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. Inequality aversion, health inequalities and health achievement.

    PubMed

    Wagstaff, Adam

    2002-07-01

    This paper addresses two issues. The first is how health inequalities can be measured in such a way as to take into account policymakers' attitudes towards inequality. The Gini coefficient and the related concentration index embody one particular set of value judgements. By generalising these indices, alternative sets of value judgements can be reflected. The other issue addressed is how information on health inequality can be used together with information on the mean of the relevant distribution to obtain an overall measure of health "achievement". PMID:12146594

  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. Student Health and Academic Achievement

    MedlinePlus

    ... 11 Resources Health and Academics Data and Statistics Bullying and Absenteeism: Information for State and Local Education Agencies [PDF - 624 KB] Anti-Bullying Policies and Enumeration: An Infobrief for Local Education ...

  5. [Optimizing health care using the example of rehabilitation. Intended goals have to be defined and achieved goals have to be confirmed].

    PubMed

    Porzsolt, Franz; Zimmermann, Theo

    2010-05-01

    In this article, the authors try to apply the actual problem of health care financing to the area of rehabilitation medicine. It is shown that there are considerable reserves in this system - like in any other area of health care -, which should not be saved but should be rather transformed into efficient health services. If we save these resources, the problems will remain the same but it will be easier to pay for them. If, however, we consider how to generate additional health care values, we will solve more problems than before.The article shows that these improvements require a clear definition of goals of health care. Goals of health care can be attained only if they are defined, and the conditions which have to be met for goal attainment can be identified only if the attained goals are quantified. There is need for action if it is unknown how often intended goals can really be attained.

  6. Building health research systems to achieve better health

    PubMed Central

    Hanney, Stephen R; González Block, Miguel A

    2006-01-01

    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

  7. Building health research systems to achieve better health.

    PubMed

    Hanney, Stephen R; González Block, Miguel A

    2006-01-01

    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

  8. The Effects of Academic Optimism on Elementary Reading Achievement

    ERIC Educational Resources Information Center

    Bevel, Raymona K.; Mitchell, Roxanne M.

    2012-01-01

    Purpose: The purpose of this paper is to explore the relationship between academic optimism (AO) and elementary reading achievement (RA). Design/methodology/approach: Using correlation and hierarchical linear regression, the authors examined school-level effects of AO on fifth grade reading achievement in 29 elementary schools in Alabama.…

  9. WFH: closing the global gap--achieving optimal care.

    PubMed

    Skinner, Mark W

    2012-07-01

    For 50 years, the World Federation of Hemophilia (WFH) has been working globally to close the gap in care and to achieve Treatment for All patients, men and women, with haemophilia and other inherited bleeding disorders, regardless of where they might live. The WFH estimates that more than one in 1000 men and women has a bleeding disorder equating to 6,900,000 worldwide. To close the gap in care between developed and developing nations a continued focus on the successful strategies deployed heretofore will be required. However, in response to the rapid advances in treatment and emerging therapeutic advances on the horizon it will also require fresh approaches and renewed strategic thinking. It is difficult to predict what each therapeutic advance on the horizon will mean for the future, but there is no doubt that we are in a golden age of research and development, which has the prospect of revolutionizing treatment once again. An improved understanding of "optimal" treatment is fundamental to the continued evolution of global care. The challenges of answering government and payer demands for evidence-based medicine, and cost justification for the introduction and enhancement of treatment, are ever-present and growing. To sustain and improve care it is critical to build the body of outcome data for individual patients, within haemophilia treatment centers (HTCs), nationally, regionally and globally. Emerging therapeutic advances (longer half-life therapies and gene transfer) should not be justified or brought to market based only on the notion that they will be economically more affordable, although that may be the case, but rather more importantly that they will be therapeutically more advantageous. Improvements in treatment adherence, reductions in bleeding frequency (including microhemorrhages), better management of trough levels, and improved health outcomes (including quality of life) should be the foremost considerations. As part of a new WFH strategic plan

  10. WFH: closing the global gap--achieving optimal care.

    PubMed

    Skinner, Mark W

    2012-07-01

    For 50 years, the World Federation of Hemophilia (WFH) has been working globally to close the gap in care and to achieve Treatment for All patients, men and women, with haemophilia and other inherited bleeding disorders, regardless of where they might live. The WFH estimates that more than one in 1000 men and women has a bleeding disorder equating to 6,900,000 worldwide. To close the gap in care between developed and developing nations a continued focus on the successful strategies deployed heretofore will be required. However, in response to the rapid advances in treatment and emerging therapeutic advances on the horizon it will also require fresh approaches and renewed strategic thinking. It is difficult to predict what each therapeutic advance on the horizon will mean for the future, but there is no doubt that we are in a golden age of research and development, which has the prospect of revolutionizing treatment once again. An improved understanding of "optimal" treatment is fundamental to the continued evolution of global care. The challenges of answering government and payer demands for evidence-based medicine, and cost justification for the introduction and enhancement of treatment, are ever-present and growing. To sustain and improve care it is critical to build the body of outcome data for individual patients, within haemophilia treatment centers (HTCs), nationally, regionally and globally. Emerging therapeutic advances (longer half-life therapies and gene transfer) should not be justified or brought to market based only on the notion that they will be economically more affordable, although that may be the case, but rather more importantly that they will be therapeutically more advantageous. Improvements in treatment adherence, reductions in bleeding frequency (including microhemorrhages), better management of trough levels, and improved health outcomes (including quality of life) should be the foremost considerations. As part of a new WFH strategic plan

  11. Achieving population health in accountable care organizations.

    PubMed

    Hacker, Karen; Walker, Deborah Klein

    2013-07-01

    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.

  12. Academic Optimism and Student Achievement in Urban Elementary Schools

    ERIC Educational Resources Information Center

    Smith, Page A.; Hoy, Wayne K.

    2007-01-01

    Purpose: The aim of this study was two-fold: to demonstrate a general construct of schools called academic optimism and to show it was related to student achievement in urban elementary schools, even controlling for socioeconomic factors, and school size. Design/methodology/approach: Data were collected from 99 urban elementary schools in Texas…

  13. 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. PMID:19255042

  14. 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. PMID:25266429

  15. Achieving Quality Health Services for Adolescents.

    PubMed

    2016-08-01

    This update of the 2008 statement from the American Academy of Pediatrics redirects the discussion of quality health care from the theoretical to the practical within the medical home. This statement reviews the evolution of the medical home concept and challenges the provision of quality adolescent health care within the patient-centered medical home. Areas of attention for quality adolescent health care are reviewed, including developmentally appropriate care, confidentiality, location of adolescent care, providers who offer such care, the role of research in advancing care, and the transition to adult care. PMID:27432849

  16. "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,…

  17. 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 ...

  18. 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

  19. 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. PMID:26438747

  20. 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.

  1. 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…

  2. 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. PMID:24268002

  3. 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.

  4. 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

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

    PubMed

    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

  6. Achieving Millennium Development Goal 5, the improvement of maternal health.

    PubMed

    Callister, Lynn Clark; Edwards, Joan E

    2010-01-01

    The purpose of this article is to describe the progress made toward the achievement of Millennium Development Goal 5, the improvement of maternal health. Maternal mortality rates (MMR) remain high globally, and in the United States there have been recent increases in MMR. Interventions to improve global maternal health are described. Nurses should be aware of the enduring epidemic of global maternal mortality, advocate for childbearing women, and contribute to implementing effective interventions to reduce maternal mortality. PMID:20673318

  7. Creating the Business Case for Achieving Health Equity.

    PubMed

    Chin, Marshall H

    2016-07-01

    Health care organizations have increasingly acknowledged the presence of health care disparities across race/ethnicity and socioeconomic status, but significantly fewer have made health equity for diverse patients a true priority. Lack of financial incentives is a major barrier to achieving health equity. To create a business case for equity, governmental and private payors can: 1) Require health care organizations to report clinical performance data stratified by race, ethnicity, and socioeconomic status. 2) Incentivize preventive care and primary care. Implement more aggressive shared savings plans, update physician relative value unit fee schedules, and encourage partnerships across clinical and non-clinical sectors. 3) Incentivize the reduction of health disparities with equity accountability measures in payment programs. 4) Align equity accountability measures across public and private payors. 5) Assist safety-net organizations. Provide adequate Medicaid reimbursement, risk-adjust clinical performance scores for sociodemographic characteristics of patients, provide support for quality improvement efforts, and calibrate cuts to Disproportionate Share Hospital (DSH) payments to the pace of health insurance expansion. 6) Conduct demonstration projects to test payment and delivery system reform interventions to reduce disparities. Commitment to social justice is essential to achieve health equity, but insufficient without a strong business case that makes interventions financially feasible.

  8. Creating the Business Case for Achieving Health Equity.

    PubMed

    Chin, Marshall H

    2016-07-01

    Health care organizations have increasingly acknowledged the presence of health care disparities across race/ethnicity and socioeconomic status, but significantly fewer have made health equity for diverse patients a true priority. Lack of financial incentives is a major barrier to achieving health equity. To create a business case for equity, governmental and private payors can: 1) Require health care organizations to report clinical performance data stratified by race, ethnicity, and socioeconomic status. 2) Incentivize preventive care and primary care. Implement more aggressive shared savings plans, update physician relative value unit fee schedules, and encourage partnerships across clinical and non-clinical sectors. 3) Incentivize the reduction of health disparities with equity accountability measures in payment programs. 4) Align equity accountability measures across public and private payors. 5) Assist safety-net organizations. Provide adequate Medicaid reimbursement, risk-adjust clinical performance scores for sociodemographic characteristics of patients, provide support for quality improvement efforts, and calibrate cuts to Disproportionate Share Hospital (DSH) payments to the pace of health insurance expansion. 6) Conduct demonstration projects to test payment and delivery system reform interventions to reduce disparities. Commitment to social justice is essential to achieve health equity, but insufficient without a strong business case that makes interventions financially feasible. PMID:26883523

  9. The optimal polarizations for achieving maximum contrast in radar images

    NASA Technical Reports Server (NTRS)

    Swartz, A. A.; Yueh, H. A.; Kong, J. A.; Novak, L. M.; Shin, R. T.

    1988-01-01

    There is considerable interest in determining the optimal polarizations that maximize contrast between two scattering classes in polarimetric radar images. A systematic approach is presented for obtaining the optimal polarimetric matched filter, i.e., that filter which produces maximum contrast between two scattering classes. The maximization procedure involves solving an eigenvalue problem where the eigenvector corresponding to the maximum contrast ratio is an optimal polarimetric matched filter. To exhibit the physical significance of this filter, it is transformed into its associated transmitting and receiving polarization states, written in terms of horizontal and vertical vector components. For the special case where the transmitting polarization is fixed, the receiving polarization which maximizes the contrast ratio is also obtained. Polarimetric filtering is then applies to synthetic aperture radar images obtained from the Jet Propulsion Laboratory. It is shown, both numerically and through the use of radar imagery, that maximum image contrast can be realized when data is processed with the optimal polarimeter matched filter.

  10. Optimizing density patterns to achieve desired light extraction for displays

    NASA Astrophysics Data System (ADS)

    Davenport, T. L. R.; Cassarly, W. J.

    2007-01-01

    In displays such as backlights and signage, it is often desirable to produce a particular spatial luminance distribution of light. This work demonstrates an iterative optimization technique for determining the density of light extractors required to produce desired luminance distributions.

  11. 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…

  12. 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)

  13. 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…

  14. 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.

  15. 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.

  16. 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

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

    SciTech Connect

    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.

  18. 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.

  19. Health care financing in Nigeria: Implications for achieving universal health coverage.

    PubMed

    Uzochukwu, B S C; Ughasoro, M D; Etiaba, E; Okwuosa, C; Envuladu, E; Onwujekwe, O E

    2015-01-01

    The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms. The difference in the proportionate contribution from these stated sources determine the extent to which such health sector will go in achieving successful health care financing system. Unfortunately, in Nigeria, achieving the correct blend of these sources remains a challenge. This review draws on relevant literature to provide an overview and the state of health care financing in Nigeria, including policies in place to enhance healthcare financing. We searched PubMed, Medline, The Cochrane Library, Popline, Science Direct and WHO Library Database with search terms that included, but were not restricted to health care financing Nigeria, public health financing, financing health and financing policies. Further publications were identified from references cited in relevant articles and reports. We reviewed only papers published in English. No date restrictions were placed on searches. It notes that health care in Nigeria is financed through different sources including but not limited to tax revenue, out-of-pocket payments (OOPs), donor funding, and health insurance (social and community). In the face of achieving UHC, achieving successful health care financing system continues to be a challenge in Nigeria and concludes that to achieve universal coverage using health financing as the strategy, there is a dire need to review the system of financing health and ensure that resources are used more efficiently while at the same time removing financial barriers to access by shifting focus from OOPs to other hidden resources. There is also need to give presidential assent to the national health bill and its prompt implementation when signed into law.

  20. Health care financing in Nigeria: Implications for achieving universal health coverage.

    PubMed

    Uzochukwu, B S C; Ughasoro, M D; Etiaba, E; Okwuosa, C; Envuladu, E; Onwujekwe, O E

    2015-01-01

    The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms. The difference in the proportionate contribution from these stated sources determine the extent to which such health sector will go in achieving successful health care financing system. Unfortunately, in Nigeria, achieving the correct blend of these sources remains a challenge. This review draws on relevant literature to provide an overview and the state of health care financing in Nigeria, including policies in place to enhance healthcare financing. We searched PubMed, Medline, The Cochrane Library, Popline, Science Direct and WHO Library Database with search terms that included, but were not restricted to health care financing Nigeria, public health financing, financing health and financing policies. Further publications were identified from references cited in relevant articles and reports. We reviewed only papers published in English. No date restrictions were placed on searches. It notes that health care in Nigeria is financed through different sources including but not limited to tax revenue, out-of-pocket payments (OOPs), donor funding, and health insurance (social and community). In the face of achieving UHC, achieving successful health care financing system continues to be a challenge in Nigeria and concludes that to achieve universal coverage using health financing as the strategy, there is a dire need to review the system of financing health and ensure that resources are used more efficiently while at the same time removing financial barriers to access by shifting focus from OOPs to other hidden resources. There is also need to give presidential assent to the national health bill and its prompt implementation when signed into law

  1. Regulatory schemes to achieve optimal flux partitioning in bacterial metabolism

    NASA Astrophysics Data System (ADS)

    Tang, Lei-Han; Yang, Zhu; Hui, Sheng; Kim, Pan-Jun; Li, Xue-Fei; Hwa, Terence

    2012-02-01

    The flux balance analysis (FBA) offers a way to compute the optimal performance of a given metabolic network when the maximum incoming flux of nutrient molecules and other essential ingredients for biosynthesis are specified. Here we report a theoretical and computational analysis of the network structure and regulatory interactions in an E. coli cell. An automated scheme is devised to simplify the network topology and to enumerate the independent flux degrees of freedom. The network organization revealed by the scheme enables a detailed interpretation of the three layers of metabolic regulation known in the literature: i) independent transcriptional regulation of biosynthesis and salvage pathways to render the network tree-like under a given nutrient condition; ii) allosteric end-product inhibition of enzyme activity at entry points of synthesis pathways for metabolic flux partitioning according to consumption; iii) homeostasis of currency and carrier compounds to maintain sufficient supply of global commodities. Using the amino-acid synthesis pathways as an example, we show that the FBA result can be reproduced with suitable implementation of the three classes of regulatory interactions with literature evidence.

  2. 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.

  3. 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. PMID:26545194

  4. Forging partnerships to solve the global health workforce crisis and achieve the health MDGs.

    PubMed

    Cometto, Giorgio; Sheikh, Mubashar

    2010-01-01

    The health workforce is in many countries the weakest link in the effective and equitable delivery of quality health services, and the largest impediment to the achievement of health Millennium Development Goals. The Kampala Declaration and Agenda for Global Action, championed by the Global Health Workforce Alliance, provide an effective overarching framework for the bold, concerted and sustained action which is required at the international, national and local level.

  5. 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.

  6. 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

  7. Paths to success: optimal and equitable health outcomes for all.

    PubMed

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

    2012-05-01

    Abstract: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.

  8. 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.

  9. 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.

  10. 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…

  11. State-level variations in income-related inequality in health and health achievement in the US.

    PubMed

    Xu, Ke Tom

    2006-07-01

    The objective of this study was to examine state-level variations in income-related inequality in health and overall health achievement in the US. Data that were representative of the US and each state in 2001 were extracted from the Current Population Survey 2001. Income-related inequality in health and health achievement were measured by Health Concentration and Health Achievement Indices, respectively. Significant variations were found across states in income-related inequality in health and health achievement. In particular, states in the south and east regions, on average, experienced a higher degree of health inequality and lower health achievement. About 80% of the state-level variation in health achievement could be explained by demographics, economic structure and performance, and state and local government spending and burden. In contrast, medical care resource indicators were not found to contribute to health achievement in states. States with better health achievement were more urbanized, had lower proportions of minority groups, females and the elderly, fewer individuals below the poverty line, larger primary industry, and lower unemployment rates. Also, per capita state and local government spending, particularly the proportion spent on public health, was positively associated with better health achievement. Because of the direct implications of health level and distribution in resource allocation and social norms, states with a lower level of health achievement need to prioritize efforts in increasing and reallocating resources to diminish health inequality and to improve population health.

