (95%CI: 0.55-0.90), incident CHD= 0.75 (95%CI: 0.62...into fatal CHD and nonfatal MI from verified angina showed a similar relationship direction, although high and moderate levels of optimism were only

  4. Controversies in knowledge translation for community-based drug treatment: the need to the end policies of the war on drugs and mass incarceration of drug offenders to achieve health equity.

    PubMed

    Wallace, Barbara C

    2012-12-01

    The purpose of this article was to discuss significant challenges to the achievement of urban health, specifically acknowledging numerous controversies in knowledge translation for community-based drug treatment that prevent the achievement of health equity. Seven specific controversies are analyzed in this article. The results of the analysis are recommendations for moving toward the resolution of each controversy. Among the most important recommendations is a call to end the policies of the war on drugs and mass incarceration of drug offenders-as policies reflecting how politics and the misuse of power may derail knowledge translation. The article provides justification for evidence-based policy that supports community-based drug treatment as a public health approach consistent with the goals of health equity, ethical practice, and effective knowledge translation.

  5. Vitamin D and its role during pregnancy in attaining optimal health of mother and fetus.

    PubMed

    Wagner, Carol L; Taylor, Sarah N; Dawodu, Adekunle; Johnson, Donna D; Hollis, Bruce W

    2012-03-01

    Despite its discovery a hundred years ago, vitamin D has emerged as one of the most controversial nutrients and prohormones of the 21st century. Its role in calcium metabolism and bone health is undisputed but its role in immune function and long-term health is debated. There are clear indicators from in vitro and animal in vivo studies that point to vitamin D's indisputable role in both innate and adaptive immunity; however, the translation of these findings to clinical practice, including the care of the pregnant woman, has not occurred. Until recently, there has been a paucity of data from randomized controlled trials to establish clear cut beneficial effects of vitamin D supplementation during pregnancy. An overview of vitamin metabolism, states of deficiency, and the results of recent clinical trials conducted in the U.S. are presented with an emphasis on what is known and what questions remain to be answered.

  6. The Bremerton enrollment capacity model: an enrollment capacity model supporting the military health system optimization plan.

    PubMed

    Helmers, S

    2001-12-01

    The Department of Defense has launched several initiatives to improve efficiency and quality of care in the military health system. The goal of empaneling 1,300 to 1,500 patients per primary care manager did not correlate well with Naval Hospital Bremerton's experience and did not accurately account for military-specific requirements. The Bremerton Model Task Force was chartered to assess current business practices, identify areas for improvement, and develop a capacity model reflecting military readiness and residency training requirements. Methods included a 12-month review of patient visits and staff surveys of how providers spent their day, with time-and-motion analysis to verify assumptions. Our capacity results (average, 791 enrollees per primary care manager) demonstrated that objective measures at the local level do not support enrollment to Department of Defense-specified levels. Significant changes in "corporate culture" are necessary to accomplish the military health system goals.

  7. Vitamin D and Its Role During Pregnancy in Attaining Optimal Health of Mother and Fetus

    PubMed Central

    Wagner, Carol L.; Taylor, Sarah N.; Dawodu, Adekunle; Johnson, Donna D.; Hollis, Bruce W.

    2012-01-01

    Despite its discovery a hundred years ago, vitamin D has emerged as one of the most controversial nutrients and prohormones of the 21st century. Its role in calcium metabolism and bone health is undisputed but its role in immune function and long-term health is debated. There are clear indicators from in vitro and animal in vivo studies that point to vitamin D’s indisputable role in both innate and adaptive immunity; however, the translation of these findings to clinical practice, including the care of the pregnant woman, has not occurred. Until recently, there has been a paucity of data from randomized controlled trials to establish clear cut beneficial effects of vitamin D supplementation during pregnancy. An overview of vitamin metabolism, states of deficiency, and the results of recent clinical trials conducted in the U.S. are presented with an emphasis on what is known and what questions remain to be answered. PMID:22666547

  8. Best Practices for Optimizing DoD Contractor Safety and Occupational Health Program Performance

    DTIC Science & Technology

    2012-12-01

    professionals who have advanced degrees in counseling or related academic disciplines and who meet all requirements for State licensure and board...Health Insurance Portability and Accountability Act (HIPAA), P.L. 104-191). (c) The government may subject itself to liability for malpractice ...allegation of malpractice , whether or not successful, would require costly efforts to defend against even unsupported allegations. Based on these

  9. Relationship between optimism, disease variables, and health perception and quality of life in individuals with epilepsy.

    PubMed

    Pais-Ribeiro, J; da Silva, A Martins; Meneses, R F; Falco, C

    2007-08-01

    Epilepsy is a relatively frequent chronic condition with an important impact on the health perception and quality of life (QOL) of patients. The aim of the present study was to identify variables related to health status perception and QOL in persons with epilepsy. Participants were 200 persons with epilepsy, 53.5% of whom were males. The mean age was 39.6; 95% had seizures, and 99% were taking antiepileptic medication. The self-report questionnaire administered assessed four types of variables: demographic, disease, epilepsy-specific optimistic attitude, and outcome variables. Results demonstrated that an optimistic orientation is related to better perception of physical and mental health status and better perception of QOL. The variables that best predict positive outcomes are optimistic orientation, perception of cognitive functioning, and perception of seizure control. These results question the importance attributed to seizure characteristics for everyday functioning and everyday life of individuals with epilepsy, and stress the importance of facilitating an epilepsy-specific optimistic orientation.

  10. The Integrated Medical Model - Optimizing In-flight Space Medical Systems to Reduce Crew Health Risk and Mission Impacts

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric; Walton, Marlei; Minard, Charles; Saile, Lynn; Myers, Jerry; Butler, Doug; Lyengar, Sriram; Fitts, Mary; Johnson-Throop, Kathy

    2009-01-01

    The Integrated Medical Model (IMM) is a decision support tool used by medical system planners and designers as they prepare for exploration planning activities of the Constellation program (CxP). IMM provides an evidence-based approach to help optimize the allocation of in-flight medical resources for a specified level of risk within spacecraft operational constraints. Eighty medical conditions and associated resources are represented in IMM. Nine conditions are due to Space Adaptation Syndrome. The IMM helps answer fundamental medical mission planning questions such as What medical conditions can be expected? What type and quantity of medical resources are most likely to be used?", and "What is the probability of crew death or evacuation due to medical events?" For a specified mission and crew profile, the IMM effectively characterizes the sequence of events that could potentially occur should a medical condition happen. The mathematical relationships among mission and crew attributes, medical conditions and incidence data, in-flight medical resources, potential clinical and crew health end states are established to generate end state probabilities. A Monte Carlo computational method is used to determine the probable outcomes and requires up to 25,000 mission trials to reach convergence. For each mission trial, the pharmaceuticals and supplies required to diagnose and treat prevalent medical conditions are tracked and decremented. The uncertainty of patient response to treatment is bounded via a best-case, worst-case, untreated case algorithm. A Crew Health Index (CHI) metric, developed to account for functional impairment due to a medical condition, provides a quantified measure of risk and enables risk comparisons across mission scenarios. The use of historical in-flight medical data, terrestrial surrogate data as appropriate, and space medicine subject matter expertise has enabled the development of a probabilistic, stochastic decision support tool capable of