  12. Principal Leadership: Creating a Culture of Academic Optimism to Improve Achievement for All Students

    ERIC Educational Resources Information Center

    McGuigan, Leigh; Hoy, Wayne K.

    2006-01-01

    Since the Coleman Report (1966), educational researchers have tried to identify school properties that make a difference in student achievement and overcome the negative influence of low socioeconomic status. We theorized that academic optimism was a latent construct that enhanced student achievement and that enabling school structure provided a…

  13. Great expectations for the World Health Organization: a Framework Convention on Global Health to achieve universal health coverage.

    PubMed

    Ooms, G; Marten, R; Waris, A; Hammonds, R; Mulumba, M; Friedman, E A

    2014-02-01

    Establishing a reform agenda for the World Health Organization (WHO) requires understanding its role within the wider global health system and the purposes of that wider global health system. In this paper, the focus is on one particular purpose: achieving universal health coverage (UHC). The intention is to describe why achieving UHC requires something like a Framework Convention on Global Health (FCGH) that have been proposed elsewhere,(1) why WHO is in a unique position to usher in an FCGH, and what specific reforms would help enable WHO to assume this role.

  14. The World Health Organization European Health in Prisons Project After 10 Years: Persistent Barriers and Achievements

    PubMed Central

    Gatherer, Alex; Moller, Lars; Hayton, Paul

    2005-01-01

    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. PMID:16186449

  15. 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. PMID:26960445

  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". PMID:26667120

  19. 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".

  20. Toward Achieving Health Equity: Emerging Evidence and Program Practice.

    PubMed

    Dicent Taillepierre, Julio C; Liburd, Leandris; OʼConnor, Ann; Valentine, Jo; Bouye, Karen; McCree, Donna Hubbard; Chapel, Thomas; Hahn, Robert

    2016-01-01

    Health equity, in the context of public health in the United States, can be characterized as action to ensure all population groups living within a targeted jurisdiction have access to the resources that promote and protect health. There appear to be several elements in program design that enhance health equity. These design elements include consideration of sociodemographic characteristics, understanding the evidence base for reducing health disparities, leveraging multisectoral collaboration, using clustered interventions, engaging communities, and conducting rigorous planning and evaluation. This article describes selected examples of public health programs the Centers for Disease Control and Prevention (CDC) has supported related to these design elements. In addition, it describes an initiative to ensure that CDC extramural grant programs incorporate program strategies to advance health equity, and examples of national reports published by the CDC related to health disparities, health equity, and social determinants of health. PMID:26599028

  1. 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

  2. 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. PMID:25217356

  3. 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.

  4. 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. PMID:26183890

  5. 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

  6. Achieving optimal aesthetics for direct and indirect restorations with microhybrid composite resins.

    PubMed

    Okuda, Wynn H

    2005-04-01

    In aesthetic dentistry, material science has played a key role in the development of natural-appearing restorations. Despite the progress, there have been challenges in achieving a harmonious integration of direct and indirect posterior restorations. Although porcelain restorations provide natural aesthetics, ceramics cannot be applied via direct techniques. Consequently, composite resins are valuable alternatives for conservative posterior restorations. In addition, because of their differing physical and optical properties, optimal aesthetic blending with porcelain and resin cannot be routinely achieved. This article explores the potential of composite resins as a direct and indirect restorative option in achieving the most favorable natural blend in the posterior region.

  7. 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…

  8. 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. PMID:19199139

  9. Optimal health insurance for multiple goods and time periods.

    PubMed

    Ellis, Randall P; Jiang, Shenyi; Manning, Willard G

    2015-05-01

    We examine the efficiency-based arguments for second-best optimal health insurance with multiple treatment goods and multiple time periods. Correlated shocks across health care goods and over time interact with complementarity and substitutability to affect optimal cost sharing. Health care goods that are substitutes or have positively correlated demand shocks should have lower optimal patient cost sharing. Positive serial correlations of demand shocks and uncompensated losses that are positively correlated with covered health services also reduce optimal cost sharing. Our results rationalize covering pharmaceuticals and outpatient spending more fully than is implied by static, one good, or one period models.

  10. 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'…

  11. Achieving Cultural Competence: The Challenges for Health Educators

    ERIC Educational Resources Information Center

    Luquis, Raffy R.; Perez, Miguel A.

    2003-01-01

    The racial and ethnic diversification of the U.S. population presents a clear call for health educators to surmount the barriers they have encountered in reaching U.S. racial and ethnic groups with culturally appropriate health promotion and prevention messages. As the population becomes more culturally and ethnically diverse, the preparation of…

  12. 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,…

  13. 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

  14. 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.

  15. Integrating Health Information Technology to Achieve Seamless Care Transitions.

    PubMed

    Marcotte, Leah; Kirtane, Janhavi; Lynn, Joanne; McKethan, Aaron

    2015-12-01

    Improving care transitions, or "handoffs" as patients migrate from one care setting to another, is a priority across stakeholder groups and health-care settings and additionally is included in national health-care goals set forth in the National Quality Strategy. Although many demonstrations of improved care transitions have succeeded, particularly for hospital discharges, ensuring consistent, high-quality, and safe transitions of care remains challenging. This paper highlights the potential for health information technology to become an increasing part of effective transitional care interventions, with the potential to reduce the resource burden currently associated with effective care transitions, the ability to spread improved practices to larger numbers of patients and providers efficiently and at scale, and, as health technology interoperability increases, the potential to facilitate critical information flow and feedback loops to clinicians, patients, and caregivers across disparate information systems and care settings.

  16. 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. PMID:27274598

  17. Priority-setting for achieving universal health coverage

    PubMed Central

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

    2016-01-01

    Abstract 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. PMID:27274598

  18. Worksite health and wellness programs: Canadian achievements & prospects.

    PubMed

    Després, Jean-Pierre; Alméras, Natalie; Gauvin, Lise

    2014-01-01

    Canada has experienced a substantial reduction in mortality related to cardiovascular disease (CVD). There is a general consensus that more effective and widespread health promotion interventions may lead to further reductions in CVD risk factors and actual disease states. In this paper, we briefly outline the prevalence of selected risk factors for CVD in Canada, describe characteristics of the Canadian labor market and workforce, and depict what is known about health and wellness program delivery systems in Canadian workplaces. Our review indicates that there have been numerous and diverse relevant legislative and policy initiatives to create a context conducive to improve the healthfulness of Canadian workplaces. However, there is still a dearth of evidence on the effectiveness of the delivery system and the actual impact of workplace health and wellness programs in reducing CVD risk in Canada. Thus, while a promising model, more research is needed in this area.

  19. 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.

  20. 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

  1. 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,…

  2. 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…

  3. Optimal quality, waits and charges in health insurance.

    PubMed

    Gravelle, Hugh; Siciliani, Luigi

    2008-05-01

    We examine the role of quality and waiting time in health insurance when there is ex post moral hazard. Quality and waiting time provide additional instruments to control demand and potentially can improve the trade-off between optimal risk bearing and optimal consumption of health care. We show that optimal quality is lower than it would be in the absence of ex post moral hazard. But it is never optimal to have a positive waiting time if the marginal cost of waiting is higher for patients with greater benefits from health care.

  4. 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

  5. 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.

  6. A prospective study of hope, optimism, and health.

    PubMed

    Scioli, A; Chamberlin, C M; Samor, C M; Lapointe, A B; Campbell, T L; MacLeod, A R; McLenon, J

    1997-12-01

    The present investigation sought to distinguish hope from optimism in the context of a 10-wk. prospective study involving reports of health outcomes. Gottschalk's (1985) Hope Scale and Scheier and Carver's (1987) Life Orientation Test which assesses optimism were given to subjects, along with a health questionnaire. Ten weeks later subjects were given a second health questionnaire. To rule out potential confounds we included measures of neuroticism, depression, extroversion, and social desirability. After controlling for the effects of correlated confounds, we found that lower hope scores (but not optimism) were correlated with several dimensions of reported health, including frequency and severity of illness.

  7. 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. PMID:22111753

  8. 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

  9. 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…

  10. 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. PMID:25961116

  11. 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

  12. 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. PMID:27409790

  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. 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.

  15. Soy foods: are they useful for optimal bone health?

    PubMed

    Lanou, Amy J

    2011-12-01

    Numerous studies have investigated the relationship between soy foods, soy protein, or isoflavone extracts and markers of bone health and osteoporosis prevention, and have come to conflicting conclusions. Research on dietary patterns, rather than on specific food ingredients or individual foods, may offer an opportunity for better understanding the role of soy foods in bone health. Evidence is reviewed regarding the question of whether soy foods contribute to a dietary pattern in humans that supports and promotes bone health. Soy foods are associated with improved markers of bone health and improved outcomes, especially among Asian women. Although the optimal amounts and types of soy foods needed to support bone health are not yet clear, dietary pattern evidence suggests that regular consumption of soy foods is likely to be useful for optimal bone health as an integral part of a dietary pattern that is built largely from whole plant foods.

  16. 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

  17. Mobile Health Systems that Optimize Resources in Emergency Response Situations.

    PubMed

    Massey, Tammara; Gao, Tia

    2010-11-13

    During mass casualty incidents, a large number of patients need to be triaged accurately in order to save the maximum number of lives. Recently portable health systems have been developed that can gather patient's vital signs and wireless transmit this information to a central location for analysis. This research introduces a methodology to improve triage in mass casualty incidents by combining statistical optimization techniques with mobile health systems to manage resources using evidence based data. We combine data collected during a field test with data of patient's vital signs to simulate how mobile health systems can optimize resources in emergency response situations.

  18. 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…

  19. 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…

  20. Middle School Climate: An Empirical Assessment of Organizational Health and Student Achievement.

    ERIC Educational Resources Information Center

    Hoy, Wayne K.; Hannum, John W.

    1997-01-01

    Although researchers and reformers consider school climate an important aspect of effective schools, the concept is difficult to measure. This paper uses a health metaphor to conceptualize and measure school climate. It examines relationships between school health and student achievement in a sample of New Jersey middle schools. Organizational…

  1. Towards achievement of universal health care in India by 2020: a call to action

    PubMed Central

    Reddy, K Srinath; Patel, Vikram; Jha, Prabhat; Paul, Vinod K; Shiva Kumar, A K; Dandona, Lalit

    2016-01-01

    To sustain the positive economic trajectory that India has had during the past decade, and to honour the fundamental right of all citizens to adequate health care, the health of all Indian people has to be given the highest priority in public policy. We propose the creation of the Integrated National Health System in India through provision of universal health insurance, establishment of autonomous organisations to enable accountable and evidence-based good-quality health-care practices and development of appropriately trained human resources, the restructuring of health governance to make it coordinated and decentralised, and legislation of health entitlement for all Indian people. The key characteristics of our proposal are to strengthen the public health system as the primary provider of promotive, preventive, and curative health services in India, to improve quality and reduce the out-of-pocket expenditure on health care through a well regulated integration of the private sector within the national health-care system. Dialogue and consensus building among the stakeholders in the government, civil society, and private sector are the next steps to formalise the actions needed and to monitor their achievement. In our call to action, we propose that India must achieve health care for all by 2020. PMID:21227489

  2. Poor Child Health, Family Capital and Cumulative Inequality in Academic Achievement

    PubMed Central

    Jackson, Margot

    2015-01-01

    Our understanding of health and social stratification can be enriched by testing tenets of cumulative inequality theory that emphasize how the accumulation of inequality is dependent on the developmental stage being considered; the duration and stability of poor health; and the family resources available to children. I analyze longitudinal data from the British National Child Development Study (N=9,252) to ask: 1) if child health is a source of cumulative inequality in academic achievement; 2) whether this relationship depends on the timing and duration of poor health; and 3) whether trajectories are sensitive to levels of family capital. The results suggest that the relationship between health and academic achievement emerges very early in life and persists, and that whether we observe shrinking or widening inequality as children age depends on when we measure their health, and whether children have access to compensatory resources. PMID:25926564

  3. Trialling of an optimal health programme (OHP) across chronic disease.

    PubMed

    Ski, Chantal F; Thompson, David R; Castle, David J

    2016-01-01

    Population ageing is a worldwide phenomenon, most advanced in developed countries and expected to continue over the next few decades. As people are surviving longer with age-associated disease and disability, there is an imperative to identify innovative solutions for an already overburdened health care system. Such innovations need to be focused on disease management, taking into consideration the strong associations that have been established between psychosocial factors and pathophysiological mechanisms associated with chronic disease. Aside from personal and community costs, chronic diseases produce a significant economic burden due to the culmination of health care costs and lost productivity. This commentary reports on a programme of research, Translating Research, Integrated Public Health Outcomes and Delivery, which will evaluate an optimal health programme that adopts a person-centred approach and engages collaborative therapy to educate, support and improve the psychosocial health of those with chronic disease. The effectiveness of the optimal health programme will be evaluated across three of the most significant contributors to disease burden: diabetes mellitus, chronic kidney disease and stroke. Cost-effectiveness will also be evaluated. The findings derived from this series of randomised controlled trials will also provide evidence attesting to the potential applicability of the optimal health programme in other chronic conditions. PMID:27612634

  4. Trialling of an optimal health programme (OHP) across chronic disease.

    PubMed

    Ski, Chantal F; Thompson, David R; Castle, David J

    2016-09-09

    Population ageing is a worldwide phenomenon, most advanced in developed countries and expected to continue over the next few decades. As people are surviving longer with age-associated disease and disability, there is an imperative to identify innovative solutions for an already overburdened health care system. Such innovations need to be focused on disease management, taking into consideration the strong associations that have been established between psychosocial factors and pathophysiological mechanisms associated with chronic disease. Aside from personal and community costs, chronic diseases produce a significant economic burden due to the culmination of health care costs and lost productivity. This commentary reports on a programme of research, Translating Research, Integrated Public Health Outcomes and Delivery, which will evaluate an optimal health programme that adopts a person-centred approach and engages collaborative therapy to educate, support and improve the psychosocial health of those with chronic disease. The effectiveness of the optimal health programme will be evaluated across three of the most significant contributors to disease burden: diabetes mellitus, chronic kidney disease and stroke. Cost-effectiveness will also be evaluated. The findings derived from this series of randomised controlled trials will also provide evidence attesting to the potential applicability of the optimal health programme in other chronic conditions.

  5. 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. PMID:26355053

  6. 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.

  7. Academic abilities in children and adolescents with a history of autism spectrum disorders who have achieved optimal outcomes.

    PubMed

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

    2014-04-01

    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 as having achieved "optimal outcomes." Performance of 32 individuals who achieved optimal outcomes, 41 high-functioning individuals with a current autism spectrum disorder diagnosis (high-functioning autism), and 34 typically developing peers was compared on measures of decoding, reading comprehension, mathematical problem solving, and written expression. Groups were matched on age, sex, and nonverbal IQ; however, the high-functioning autism group scored significantly lower than the optimal outcome and typically developing groups on verbal IQ. All three groups performed in the average range on all subtests measured, and no significant differences were found in performance of the optimal outcome and typically developing groups. The high-functioning autism group scored significantly lower on subtests of reading comprehension and mathematical problem solving than the optimal outcome group. These findings suggest that the academic abilities of individuals who achieved optimal outcomes are similar to those of their typically developing peers, even in areas where individuals who have retained their autism spectrum disorder diagnoses exhibit some ongoing difficulty.

  8. 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

  9. Role of well-being therapy in achieving a balanced and individualized path to optimal functioning.

    PubMed

    Ruini, Chiara; Fava, Giovanni A

    2012-01-01

    A specific psychotherapeutic strategy for increasing psychological well-being and resilience, well-being therapy (WBT), based on Ryff's conceptual model, has been developed and tested in a number of randomized controlled trials. The findings indicate that flourishing and resilience can be promoted by specific interventions leading to a positive evaluation of one's self, a sense of continued growth and development, the belief that life is purposeful and meaningful, the possession of quality relations with others, the capacity to manage effectively one's life and a sense of self-determination. A decreased vulnerability to depression, mood swings and anxiety has been demonstrated after WBT in high-risk populations. School interventions based on the principles of WBT have been found to yield both promotion of well-being and decrease of distress compared with control groups. The differential technical characteristics and indications of WBT are described, with a special reference to the promotion of an individualized and balanced path to achieve optimal human functioning, avoiding the polarities in positive psychological dimensions. PMID:22570318

  10. Achieving and Sustaining Automated Health Data Linkages for Learning Systems: Barriers and Solutions

    PubMed Central

    Van Eaton, Erik G.; Devlin, Allison B.; Devine, Emily Beth; Flum, David R.; Tarczy-Hornoch, Peter

    2014-01-01

    challenges of idiosyncratic EHR implementations required each hospital to devote more IT resources than were predicted. Cost savings did not meet projections because of the increased IT resource requirements and a different source of lowered chart review costs. Discussion: CERTAIN succeeded in recruiting unaffiliated hospitals into the Automation Project to create an enhanced registry to achieve AHRQ goals. This case report describes several distinct barriers to central data aggregation for QI and CER across unaffiliated hospitals: (1) competition for limited on-site IT expertise, (2) concerns about data use for QI versus research, (3) restrictions on data automation to a defined subset of patients, and (4) unpredictable resource needs because of idiosyncrasies among unaffiliated hospitals in how EHR data are coded, stored, and made available for transmission—even between hospitals using the same vendor’s EHR. Therefore, even a fully optimized automation infrastructure would still not achieve complete automation. The Automation Project was unable to align sufficiently with internal hospital objectives, so it could not show a compelling case for sustainability. PMID:25848606

  11. Communication and Cancer: The Role of Health Communication Specialists in Achieving National Health Goals.

    ERIC Educational Resources Information Center

    Cline, Rebecca J.