  11. Optimizing the electronic health record to standardize administration and documentation of nutritional supplements.

    PubMed

    Citty, Sandra W; Kamel, Amir; Garvan, Cynthia; Marlowe, Lee; Westhoff, Lynn

    2017-01-01

    Malnutrition in hospitalized patients is a major cause for hospital re-admission, pressure ulcers and increased hospital costs. Methods to improve the administration and documentation of nutritional supplements for hospitalized patients are needed to improve patient care, outcomes and resource utilization. Staff at a medium-sized academic health science center hospital in the southeastern United States noted that nutritional supplements ordered for patients at high risk for malnutrition were not offered or administered to patients in a standardized manner and/or not documented clearly in the electronic health record as per prescription. This paper reports on a process improvement project that redesigned the ordering, administration and documentation process of oral nutritional supplements in the electronic health record. By adding nutritional products to the medication order sets and adding an electronic nutrition administration record (ENAR) tab, the multidisciplinary team sought to standardize nutritional supplement ordering, documentation and administration at prescribed intervals. This process improvement project used a triangulated approach to evaluating pre- and post-process change including: medical record reviews, patient interviews, and nutrition formula room log reports. Staff education and training was carried out prior to initiation of the system changes. This process change resulted in an average decrease in the return of unused nutritional formula from 76% returned at baseline to 54% post-process change. The process change resulted in 100% of nutritional supplement orders having documentation about nutritional medication administration and/or reason for non-administration. Documentation in the ENAR showed that 41% of ONS orders were given and 59% were not given. Significantly more patients reported being offered the ONS product (p=0.0001) after process redesign and more patients (5% before ENAR and 86% after ENAR reported being offered the correct

  12. Optimizing the electronic health record to standardize administration and documentation of nutritional supplements

    PubMed Central

    Citty, Sandra W.; Kamel, Amir; Garvan, Cynthia; Marlowe, Lee; Westhoff, Lynn

    2017-01-01

    Malnutrition in hospitalized patients is a major cause for hospital re-admission, pressure ulcers and increased hospital costs. Methods to improve the administration and documentation of nutritional supplements for hospitalized patients are needed to improve patient care, outcomes and resource utilization. Staff at a medium-sized academic health science center hospital in the southeastern United States noted that nutritional supplements ordered for patients at high risk for malnutrition were not offered or administered to patients in a standardized manner and/or not documented clearly in the electronic health record as per prescription. This paper reports on a process improvement project that redesigned the ordering, administration and documentation process of oral nutritional supplements in the electronic health record. By adding nutritional products to the medication order sets and adding an electronic nutrition administration record (ENAR) tab, the multidisciplinary team sought to standardize nutritional supplement ordering, documentation and administration at prescribed intervals. This process improvement project used a triangulated approach to evaluating pre- and post-process change including: medical record reviews, patient interviews, and nutrition formula room log reports. Staff education and training was carried out prior to initiation of the system changes. This process change resulted in an average decrease in the return of unused nutritional formula from 76% returned at baseline to 54% post-process change. The process change resulted in 100% of nutritional supplement orders having documentation about nutritional medication administration and/or reason for non-administration. Documentation in the ENAR showed that 41% of ONS orders were given and 59% were not given. Significantly more patients reported being offered the ONS product (p=0.0001) after process redesign and more patients (5% before ENAR and 86% after ENAR reported being offered the correct

  13. Predictors of Optimal Cognitive Aging in 80+ Women: The Women’s Health Initiative Memory Study

    PubMed Central

    Rapp, Stephen R.; Hogan, Patricia E.; Driscoll, Ira; Tindle, Hilary A.; Smith, J. Carson; Kesler, Shelli R.; Zaslavsky, Oleg; Rossom, Rebecca C.; Ockene, Judith K.; Yaffe, Kristine; Manson, JoAnn E.; Resnick, Susan M.; Espeland, Mark A.

    2016-01-01

    Background. Independent predictors of preserved cognitive functioning and factors associated with maintaining high preserved cognitive function in women ≥80 years remain elusive. Methods. Two thousand two hundred twenty-eight women with a mean age of 85 years who participated in the Women’s Health Initiative Memory Study were classified as cognitively normal (n = 1,905, 85.5%), mild cognitive impairment (n = 88, 3.9%), dementia (n = 121, 5.4%) or other cognitive impairment (n = 114, n = 5.1%) by central adjudication. Global cognitive functioning was assessed using telephone interview for cognitive status-modified in those women who did not meet cognitive impairment criteria. Differences between women grouped by cognitive status with respect to each potential risk factor were assessed using chi-squared tests and t-tests. Backward stepwise logistic regression was used to select factors that were independently associated with cognitive status. Results. Factors associated with preserved cognitive functioning were younger age, higher education, and family incomes, being non-Hispanic white, better emotional wellbeing, fewer depressive symptoms, more insomnia complaints, being free of diabetes, and not carrying the apolipoprotein E-epsilon 4 allele. Cognitively normal women who demonstrated sustained high preserved cognition were younger, more educated, and endorsed better self-reported general health, emotional wellbeing, and higher physical functioning. Conclusions. Addressing sociodemographic disparities such as income inequality, and targeting interventions to improve depressive symptoms and vascular risk factors, including diabetes, may play an important role in preserving cognition among women who survive to 80 years of age. Person-centered approaches that combine interventions to improve physical, cognitive, and psychosocial functioning may promote maintenance of high preserved cognitive health in the oldest-old. PMID:26858326

  14. [Establishing the idea of holistic integrative medicine, optimizing the quality of health care service in prevention and treatment].

    PubMed

    Sun, Xing-guo

    2015-07-01

    Under background of reductionism in the modern science, physiology and medicine are stepwise refined into system, organ, disease, cell and gene etc. Although clinical medicine, only service in whole human object, obviously brought tremendous progress, it also appeared obvious defects and limits at the same time. Professionalized and specialized medicine not only needs to be integrated from basics to clinical fields, but also from prevention, health management, clinical treatment and functional rehabilitation medicine. People are indivisible organic whole. Professionalization, translation and integration must be combined. In order to provide the best quality and optimized medical service for the Chinese people and to lead in the world, we have to strengthen professional and technical knowledge, and have to establish the holistic integrative medical philosophy for physiology and medicine too.

  15. Can Social Support Protect Bullied Adolescents from Adverse Outcomes? A Prospective Study on the Effects of Bullying on the Educational Achievement and Mental Health of Adolescents at Secondary Schools in East London

    ERIC Educational Resources Information Center

    Rothon, Catherine; Head, Jenny; Klineberg, Emily; Stansfeld, Stephen

    2011-01-01

    This paper investigates the extent to which social support can have a buffering effect against the potentially adverse consequences of bullying on school achievement and mental health. It uses a representative multiethnic sample of adolescents attending East London secondary schools in three boroughs. Bullied adolescents were less likely to…

  16. Optimizing and Validating a Brief Assessment for Identifying Children of Service Members at Risk for Psychological Health Problems Following Parent Deployment

    DTIC Science & Technology

    2013-07-01

    Children (BASC) ADHD Monitor. Circle Pines, MN: American Guidance Service. Keane, T., Fairbank, J., Caddell, J., Zimering, R., Taylor, K., & Mora, C...0036 TITLE: Optimizing and Validating a Brief Assessment for Identifying Children of Service Members at Risk for Psychological Health Problems...DATES COVERED (From - To) 15 June 2012- 14 June 2013 Optimizing and Validating a Brief Assessment for Identifying Children of Service Members at Risk

  17. Optimized guided wave excitations for health monitoring of a bolted joint

    NASA Astrophysics Data System (ADS)

    Fasel, Timothy R.; Olson, Colin C.; Todd, Michael D.

    2008-03-01

    Recent research has shown that chaotic structural excitation and state space reconstruction may be used beneficially in structural health monitoring (SHM) processes. This relationship has been exploited for use in detection of bolt preload reduction by using a chaotic waveform with ultrasonic frequency content with a damage detection algorithm based on auto-regressive (AR) modeling. The signal is actively applied to a structure using a bonded macro fiber composite (MFC) patch. The response generated by the mechanical interaction of the MFC patch with the structure is then measured by other affixed MFC patches. In this study the suitability of particular chaotic waveforms will be investigated through the use of evolutionary algorithms. These algorithms are able to find an optimum excitation for maximum damage state discernability whose fitness is two orders of magnitude greater than choosing random parameters for signal creation.

  18. Optimizing Weight for Maternal and Infant Health - Tenable, or Too Late?

    PubMed

    Nicklas, Jacinda M; Barbour, Linda A

    Obesity in pregnancy is the leading cause of maternal and fetal morbidity, and gestational weight gain (GWG) is one modifiable risk factor that improves pregnancy outcomes. Most pregnant women gain more than the 2009 Institute of Medicine recommendations, particularly overweight and obese women. GWG even less than the 2009 IOM guidelines in obese women may improve pregnancy outcomes and reduce large-for-gestational-age (LGA) infants, an independent risk factor for childhood obesity, without increasing small-for-gestational-age (SGA) infants. Unfortunately, despite the fact that over 50 interventional trials designed to decrease excess GWG have been conducted, these interventions have been only modestly effective, and interventions designed to facilitate weight postpartum weight loss have also been disappointing. Successful interventions are of paramount importance not only to improve pregnancy outcomes but also for the future metabolic health of the mother and her infant, and may be key in attenuating the trans-generational risk on childhood obesity.

  19. Optimizing Weight for Maternal and Infant Health – Tenable, or Too Late?

    PubMed Central

    Barbour, Linda A.

    2015-01-01

    Obesity in pregnancy is the leading cause of maternal and fetal morbidity, and gestational weight gain (GWG) is one modifiable risk factor that improves pregnancy outcomes. Most pregnant women gain more than the 2009 Institute of Medicine recommendations, particularly overweight and obese women. GWG even less than the 2009 IOM guidelines in obese women may improve pregnancy outcomes and reduce large-for-gestational-age (LGA) infants, an independent risk factor for childhood obesity, without increasing small-for-gestational-age (SGA) infants. Unfortunately, despite the fact that over 50 interventional trials designed to decrease excess GWG have been conducted, these interventions have been only modestly effective, and interventions designed to facilitate weight postpartum weight loss have also been disappointing. Successful interventions are of paramount importance not only to improve pregnancy outcomes but also for the future metabolic health of the mother and her infant, and may be key in attenuating the trans-generational risk on childhood obesity. PMID:26442123

  20. The relation of illness representations to the 'end-stage' appraisal of outcomes through health status, and the moderating role of optimism.

    PubMed

    Karademas, Evangelos C; Kynigopoulou, Eleftheria; Aghathangelou, Eleni; Anestis, Dimitrios

    2011-05-01

    The aim of this study was to examine an important pathway suggested by the common sense model (CSM): the relation of illness representations to the 'end-stage' appraisal of outcomes through health status. A further aim was to examine the moderating role of optimism in this relationship. One hundred and six chronic cardiac patients completed questionnaires about illness representations and dispositional optimism at baseline, and health status and illness-related helplessness (as an indicator of the 'end-stage' appraisal of outcomes) at a follow-up interview, 6 months later. Indirect (mediation) as well as conditional indirect (moderated mediation) effects were examined using bootstrapped models. According to the results, the effect of illness representations on helplessness was mediated by at least one of the health measures used. Also, most of these indirect relations were conditional on the values of optimism. That is, optimism moderated the 'illness representations-health status-"end-stage" appraisal of outcomes' relationship, as the mediating effects were absent at higher levels of optimism. These findings can provide us with a more comprehensive picture of adaptation to illness, as well as of the ways the illness-related information is being processed by patients. Thus, they have significant implications for theory, research and practice.

  1. Thin sheets achieve optimal wrapping of liquids

    NASA Astrophysics Data System (ADS)

    Paulsen, Joseph; Démery, Vincent; Davidovitch, Benny; Santangelo, Christian; Russell, Thomas; Menon, Narayanan

    2015-03-01

    A liquid drop can wrap itself in a sheet using capillary forces [Py et al., PRL 98, 2007]. However, the efficiency of ``capillary origami'' at covering the surface of a drop is hampered by the mechanical cost of bending the sheet. Thinner sheets deform more readily by forming small-scale wrinkles and stress-focussing patterns, but it is unclear how coverage efficiency competes with mechanical cost as thickness is decreased, and what wrapping shapes will emerge. We place a thin (~ 100 nm) polymer film on a drop whose volume is gradually decreased so that the sheet covers an increasing fraction of its surface. The sheet exhibits a complex sequence of axisymmetric and polygonal partially- and fully- wrapped shapes. Remarkably, the progression appears independent of mechanical properties. The gross shape, which neglects small-scale features, is correctly predicted by a simple geometric approach wherein the exposed area is minimized. Thus, simply using a thin enough sheet results in maximal coverage.

  2. Challenges in defining an optimal approach to formula-based allocations of public health funds in the United States

    PubMed Central

    Buehler, James W; Holtgrave, David R

    2007-01-01

    -based versus competitive allocation methods are needed to promote the optimal use of public health funds. In the meantime, those who use formula-based strategies to allocate funds should be familiar with the nuances of this approach. PMID:17394645

  3. The Use of Health Related Physical Fitness Tests to Achieve Sex Fair Ability Grouping of Students in Junior and Senior High School Physical Education Classes.