    Proceeding from the implicit message promoted by the National Cancer Institute to the communication profession--expertise in health communication is central to the effort to alleviate the costs of the national burden placed on the economy because of cancer--this paper proposes the development of health communication as a career. Specifically, the…

  12. 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.

  13. Women's health: an achievable goal for public health nursing in Pakistan.

    PubMed

    Vertejee, Samina Subzali; Karamali, Noureen Nasruddin

    2013-12-01

    Monsoons of 2010; left devastated effects in Pakistan; it wiped away thousands of houses and damaged health infrastructure. The national and international communities rescued Internally Displaced People (IDP). Alongside the other health professionals' Public health nurses (PHN) were instrumental in assisting IDPs. This is a case study of a 30-year-old postnatal woman; who sustained an injury on her right breast and developed an abscess in IDP camp. The client was assisted by the team of public health nurses by timely referral to undergo incision and drainage for appropriate management. Moreover, post procedure follow-up assisted the woman in wound management and neonate care, especially the breast feeding. The family was also involved in client's care to ensure their empowerment in managing the case. Thus, the efforts of PHN and their health assessment saved the life of one family by saving the life of a woman in that IDP camp. PMID:24397102

  14. 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

  15. 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.

  16. Calibration of STUD+ parameters to achieve optimally efficient broadband adiabatic decoupling in a single transient

    PubMed

    Bendall; Skinner

    1998-10-01

    for a single sech/tanh pulse. Residual splitting of the centerband, normally associated with incomplete or inefficient decoupling, is not seen in sech/tanh decoupling and therefore cannot be used as a measure of adiabatic decoupling efficiency. The calibrated experimental performance levels achieved in this study are within 20% of theoretical performance levels derived previously for ideal sech/tanh decoupling at high power, indicating a small scope for further improvement at practical RF power levels. The optimization procedures employed here will be generally applicable to any good combination of adiabatic inversion pulse and phase cycle. Copyright 1998 Academic Press. PMID:9761708

  17. 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

  18. Working together to achieve the best outcomes for equine health and welfare.

    PubMed

    2016-03-19

    Gill Harris reports from this year's National Equine Forum where a key theme was the importance of collaboration and effective communication in achieving the best outcomes for the health and welfare of the horse and the future of equestrianism in the UK. PMID:26993448

  19. 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…

  20. 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…

  1. 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…

  2. The Relation among School District Health, Total Quality Principles for School Organization and Student Achievement

    ERIC Educational Resources Information Center

    Marshall, Jon; Pritchard, Ruie; Gunderson, Betsey

    2004-01-01

    The purpose of this study was to determine the congruence among W. E. Deming's 14 points for Total Quality Management (TQM), the organizational health of school districts, and student achievement. Based on Kanter's (1983) concept of a Culture of Pride with a Climate of Success, healthy districts were defined as having an organizational culture…

  3. 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

  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. Toward a fourth generation of disparities research to achieve health equity.

    PubMed

    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.

  6. Meanings in policy: a textual analysis of Canada's "Achieving Health For All" document.

    PubMed

    Iannantuono, A; Eyles, J

    1997-06-01

    This paper presents a textual analysis of a key Canadian health policy document--Achieving Health for All (AHFA). It begins by establishing the importance of policy language and an interpretive approach to reveal dominant meanings and assumptions. This approach points out the significance of language and its contexts (text and intertext) and of developing a formal analytic strategy, based on semiotics. The paper concludes with a detailed, illustrated analysis of AHFA, suggesting that the document's discourse, through appealing to all, with emphases on the nation, community and all Canadians, establishes a frame of individual responsibility and rights, health promotion and broad health determinants--a frame that resonates with the cost-constrained nature of health care delivery-as found in provincial reform documents in the 1980s and 1990s.

  7. 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

  8. 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.

  9. 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. PMID:23303997

  10. 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.

  11. 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

    2012-10-01

    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. PMID

  12. 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

    2012-10-01

    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.

  13. 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. PMID:27145707

  14. 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

  15. 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…

  16. 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…

  17. 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…

  18. 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…

  19. 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…

  20. Optimal vortex formation as an index of cardiac health

    PubMed Central

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

    2006-01-01

    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. PMID:16606852

  1. The Integration of LNT and Hormesis for Cancer Risk Assessment Optimizes Public Health Protection.

    PubMed

    Calabrese, Edward J; Shamoun, Dima Yazji; Hanekamp, Jaap C

    2016-03-01

    This paper proposes a new cancer risk assessment strategy and methodology that optimizes population-based responses by yielding the lowest disease/tumor incidence across the entire dose continuum. The authors argue that the optimization can be achieved by integrating two seemingly conflicting models; i.e., the linear no-threshold (LNT) and hormetic dose-response models. The integration would yield the optimized response at a risk of 10 with the LNT model. The integrative functionality of the LNT and hormetic dose response models provides an improved estimation of tumor incidence through model uncertainty analysis and major reductions in cancer incidence via hormetic model estimates. This novel approach to cancer risk assessment offers significant improvements over current risk assessment approaches by revealing a regulatory sweet spot that maximizes public health benefits while incorporating practical approaches for model validation. PMID:26808876

  2. 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

    2011-03-01

    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. PMID:21269682

  3. Can a public health care system achieve equity? The Norwegian experience.

    PubMed

    Grytten, J; Rongen, G; Sørensen, R

    1995-09-01

    Equity in health care provision is an important policy goal in Norway. This article addresses equality in the services provided by primary care physicians. These services are the responsibility of local government financed mainly through public funding. Patient fees are low. The local government system results in geographical variation in the number of physicians relative to local health demands. The authors present the hypothesis that this generates inequalities in health care utilization. The system of government finance is based on the assumption that utilization of health services is independent of patient income. Therefore, variation in income is expected to have only a small impact on utilization. The authors estimate a demand model by combining extensive micro data with aggregate data on municipal supply. There is very little relationship between indicators of access and health care utilization. The estimated income elasticities approximate zero, supporting the argument that equality in utilization has been achieved. However, the authors results also raise the question of whether equality has been achieved at the cost of limiting supply of services for people who could afford to consume more, or to pay for services of higher quality. PMID:7666707

  4. Can a public health care system achieve equity? The Norwegian experience.

    PubMed

    Grytten, J; Rongen, G; Sørensen, R

    1995-09-01

    Equity in health care provision is an important policy goal in Norway. This article addresses equality in the services provided by primary care physicians. These services are the responsibility of local government financed mainly through public funding. Patient fees are low. The local government system results in geographical variation in the number of physicians relative to local health demands. The authors present the hypothesis that this generates inequalities in health care utilization. The system of government finance is based on the assumption that utilization of health services is independent of patient income. Therefore, variation in income is expected to have only a small impact on utilization. The authors estimate a demand model by combining extensive micro data with aggregate data on municipal supply. There is very little relationship between indicators of access and health care utilization. The estimated income elasticities approximate zero, supporting the argument that equality in utilization has been achieved. However, the authors results also raise the question of whether equality has been achieved at the cost of limiting supply of services for people who could afford to consume more, or to pay for services of higher quality.

  5. 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

    2011-03-01

    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.

  6. 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

  7. 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

  8. 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

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

    PubMed Central

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

    2015-01-01

    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

  10. From Headline to Hard Grind: The Importance of Understanding Public Administration in Achieving Health Outcomes

    PubMed Central

    O’Flynn, Janine

    2016-01-01

    Many public policy programs fail to translate ambitious headlines to on-the-ground action. The reasons for this are many and varied, but for public administration and management scholars a large part of the gap between ambition and achievement is the challenge associated with the operation of the machinery of government itself, and how it relates to the other parties that it relies on to fulfill these outcomes. In their article, Carey and Friel set out key reasons why public health scholars should seek to better understand important ideas in public administration. In commenting on their contribution, I draw out two critical questions that are raised by this discussion: (i) what are boundaries and what forms do they take? and (ii) why work across boundaries? Expanding on these key questions extends the points made by Carey and Friel on the importance of understanding public administration and will better place public health scholars and practitioners to realise health outcomes. PMID:27694672

  11. Achieving the health Millennium Development Goals for South Africa: challenges and priorities.

    PubMed

    Chopra, Mickey; Lawn, Joy E; Sanders, David; Barron, Peter; Abdool Karim, Salim S; Bradshaw, Debbie; Jewkes, Rachel; Abdool Karim, Quarraisha; Flisher, Alan J; Mayosi, Bongani M; Tollman, Stephen M; Churchyard, Gavin J; Coovadia, Hoosen

    2009-09-19

    15 years after liberation from apartheid, South Africans are facing new challenges for which the highest calibre of leadership, vision, and commitment is needed. The effect of the unprecedented HIV/AIDS epidemic has been immense. Substantial increases in mortality and morbidity are threatening to overwhelm the health system and undermine the potential of South Africa to attain the Millennium Development Goals (MDGs). However The Lancet's Series on South Africa has identified several examples of leadership and innovation that point towards a different future scenario. We discuss the type of vision, leadership, and priority actions needed to achieve such a change. We still have time to change the health trajectory of the country, and even meet the MDGs. The South African Government, installed in April, 2009, has the mandate and potential to address the public health emergencies facing the country--will they do so or will another opportunity and many more lives be lost?

  12. Fairness: How to Achieve It and How to Optimize in a Fair-Division Procedure

    ERIC Educational Resources Information Center

    Jones, Michael A.; Cohen, Stanley F.

    2004-01-01

    A simple and practical application of mathematics is for fairly resolving the dispute of division of items for which two parties have equal claim. Basic properties of fair division are explained, which would enable students to learn concepts on optimization without introducing calculus.

  13. Achieving diverse and monoallelic olfactory receptor selection through dual-objective optimization design.

    PubMed

    Tian, Xiao-Jun; Zhang, Hang; Sannerud, Jens; Xing, Jianhua

    2016-05-24

    Multiple-objective optimization is common in biological systems. In the mammalian olfactory system, each sensory neuron stochastically expresses only one out of up to thousands of olfactory receptor (OR) gene alleles; at the organism level, the types of expressed ORs need to be maximized. Existing models focus only on monoallele activation, and cannot explain recent observations in mutants, especially the reduced global diversity of expressed ORs in G9a/GLP knockouts. In this work we integrated existing information on OR expression, and constructed a comprehensive model that has all its components based on physical interactions. Analyzing the model reveals an evolutionarily optimized three-layer regulation mechanism, which includes zonal segregation, epigenetic barrier crossing coupled to a negative feedback loop that mechanistically differs from previous theoretical proposals, and a previously unidentified enhancer competition step. This model not only recapitulates monoallelic OR expression, but also elucidates how the olfactory system maximizes and maintains the diversity of OR expression, and has multiple predictions validated by existing experimental results. Through making an analogy to a physical system with thermally activated barrier crossing and comparative reverse engineering analyses, the study reveals that the olfactory receptor selection system is optimally designed, and particularly underscores cooperativity and synergy as a general design principle for multiobjective optimization in biology.

  14. 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…

  15. Achieving diverse and monoallelic olfactory receptor selection through dual-objective optimization design.

    PubMed

    Tian, Xiao-Jun; Zhang, Hang; Sannerud, Jens; Xing, Jianhua

    2016-05-24

    Multiple-objective optimization is common in biological systems. In the mammalian olfactory system, each sensory neuron stochastically expresses only one out of up to thousands of olfactory receptor (OR) gene alleles; at the organism level, the types of expressed ORs need to be maximized. Existing models focus only on monoallele activation, and cannot explain recent observations in mutants, especially the reduced global diversity of expressed ORs in G9a/GLP knockouts. In this work we integrated existing information on OR expression, and constructed a comprehensive model that has all its components based on physical interactions. Analyzing the model reveals an evolutionarily optimized three-layer regulation mechanism, which includes zonal segregation, epigenetic barrier crossing coupled to a negative feedback loop that mechanistically differs from previous theoretical proposals, and a previously unidentified enhancer competition step. This model not only recapitulates monoallelic OR expression, but also elucidates how the olfactory system maximizes and maintains the diversity of OR expression, and has multiple predictions validated by existing experimental results. Through making an analogy to a physical system with thermally activated barrier crossing and comparative reverse engineering analyses, the study reveals that the olfactory receptor selection system is optimally designed, and particularly underscores cooperativity and synergy as a general design principle for multiobjective optimization in biology. PMID:27162367

  16. 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.

  17. Accelerators/decelerators of achieving universal access to sexual and reproductive health services: a case study of Iranian health system

    PubMed Central

    2013-01-01

    Background At the 1994 International Conference on Population and Development (ICPD), held in Cairo, the global community agreed to the goal of achieving universal access to sexual and reproductive health (SRH) and rights by 2015. This research explores the accelerators and decelerators of achieving universal access to the sexual and reproductive health targets and accordingly makes some suggestions. Method We have critically reviewed the latest national reports and extracted the background data on each SRH indicator. The key stakeholders, both national and international, were visited and interviewed at two sites. A total of 55 in-depth interviews were conducted with religious leaders, policy-makers, senior managers, senior academics, and health care managers. Six focus-group discussions were also held among health care providers. The study was qualitative in nature. Results Obstacles on the road to achieving universal access to SRH can be viewed from two perspectives. One gap exists between current achievements and the targets. The other gap arises due to age, marital status, and residency status. The most recently observed trends in the indicators of the universal access to SRH shows that the achievements in the “unmet need for family planning” have been poor. Unmet need for family planning could directly be translated to unwanted pregnancies and unwanted childbirths; the former calls for sexual education to underserved people, including adolescents; and the latter calls for access to safe abortion. Local religious leaders have not actively attended international goal-setting programs. Therefore, they usually do not presume a positive attitude towards these goals. Such negative attitudes seem to be the most important factors hindering the progress towards universal access to SRH. Lack of international donors to fund for SRH programs is also another barrier. In national levels both state and the society are interactively playing their roles. We have used a

  18. 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…

  19. Achieving Optimal Self-Adaptivity for Dynamic Tuning of Organic Semiconductors through Resonance Engineering.

    PubMed

    Tao, Ye; Xu, Lijia; Zhang, Zhen; Chen, Runfeng; Li, Huanhuan; Xu, Hui; Zheng, Chao; Huang, Wei

    2016-08-01

    Current static-state explorations of organic semiconductors for optimal material properties and device performance are hindered by limited insights into the dynamically changed molecular states and charge transport and energy transfer processes upon device operation. Here, we propose a simple yet successful strategy, resonance variation-based dynamic adaptation (RVDA), to realize optimized self-adaptive properties in donor-resonance-acceptor molecules by engineering the resonance variation for dynamic tuning of organic semiconductors. Organic light-emitting diodes hosted by these RVDA materials exhibit remarkably high performance, with external quantum efficiencies up to 21.7% and favorable device stability. Our approach, which supports simultaneous realization of dynamically adapted and selectively enhanced properties via resonance engineering, illustrates a feasible design map for the preparation of smart organic semiconductors capable of dynamic structure and property modulations, promoting the studies of organic electronics from static to dynamic. PMID:27403886

  20. 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.

  1. 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

  2. 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.

  3. Optimal thickness of silicon membranes to achieve maximum thermoelectric efficiency: A first principles study

    NASA Astrophysics Data System (ADS)

    Mangold, Claudia; Neogi, Sanghamitra; Donadio, Davide

    2016-08-01

    Silicon nanostructures with reduced dimensionality, such as nanowires, membranes, and thin films, are promising thermoelectric materials, as they exhibit considerably reduced thermal conductivity. Here, we utilize density functional theory and Boltzmann transport equation to compute the electronic properties of ultra-thin crystalline silicon membranes with thickness between 1 and 12 nm. We predict that an optimal thickness of ˜7 nm maximizes the thermoelectric figure of merit of membranes with native oxide surface layers. Further thinning of the membranes, although attainable in experiments, reduces the electrical conductivity and worsens the thermoelectric efficiency.

  4. 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

  5. Optimization of the cooling profile to achieve crack-free Yb:S-FAP crystals

    NASA Astrophysics Data System (ADS)

    Fang, H. S.; Qiu, S. R.; Zheng, L. L.; Schaffers, K. I.; Tassano, J. B.; Caird, J. A.; Zhang, H.

    2008-08-01

    Yb:S-FAP [Yb 3+:Sr 5(PO 4) 3F] crystals are an important gain medium for diode-pumped laser applications. Growth of 7.0 cm diameter Yb:S-FAP crystals utilizing the Czochralski (CZ) method from SrF 2-rich melts often encounters cracks during the post-growth cool-down stage. To suppress cracking during cool-down, a numerical simulation of the growth system was used to understand the correlation between the furnace power during cool-down and the radial temperature differences within the crystal. The critical radial temperature difference, above which the crystal cracks, has been determined by benchmarking the simulation results against experimental observations. Based on this comparison, an optimal three-stage ramp-down profile was implemented, which produced high-quality, crack-free Yb:S-FAP crystals.

  6. Optimization of the cooling profile to achieve crack-free Yb:S-FAP crystals

    SciTech Connect

    Fang, H; Qiu, S; Kheng, L; Schaffers, K; Tassano, J; Caird, J; Zhang, H

    2007-08-20

    Yb:S-FAP [Yb{sup 3+}:Sr{sub 5}(PO{sub 4}){sub 3}F] crystals are an important gain medium for diode-pumped laser applications. Growth of 7.0 cm diameter Yb:S-FAP crystals utilizing the Czochralski (CZ) method from SrF{sub 2}-rich melts often encounter cracks during the post growth cool down stage. To suppress cracking during cool down, a numerical simulation of the growth system was used to understand the correlation between the furnace power during cool down and the radial temperature differences within the crystal. The critical radial temperature difference, above which the crystal cracks, has been determined by benchmarking the simulation results against experimental observations. Based on this comparison, an optimal three-stage ramp-down profile was implemented and produced high quality, crack-free Yb:S-FAP crystals.

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

    PubMed

    Dutta, Anindita; Bahar, Ivet

    2010-09-01

    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 data set 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.

  8. Achieving optimal delivery of follow-up care for prostate cancer survivors: improving patient outcomes

    PubMed Central

    Hudson, Shawna V; O’Malley, Denalee M; Miller, Suzanne M

    2015-01-01

    Background Prostate cancer is the most commonly diagnosed cancer in men in the US, and the second most prevalent cancer in men worldwide. High incidence and survival rates for prostate cancer have resulted in a large and growing population of long-term prostate cancer survivors. Long-term follow-up guidelines have only recently been developed to inform approaches to this phase of care for the prostate cancer population. Methods A PubMed search of English literature through August 2014 was performed. Articles were retrieved and reviewed to confirm their relevance. Patient-reported measures that were used in studies of long-term prostate cancer survivors (ie, at least 2 years posttreatment) were reviewed and included in the review. Results A total of 343 abstracts were initially identified from the database search. After abstract review, 105 full-text articles were reviewed of which seven met inclusion criteria. An additional 22 articles were identified from the references of the included articles, and 29 were retained. From the 29 articles, 68 patient-reported outcome measures were identified. The majority (75%) were multi-item scales that had been previously validated in existing literature. We identified four main areas of assessment: 1) physical health; 2) quality of life – general, physical, and psychosocial; 3) health promotion – physical activity, diet, and tobacco cessation; and 4) care quality outcomes. Conclusion There are a number of well-validated measures that assess patient-reported outcomes that document key aspects of long-term follow-up with respect to patient symptoms and quality of life. However, there are fewer patient-reported outcomes related to health promotion and care quality within the prevention, surveillance, and care coordination components of cancer survivorship. Future research should focus on development of additional patient-centered and patient-related outcomes that enlarge the assessment portfolio. PMID:25834471

  9. 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

    2015-05-01

    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.

  10. Optimizing Digital Health Informatics Interventions Through Unobtrusive Quantitative Process Evaluations.

    PubMed

    Gude, Wouter T; van der Veer, Sabine N; de Keizer, Nicolette F; Coiera, Enrico; Peek, Niels

    2016-01-01

    Health informatics interventions such as clinical decision support (CDS) and audit and feedback (A&F) are variably effective at improving care because the underlying mechanisms through which these interventions bring about change are poorly understood. This limits our possibilities to design better interventions. Process evaluations can be used to improve this understanding by assessing fidelity and quality of implementation, clarifying causal mechanisms, and identifying contextual factors associated with variation in outcomes. Coiera describes the intervention process as a series of stages extending from interactions to outcomes: the "information value chain". However, past process evaluations often did not assess the relationships between those stages. In this paper we argue that the chain can be measured quantitatively and unobtrusively in digital interventions thanks to the availability of electronic data that are a by-product of their use. This provides novel possibilities to study the mechanisms of informatics interventions in detail and inform essential design choices to optimize their efficacy. PMID:27577453

  11. 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.

  12. 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.

  13. [Social participation in the achievement of health policies to women in Brazil].

    PubMed

    Costa, Ana Maria

    2009-01-01

    This article analyzes the evolution of the participatory process in women's movements, especially those related to feminism, in the elaboration of health care policies to women in Brazil, from the 1970s until the present time. For this purpose, it is based on bibliography and on documentary analysis. The article determines the collaboration character that predominated in the beginning of the feminist movements relations with State institutions, and their recent actions regarding institutionalized instances of social participation and control. It further underlines some changes in the political activism of these movements, formerly advocating comprehensive health care to women and approaching the complexity of the broad demands and needs, and subsequently shifting to the defense of a focused acting, essentially when it comes to reproductive rights matters. Parallel to the acknowledgement of several achievements, the author emphasizes the necessity of disseminating the debate over women's health care in every space available for dialogue between the Government and the civil society in order to re-politicize this debate and to strengthen women's demands.

  14. Scale-up of HIV treatment through PEPFAR: a historic public health achievement.

    PubMed

    El-Sadr, Wafaa M; Holmes, Charles B; Mugyenyi, Peter; Thirumurthy, Harsha; Ellerbrock, Tedd; Ferris, Robert; Sanne, Ian; Asiimwe, Anita; Hirnschall, Gottfried; Nkambule, Rejoice N; Stabinski, Lara; Affrunti, Megan; Teasdale, Chloe; Zulu, Isaac; Whiteside, Alan

    2012-08-15

    Since its inception in 2003, the US President's Emergency Plan for AIDS Relief (PEPFAR) has been an important driving force behind the global scale-up of HIV care and treatment services, particularly in expansion of access to antiretroviral therapy. Despite initial concerns about cost and feasibility, PEPFAR overcame challenges by leveraging and coordinating with other funders, by working in partnership with the most affected countries, by supporting local ownership, by using a public health approach, by supporting task-shifting strategies, and by paying attention to health systems strengthening. As of September 2011, PEPFAR directly supported initiation of antiretroviral therapy for 3.9 million people and provided care and support for nearly 13 million people. Benefits in terms of prevention of morbidity and mortality have been reaped by those receiving the services, with evidence of societal benefits beyond the anticipated clinical benefits. However, much remains to be accomplished to achieve universal access, to enhance the quality of programs, to ensure retention of patients in care, and to continue to strengthen health systems. PMID:22797746

  15. Scale-up of HIV treatment through PEPFAR: a historic public health achievement.

    PubMed

    El-Sadr, Wafaa M; Holmes, Charles B; Mugyenyi, Peter; Thirumurthy, Harsha; Ellerbrock, Tedd; Ferris, Robert; Sanne, Ian; Asiimwe, Anita; Hirnschall, Gottfried; Nkambule, Rejoice N; Stabinski, Lara; Affrunti, Megan; Teasdale, Chloe; Zulu, Isaac; Whiteside, Alan

    2012-08-15

    Since its inception in 2003, the US President's Emergency Plan for AIDS Relief (PEPFAR) has been an important driving force behind the global scale-up of HIV care and treatment services, particularly in expansion of access to antiretroviral therapy. Despite initial concerns about cost and feasibility, PEPFAR overcame challenges by leveraging and coordinating with other funders, by working in partnership with the most affected countries, by supporting local ownership, by using a public health approach, by supporting task-shifting strategies, and by paying attention to health systems strengthening. As of September 2011, PEPFAR directly supported initiation of antiretroviral therapy for 3.9 million people and provided care and support for nearly 13 million people. Benefits in terms of prevention of morbidity and mortality have been reaped by those receiving the services, with evidence of societal benefits beyond the anticipated clinical benefits. However, much remains to be accomplished to achieve universal access, to enhance the quality of programs, to ensure retention of patients in care, and to continue to strengthen health systems.

  16. [Social participation in the achievement of health policies to women in Brazil].

    PubMed

    Costa, Ana Maria

    2009-01-01

    This article analyzes the evolution of the participatory process in women's movements, especially those related to feminism, in the elaboration of health care policies to women in Brazil, from the 1970s until the present time. For this purpose, it is based on bibliography and on documentary analysis. The article determines the collaboration character that predominated in the beginning of the feminist movements relations with State institutions, and their recent actions regarding institutionalized instances of social participation and control. It further underlines some changes in the political activism of these movements, formerly advocating comprehensive health care to women and approaching the complexity of the broad demands and needs, and subsequently shifting to the defense of a focused acting, essentially when it comes to reproductive rights matters. Parallel to the acknowledgement of several achievements, the author emphasizes the necessity of disseminating the debate over women's health care in every space available for dialogue between the Government and the civil society in order to re-politicize this debate and to strengthen women's demands. PMID:19721948

  17. Optimizing Decision Support for Tailored Health Behavior Change Applications.

    PubMed

    Kukafka, Rita; Jeong, In cheol; Finkelstein, Joseph

    2015-01-01

    The Tailored Lifestyle Change Decision Aid (TLC DA) system was designed to provide support for a person to make an informed choice about which behavior change to work on when multiple unhealthy behaviors are present. TLC DA can be delivered via web, smartphones and tablets. The system collects a significant amount of information that is used to generate tailored messages to consumers to persuade them in certain healthy lifestyles. One limitation is the necessity to collect vast amounts of information from users who manually enter. By identifying an optimal set of self-reported parameters we will be able to minimize the data entry burden of the app users. The study was to identify primary determinants of health behavior choices made by patients after using the system. Using discriminant analysis an optimal set of predictors was identified. The resulting set included smoking status, smoking cessation success estimate, self-efficacy, body mass index and diet status. Predicting smoking cessation choice was the most accurate, followed by weight management. Physical activity and diet choices were better identified in a combined cluster. PMID:26262020

  18. Integrating big data and actionable health coaching to optimize wellness.

    PubMed

    Hood, Leroy; Lovejoy, Jennifer C; Price, Nathan D

    2015-01-01

    The Hundred Person Wellness Project (HPWP) is a 10-month pilot study of 100 'well' individuals where integrated data from whole-genome sequencing, gut microbiome, clinical laboratory tests and quantified self measures from each individual are used to provide actionable results for health coaching with the goal of optimizing wellness and minimizing disease. In a commentary in BMC Medicine, Diamandis argues that HPWP and similar projects will likely result in 'unnecessary and potential harmful over-testing'. We argue that this new approach will ultimately lead to lower costs, better healthcare, innovation and economic growth. The central points of the HPWP are: 1) it is focused on optimizing wellness through longitudinal data collection, integration and mining of individual data clouds, enabling development of predictive models of wellness and disease that will reveal actionable possibilities; and 2) by extending this study to 100,000 well people, we will establish multiparameter, quantifiable wellness metrics and identify markers for wellness to early disease transitions for most common diseases, which will ultimately allow earlier disease intervention, eventually transitioning the individual early on from a disease back to a wellness trajectory.

  19. Standardization and Optimization of Computed Tomography Protocols to Achieve Low-Dose

    PubMed Central

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

    2014-01-01

    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 we summarize approaches to reduce dose, as discussed in lectures comprising the first session of the 2013 UCSF Virtual Symposium on Radiation Safety in 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. PMID:24589403

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

    PubMed

    Frye, Richard E; Rossignol, Daniel A

    2016-01-01

    the optimal treatments for these abnormalities. PMID:27330338

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

    PubMed Central

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

    2015-01-01

    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

  2. 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

  3. 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

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

    PubMed

    Frye, Richard E; Rossignol, Daniel A

    2016-01-01

    the optimal treatments for these abnormalities.

  5. Need for coordinated programs to improve global health by optimizing salt and iodine intake.

    PubMed

    Campbell, Norm R C; Dary, Omar; Cappuccio, Francesco P; Neufeld, Lynnette M; Harding, Kim B; Zimmermann, Michael B

    2012-10-01

    High dietary salt is a major cause of increased blood pressure, the leading risk for death worldwide. The World Health Organization (WHO) has recommended that salt intake be less than 5 g/day, a goal that only a small proportion of people achieve. Iodine deficiency can cause cognitive and motor impairment and, if severe, hypothyroidism with serious mental and growth retardation. More than 2 billion people worldwide are at risk of iodine deficiency. Preventing iodine deficiency by using salt fortified with iodine is a major global public health success. Programs to reduce dietary salt are technically compatible with programs to prevent iodine deficiency through salt fortification. However, for populations to fully benefit from optimum intake of salt and iodine, the programs must be integrated. This review summarizes the scientific basis for salt reduction and iodine fortification programs, the compatibility of the programs, and the steps that need to be taken by the WHO, national governments, and nongovernmental organizations to ensure that populations fully benefit from optimal intake of salt and iodine. Specifically, expert groups must be convened to help countries implement integrated programs and context-specific case studies of successfully integrated programs; lessons learned need to be compiled and disseminated. Integrated surveillance programs will be more efficient and will enhance current efforts to optimize intake of iodine and salt. For populations to fully benefit, governments need to place a high priority on integrating these two important public health programs. PMID:23299289

  6. 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

  7. Strategies To Boost Maternal Immunization To Achieve Further Gains In Improved Maternal And Newborn Health.

    PubMed

    Steedman, Mark R; Kampmann, Beate; Schillings, Egbert; Al Kuwari, Hanan; Darzi, Ara

    2016-02-01

    Despite the indisputable successes of the United Nations Millennium Development Goals, which include goals on improving maternal health and reducing child mortality, millions of mothers and newborns still die tragically and unnecessarily each year. Many of these deaths result from vaccine-preventable diseases, since obstacles such as cost and accessibility have hampered efforts to deliver efficacious vaccines to those most in need. Additionally, many vaccines given to mothers and children under age five are not suitable for newborns, since their maturing immune systems do not respond optimally during the first few months of life. Maternal immunization-the process by which a pregnant woman's immune system is fortified against a particular disease and the protection is then transferred to her unborn child-has emerged as a strategy to prevent many unnecessary maternal and newborn deaths. We review vaccines that are already used for maternal immunization, analyze vaccines under development that could be used for maternal immunization strategies in the future, and recommend that policy makers use maternal immunization for improved maternal and newborn health. PMID:26858385

  8. Strategies To Boost Maternal Immunization To Achieve Further Gains In Improved Maternal And Newborn Health.

    PubMed

    Steedman, Mark R; Kampmann, Beate; Schillings, Egbert; Al Kuwari, Hanan; Darzi, Ara

    2016-02-01

    Despite the indisputable successes of the United Nations Millennium Development Goals, which include goals on improving maternal health and reducing child mortality, millions of mothers and newborns still die tragically and unnecessarily each year. Many of these deaths result from vaccine-preventable diseases, since obstacles such as cost and accessibility have hampered efforts to deliver efficacious vaccines to those most in need. Additionally, many vaccines given to mothers and children under age five are not suitable for newborns, since their maturing immune systems do not respond optimally during the first few months of life. Maternal immunization-the process by which a pregnant woman's immune system is fortified against a particular disease and the protection is then transferred to her unborn child-has emerged as a strategy to prevent many unnecessary maternal and newborn deaths. We review vaccines that are already used for maternal immunization, analyze vaccines under development that could be used for maternal immunization strategies in the future, and recommend that policy makers use maternal immunization for improved maternal and newborn health.

  9. 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. PMID:25217357

  10. 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.

  11. 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. PMID:27234674

  12. Family socioeconomic status, family health, and changes in students' math achievement across high school: A mediational model.

    PubMed

    Barr, Ashley Brooke

    2015-09-01

    In response to recent calls to integrate understandings of socioeconomic disparities in health with understandings of socioeconomic disparities in academic achievement, this study tested a mediational model whereby family socioeconomic status predicted gains in academic achievement across high school through its impact on both student and parent health. Data on over 8000 high school students in the U.S. were obtained from wave 1 (2009-2010) and wave 2 (2012) of the High School Longitudinal Study of 2009 (HSLS:09), and structural equation modeling with latent difference scores was used to determine the role of family health problems in mediating the well-established link between family SES and gains in academic achievement. Using both static and dynamic indicators of family SES, support was found for this mediational model. Higher family SES in 9th grade reduced the probability of students and their parents experiencing a serious health problem in high school, thereby promoting growth in academic achievement. In addition, parent and student health problems mediated the effect of changes in family SES across high school on math achievement gains. Results emphasize the importance of considering the dynamic nature of SES and that both student and parent health should be considered in understanding SES-related disparities in academic achievement. This relational process provides new mechanisms for understanding the intergenerational transmission of socioeconomic status and the status attainment process more broadly.

  13. 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

  14. Men's Health Index: A Pragmatic Approach to Stratifying and Optimizing Men's Health

    PubMed Central

    Tan, Hui Meng; Tan, Wei Phin; Wong, Jun Hoe; Teo, Chin Hai; Ng, Chirk Jenn

    2014-01-01

    Purpose The proposed Men's Health Index (MHI) aims to provide a practical and systematic framework for comprehensively assessing and stratifying older men with the intention of optimising their health and functional status. Materials and Methods A literature search was conducted using PubMed from 1980 to 2012. We specifically looked for instruments which: assess men's health, frailty and fitness; predict life expectancy, mortality and morbidities. The instruments were assessed by the researchers who then agreed on the tools to be included in the MHI. When there was disagreements, the researchers discussed and reached a consensus guided by the principle that the MHI could be used in the primary care setting targetting men aged 55-65 years. Results The instruments chosen include the Charlson's Combined Comorbidity-Age Index; the International Index of Erectile Function-5; the International Prostate Symptom Score; the Androgen Deficiency in Aging Male; the Survey of Health, Ageing and Retirement in Europe Frailty Instrument; the Sitting-Rising Test; the Senior Fitness Test; the Fitness Assessment Score; and the Depression Anxiety Stress Scale-21. A pilot test on eight men was carried out and showed that the men's health index is viable. Conclusions The concept of assessing, stratifying, and optimizing men's health should be incorporated into routine health care, and this can be implemented by using the MHI. This index is particularly useful to primary care physicians who are in a strategic position to engage men at the peri-retirement age in a conversation about their life goals based on their current and predicted health status. PMID:25405012

  15. [The introduction of the achievements of medical science in public health practice with using modern information technologies].