    ERIC Educational Resources Information Center

    Plowman, Sharon Ann

    The use of health-related physical fitness tests for sex-fair ability grouping in physical education classes requires the verification of two assumptions: (1) that there exists a direct positive relationship between health-related physical fitness and development and/or improvement of various sport skills; and (2) that there is a physiological…

  4. A role for supplements in optimizing health: the metabolic tune-up.

    PubMed

    Ames, Bruce N

    2004-03-01

    An optimum intake of micronutrients and metabolites, which varies with age and genetic constitution, would tune up metabolism and give a marked increase in health, particularly for the poor, young, obese, and elderly, at little cost. (1) DNA damage. Deficiency of vitamins B-12, folic acid, B-6, C or E, or iron or zinc appears to mimic radiation in damaging DNA by causing single- and double-strand breaks, oxidative lesions or both. Half of the population may be deficient in at least one of these micronutrients. (2) The Km concept. Approximately 50 different human genetic diseases that are due to a poorer binding affinity (Km) of the mutant enzyme for its coenzyme can be remedied by feeding high-dose B vitamins, which raise levels of the corresponding coenzyme. Many polymorphisms also result in a lowered affinity of enzyme for coenzyme. (3) Mitochondrial oxidative decay. This decay, which is a major contributor to aging, can be ameliorated by feeding old rats the normal mitochondrial metabolites acetyl carnitine and lipoic acid at high levels. Many common micronutrient deficiencies, such as iron or biotin, cause mitochondrial decay with oxidant leakage leading to accelerated aging and neural decay.

  5. Rationalizing definitions and procedures for optimizing clinical care and public health in fetal death and stillbirth.

    PubMed

    Joseph, K S; Kinniburgh, Brooke; Hutcheon, Jennifer A; Mehrabadi, Azar; Dahlgren, Leanne; Basso, Melanie; Davies, Cheryl; Lee, Lily

    2015-04-01

    Despite the recent focus on stillbirth, there remains a profound need to address problems associated with the definitions and procedures related to fetal death and stillbirth. The current definition of fetal death, first proposed in 1950, needs to be updated to distinguish between the timing of fetal death (which has etiologic and prognostic significance) and the timing of stillbirth (ie, the delivery of the dead fetus). Stillbirth registration procedures, modeled after live birth registration and not death registration, also need to be modernized because they can be an unnecessary burden on some grieving families. The problems associated with fetal death definitions and stillbirth-associated procedures are highlighted by selective fetal reduction in multifetal pregnancy; in many countries, the fetus reduced at 10-13 weeks of gestation and delivered at term gestation requires stillbirth registration and a burial permit even if fetal remains cannot be identified. An international consensus is needed to standardize the definition of reportable fetal deaths; ideally this should be based on the timing of fetal death and should address the status of pregnancy terminations. In this article, we list propositions for initiating an international dialogue that will rationalize fetal death definitions, registration criteria, and associated procedures, and thereby improve clinical care and public health.

  6. l-Ascorbic acid (vitamin C) supplementation to optimize health and reproduction in cattle.

    PubMed

    Ranjan, R; Ranjan, A; Dhaliwal, G S; Patra, R C

    2012-01-01

    Cattle can synthesize L-ascorbic acid (or Vitamin C) from either D-glucose or D-galactose through glucuronic acid pathway in the liver. L-Ascorbic acid present in cattle diet is almost totally destroyed by rumen microorganisms making them essentially dependent on its endogenous synthesis, which is assumed sufficient to meet the physiological requirement. Therefore, the role of vitamin C in cattle health and disease has remained widely overlooked. However, there is mounting evidence that the level of L-ascorbic acid in blood and other tissues decreases in association with stress and disease, and Vitamin C supplementation revealed favorable response as evident from early recovery. The present review is an attempt to summarize the existing literature pertaining to the physiological role of L-ascorbic acid and the scope of its supplementation in the prevention and treatment of diseases in cattle. It should be realized that the aqueous solution of vitamin C is highly acidic and subcutaneous or intramuscular administration may cause tissue irritation and inflammation, whereas the sodium ascorbate solution is less acidic and might be used for intramuscular administration.

  7. Optimizing the perceived benefits and health outcomes of writing about traumatic life events.

    PubMed

    Andersson, Matthew A; Conley, Colleen S

    2013-02-01

    Expressive writing, which involves disclosing one's deepest thoughts and feelings about a stressful life event by using a first-person perspective, has been linked to gains in health and well-being, though effect sizes range widely. Assuming a third-person perspective is a natural and effective way of coping with highly distressing events. Therefore, the current study examined whether a distanced, third-person approach to expressive writing might be more beneficial than a traditional, first-person intervention for high baseline levels of event-linked intrusive thinking. Randomly assigned participants wrote expressively about traumatic life events by using a first-person or third-person-singular perspective. Linguistic analyses showed that assuming a first-person perspective is linked to higher levels of in-text cognitive engagement, whereas a third-person perspective is linked to lower cognitive engagement. However, in a context of higher levels of intrusive thinking, third-person expressive writing, relative to a traditional first-person approach, yielded (1) greater perceived benefits and positive, long-lasting effects as well as (2) fewer days of activity restriction due to illness. Although more research is needed, these results suggest that third-person expressive writing may be an especially fitting technique for recovering from traumatic or highly stressful life events.

  8. Optimizing data collection for public health decisions: a data mining approach

    PubMed Central

    2014-01-01

    Background Collecting data can be cumbersome and expensive. Lack of relevant, accurate and timely data for research to inform policy may negatively impact public health. The aim of this study was to test if the careful removal of items from two community nutrition surveys guided by a data mining technique called feature selection, can (a) identify a reduced dataset, while (b) not damaging the signal inside that data. Methods The Nutrition Environment Measures Surveys for stores (NEMS-S) and restaurants (NEMS-R) were completed on 885 retail food outlets in two counties in West Virginia between May and November of 2011. A reduced dataset was identified for each outlet type using feature selection. Coefficients from linear regression modeling were used to weight items in the reduced datasets. Weighted item values were summed with the error term to compute reduced item survey scores. Scores produced by the full survey were compared to the reduced item scores using a Wilcoxon rank-sum test. Results Feature selection identified 9 store and 16 restaurant survey items as significant predictors of the score produced from the full survey. The linear regression models built from the reduced feature sets had R2 values of 92% and 94% for restaurant and grocery store data, respectively. Conclusions While there are many potentially important variables in any domain, the most useful set may only be a small subset. The use of feature selection in the initial phase of data collection to identify the most influential variables may be a useful tool to greatly reduce the amount of data needed thereby reducing cost. PMID:24919484

  9. Back to the basics: Identifying and addressing underlying challenges in achieving high quality and relevant health statistics for indigenous populations in Canada

    PubMed Central

    Smylie, Janet; Firestone, Michelle

    2015-01-01

    Canada is known internationally for excellence in both the quality and public policy relevance of its health and social statistics. There is a double standard however with respect to the relevance and quality of statistics for Indigenous populations in Canada. Indigenous specific health and social statistics gathering is informed by unique ethical, rights-based, policy and practice imperatives regarding the need for Indigenous participation and leadership in Indigenous data processes throughout the spectrum of indicator development, data collection, management, analysis and use. We demonstrate how current Indigenous data quality challenges including misclassification errors and non-response bias systematically contribute to a significant underestimate of inequities in health determinants, health status, and health care access between Indigenous and non-Indigenous people in Canada. The major quality challenge underlying these errors and biases is the lack of Indigenous specific identifiers that are consistent and relevant in major health and social data sources. The recent removal of an Indigenous identity question from the Canadian census has resulted in further deterioration of an already suboptimal system. A revision of core health data sources to include relevant, consistent, and inclusive Indigenous self-identification is urgently required. These changes need to be carried out in partnership with Indigenous peoples and their representative and governing organizations. PMID:26793283

  10. Back to the basics: Identifying and addressing underlying challenges in achieving high quality and relevant health statistics for indigenous populations in Canada.