    PubMed

    Horban', A Ie

    2012-01-01

    The article analyzes some factors that complicate the availability of scholarly communication professionals of health of Ukraine to introduce the achievements of medical science into practice. Improved access will help the implementation created by the Ministry of Health of Ukraine United e-data-processing system.

  16. Anger and health in dementia caregivers: exploring the mediation effect of optimism.

    PubMed

    López, J; Romero-Moreno, R; Márquez-González, M; Losada, A

    2015-04-01

    Although previous studies indicate a negative association between caregivers' anger and health, the potential mechanisms linking this relationship are not yet fully understood. The aim of this study was to explore the potential mediating role of optimism in the relationship between anger and caregivers' physical health. Dementia caregivers (n = 108) were interviewed and filled out instruments assessing their anger (reaction), optimism and health (vitality). A mediational model was tested to determine whether optimism partially mediated the relationship between anger and vitality. Angry reaction was negatively associated with optimism and vitality; optimism was positively associated with vitality. Finally, the relationship between angry reaction and vitality decreased when optimism was entered simultaneously. A non-parametric bootstrap approach confirmed that optimism significantly mediated some of the relationship between angry reaction and vitality. These findings suggest that low optimism may help explain the association between caregivers' anger and reduced sense of vitality. The results provide a specific target for intervention with caregivers.

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. 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. PMID:21845315

  2. Can an electronic health record system be used for preconception health optimization?

    PubMed

    Straub, Heather; Adams, Marci; Silver, Richard K

    2014-11-01

    To explore the potential of an integrated outpatient electronic health record (EHR) for preconception health optimization. An automated case-finding EHR-derived algorithm was designed to identify women of child-bearing age having outpatient encounters in an 85-site, integrated health system. The algorithm simultaneously cross-referenced multiple discrete data fields to identify selected preconception factors (obesity, hypertension, diabetes, teratogen use including ACE inhibitors, multivitamin supplementation, anemia, renal insufficiency, untreated sexually transmitted infection, HIV positivity, and tobacco, alcohol or illegal drug use). Surveys were mailed to a random sample of patients to obtain their self-reported health profiles for these same factors. Concordance was assessed between the algorithm output, survey results, and manual data abstraction. Between 8/2010-2/2012, 107,339 female outpatient visits were identified, from which 29,691 unique women were presumed to have child-bearing potential. 19,624 (66 %) and 8,652 (29 %) had 1 or ≥2 health factors, respectively while only 1,415 (5 %) had none. Using the patient survey results as a reference point, health-factor agreement was similar comparing the algorithm (85.8 %) and the chart abstraction (87.2 %) results. Incorrect or missing data entries in the EHR encounters were largely responsible for discordances observed. Preconception screening using an automated algorithm in a system-wide EHR identified a large group of women with potentially modifiable preconception health conditions. The issue most responsible for limiting algorithm performance was incomplete point of care documentation. Accurate data capture during patient encounters should be a focus for quality improvement, so that novel applications of system-wide data mining can be reliably implemented. PMID:24627232

  3. 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

    2015-01-01

    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. PMID:26673345

  4. Perspectives on Federal Funding for State Health Care-Associated Infection Programs: Achievements, Barriers, and Implications for Sustainability.

    PubMed

    Ellingson, Katherine; McCormick, Kelly; Woodard, Tiffanee; Garcia-Williams, Amanda; Mendel, Peter; Kahn, Katherine; McDonald, Clifford; Jernigan, John; Sinkowitz-Cochran, Ronda

    2014-08-01

    In September 2009, federal funding for health care-associated infection (HAI) program development was dispersed through a cooperative agreement to 51 state and territorial health departments. From July to September 2011, 69 stakeholders from six states-including state health department employees, representatives from partner organizations, and health care facility employees-were interviewed to assess state HAI program achievements, implementation barriers, and strategies for sustainability. Respondents most frequently cited enhanced HAI surveillance as a program achievement and resource constraints as an implementation barrier. To sustain programs, respondents recommended ongoing support for HAI prevention activities, improved surveillance processes, and maintenance of partnerships. Findings suggest that state-level HAI program growth was achieved during the cooperative agreement but that maintenance of programs faces challenges.

  5. Optimizing Early Protein Intake for Long-Term Health of Preterm Infants.

    PubMed

    Singhal, Atul

    2016-01-01

    The idea that early protein intake may influence, or program, long-term health in preterm infants is strongly supported by decades of research starting from the early 1980s. At this time, it was recognized that preterm infants required a high protein intake to achieve postnatal growth closer to the intrauterine growth rate of a normal fetus of the same postconceptional age, a goal regarded optimal for short- and long-term health. Subsequently, follow-up of preterm infants randomized to different neonatal diets demonstrated that those receiving higher protein intakes that promoted growth had benefits for brain structure and function up to 16 years later, but also detrimental effects on cardiovascular risk factors such as insulin resistance and adiposity. These effects of early growth on risk of metabolic disease, termed the 'growth acceleration' hypothesis, have been demonstrated in randomized and observational studies in infants born preterm and at term. Nevertheless, on balance, current nutrition policy for preterm infants is based on the consensus that supporting optimal neurodevelopment is the neonatologist's highest priority. Therefore, this policy appropriately favors early administration of a high protein intake to benefit neurodevelopment, irrespective of any increase in cardiovascular risk. The current review will consider the evidence underlying this policy. PMID:27336311

  6. Reduction of exposure to acrylamide: achievements, potential of optimization, and problems encountered from the perspectives of a Swiss enforcement laboratory.

    PubMed

    Grob, Koni

    2005-01-01

    The most important initiatives taken in Switzerland to reduce exposure of consumers to acrylamide are the separate sale of potatoes low in reducing sugars for roasting and frying, the optimization of the raw material and preparation of french fries, and campaigns to implement suitable preparation methods in the gastronomy and homes. Industry works on improving a range of other products. Although these measures can reduce high exposures by some 80%, they have little effect on the background exposure resulting from coffee, bread, and numerous other products for which no substantial improvement is in sight. At this stage, improvements should be achieved by supporting voluntary activity rather than legal limits. Committed and consistent risk communication is key, and the support of improvements presupposes innovative approaches.

  7. Achieving consistent image quality with dose optimization in 64-row multidetector computed tomography prospective ECG gated coronary calcium scoring.

    PubMed

    Pan, Zilai; Pang, Lifang; Li, Jianying; Zhang, Huan; Yang, Wenjie; Ding, Bei; Chai, Weimin; Chen, Kemin; Yao, Weiwu

    2011-04-01

    To evaluate the clinical value of a body mass index (BMI) based tube current (mA) selection method for obtaining consistent image quality with dose optimization in MDCT prospective ECG gated coronary calcium scoring. A formula for selecting mA to achieve desired image quality based on patient BMI was established using a control group (A) of 200 MDCT cardiac patients with a standard scan protocol. One hundred patients in Group B were scanned with this BMI-dependent mA for achieving a desired noise level of 18 HU at 2.5 mm slice thickness. The CTDIvol and image noise on the ascending aorta for the two groups were recorded. Two experienced radiologists quantitatively evaluated the image quality using scores of 1-4 with 4 being the highest. The image quality scores had no statistical difference (P = 0.71) at 3.89 ± 0.32, 3.87 ± 0.34, respectively, for groups A and B of similar BMI. The image noise in Group A had linear relationship with BMI. The image noise in Group B using BMI-dependent mA was independent of BMI with average value of 17.9 HU and smaller deviations for the noise values than in Group A (2.0 vs. 2.9 HU). There was a 35% dose reduction with BMI-dependent mA selection method on average with the lowest effective dose being only 0.35 mSv for patient with BMI of 18.3. A quantitative BMI-based mA selection method in MDCT prospective ECG gated coronary calcium scoring has been proposed to obtain a desired and consistent image quality and provide dose optimization across patient population.

  8. 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.

  9. Optimization Correction Strength Using Contra Bending Technique without Anterior Release Procedure to Achieve Maximum Correction on Severe Adult Idiopathic Scoliosis

    PubMed Central

    Rahyussalim, Ahmad Jabir; Saleh, Ifran; Purnaning, Dyah; Kurniawati, Tri

    2016-01-01

    Adult scoliosis is defined as a spinal deformity in a skeletally mature patient with a Cobb angle of more than 10 degrees in the coronal plain. Posterior-only approach with rod and screw corrective manipulation to add strength of contra bending manipulation has correction achievement similar to that obtained by conventional combined anterior release and posterior approach. It also avoids the complications related to the thoracic approach. We reported a case of 25-year-old male adult idiopathic scoliosis with double curve. It consists of main thoracic curve of 150 degrees and lumbar curve of 89 degrees. His curve underwent direct contra bending posterior approach using rod and screw corrective manipulation technique to achieve optimal correction. After surgery the main thoracic Cobb angle becomes 83 degrees and lumbar Cobb angle becomes 40 degrees, with 5 days length of stay and less than 800 mL blood loss during surgery. There is no complaint at two months after surgery; he has already come back to normal activity with good functional activity. PMID:27064801

  10. 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, &…

  11. 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

  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. 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.

  14. 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.

  15. 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.

  16. Flourishing after depression: Factors associated with achieving complete mental health among those with a history of depression.

    PubMed

    Fuller-Thomson, Esme; Agbeyaka, Senyo; LaFond, Deborah M; Bern-Klug, Mercedes

    2016-08-30

    This study investigated factors associated with complete mental health among a nationally representative sample of Canadians with a history of depression by conducting secondary analysis of the 2012 Canadian Community Health Survey- Mental Health (n=20,955). Complete mental health was defined as 1) the absence of mental illness, substance abuse, or suicidal ideation in the past year; 2) happiness or life satisfaction almost every day/past month, and 3) social and psychological well-being. The prevalence of complete mental health among those with and without a history of depression was determined. In a sample of formerly depressed respondents (n=2528), a series of logistic regressions were completed controlling for demographics, socioeconomic status, health and lifetime mental health conditions, health behaviours, social support, adverse childhood experiences, and religiosity. Two in five individuals (39%) with a history of depression had achieved complete mental health in comparison to 78% of those without a history of depression. In comparison to the formally depressed adults who were not in complete mental health, those in complete mental health were more likely to be female, White, older, affluent, married, with a confidant, free of disabling pain, insomnia, and childhood adversities and without a history of substance abuse. They were also more likely to exercise regularly and use spirituality to cope. PMID:27267442

  17. 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…

  18. 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

  19. 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

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

    PubMed Central

    Starfield, Barbara; Birn, Anne‐Emanuelle

    2007-01-01

    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. PMID:18000124

  1. 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.

  2. 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

  3. 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. PMID:23297272

  4. 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

  5. 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

    2011-01-01

    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

  6. Achieving accessible health care for people with disabilities: why the ADA is only part of the solution.

    PubMed

    Yee, Silvia; Breslin, Mary Lou

    2010-10-01

    People with various disabilities encounter numerous physical and programmatic barriers to receiving health care of equal quality and effectiveness as that received by people without disabilities. Litigation and settlement negotiations under such federal laws as the Americans with Disabilities Act of 1990 have resulted in the removal of access barriers in specific instances, but have not yet resulted in the kind of systemic change needed in the health care delivery system. This article analyses some of the factors that make accessible health care so difficult to achieve. Accessible health care is viewed through a public health lens by which changes in public policy and social views of disability are necessary for achieving sustainable long-term success. The advantages and disadvantages of judicial policy making in the analogous contexts of tobacco cessation and Title VI medical discrimination in the United States is briefly discussed. The powerful but blunt tool of litigation is analyzed as only one tool among an array of public policy and legislative tools needed to effect barrier removal in the field of health care, especially among the smaller provider clinics and practices where a majority of outpatient visits take place. Lawsuits and other policy tools, such as enacting further legislation to link accessibility standards to federal agency enforcement, creating federally funded technical assistance centers that will disseminate practical policy and procedural tools to providers, and mandating the gathering of disability-specific disparities and effectiveness data, must work in concert to transform our health care system.

  7. Achieving accessible health care for people with disabilities: why the ADA is only part of the solution.

    PubMed

    Yee, Silvia; Breslin, Mary Lou

    2010-10-01

    People with various disabilities encounter numerous physical and programmatic barriers to receiving health care of equal quality and effectiveness as that received by people without disabilities. Litigation and settlement negotiations under such federal laws as the Americans with Disabilities Act of 1990 have resulted in the removal of access barriers in specific instances, but have not yet resulted in the kind of systemic change needed in the health care delivery system. This article analyses some of the factors that make accessible health care so difficult to achieve. Accessible health care is viewed through a public health lens by which changes in public policy and social views of disability are necessary for achieving sustainable long-term success. The advantages and disadvantages of judicial policy making in the analogous contexts of tobacco cessation and Title VI medical discrimination in the United States is briefly discussed. The powerful but blunt tool of litigation is analyzed as only one tool among an array of public policy and legislative tools needed to effect barrier removal in the field of health care, especially among the smaller provider clinics and practices where a majority of outpatient visits take place. Lawsuits and other policy tools, such as enacting further legislation to link accessibility standards to federal agency enforcement, creating federally funded technical assistance centers that will disseminate practical policy and procedural tools to providers, and mandating the gathering of disability-specific disparities and effectiveness data, must work in concert to transform our health care system. PMID:21122794

  8. 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…

  9. 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…

  10. 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 schools and…

  11. 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

  12. Breadth of knowledge vs. grades: What best predicts achievement in the first year of health sciences programmes?

    PubMed Central

    Li, Meisong; McKimm, Judy; Smith, Melinda

    2012-01-01

    This study aimed to identify those features within secondary school curricula and assessment, particularly science subjects that best predict academic achievement in the first year of three different three-year undergraduate health professional programmes (nursing, pharmacy, and health sciences) at a large New Zealand university. In particular, this study compared the contribution of breadth of knowledge (number of credits acquired) versus grade level (grade point average) and explored the impact of demographic variables on achievement. The findings indicated that grades are the most important factor predicting student success in the first year of university. Although taking biology and physics at secondary school has some impact on university first year achievement, the effect is relatively minor. PMID:22639706

  13. Breadth of knowledge vs. grades: What best predicts achievement in the first year of health sciences programmes?

    PubMed

    Shulruf, Boaz; Li, Meisong; McKimm, Judy; Smith, Melinda

    2012-01-01

    This study aimed to identify those features within secondary school curricula and assessment, particularly science subjects that best predict academic achievement in the first year of three different three-year undergraduate health professional programmes (nursing, pharmacy, and health sciences) at a large New Zealand university. In particular, this study compared the contribution of breadth of knowledge (number of credits acquired) versus grade level (grade point average) and explored the impact of demographic variables on achievement. The findings indicated that grades are the most important factor predicting student success in the first year of university. Although taking biology and physics at secondary school has some impact on university first year achievement, the effect is relatively minor.

  14. Nutritionists in industry can play a key role in helping to achieve Health of the Nation targets for nutrition.

    PubMed

    Kirk, T R; de Looy, A; Fletcher, R; Ruxton, C H

    2007-06-01

    Nutritionists working in food manufacturing and retailing are potentially in a more powerful position than any other professional group to contribute towards achieving the national targets for nutrition and the reduction of nutrition-related diseases, set out in The Health of the Nation (DoH, 1992) and in Scotland's Health, A Challenge to Us All (Scottish Office, 1993). The present paper sets out the details of this argument. First, a review is given of the functions and types of activities carried out by nutritionists in industry. Then a number of key practical ways in which nutritionists, through their activities and functions, can help towards achieving national targets for nutrition and nutrition-related diseases are described. Finally, suggestions are made about the knowledge, skills, and personal attributes needed by nutritionists who intend making successful careers in industry and who wish, at the same time, to contribute towards improving the health of the nation. PMID:17539871

  15. [The relationship between the contents and the level of achievement of objectives in an occupational health nursing practicum].

    PubMed

    Nakatani, Junko; Hara, Yoshiko; Ikeda, Tomoko; Ishihara, Itsuko

    2010-03-01

    The purpose of this study was to evaluate the program and teaching methods of the occupational health nursing practicum in order to enforce students' learning experience in the clinical practice. Self-evaluation sheets graded from levels 1 to 4 were from 63 students, and statistical analysis was performed in relation to their performance levels. The results of the analysis of 63 students' performance sheets indicated that the students achieved 3 points above average in all 14 course objectives. Scales analysis of the students' evaluation sheets also revealed that students' achievement levels were lower at the Industrial Health Organization in comparison with those at the industrial enterprises. To make students' practice more valuable, students' assessment skills of the workers and working environment should be emphasized in the classroom teaching and experience of learning at the laboratory. Moreover, the course objectives should be sufficiently linked to the practice areas in order to differentiate between the features of the Health organizations and enterprises.