    PubMed

    Smylie, Janet; Firestone, Michelle

    Canada is known internationally for excellence in both the quality and public policy relevance of its health and social statistics. There is a double standard however with respect to the relevance and quality of statistics for Indigenous populations in Canada. Indigenous specific health and social statistics gathering is informed by unique ethical, rights-based, policy and practice imperatives regarding the need for Indigenous participation and leadership in Indigenous data processes throughout the spectrum of indicator development, data collection, management, analysis and use. We demonstrate how current Indigenous data quality challenges including misclassification errors and non-response bias systematically contribute to a significant underestimate of inequities in health determinants, health status, and health care access between Indigenous and non-Indigenous people in Canada. The major quality challenge underlying these errors and biases is the lack of Indigenous specific identifiers that are consistent and relevant in major health and social data sources. The recent removal of an Indigenous identity question from the Canadian census has resulted in further deterioration of an already suboptimal system. A revision of core health data sources to include relevant, consistent, and inclusive Indigenous self-identification is urgently required. These changes need to be carried out in partnership with Indigenous peoples and their representative and governing organizations.

  11. From making pamphlets to making policies: results from a collaborative training to increase knowledge, motivation, and self-efficacy for achieving public health policy and systems change.

    PubMed

    Dilley, Julia A; Reuer, Jennifer R; Colman, Victor; Norman, Robbi Kay

    2009-04-01

    Steps to a Healthier Washington, in collaboration with other programs in the Washington State Department of Health and external partners, has implemented training to improve public health practice and create greater organizational and staff capacity for promoting effective policy and systems changes, including reducing disparities. The training is grounded in behavior change and adult learning theories. A comprehensive post training evaluation found long-term improvements in self-efficacy, reported changes in work, and attribution of those changes to the training. Organizations working to refocus public health work on policy and systems change should consider providing skills-based policy training to their staff. This study suggests that an integrated training, using adult learning theory, has led to long-term improvements in capacity among public health staff and partners.

  12. Shifting paradigms: how the fight for 'universal access to AIDS treatment and prevention' supports achieving 'comprehensive primary health care for all'

    PubMed Central

    Ooms, Gorik

    2008-01-01

    In a recent issue of Globalization and Health, Yu et al. examine the impact of HIV/AIDS programs on health care systems. This editorial considers their position and confirms that the former actually supports the latter aim; the two approaches are not at odds with one another, but could be viewed as complementary. A key requirement towards meeting both objectives is to ensure sustained international aid. PMID:19017377

  13. Shifting paradigms: how the fight for 'universal access to AIDS treatment and prevention' supports achieving 'comprehensive primary health care for all'.

    PubMed

    Ooms, Gorik

    2008-11-18

    In a recent issue of Globalization and Health, Yu et al. examine the impact of HIV/AIDS programs on health care systems. This editorial considers their position and confirms that the former actually supports the latter aim; the two approaches are not at odds with one another, but could be viewed as complementary. A key requirement towards meeting both objectives is to ensure sustained international aid.

  14. Effects of optimism, social support, fighting spirit, cancer worry and internal health locus of control on positive affect in cancer survivors: a path analysis.

    PubMed

    Hodges, Kayleigh; Winstanley, Sue

    2012-12-01

    The psychological impact of a cancer diagnosis can extend through treatment, well into cancer survivorship and can be influenced by a range of psychosocial resources. At different stages in this trajectory, optimism is known to affect well-being directly. This study focusing upon the potential to flourish after cancer, investigates the relationship between optimism and positive affect during cancer survivorship together with four possible mediators: social support, fighting spirit, internal health locus of control and cancer worry, all of which have been shown to be important predictors of well-being in cancer patients. Participants (n = 102) from online cancer forums completed standardized questionnaires, and path analysis confirmed that optimism had a direct effect on positive affect in cancer survivors. Social support and fighting spirit were also shown to be significant mediators of this relationship, accounting collectively for 50% of the variance in positive affect. Whilst cancer worry and internal health locus of control could be predicted from levels of optimism, they did not mediate the optimism-positive affect relationship. Efforts to promote optimism and thus encourage fighting spirit at diagnosis through treatment may be worthwhile interventions, as would ensuring appropriate social support through the trajectory.

  15. Optimizing Antiretroviral Therapy (ART) for Maternal and Child Health (MCH): Rationale and Design of the MCH-ART Study

    PubMed Central

    Phillips, Tamsin K.; Zerbe, Allison; Ronan, Agnes; Hsiao, Nei-Yuan; Mellins, Claude A.; Remien, Robert H.; Le Roux, Stanzi M.; Brittain, Kirsty; Ciaranello, Andrea; Petro, Greg; McIntyre, James A.; Abrams, Elaine J.

    2016-01-01

    Background: Prevention of mother-to-child transmission of HIV implementation faces significant challenges globally, particularly in the context of universal lifelong antiretroviral therapy (ART) for all HIV-infected pregnant women. Methods: We describe the rationale and methods of the Maternal and Child Health-Antiretroviral Therapy (MCH-ART) study, an implementation science project examining strategies for providing HIV care and treatment to HIV-infected women who initiate ART during pregnancy and their HIV-exposed infants. Results: MCH-ART is composed of 3 interrelated study designs across the antenatal and postnatal periods. Phase 1 is a cross-sectional evaluation of consecutive HIV-infected pregnant women seeking antenatal care; phase 2 is an observational cohort of all women from phase 1 who are eligible for initiation of ART following local guidelines; and phase 3 is a randomized trial of strategies for delivering ART to breastfeeding women from phase 2 during the postpartum period. During each phase, a set of study measurement visits is carried out separately from antenatal care and ART services; a maximum of 9 visits takes place from the beginning of antenatal care through 12 months postpartum. In parallel, in-depth interviews are used to examine issues of ART adherence and retention qualitatively, and costs and cost-effectiveness of models of care are examined. Separate substudies examine health outcomes in HIV-uninfected women and their HIV-unexposed infants, and the role of the adherence club model for long-term adherence and retention. Discussion: Combining observational and experimental components, the MCH-ART study presents a novel approach to understand and optimize ART delivery for MCH. PMID:27355508

  16. The Effects of Health Insurance Coverage on the Math Achievement Trajectories of School Children in Yuma County, Arizona: Implications for Education Accountability Policy

    ERIC Educational Resources Information Center

    Garcy, Anthony M.

    2013-01-01

    U.S. Federal and state education policies place considerable emphasis on assessing the effects that schools and teachers have on student test score performance. It is important for education policy makers to also consider other factors that can affect student achievement. This study finds that an exogenous school factor, discontinuous health…

  17. An Exploratory Study of the Relationship among Perceived Personal and Social Competence, Health Risk Behaviors, and Academic Achievement of Selected Undergraduate Students

    ERIC Educational Resources Information Center

    Rhodes, Darson L.

    2009-01-01

    A sample of 656 undergraduate students from multiple sections of an introductory nutrition course, a personal health course, and a physical fitness course at a large Midwestern University completed one of four surveys. Using matrix sampling, each participant completed a survey measuring one of four personal and social competence constructs; coping…

  18. Achieving Success in Small Business: A Self-Instruction Program for Small Business Owner-Managers. Assessing the Health of Your Business.

    ERIC Educational Resources Information Center

    Virginia Polytechnic Inst. and State Univ., Blacksburg. Div. of Vocational-Technical Education.

    This self-instructional module on assessing the health of your business is the eleventh in a set of twelve modules designed for small business owner-managers. The competency for this module is to assess the financial condition of your business. Provided are information sections (key business records, balance sheet and profit and loss statements,…

  19. The Progress of Nations: The Nations of the World Ranked Acording to Their Achievements in Health, Nutrition, Education, Family Planning, and Progress for Women.

    ERIC Educational Resources Information Center

    Adamson, Peter, Ed.

    This report documents the progress made in developing and developed nations to improve health, nutrition, education, family planning, and the condition of women over the last 40 years. It presents tables that rank the world's nations and regions on: (1) the mortality rate of children under 5 years of age; (2) the percent of children under 5 years…

  20. A resolution supporting and recognizing the achievements of the family planning services programs operating under title X of the Public Health Service Act.

    THOMAS, 111th Congress

    Sen. Merkley, Jeff [D-OR

    2010-06-24

    06/24/2010 Referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S5447-5448) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  1. Longitudinal Dynamic Analyses of Depression and Academic Achievement in the Hawaiian High Schools Health Survey using Contemporary Latent Variable Change Models

    PubMed Central

    McArdle, Jack; Hamagami, Fumiaki; Chang, Janice Y.; Hishinuma, Earl S.

    2014-01-01

    The scientific literature consistently supports a negative relationship between adolescent depression and educational achievement, but we are certainly less sure on the causal determinants for this robust association. In this paper we present multivariate data from a longitudinal cohort-sequential study of high school students in Hawai‘i (following McArdle, 2009; McArdle, Johnson, Hishinuma, Miyamoto, & Andrade, 2001). We first describe the full set of data on academic achievements and self-reported depression. We then carry out and present a progression of analyses in an effort to determine the accuracy, size, and direction of the dynamic relationships among depression and academic achievement, including gender and ethnic group differences. We apply three recently available forms of longitudinal data analysis: (1) Dealing with Incomplete Data -- We apply these methods to cohort-sequential data with relatively large blocks of data which are incomplete for a variety of reasons (Little & Rubin, 1987; McArdle & Hamagami, 1992). (2) Ordinal Measurement Models (Muthén & Muthén, 2006) -- We use a variety of statistical and psychometric measurement models, including ordinal measurement models to help clarify the strongest patterns of influence. (3) Dynamic Structural Equation Models (DSEMs; McArdle, 2009). We found the DSEM approach taken here was viable for a large amount of data, the assumption of an invariant metric over time was reasonable for ordinal estimates, and there were very few group differences in dynamic systems. We conclude that our dynamic evidence suggests that depression affects academic achievement, and not the other way around. We further discuss the methodological implications of the study. PMID:25598650

  2. An Evaluation of the Policy Context on Psychosocial Risks and Mental Health in the Workplace in the European Union: Achievements, Challenges, and the Future

    PubMed Central

    Leka, Stavroula; Jain, Aditya; Iavicoli, Sergio; Di Tecco, Cristina

    2015-01-01

    Despite the developments both in hard and soft law policies in the European Union in relation to mental health and psychosocial risks in the workplace, a review of these policies at EU level has not been conducted to identify strengths, weaknesses, and gaps to be addressed in the future. Keeping in mind that the aim should be to engage employers in good practice, ideally such policies should include key definitions and elements of the psychosocial risk management process, covering risk factors, mental health outcomes, risk assessment and preventive actions, or interventions. The current paper aims to fill this gap by reviewing hard and soft law policies on mental health in the workplace and psychosocial risks applicable at EU level and conducting a gap analysis according to a set of dimensions identified in models of good practice in this area. Our review of ninety-four policies in total revealed several gaps, especially in relation to binding in comparison to nonbinding policies. These are discussed in light of the context of policy-making in the EU, and recommendations are offered for future actions in this area. PMID:26557655

  3. Primary health care and public health: foundations of universal health systems.

    PubMed

    White, Franklin

    2015-01-01

    The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable.

  4. Optimal Cutoffs of Obesity Measures in Relation to Cancer Risk in Postmenopausal Women in the Women's Health Initiative Study

    PubMed Central

    Kabat, Geoffrey C.; Strickler, Howard D.; Lin, Juan; Hou, Lifang; Stefanick, Marcia L.; Anderson, Garnet L.; Rohan, Thomas E.

    2015-01-01

    Abstract Background: Obesity is a risk factor for several cancers in postmenopausal women. We attempted to determine cutoffs of adiposity measures in relation to risk of obesity-related cancers among postmenopausal women and to examine the effects of hormone therapy (HT) use on the cutoffs, neither of which has been broadly studied. Methods: We used data from the Women's Health Initiative cohort (n=144,701) and applied Cox-proportional hazards regressions to each combination of 17 cancer types and 6 anthropometric measures (weight, body mass index [BMI], weight to height ratio, waist circumference, waist to hip ratio [WHR], and waist to height ratio). Interactions between the anthropometric measures and HT use were also examined. Cutoffs were determined by applying a grid search followed by a two-fold cross validation method. Survival ROC analysis of 5- and 10-year incidence followed. Results: Breast, colorectal, colon, endometrium, kidney, and all cancers combined were significantly positively associated with all six anthropometric measures, whereas lung cancer among ever smokers was significantly inversely associated with all measures except WHR. The derived cutoffs of each obesity measure varied across cancers (e.g., BMI cutoffs for breast and endometrium cancers were 30 kg/m2 and 34 kg/m2, respectively), and also depended on HT use. The Youden indices of the cutoffs for predicting 5- and 10-year cancer incidence were higher among HT never users. Conclusion: Using a panel of different anthropometric measures, we derived optimal cut-offs categorizing populations into high- and low-risk groups, which differed by cancer type and HT use. Although the discrimination abilities of these risk categories were generally poor, the results of this study could serve as a starting point from which to determine adiposity cutoffs for inclusion in risk prediction models for specific cancer types. PMID:25587642

  5. Care Groups II: A Summary of the Child Survival Outcomes Achieved Using Volunteer Community Health Workers in Resource-Constrained Settings

    PubMed Central

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

    2015-01-01

    The Care Group approach, described in detail in a companion paper in this journal, uses volunteers to convey health promotion messages to their neighbors. This article summarizes the available evidence on the effectiveness of the Care Group approach, drawing on articles published in the peer-reviewed literature as well as data from unpublished but publicly available project evaluations and summary analyses of these evaluations. When implemented by strong international NGOs with adequate funding, Care Groups have been remarkably effective in increasing population coverage of key child survival interventions. There is strong evidence that Care Groups can reduce childhood undernutrition and reduce the prevalence of diarrhea. Finally, evidence from multiple sources, comprising independent assessments of mortality impact, vital events collected by Care Group Volunteers themselves, and analyses using the Lives Saved Tool (LiST), that Care Groups are effective in reducing under-5 mortality. For example, the average decline in under-5 mortality, estimated using LiST, among 8 Care Group projects was 32%. In comparison, among 12 non-Care Group child survival projects, the under-5 mortality declined, on average, by an estimated 11%. Care Group projects cost in the range of US$3–$8 per beneficiary per year. The cost per life saved is in the range of $441–$3,773, and the cost per disability-adjusted life year (DALY) averted is in the range of $15–$126. The Care Group approach, when implemented as described, appears to be highly cost-effective based on internationally accepted criteria. Care Groups represent an important and promising innovative, low-cost approach to increasing the coverage of key child survival interventions in high-mortality, resource-constrained settings. Next steps include further specifying the adjustments needed in government health systems to successfully incorporate the Care Group approach, testing the feasibility of these adjustments and of the