  16. The Americans With Disabilities Act: preparing your health care facility to achieve compliance.

    PubMed

    Schneid, T D

    The article discusses the Americans With Disabilities Act, signed into law by President Bush on July 26, 1990, and its potential effects on the health care industry. The author offers advice on how health care facilities can insure compliance with this sweeping legislation.

  17. 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…

  18. A System for Planning and Achieving Comprehensive Health Care in Residential Institutions for the Mentally Retarded.

    ERIC Educational Resources Information Center

    Decker, Harold A.

    Based on a view of health care intertwining medicine intimately with other components of institutional care, the monograph presents a system of concepts and operating techniques for providing comprehensive health care to institutionalized retardates. Background of the system is explained in terms of its research basis (two studies by the author of…

  19. Achieving the Promise: The Significant Role of Schools in Transforming Children's Mental Health in America

    ERIC Educational Resources Information Center

    Lechtenberger, DeAnn; Mullins, Frank Edward; Greenword, Dale

    2008-01-01

    Teacher preparation programs can play an essential role in disseminating information on children's mental health and design curricula that teach the skills necessary for promoting good mental health in schools to preservice and inservice professionals from diverse backgrounds and disciplines. The strategies presented in this article will provide…

  20. 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…

  1. Do we have the right models for scaling up health services to achieve the Millennium Development Goals?

    PubMed Central

    2011-01-01

    Background There is widespread agreement on the need for scaling up in the health sector to achieve the Millennium Development Goals (MDGs). But many countries are not on track to reach the MDG targets. The dominant approach used by global health initiatives promotes uniform interventions and targets, assuming that specific technical interventions tested in one country can be replicated across countries to rapidly expand coverage. Yet countries scale up health services and progress against the MDGs at very different rates. Global health initiatives need to take advantage of what has been learned about scaling up. Methods A systematic literature review was conducted to identify conceptual models for scaling up health in developing countries, with the articles assessed according to the practical concerns of how to scale up, including the planning, monitoring and implementation approaches. Results We identified six conceptual models for scaling up in health based on experience with expanding pilot projects and diffusion of innovations. They place importance on paying attention to enhancing organizational, functional, and political capabilities through experimentation and adaptation of strategies in addition to increasing the coverage and range of health services. These scaling up approaches focus on fostering sustainable institutions and the constructive engagement between end users and the provider and financing organizations. Conclusions The current approaches to scaling up health services to reach the MDGs are overly simplistic and not working adequately. Rather than relying on blueprint planning and raising funds, an approach characteristic of current global health efforts, experience with alternative models suggests that more promising pathways involve "learning by doing" in ways that engage key stakeholders, uses data to address constraints, and incorporates results from pilot projects. Such approaches should be applied to current strategies to achieve the MDGs

  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. Achieving a shared vision for girls' health in a low-income community.

    PubMed

    Miller, M Elizabeth; Vaughn, Lisa M

    2015-01-01

    In response to a lack of information related to girls' health in a low-income community, an initiative was developed to create a community-wide vision for girls' health. A forum was conducted following a photovoice project to generate sustainable action steps. Forty-four participants attended the forum. Key action steps included decreasing barriers to participation in girls' programs, offering leadership roles and interpersonal communication skills for girls in the community, and engaging girls in community organizations. Integral to the forum's success were the initial photos, which provided a bridge from understanding the issues of girls' health to the development of the action steps.

  4. Equity of the premium of the Ghanaian national health insurance scheme and the implications for achieving universal coverage

    PubMed Central

    2013-01-01

    The Ghanaian National Health Insurance Scheme (NHIS) was introduced to provide access to adequate health care regardless of ability to pay. By law the NHIS is mandatory but because the informal sector has to make premium payment before they are enrolled, the authorities are unable to enforce mandatory nature of the scheme. The ultimate goal of the Scheme then is to provide all residents with access to adequate health care at affordable cost. In other words, the Scheme intends to achieve universal coverage. An important factor for the achievement of universal coverage is that revenue collection be equitable. The purpose of this study is to examine the vertical and horizontal equity of the premium collection of the Scheme. The Kakwani index method as well as graphical analysis was used to study the vertical equity. Horizontal inequity was measured through the effect of the premium on redistribution of ability to pay of members. The extent to which the premium could cause catastrophic expenditure was also examined. The results showed that revenue collection was both vertically and horizontally inequitable. The horizontal inequity had a greater effect on redistribution of ability to pay than vertical inequity. The computation of catastrophic expenditure showed that a small minority of the poor were likely to incur catastrophic expenditure from paying the premium a situation that could impede the achievement of universal coverage. The study provides recommendations to improve the inequitable system of premium payment to help achieve universal coverage. PMID:23294982

  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. Technical Assistance From State Health Departments for Communities Engaged in Policy, Systems, and Environmental Change: The ACHIEVE Program

    PubMed Central

    Hefelfinger, Jenny; Patty, Alice; Ussery, Ann

    2013-01-01

    Introduction This study assessed the value of technical assistance provided by state health department expert advisors and by the staff of the National Association of Chronic Disease Directors (NACDD) to community groups that participated in the Action Communities for Health, Innovation, and Environmental Change (ACHIEVE) Program, a CDC-funded health promotion program. Methods We analyzed quantitative and qualitative data reported by community project coordinators to assess the nature and value of technical assistance provided by expert advisors and NACDD staff and the usefulness of ACHIEVE resources in the development and implementation of community action plans. A grounded theory approach was used to analyze and categorize phrases in text data provided by community coordinators. Open coding placed conceptual labels on text phrases. Frequency distributions of the quantitative data are described and discussed. Results The most valuable technical assistance and program support resources were those determined to be in the interpersonal domain (ie, interactions with state expert advisors, NACDD staff, and peer-to-peer support). The most valuable technical assistance events were action institutes, coaches’ meetings, webinars, and technical assistance conference calls. Conclusion This analysis suggests that ACHIEVE communities valued the management and training assistance provided by expert advisors and NACDD staff. State health department expert advisors provided technical guidance and support, including such skills or knowledge-based services as best-practice strategies, review and discussion of community assessment data, sustainability planning, and identification of possible funding opportunities. NACDD staff led development and implementation of technical assistance events. PMID:24157078

  7. Key Challenges to Achieving Health for All in an Inequitable Society: The Case of South Africa

    PubMed Central

    Sanders, David; Chopra, Mickey

    2006-01-01

    The health inequalities in South Africa are rapidly worsening. Since 1994, the new democratic government has initiated a number of large-scale policies and programs with explicit pro-equity objectives that have improved access to health care and other social resources. However, these policies and programs have been constrained by macroeconomic policies that dictate fiscal restraint and give priority to technical rather than developmental considerations. We propose an approach to improving health for all that focuses on equity in the allocation of health resources. The implementation of pro-equity policies requires, in addition to technically efficacious interventions, both advocacy initiatives and communication with, and the involvement of, affected communities. The Cape Town Equity Gauge project is presented as one example of a response to the challenge of inequity. PMID:16317201

  8. 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

  9. Environmental health in China: challenges to achieving clean air and safe water

    PubMed Central

    Zhang, Junfeng (Jim); Mauzerall, Denise L.; Zhu, Tong; Liang, Song; Ezzati, Majid; Remais, Justin

    2014-01-01

    The health effects of environmental risks, especially those of air and water pollution, remain a major source of morbidity and mortality in China. Biomass fuel and coal are routinely burned for cooking and heating in almost all rural and many urban households resulting in severe indoor air pollution that contributes greatly to the burden of disease. Many communities lack access to safe drinking water and santiation, and thus the risk of waterborne disease in many regions remains high. At the same time, China is rapidly industrializing with associated increases in energy use and industrial waste. While economic growth resulting from industrialization has improved health and quality of life indicators in China, it has also increased the incidence of environmental disasters and the release of chemical toxins into the environment, with severe impacts on health. Air quality in China's cities is among the worst in the world and industrial water pollution has become a widespread health hazard. Moreover, emissions of climate-warming greenhouse gases from energy use are rapidly increasing. Global climate change will inevitably intensify China's environmental health problems, with potentially catastrophic outcomes from major shifts in temperature and precipitation. Facing the overlap of traditional, modern, and emerging environmental problems, China has committed substantial resources to environmental improvement. China has the opportunity to both address its national environmental health challenges and to assume a central role in the international effort to improve the global environment. PMID:20346817

  10. 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

  11. Electronic health record meets digital library: a new environment for achieving an old goal.

    PubMed

    Humphreys, B L

    2000-01-01

    Linking the electronic health record to the digital library is a Web-era reformulation of the long-standing informatics goal of seamless integration of automated clinical data and relevant knowledge-based information to support informed decisions. The spread of the Internet, the development of the World Wide Web, and converging format standards for electronic health data and digital publications make effective linking increasingly feasible. Some existing systems link electronic health data and knowledge-based information in limited settings or limited ways. Yet many challenging informatics research problems remain to be solved before flexible and seamless linking becomes a reality and before systems become capable of delivering the specific piece of information needed at the time and place a decision must be made. Connecting the electronic health record to the digital library also requires positive resolution of important policy issues, including health data privacy, government encouragement of high-speed communications, electronic intellectual property rights, and standards for health data and for digital libraries. Both the research problems and the policy issues should be important priorities for the field of medical informatics.

  12. 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…

  13. Political and cultural factors in achieving continuity with a primary health care provider at an Indian Health Service hospital.

    PubMed

    Dietrich, A J; Olson, A L

    1981-01-01

    A primary care system was established at Zuni-Ramah Indian Health Service Hospital and clinic in New Mexico. Continuity and coordination of care were added to a health care system that was already accountable, accessible, and comprehensive. The new system offered each patient a personal health care provider who worked as a member of a multidisciplinary team. In changing the health care system, special attention was given to its cultural and political setting, the village of Zuni. After thorough discussion with community and staff, community members' concerns about patients' privacy and free choice were better understood, and special efforts were made to safeguard them. Ongoing evaluation is essential to maintain continuity. Eight months after the primary care system was begun, 64 percent of patients who came for care had established a personal relationship with a health care provider. For 59 percent of the visits during the 1-month evaluation period, patients saw their regular provider and, for 82 percent, patients saw their provider or one of his or her team colleagues. These percentages include night and walk-in visits. The system required no extra funding or staff. The political process of planning and consultation helped anticipate and alleviate the community's concerns, but resistance from physician's assistants and some physicians was unexpected. A flexible approach has led to a gradual acceptance of this voluntary system. This experience with the people of Zuni village shows that a primary care system can be started in a rural Indian Health Service facility with minimal outside help. Apparent improvements in quality of care make the continuity of primary care worthy of further consideration in the IHS and similar health services systems.

  14. 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.

  15. 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…

  16. 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

  17. 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

  18. 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…

  19. 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…

  20. Achieving Equity and Excellence: The Role of School Mental Health Providers in Shrinking Excellence Gaps

    ERIC Educational Resources Information Center

    Harris, Bryn; Plucker, Jonathan

    2014-01-01

    The United States is becoming more racially, ethnically, and linguistically diverse, yet the educational attainment of various student groups has been very uneven. For decades, educators and policymakers have been focused on minimal competencies rather than advanced achievement. Specifically, federal and state education policies have focused on…

  1. 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.

  2. Building blocks for reform: achieving universal coverage with private and public group health insurance.

    PubMed

    Schoen, Cathy; Davis, Karen; Collins, Sara R

    2008-01-01

    This paper presents a framework for universal health insurance that builds on the current U.S. mixed private-public system by expanding group coverage through private markets and publicly sponsored insurance. This Building Blocks approach includes a new national insurance "connector" that offers small businesses and individuals a structured choice of a Medicare-like public option and private plans. Other features include an individual mandate, required employer contributions, Medicaid/State Children's Health Insurance Program (SCHIP) expansion, and tax credits to assure affordability. The paper estimates coverage and costs, and assesses the approach. Our findings indicate that the framework could reach near-universal coverage with little net increase in national health spending. PMID:18474952

  3. 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

  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. 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. PMID:27102018

  6. 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…

  7. Reducing the Academic Risks of Over-Optimism: The Longitudinal Effects of Attributional Retraining on Cognition and Achievement

    ERIC Educational Resources Information Center

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

    2006-01-01

    Although optimism is generally regarded as a positive dispositional characteristic, unmitigated optimism can be problematic. The adaptiveness of overly optimistic expectations in novel or unfamiliar settings is questionable because individuals have little relevant experience on which to base such expectations. In this four-phase longitudinal…

  8. Consequences of Physical Health and Mental Illness Risks for Academic Achievement in Grades K-12

    ERIC Educational Resources Information Center

    Joe, Sean; Joe, Emanique; Rowley, Larry L.

    2009-01-01

    Educational research, practice, and institutions regularly highlight the significance of factors outside of schooling that affect children's engagement and participation in classroom learning. The health of children and families is one such issue with implications for the quality of children's school experiences, treatment in school, and academic…

  9. VISUAL BEACH: SOFTWARE FOR ACHIEVING BEACH AESTHETIC AND PUBLIC HEALTH PROTECTION

    EPA Science Inventory

    The Beaches Environmental Assessment and Coastal Health Act of 2000 directs the EPA to assure that 100% of significant public beaches are managed by 2008. Under the Act EPA is developing a program to monitor beach water quality and strategies for timely notification of the public...

  10. 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…

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

    PubMed

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

    2013-01-01

    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

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

    PubMed

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

    2013-01-01

    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

  13. Evaluation of an occupational health nursing program through competency achievement: on-campus and distance education, 2005 and 2008.

    PubMed

    Randolph, Susan A; Rogers, Bonnie; Ostendorf, Judith S

    2011-09-01

    This descriptive cross-sectional study was conducted in 2005 and 2008 to evaluate self-reported competency achievement by occupational health nursing program graduates. Twelve competencies were evaluated at three levels: competent, proficient, and expert. In 2005, most graduates believed they were at the proficient level in 10 of the 12 competencies, with three competencies approaching the expert level. In 2008, all graduates rated their competency achievement at the proficient level for all 12 competencies, with nine competencies approaching the expert level. Graduates entering the program with experience had higher competency scores compared to those without experience. Distance education learners had higher competency scores compared to on-campus graduates. From 2005 to 2008, reported competency achievement increased in all areas except research, which was only marginally reduced by a 0.1 score. Based on competency findings, curriculum and course assignments related to leadership role, policy development, professional development, and research were modified.

  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. [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.

  16. [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. PMID:24100770

  17. Managing the public-private mix to achieve universal health coverage.

    PubMed

    McPake, Barbara; Hanson, Kara

    2016-08-01

    The private sector has a large and growing role in health systems in low-income and middle-income countries. The goal of universal health coverage provides a renewed focus on taking a system perspective in designing policies to manage the private sector. This perspective requires choosing policies that will contribute to the performance of the system as a whole, rather than of any sector individually. Here we draw and extrapolate main messages from the papers in this Series and additional sources to inform policy and research agendas in the context of global and country level efforts to secure universal health coverage in low-income and middle-income countries. Recognising that private providers are highly heterogeneous in terms of their size, objectives, and quality, we explore the types of policy that might respond appropriately to the challenges and opportunities created by four stylised private provider types: the low-quality, underqualified sector that serves poor people in many countries; not-for-profit providers that operate on a range of scales; formally registered small-to-medium private practices; and the corporate commercial hospital sector, which is growing rapidly and about which little is known. PMID:27358252

  18. Reproductive health in Iran: pragmatic achievements, unmet needs, and ethical challenges in a theocratic system.

    PubMed

    Mehryar, Amir H; Ahmad-Nia, Shirin; Kazemipour, Shahla

    2007-12-01

    Since its revival in 1989, the reproductive health and family planning program of Iran has made great strides in raising the contraceptive prevalence rate and reducing fertility. The majority of couples are using modern methods promoted and provided by the national program, although a sizable proportion of couples continue to depend on the traditional method of withdrawal. The longstanding urban-rural gap in contraceptive prevalence rates has been reduced to about 10 percent, which is mainly the result of better-educated urban couples' continued practice of withdrawal. Despite its enormous success in meeting the needs of married couples, in narrowing the urban-rural gap in access to and use of modern contraceptives, and in reducing fertility, the Iranian family planning program is open to criticism for confining its target audience to married couples and failing to address the issue of abortion. The restrictive aspects of the program are often justified on the grounds of religious values and fear of encouraging sexual promiscuity. Because of the theocratic nature of the political system and the immense power enjoyed by Shiite ulama (religious leaders), no step can be taken to address these restrictions without their implicit support and approval. This study describes some of the ethical issues facing the reproductive health program of Iran and indicates how pragmatic approaches adopted by the ruling Shiite ulama to solve some of the social and medical challenges of a rapidly modernizing society may be extended to overcome ethical hurdles faced by the reproductive health program. PMID:18284048

  19. Managing the public-private mix to achieve universal health coverage.

    PubMed

    McPake, Barbara; Hanson, Kara

    2016-08-01

    The private sector has a large and growing role in health systems in low-income and middle-income countries. The goal of universal health coverage provides a renewed focus on taking a system perspective in designing policies to manage the private sector. This perspective requires choosing policies that will contribute to the performance of the system as a whole, rather than of any sector individually. Here we draw and extrapolate main messages from the papers in this Series and additional sources to inform policy and research agendas in the context of global and country level efforts to secure universal health coverage in low-income and middle-income countries. Recognising that private providers are highly heterogeneous in terms of their size, objectives, and quality, we explore the types of policy that might respond appropriately to the challenges and opportunities created by four stylised private provider types: the low-quality, underqualified sector that serves poor people in many countries; not-for-profit providers that operate on a range of scales; formally registered small-to-medium private practices; and the corporate commercial hospital sector, which is growing rapidly and about which little is known.