  6. Behavioral Health in the Patient Centered Medical Home (PCMH): An Important Part of Meeting the Quadruple Aim and Achieving Level II & III NCQA PCMH Recognition

    DTIC Science & Technology

    2011-01-24

    Care Behavioral Health Model Focused on all enrolled patients • Embedded with PC team • BHPs & PCMs share patient information • Brings a team-based...enrolled patients • Care Manager and Embedded BHP – Continuity of Care – Stepped Care – Access to all enrollees to BHP in the PCMH – Clinical...available for each Service as funds to hire new BHP in the PCMH comes available. Way Ahead 2011 MHS Conference 21 – It is coming • Funding expected to be

  7. Programa Geração Biz, Mozambique: how did this adolescent health initiative grow from a pilot to a national programme, and what did it achieve?

    PubMed

    Chandra-Mouli, Venkatraman; Gibbs, Susannah; Badiani, Rita; Quinhas, Fernandes; Svanemyr, Joar

    2015-02-17

    Adolescent sexual and reproductive health gained particular traction in Mozambique following the 1994 International Conference on Population and Development leading to the inception of Programa Geração Biz (PGB), a multi-sectoral initiative that was piloted starting in 1999 and fully scaled-up to all provinces by 2007. We conducted a systematic review of the literature to gather information on PGB and analyzed how it planned and managed the scale-up effort using the WHO-ExpandNet framework. PGB's activities comprised a clear and credible innovation. Appropriate resource and user organizations further facilitated national scale-up. Challenges relating to the complex nature of the multi-sectoral approach and resistance due to norms about adolescent sexual and reproductive health hindered scaling-up in some geographic areas. The national government exhibited commitment and ownership to PGB through budgetary support and integration into multiple policies. This study adds to the documentation of successful scaling-up strategies that can provide guidance for policy makers and programme managers.

  8. Primary care in Brazil, and the Mais Médicos (More Doctors) Program in the Unified Health System: achievements and limits.

    PubMed

    Campos, Gastão Wagner de Sousa; Pereira, Nilton

    2016-09-01

    An historical analysis of Brazil's policies in Primary Healthcare, with emphasis on the Family Health Strategy (FHS), and the Mais Médicos Program (PMM). Studies were made of documents and secondary official data, and the bibliography that has been produced on this theme. It was found that primary healthcare has been established and successfully consolidated as an option in healthcare for a great part of the population of Brazil. There have, however, been structural hurdles, which have tended to compromise the effectiveness and sustainability of this policy. It was identified that these obstacles arise principally from insufficient financing and from inefficient modes of planning and management. The Mais Médicos Program has widened care coverage and made the distribution of primary healthcare doctors more equitable, although it has not resolved the structural problems of the public system.

  9. Graded Achievement, Tested Achievement, and Validity

    ERIC Educational Resources Information Center

    Brookhart, Susan M.

    2015-01-01

    Twenty-eight studies of grades, over a century, were reviewed using the argument-based approach to validity suggested by Kane as a theoretical framework. The review draws conclusions about the meaning of graded achievement, its relation to tested achievement, and changes in the construct of graded achievement over time. "Graded…

  10. Social and Developmental Predictors of Optimism from Infancy to Early Adulthood

    ERIC Educational Resources Information Center

    Ek, Ellen; Remes, Jouko; Sovio, Ulla

    2004-01-01

    The positive effects of dispositional optimism on mental and physical health are well documented, but little is known about its developmental origins. The present population-based longitudinal study of young adults (n = 8673) examined predictors of optimism that were related to early childhood family conditions, school achievement in middle…

  11. Variation in Patient Profiles and Outcomes in US and Non-US Subgroups of the Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition (CHAMPION) PHOENIX Trial

    PubMed Central

    Vaduganathan, Muthiah; Harrington, Robert A.; Stone, Gregg W.; Steg, Ph. Gabriel; Gibson, C. Michael; Hamm, Christian W.; Price, Matthew J.; Prats, Jayne; Deliargyris, Efthymios N.; Mahaffey, Kenneth W.; White, Harvey D.

    2016-01-01

    Background— The Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition (CHAMPION) PHOENIX trial demonstrated superiority of cangrelor in reducing ischemic events at 48 hours in patients undergoing percutaneous coronary intervention compared with clopidogrel. Methods and Results— We analyzed all patients included in the modified intention-to-treat analysis in US (n=4097; 37.4%) and non-US subgroups (n=6845; 62.6%). The US cohort was older, had a higher burden of cardiovascular risk factors, and had more frequently undergone prior cardiovascular procedures. US patients more frequently underwent percutaneous coronary intervention for stable angina (77.9% versus 46.2%). Almost all US patients (99.1%) received clopidogrel loading doses of 600 mg, whereas 40.5% of non-US patients received 300 mg. Bivalirudin was more frequently used in US patients (56.7% versus 2.9%). At 48 hours, rates of the primary composite end point were comparable in the US and non-US cohorts (5.5% versus 5.2%; P=0.53). Cangrelor reduced rates of the primary composite end point compared with clopidogrel in US (4.5% versus 6.4%; odds ratio 0.70 [95% confidence interval 0.53–0.92]) and in non-US patients (4.8% versus 5.6%; odds ratio 0.85 [95% confidence interval 0.69–1.05]; interaction P=0.26). Similarly, rates of the key secondary end point, stent thrombosis, were reduced by cangrelor in both regions. Rates of Global Use of Strategies to Open Occluded Arteries (GUSTO)–defined severe bleeding were low and not significantly increased by cangrelor in either region. Conclusions— Despite broad differences in clinical profiles and indications for percutaneous coronary intervention by region in a large global cardiovascular clinical trial, cangrelor consistently reduced rates of ischemic end points compared with clopidogrel without an excess in severe bleeding in both the US and non-US subgroups. Clinical Trial Registration— URL: http

  12. Lessons from San Francisco: health impact assessments have advanced political conditions for improving population health.

    PubMed

    Bhatia, Rajiv; Corburn, Jason

    2011-12-01

    Health impact assessment is a structured decision support tool used to systematically characterize the anticipated health effects, both adverse and beneficial, of societal decisions. In San Francisco, the use of health impact assessments has not only produced evidence to inform health policy decision making but has also contributed to the political conditions needed to achieve optimal population health. Health impact assessments have helped increase public awareness of the determinants of health, routine monitoring of these determinants, cooperation among institutions, health-protective laws and regulations, and organizational networks for health advocacy and accountability. Drawing on more than a decade of local experience, we identify the direct and indirect effects of the assessments on the politics of governance as well as on health. We demonstrate that health impact assessment is both an analytic tool and a process that helps build the social institutions that can improve health.