  20. 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.

  1. 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.

  2. Achieving polio eradication: a review of health communication evidence and lessons learned in India and Pakistan.

    PubMed

    Obregón, Rafael; Chitnis, Ketan; Morry, Chris; Feek, Warren; Bates, Jeffrey; Galway, Michael; Ogden, Ellyn

    2009-08-01

    Since 1988, the world has come very close to eradicating polio through the Global Polio Eradication Initiative, in which communication interventions have played a consistently central role. Mass media and information dissemination approaches used in immunization efforts worldwide have contributed to this success. However, reaching the hardest-to-reach, the poorest, the most marginalized and those without access to health services has been challenging. In the last push to eradicate polio, Polio Eradication Initiative communication strategies have become increasingly research-driven and innovative, particularly through the introduction of sustained interpersonal communication and social mobilization approaches to reach unreached populations. This review examines polio communication efforts in India and Pakistan between the years 2000 and 2007. It shows how epidemiological, social and behavioural data guide communication strategies that have contributed to increased levels of polio immunity, particularly among underserved and hard-to-reach populations. It illustrates how evidence-based and planned communication strategies - such as sustained media campaigns, intensive community and social mobilization, interpersonal communication and political and national advocacy combined - have contributed to reducing polio incidence in these countries. Findings show that communication strategies have contributed on several levels by: mobilizing social networks and leaders; creating political will; increasing knowledge; ensuring individual and community-level demand; overcoming gender barriers and resistance to vaccination; and reaching out to the poorest and marginalized populations. The review concludes with observations about the added value of communication strategies in polio eradication efforts and implications for global and local public health communication interventions.

  3. 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

    2015-01-01

    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

  4. 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

    2015-01-01

    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.

  5. Healthful School Living: Environmental Health in the School.

    ERIC Educational Resources Information Center

    Rowe, Daryl E.

    1987-01-01

    Environmental health, as it relates to schools, is defined. Site, chemical, biological, and physical health hazards are identified. Recommendations and precautions to help achieve optimal health, safety, and comfort are presented. Resources are noted. (Author/MT)

  6. 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

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

    PubMed

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

    2016-03-01

    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.

  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. 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

  10. Optimizing Performance on Linux Clusters Using Advanced Communication Protocols: Achieving Over 10 Teraflops on a 8.6 Teraflops Linpack-Rated Linux Cluster

    SciTech Connect

    Krishnan, Manoj Kumar; Nieplocha, Jarek

    2005-04-26

    Advancements in high-performance networks (Quadrics, Infiniband or Myrinet) continue to improve the efficiency of modern clusters. However, the average application efficiency is as small fraction of the peak as the system’s efficiency. This paper describes techniques for optimizing application performance on Linux clusters using Remote Memory Access communication protocols. The effectiveness of these optimizations is presented in the context of an application kernel, dense matrix multiplication. The result was achieving over 10 teraflops on HP Linux cluster on which LINPACK performance is measured as 8.6 teraflops.

  11. 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.

  12. Quality of vegetable oil prior to fortification is an important criteria to achieve a health impact.

    PubMed

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

    2014-11-01

    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. Quality of vegetable oil prior to fortification is an important criteria to achieve a health impact.

    PubMed

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

    2014-11-11

    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.

  14. I. An introduction to the relation of physical activity to cognitive and brain health, and scholastic achievement.

    PubMed

    Hillman, Charles H

    2014-12-01

    The current pandemic of physical inactivity threatens both physical and cognitive health throughout the lifespan. This monograph describes the multidisciplinary study of aspects of childhood health and its relationship to cognitive and brain function, and scholastic performance. Specifically, we focus on physical activity and physical fitness along with nutrition and obesity; interconnected aspects of health that have declined over the past 30 years in children of industrialized nations. Although much emphasis has been placed on correcting physical aspects of these public health concerns, it is only more recently that attention has been paid to the relation between physical health and cognitive health among school age children. The monograph begins with an overview of current behavioral trends that compete with physical activity engagement and contribute to the failure to achieve the public health recommendations for physical activity among children in the United States. Following the epidemiological overview, the relation of childhood fitness to brain structure and function is examined among children with varying fitness levels. The observed dissimilarities between higher- and lower-fit children are discussed within the context of typical brain development. To broaden the scope of research presented herein, the relation of nutrient intake--among both undernourished and well-nourished children--and obesity on cognition and brain are discussed. Next, novel empirical data are presented from a correlational study that indicates a differential relation between childhood fitness and adiposity on various aspects of cognition. In an effort to provide a more comprehensive review, a later chapter is dedicated to describing a small body of literature investigating the relation of physical activity to special populations of children, including those with learning disorders. In doing so, practical applications as well as challenges and limitations of implementing physical

  15. 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. PMID:14521429

  16. The care span: The importance of transitional care in achieving health reform.

    PubMed

    Naylor, Mary D; Aiken, Linda H; Kurtzman, Ellen T; Olds, Danielle M; Hirschman, Karen B

    2011-04-01

    Under the Affordable Care Act of 2010, a variety of transitional care programs and services have been established to improve quality and reduce costs. These programs help hospitalized patients with complex chronic conditions-often the most vulnerable-transfer in a safe and timely manner from one level of care to another or from one type of care setting to another. We conducted a systematic review of the research literature and summarized twenty-one randomized clinical trials of transitional care interventions targeting chronically ill adults. We identified nine interventions that demonstrated positive effects on measures related to hospital readmissions-a key focus of health reform. Most of the interventions led to reductions in readmissions through at least thirty days after discharge. Many of the successful interventions shared similar features, such as assigning a nurse as the clinical manager or leader of care and including in-person home visits to discharged patients. Based on these findings, we recommend several strategies to guide the implementation of transitional care under the Affordable Care Act, such as encouraging the adoption of the most effective interventions through such programs as the Community-Based Care Transitions Program and Medicare shared savings and payment bundling experiments.

  17. Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries

    PubMed Central

    Ikegami, Naoki

    2016-01-01

    When the Japanese government adopted Western medicine in the late nineteenth century, it left intact the infrastructure of primary care by giving licenses to the existing practitioners and by initially setting the hurdle for entry into medical school low. Public financing of hospitals was kept minimal so that almost all of their revenue came from patient charges. When social health insurance (SHI) was introduced in 1927, benefits were focused on primary care services delivered by physicians in clinics, and not on hospital services. This was reflected in the development and subsequent revisions of the fee schedule. The policy decisions which have helped to retain primary care services might provide lessons for achieving universal health coverage in low- and middle-income countries (LMICs). PMID:27239877

  18. Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries.

    PubMed

    Ikegami, Naoki

    2016-01-01

    When the Japanese government adopted Western medicine in the late nineteenth century, it left intact the infrastructure of primary care by giving licenses to the existing practitioners and by initially setting the hurdle for entry into medical school low. Public financing of hospitals was kept minimal so that almost all of their revenue came from patient charges. When social health insurance (SHI) was introduced in 1927, benefits were focused on primary care services delivered by physicians in clinics, and not on hospital services. This was reflected in the development and subsequent revisions of the fee schedule. The policy decisions which have helped to retain primary care services might provide lessons for achieving universal health coverage in low- and middle-income countries (LMICs). PMID:27239877

  19. 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…

  20. 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.

  1. 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. PMID:24812690

  2. 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.

  3. 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. PMID:21444137

  4. 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.

  5. Leadership attributes: a key to optimal utilization of the community health nursing workforce.

    PubMed

    Ganann, Rebecca; Underwood, Jane; Matthews, Sue; Goodyear, Rosemarie; Stamler, Lynnette Leeseberg; Meagher-Stewart, Donna Marie; Munroe, Val

    2010-05-01

    This research examined leadership attributes that support the optimal utilization and practice of community health nurses (CHNs). Community health nursing is facing challenges in workforce capacity and sustainability. To meet current and future demands on the community sector, it is essential to understand workplace attributes that facilitate effective utilization of existing human resources and recruitment of new nurses. This pan-Canadian, mixed-methods study included a demographic analysis of CHNs in Canada, a survey involving responses from approximately 6,700 CHNs to identify enablers and barriers to community health nursing practice and 23 focus groups to examine organizational attributes that "best" support optimal practice within the public health nursing subsector. Nursing leadership was identified as an important attribute in organizations' utilization and support of CHNs working to work effectively. This effectiveness, in turn, will enhance community health programs and overall healthcare system efficiency. This paper highlights findings related to the role of nursing leadership and leadership development in optimizing community health nursing practice.

  6. Codon optimization, promoter and expression system selection that achieved high-level production of Yarrowia lipolytica lipase in Pichia pastoris.

    PubMed

    Zhou, Wen-Jing; Yang, Jiang-Ke; Mao, Lin; Miao, Li-Hong

    2015-04-01

    Lipase (EC 3.1.1.3) stands amongst the most important and promising biocatalysts for industrial applications. In this study, in order to realize a high-level expression of the Yarrowia lipolytica lipase gene in Pichia pastoris, we optimized the codon of LIP2 by de novo gene design and synthesis, which significantly improved the lipase expression when compared to the native lip2 gene. We also comparatively analyzed the effects of the promoter types (PAOX1 and PFLD1) and the Pichia expression systems, including the newly developed PichiaPink system, on lipase production and obtained the optimal recombinants. Bench-top scale fermentation studies indicated that the recombinant carrying the codon-optimized lipase gene syn-lip under the control of promoter PAOX1 has a significantly higher lipase production capacity in the fermenter than other types of recombinants. After undergoing methanol inducible expression for 96h, the wet cell weight of Pichia, the lipase activity and the protein content in the fermentation broth reached their highest values of 262g/L, 38,500U/mL and 2.82g/L, respectively. This study has not only greatly facilitated the bioapplication of lipase in industrial fields but the strategies utilized, such as de novo gene design and synthesis, the comparative analysis among promoters and different generations of Pichia expression systems will also be useful as references for future work in this field. PMID:25765312

  7. 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…

  8. 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…

  9. Using health literacy and learning style preferences to optimize the delivery of health information.

    PubMed

    Giuse, Nunzia B; Koonce, Taneya Y; Storrow, Alan B; Kusnoor, Sheila V; Ye, Fei

    2012-01-01

    Limited patient understanding of hypertension contributes to poor health outcomes. In 2 sequential randomized studies, the authors determined the impact of administering information tailored to health literacy level alone or in combination with preferred learning style on patients' understanding of hypertension. Patients with high blood pressure were recruited in an academic emergency department. In Experiment 1 (N = 85), the control group received only the routine discharge instructions; the intervention group received discharge instructions combined with information consistent with their health literacy level as determined by the Short Test of Functional Health Literacy. In Experiment 2 (N = 87), the information provided to the intervention group was tailored to both health literacy and learning style, as indicated by the VARK™ Questionnaire. To measure learning, the authors compared scores on a hypertension assessment administered during the emergency department visit and 2 weeks after discharge. Participants who received materials tailored to both health literacy level and learning style preference showed greater gains in knowledge than did those receiving information customized for health literacy level only. This study demonstrates that personalizing health information to learning style preferences and literacy level improves patient understanding of hypertension.

  10. 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

  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. Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN)

    PubMed Central

    2012-01-01

    Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN) has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services. PMID:22640939

  13. Health-risk-based groundwater remediation system optimization through clusterwise linear regression.

    PubMed

    He, L; Huang, G H; Lu, H W

    2008-12-15

    This study develops a health-risk-based groundwater management (HRGM) model. The model incorporates the considerations of environmental quality and human health risks into a general framework. To solve the model, a proxy-based optimization approach is proposed, where a semiparametric statistical method (i.e., clusterwise linear regression) is used to create a set of rapid-response and easy-to-use proxy modules for capturing the relations between remediation policies and the resulting human health risks. Through replacing the simulation and health risk assessment modules with the proxy ones, many orders of magnitude of computational cost can be saved. The model solutions reveal that (i) a long remediation period corresponds to a low total pumping rate, (ii) a stringent risk standard implies a high total pumping rate, and (iii) the human health risk associated with benzene would be significantly reduced if it is regarded as constraints of the model. These implications would assist decision makers in understanding the effects of remediation duration and human-health risk level on optimal remediation policies and in designing a robust groundwater remediation system. Results from postoptimization simulation show that the carcinogenic risk would decrease to satisfy the regulated risk standard under the given remediation policies.

  14. 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,…

  15. 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

  16. Maximizing and Optimizing the Large Scale Deployment of Renewable Energy: Achieving the U.S. Government's Goal of 20% by 2030

    NASA Astrophysics Data System (ADS)

    Alliss, R.; Apling, D.; Kiley, H.; Mason, M.

    2011-12-01

    The United States Government has an ambitious goal of growing renewable energy from 1% to 20% by 2030. Two key challenges exist in order to realize this target: Creating system-level approaches to overall generation capacity expansion and integration, including difficult policy changes, and addressing the variability issues of wind and solar generation. These challenges are addressed using MORE Power (Maximizing and Optimizing Renewable Energy), a system level planning tool designed to optimize the placement of wind and solar sites to maximize high quality, useable power. This planning tool uses historical, high resolution, measurements of wind and solar parameters along with a unique, non-linear, optimization algorithm to optimize the placement of sites given a set of user specified input parameters. MORE Power is quantifying the real value of transmission as an enabler to aggregate diverse variable resources which in turn is incentivizing transmission developers to expand the grid. In addition, the issue of grid stability becomes even more critical as larger deployment of renewable resources come online. MORE Power is identifying the benefits of larger balancing areas as an enabler for greater stability and therefore a reduced need to keep transmission capacity in reserve. In the end, by addressing and minimizing the impacts of the natural variability of wind and solar, a reduction in price volatility results which favorably impacts the consumer. This presentation will show examples of how MORE Power is being used to address the variability issue of renewables in order to achieve the 20% deployment target by 2030.

  17. 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.

  18. 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.

  19. Optimal azimuthal orientation for Si(111) double-crystal monochromators to achieve the least amount of glitches in the hard X-ray region.

    PubMed

    Tang, Zheng; Zheng, Lirong; Chu, Shengqi; Wu, Min; An, Pengfei; Zhang, Long; Hu, Tiandou

    2015-09-01

    Simulations of the periods, split regularities and mirror symmetries of the glitch pattern of a Si(111) crystal along with the azimuthal angles are presented. The glitch patterns of Si(111) double-crystal monochromators (DCMs) are found to be the superposition of the two sets of glitch patterns from the two crystals. The optimal azimuthal orientation ϕ1,2 = [(2n+1)π]/6 (n = 0, ±1, ±2…) for Si(111) DCMs to achieve the least amount of glitches in the hard X-ray region has been suggested.

  20. 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…

  1. 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

  2. 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.

  3. Optimizing eHealth breast cancer interventions: which types of eHealth services are effective?

    PubMed

    Baker, Timothy B; Hawkins, Robert; Pingree, Suzanne; Roberts, Linda J; McDowell, Helene E; Shaw, Bret R; Serlin, Ron; Dillenburg, Lisa; Swoboda, Christopher M; Han, Jeong-Yeob; Stewart, James A; Carmack-Taylor, Cindy L; Salner, Andrew; Schlam, Tanya R; McTavish, Fiona; Gustafson, David H

    2011-03-01

    Little is known about the effective elements of Interactive Cancer Communication Systems (ICCSs). A randomized trial explored which types of services of a multifaceted ICCS benefited patients and the nature of the benefit. Women with breast cancer (N=450) were randomized to different types of ICCS services or to a control condition that provided internet access. The Comprehensive Health Enhancement Support System (CHESS), served as the ICCS. ICCS services providing information and support, but not coaching such as cognitive behavior therapy, produced significant benefits in health information competence and emotional processing. Provision of Information and Support ICCS services significantly benefited women with breast cancer. More complex and interactive services designed to train the user had negligible effects. PMID:21709810

  4. Strategies to optimize lithium-ion supercapacitors achieving high-performance: Cathode configurations, lithium loadings on anode, and types of separator

    NASA Astrophysics Data System (ADS)

    Cao, Wanjun; Li, Yangxing; Fitch, Brian; Shih, Jonathan; Doung, Tien; Zheng, Jim

    2014-12-01

    The Li-ion capacitor (LIC) is composed of a lithium-doped carbon anode and an activated carbon cathode, which is a half Li-ion battery (LIB) and a half electrochemical double-layer capacitor (EDLC). LICs can achieve much more energy density than EDLC without sacrificing the high power performance advantage of capacitors over batteries. LIC pouch cells were assembled using activated carbon (AC) cathode and hard carbon (HC) + stabilized lithium metal power (SLMP®) anode. Different cathode configurations, various SLMP loadings on HC anode, and two types of separators were investigated to achieve the optimal electrochemical performance of the LIC. Firstly, the cathode binders study suggests that the PTFE binder offers improved energy and power performances for LIC in comparison to PVDF. Secondly, the mass ratio of SLMP to HC is at 1:7 to obtain the optimized electrochemical performance for LIC among all the various studied mass ratios between lithium loading amounts and active anode material. Finally, compared to the separator Celgard PP 3501, cellulose based TF40-30 is proven to be a preferred separator for LIC.