  13. Childhood vaccination: achievements and challenges.

    PubMed

    Ndumbe, P

    1996-09-01

    As the goal of eradicating smallpox was being met, the World Health Organization created its Expanded Programme on Immunisation (EPI) in 1974 and reached its initial goal of achieving full vaccination of 80% of the world's children by 1990. This effort was aided by the creation of "cold chain" delivery systems and resulted in the annual saving of 3.5 million children in less-developed countries. Current EPI vaccination goals include 1) eradication of poliomyelitis by the year 2000, 2) elimination of neonatal tetanus by the year 1995, 3) control of measles and hepatitis B, and 4) immunization of 90% of the world's children 1 year or younger by the year 2000. Goals of the Children's Vaccine Initiative (formed in 1991) include 1) provision of an adequate supply of affordable, safe, and effective vaccines; 2) production of improved and new vaccines; and 3) simplification of the logistics of vaccine delivery. Future challenges are to sustain high vaccination coverage, reach the unreached, achieve proper storage of vaccines and reduce waste, integrate new vaccines into national programs, and achieve vaccine self-sufficiency. The fact that these challenges will be difficult to achieve is illustrated by the situation in Africa where the high immunization levels achieved in 1990 have dropped dramatically. Those who must act to implement immunization programs are health personnel, families, governments, and development partners. In order to achieve equity in health, every child must be reached, governments must be made accountable for programs, health workers must convince families of the importance of vaccination, delivery systems must be in place to take advantage of the new vaccines being delivered, and a multisectoral approach must be taken to assure sustainability.

  14. Hope, optimism and delusion

    PubMed Central

    McGuire-Snieckus, Rebecca

    2014-01-01

    Optimism is generally accepted by psychiatrists, psychologists and other caring professionals as a feature of mental health. Interventions typically rely on cognitive-behavioural tools to encourage individuals to ‘stop negative thought cycles’ and to ‘challenge unhelpful thoughts’. However, evidence suggests that most individuals have persistent biases of optimism and that excessive optimism is not conducive to mental health. How helpful is it to facilitate optimism in individuals who are likely to exhibit biases of optimism already? By locating the cause of distress at the individual level and ‘unhelpful’ cognitions, does this minimise wider systemic social and economic influences on mental health? PMID:25237497

  15. Conceptual framework describing a child's total (built, natural, social) environment in order to optimize health and well-being

    EPA Science Inventory

    The complexity of the components and their interactions that characterize children’s health and well-being are not adequately captured by current public health paradigms. Children are exposed to combinations of chemical and non-chemical stressors from their built, natural, ...

  16. Optimal Design of Air Quality Monitoring Network and its Application in an Oil Refinery Plant: An Approach to Keep Health Status of Workers

    PubMed Central

    ZoroufchiBenis, Khaled; Fatehifar, Esmaeil; Ahmadi, Javad; Rouhi, Alireza

    2015-01-01

    Background: Industrial air pollution is a growing challenge to humane health, especially in developing countries, where there is no systematic monitoring of air pollution. Given the importance of the availability of valid information on population exposure to air pollutants, it is important to design an optimal Air Quality Monitoring Network (AQMN) for assessing population exposure to air pollution and predicting the magnitude of the health risks to the population. Methods: A multi-pollutant method (implemented as a MATLAB program) was explored for configur­ing an AQMN to detect the highest level of pollution around an oil refinery plant. The method ranks potential monitoring sites (grids) according to their ability to represent the ambient concentration. The term of cluster of contiguous grids that exceed a threshold value was used to calculate the Station Dosage. Selection of the best configuration of AQMN was done based on the ratio of a sta­tion’s dosage to the total dosage in the network. Results: Six monitoring stations were needed to detect the pollutants concentrations around the study area for estimating the level and distribution of exposure in the population with total network efficiency of about 99%. An analysis of the design procedure showed that wind regimes have greatest effect on the location of monitoring stations. Conclusion: The optimal AQMN enables authorities to implement an effective program of air quality management for protecting human health. PMID:26933646

  17. Optimal Design of Integrated Systems Health Management (ISHM) Systems for improving safety in NASA's Exploration Vehicles: A Two-Level Multidisciplinary Design Approach

    NASA Technical Reports Server (NTRS)

    Mehr, Ali Farhang; Tumer, Irem; Barszcz, Eric

    2005-01-01

    Integrated Vehicle Health Management (ISHM) systems are used to detect, assess, and isolate functional failures in order to improve safety of space systems such as Orbital Space Planes (OSPs). An ISHM system, as a whole, consists of several subsystems that monitor different components of an OSP including: Spacecraft, Launch Vehicle, Ground Control, and the International Space Station. In this research, therefore, we propose a new methodology to design and optimize ISHM as a distributed system with multiple disciplines (that correspond to different subsystems of OSP safety). A paramount amount of interest has been given in the literature to the multidisciplinary design optimization of problems with such architecture (as will be reviewed in the full paper).

  18. Housing Affordability And Children's Cognitive Achievement.

    PubMed

    Newman, Sandra; Holupka, C Scott

    2016-11-01

    Housing cost burden-the fraction of income spent on housing-is the most prevalent housing problem affecting the healthy development of millions of low- and moderate-income children. By affecting disposable income, a high burden affects parents' expenditures on both necessities for and enrichment of their children, as well as investments in their children. Reducing those expenditures and investments, in turn, can affect children's development, including their cognitive skills and physical, social, and emotional health. This article summarizes the first empirical evidence of the effects of housing affordability on children's cognitive achievement and on one factor that appears to contribute to these effects: the larger expenditures on child enrichment by families in affordable housing. We found that housing cost burden has the same relationship to both children's cognitive achievement and enrichment spending on children, exhibiting an inverted U shape in both cases. The maximum benefit occurs when housing cost burden is near 30 percent of income-the long-standing rule-of-thumb definition of affordable housing. The effect of the burden is stronger on children's math ability than on their reading comprehension and is more pronounced with burdens above the 30 percent standard. For enrichment spending, the curve is "shallower" (meaning the effect of optimal affordability is less pronounced) but still significant.

  19. Telecourse Study Guide to "Here's to Your Health."

    ERIC Educational Resources Information Center

    Richards, Donna

    This study guide was prepared to accompany "Here's to Your Health," a telecourse focusing on lifestyle factors influencing health, which was designed to provide the tools necessary for achieving and maintaining an optimal, healthy lifestyle. For each of 27 lessons, the study guide presents learning objectives, an overview of content, study…

  20. Optimizing Cognitive Development over the Life Course and Preventing Cognitive Decline: Introducing the Cognitive Health Environment Life Course Model (CHELM)

    ERIC Educational Resources Information Center

    Anstey, Kaarin J.

    2014-01-01

    Optimal cognitive development is defined in this article as the highest level of cognitive function reached in each cognitive domain given a person's biological and genetic disposition, and the highest possible maintenance of cognitive function over the adult life course. Theoretical perspectives underpinning the development of a framework…