  5. Maximize the benefit of SNCR: Combine SNCR with combustion optimization and achieve 50% NOx reduction from a low NOx burner baseline

    SciTech Connect

    Trego, P.; Schindler, E.

    2000-07-01

    PECO Energy Company operates one coal fired boiler at its Cromby Generating Facility. Cromby Unit 1 is a B and W front fired unit rated at 160 MW. The units boiler has been retrofitted with low NOx burners and overfire air ports. Due to NOx allowance pricing, PECO began evaluating options for reducing Cromby's NOx emissions. SNCR was evaluated at the best option for the plant even though the furnace exit temperatures and CO were high at practical injection locations. RJM Corporation, a Fuel Tech NOxOUT{trademark} Implementer, was selected to supply the system because of their extensive experience in solving combustion problems and applying NOxOUT SNCR systems on utility boilers. In order to reduce emissions during the 1999 NOx season, the deadline for an operational system was set at June 2nd. The project was issued on a fast track schedule starting February 2, 1999. The boiler was started up on June 2 on schedule after a six week maintenance outage. The project's 25% NOx reduction target was achieved after two weeks of combustion optimization. Combustion optimization was followed by NOxOUT A reagent injection system optimization which resulted in a 50% combined NOx reduction. Other benefits included a reduction in CO to less than 100 ppm and a 33% reduction in LOI.

  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; 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.

  7. A Bayesian approach to optimal sensor placement for structural health monitoring with application to active sensing

    NASA Astrophysics Data System (ADS)

    Flynn, Eric B.; Todd, Michael D.

    2010-05-01

    This paper introduces a novel approach for optimal sensor and/or actuator placement for structural health monitoring (SHM) applications. Starting from a general formulation of Bayes risk, we derive a global optimality criterion within a detection theory framework. The optimal configuration is then established as the one that minimizes the expected total presence of either type I or type II error during the damage detection process. While the approach is suitable for many sensing/actuation SHM processes, we focus on the example of active sensing using guided ultrasonic waves by implementing an appropriate statistical model of the wave propagation and feature extraction process. This example implements both pulse-echo and pitch-catch actuation schemes and takes into account line-of-site visibility and non-uniform damage probabilities over the monitored structure. The optimization space is searched using a genetic algorithm with a time-varying mutation rate. We provide three actuator/sensor placement test problems and discuss the optimal solutions generated by the algorithm.

  8. 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

  9. Use of Lipid-Lowering Medications and the Likelihood of Achieving Optimal LDL-Cholesterol Goals in Coronary Artery Disease Patients.

    PubMed

    Karalis, Dean G; Victor, Brett; Ahedor, Lilian; Liu, Longjian

    2012-01-01

    Background. In clinical practice, most coronary artery disease patients are not achieving their recommend LDL-cholesterol goal of <70 mg/dL. Methods. We conducted a retrospective analysis of outpatient electronic health records and the most recent lipid profile, lipid-lowering medications and doses were collected. Results. We identified 9950 coronary artery disease patients. Only 37% on a statin alone achieved an LDL-cholesterol of <70 mg/dL, and most were on moderate-to-high-potency statins. The intensity of statin therapy did not improve LDL-cholesterol goal attainment. Among patients on combination therapy, 41% on statin plus ezetimibe and 46% on statin plus niacin achieved an LDL-cholesterol of <70 mg/dL (P = 0.01 and <0.0001 versus statin alone). If patients were switched to a high-potency statin LDL-cholesterol goal attainment of <70 mg/dL would increase to 46% and would increase up to 72% with combination therapy. Conclusions. Most coronary artery disease patients in clinical practice do not attain an LDL-cholesterol of <70 mg/dL, even among patients on high potency statins. The combination of statin plus either ezetimibe or niacin is the most effective regimen to achieve an LDL-cholesterol of <70 mg/dL, however, these drug combinations are used infrequently in clinical practice.

  10. 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.

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

    PubMed Central

    Van Itallie, Elizabeth S.; Wu, Duo

    2014-01-01

    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. PMID:24293077

  12. 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.

  13. 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

  14. 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

  15. Using optimal combination of teaching-learning methods (open book assignment and group tutorials) as revision exercises to improve learning outcome in low achievers in biochemistry.

    PubMed

    Rajappa, Medha; Bobby, Zachariah; Nandeesha, H; Suryapriya, R; Ragul, Anithasri; Yuvaraj, B; Revathy, G; Priyadarssini, M

    2016-07-01

    Graduate medical students of India are taught Biochemistry by didactic lectures and they hardly get any opportunity to clarify their doubts and reinforce the concepts which they learn in these lectures. We used a combination of teaching-learning (T-L) methods (open book assignment followed by group tutorials) to study their efficacy in improving the learning outcome. About 143 graduate medical students were classified into low (<50%: group 1, n = 23), medium (50-75%: group 2, n = 74), and high (>75%: group 3, n = 46) achievers, based on their internal assessment marks. After the regular teaching module on the topics "Vitamins and Enzymology", all the students attempted an open book assignment without peer consultation. Then all the students participated in group tutorials. The effects on the groups were evaluated by pre and posttests at the end of each phase, with the same set of MCQs. Gain from group tutorials and overall gain was significantly higher in the low achievers, compared to other groups. High and medium achievers obtained more gain from open book assignment, than group tutorials. The overall gain was significantly higher than the gain obtained from open book assignment or group tutorials, in all three groups. All the three groups retained the gain even after 1 week of the exercise. Hence, optimal use of novel T-L methods (open book assignment followed by group tutorials) as revision exercises help in strengthening concepts in Biochemistry in this oft neglected group of low achievers in graduate medical education. © 2016 by The International Union of Biochemistry and Molecular Biology, 44(4):321-325, 2016.

  16. 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. PMID:22727880

  17. 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.

  18. 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. PMID:27332478

  19. A Novel Hybridization of Applied Mathematical, Operations Research and Risk-based Methods to Achieve an Optimal Solution to a Challenging Subsurface Contamination Problem

    NASA Astrophysics Data System (ADS)

    Johnson, K. D.; Pinder, G. F.

    2013-12-01

    The objective of the project is the creation of a new, computationally based, approach to the collection, evaluation and use of data for the purpose of determining optimal strategies for investment in the solution of remediation of contaminant source areas and similar environmental problems. The research focuses on the use of existing mathematical tools assembled in a unique fashion. The area of application of this new capability is optimal (least-cost) groundwater contamination source identification; we wish to identify the physical environments wherein it may be cost-prohibitive to identify a contaminant source, the optimal strategy to protect the environment from additional insult and formulate strategies for cost-effective environmental restoration. The computational underpinnings of the proposed approach encompass the integration into a unique of several known applied-mathematical tools. The resulting tool integration achieves the following: 1) simulate groundwater flow and contaminant transport under uncertainty, that is when the physical parameters such as hydraulic conductivity are known to be described by a random field; 2) define such a random field from available field data or be able to provide insight into the sampling strategy needed to create such a field; 3) incorporate subjective information, such as the opinions of experts on the importance of factors such as locations of waste landfills; 4) optimize a search strategy for finding a potential source location and to optimally combine field information with model results to provide the best possible representation of the mean contaminant field and its geostatistics. Our approach combines in a symbiotic manner methodologies found in numerical simulation, random field analysis, Kalman filtering, fuzzy set theory and search theory. Testing the algorithm for this stage of the work, we will focus on fabricated field situations wherein we can a priori specify the degree of uncertainty associated with the

  20. 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.

  1. Wisdom and method: extraordinary practices for the realization of longevity and optimal health.

    PubMed

    Tsondu, Geshe Ngawang; Dodson-Lavelle, Brooke

    2009-08-01

    The focus in our discussion of longevity-enhancement has centered on developing techniques and technologies to control the environment as well as the physical body and its functions. The Tibetan contemplative and medical sciences offer a sophisticated view of the mind-body complex in which efforts to control the external world are insufficient without the development of "inner" technologies to train the mind. From the Tibetan perspective, training the mind is in fact essential to the realization of extraordinary levels of longevity, happiness, and optimal health.

  2. Correlates of Willingness to Engage in Residential Gardening: Implications for Health Optimization in Ibadan, Nigeria

    PubMed Central

    Motunrayo Ibrahim, Fausat

    2013-01-01

    Background: Gardening is a worthwhile adventure which engenders health op­timization. Yet, a dearth of evidences that highlights motivations to engage in gardening exists. This study examined willingness to engage in gardening and its correlates, including some socio-psychological, health related and socio-demographic variables. Methods: In this cross-sectional survey, 508 copies of a structured questionnaire were randomly self administered among a group of civil servants of Oyo State, Nigeria. Multi-item measures were used to assess variables. Step wise multiple regression analysis was used to identify predictors of willingness to engage in gar­dening Results: Simple percentile analysis shows that 71.1% of respondents do not own a garden. Results of step wise multiple regression analysis indicate that descriptive norm of gardening is a good predictor, social support for gardening is better while gardening self efficacy is the best predictor of willingness to engage in gardening (P< 0.001). Health consciousness, gardening response efficacy, education and age are not predictors of this willingness (P> 0.05). Results of t-test and ANOVA respectively shows that gender is not associated with this willingness (P> 0.05), but marital status is (P< 0.05).  Conclusion: Socio-psychological characteristics and being married are very rele­vant in motivations to engage in gardening. The nexus between gardening and health optimization appears to be highly obscured in this population. PMID:24688974

  3. 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. PMID:27318589

  4. 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.

  5. HOW MANY REPETITIONS OF CHILD CARE SKILLS ARE REQUIRED FOR HEALTH WORKER STUDENTS TO ACHIEVE PROFICIENCY? LEARNING CURVE PATTERNS IN CHILD CARE SKILLS ACQUISITION

    PubMed Central

    Emami Moghadam, Zahra; Emami Zeydi, Amir; Mazlom, Seyed Reza; Abadi, Fatemeh Sardar; Pour, Parastoo Majidi; Davoudi, Malihe; Banafsheh, Elahe

    2015-01-01

    Introduction: The vulnerability of children under 5 years old requires paying more attention to the health of this group. In the Iranian health care system, health workers are the first line of human resources for health care in rural areas. Because most health workers begin working in conditions with minimal facilities, their clinical qualifications are crucial. The aim of this study was to determine the number of repetitions of child care skills, required for health worker students to achieve proficiency based on the learning curve. Methods: A time series research design was used. Participants in this study were first year health worker students enrolled in three health schools in 2011. Data were collected using a questionnaire consisting of demographic information and a checklist evaluating the health worker students’ clinical skills proficiency for child care. Data were analyzed using SPSS version 16.0 software (SPSS Inc., Chicago, IL) using descriptive and inferential statistics including Kruskal-Wallis and Pearson correlation coefficient tests. Results: Learning curve patterns in child care skills acquisition showed that for less than 20 and between 20 to 29 times, the level of skill acquisition had an upward slope. Between 30- 39 the learning curve was descending, however the slope became ascending once more and then it leveled off (with change of less than 5%). Conclusion: It seems that 40 repetitions of child care skills are sufficient for health worker students to achieve proficiency. This suggests that time, resources and additional costs for training health worker students’ trainees can be saved by this level of repetition. PMID:26622199

  6. 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.

  7. 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. The model…

  8. 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…

  9. 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 Summit" (Peter…

  10. 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…

  11. 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.

  12. 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

  13. Optimizing Bi2O3 and TiO2 to achieve the maximum non-linear electrical property of ZnO low voltage varistor

    PubMed Central

    2013-01-01

    Background In fabrication of ZnO-based low voltage varistor, Bi2O3 and TiO2 have been used as former and grain growth enhancer factors respectively. Therefore, the molar ratio of the factors is quit important in the fabrication. In this paper, modeling and optimization of Bi2O3 and TiO2 was carried out by response surface methodology to achieve maximized electrical properties. The fabrication was planned by central composite design using two variables and one response. To obtain actual responses, the design was performed in laboratory by the conventional methods of ceramics fabrication. The actual responses were fitted into a valid second order algebraic polynomial equation. Then the quadratic model was suggested by response surface methodology. The model was validated by analysis of variance which provided several evidences such as high F-value (153.6), very low P-value (<0.0001), adjusted R-squared (0.985) and predicted R-squared (0.947). Moreover, the lack of fit was not significant which means the model was significant. Results The model tracked the optimum of the additives in the design by using three dimension surface plots. In the optimum condition, the molars ratio of Bi2O3 and TiO2 were obtained in a surface area around 1.25 point that maximized the nonlinear coefficient around 20 point. Moreover, the model predicted the optimum amount of the additives in desirable condition. In this case, the condition included minimum standard error (0.35) and maximum nonlinearity (20.03), while molar ratio of Bi2O3 (1.24 mol%) and TiO2 (1.27 mol%) was in range. The condition as a solution was tested by further experiments for confirmation. As the experimental results showed, the obtained value of the non-linearity, 21.6, was quite close to the predicted model. Conclusion Response surface methodology has been successful for modeling and optimizing the additives such as Bi2O3 and TiO2 of ZnO-based low voltage varistor to achieve maximized non-linearity properties. PMID

  14. 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…

  15. 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.

  16. How can we achieve and maintain high-quality performance of health workers in low-resource settings?

    PubMed

    Rowe, Alexander K; de Savigny, Don; Lanata, Claudio F; Victora, Cesar G

    In low and middle income countries, health workers are essential for the delivery of health interventions. However, inadequate health-worker performance is a very widespread problem. We present an overview of issues and evidence about the determinants of performance and strategies for improving it. Health-worker practices are complex behaviours that have many potential influences. Reviews of intervention studies in low and middle income countries suggest that the simple dissemination of written guidelines is often ineffective, that supervision and audit with feedback is generally effective, and that multifaceted interventions might be more effective than single interventions. Few interventions have been evaluated with rigorous cost-effectiveness trials, and such studies are urgently needed to guide policy. We propose an international collaborative research agenda to generate knowledge about the true determinants of performance and about the effectiveness of strategies to improve performance. Furthermore, we recommend that ministries of health and international organisations should actively help translate research findings into action to improve health-worker performance, and thereby improve health.

  17. Conference on "Multidisciplinary approaches to nutritional problems". Rank Prize Lecture. Global nutrition challenges for optimal health and well-being.

    PubMed

    Uauy, Ricardo; Corvalan, Camila; Dangour, Alan D

    2009-02-01

    Optimal health and well-being are now considered the true measures of human development. Integrated strategies for infant, child and adult nutrition are required that take a life-course perspective to achieve life-long health. The major nutrition challenges faced today include: (a) addressing the pending burden of undernutrition (low birth weight, severe wasting, stunting and Zn, retinol, Fe, iodine and folic acid deficits) affecting those individuals living in conditions of poverty and deprivation; (b) preventing nutrition-related chronic diseases (obesity, diabetes, CVD, some forms of cancer and osteoporosis) that, except in sub-Saharan Africa, are the main causes of death and disability globally. This challenge requires a life-course perspective as effective prevention starts before conception and continues at each stage of life. While death is unavoidable, premature death and disability can be postponed by providing the right amount and quality of food and by maintaining an active life; (c) delaying or avoiding, via appropriate nutrition and physical activity interventions, the functional declines associated with advancing age. To help tackle these challenges, it is proposed that the term 'malnutrition in all its forms', which encompasses the full spectrum of nutritional disorders, should be used to engender a broader understanding of global nutrition problems. This term may prove particularly helpful when interacting with policy makers and the public. Finally, a greater effort by the UN agencies and private and public development partners is called for to strengthen local, regional and international capacity to support the much needed change in policy and programme activities focusing on all forms of malnutrition with a unified agenda.

  18. Conference on "Multidisciplinary approaches to nutritional problems". Rank Prize Lecture. Global nutrition challenges for optimal health and well-being.

    PubMed

    Uauy, Ricardo; Corvalan, Camila; Dangour, Alan D

    2009-02-01

    Optimal health and well-being are now considered the true measures of human development. Integrated strategies for infant, child and adult nutrition are required that take a life-course perspective to achieve life-long health. The major nutrition challenges faced today include: (a) addressing the pending burden of undernutrition (low birth weight, severe wasting, stunting and Zn, retinol, Fe, iodine and folic acid deficits) affecting those individuals living in conditions of poverty and deprivation; (b) preventing nutrition-related chronic diseases (obesity, diabetes, CVD, some forms of cancer and osteoporosis) that, except in sub-Saharan Africa, are the main causes of death and disability globally. This challenge requires a life-course perspective as effective prevention starts before conception and continues at each stage of life. While death is unavoidable, premature death and disability can be postponed by providing the right amount and quality of food and by maintaining an active life; (c) delaying or avoiding, via appropriate nutrition and physical activity interventions, the functional declines associated with advancing age. To help tackle these challenges, it is proposed that the term 'malnutrition in all its forms', which encompasses the full spectrum of nutritional disorders, should be used to engender a broader understanding of global nutrition problems. This term may prove particularly helpful when interacting with policy makers and the public. Finally, a greater effort by the UN agencies and private and public development partners is called for to strengthen local, regional and international capacity to support the much needed change in policy and programme activities focusing on all forms of malnutrition with a unified agenda. PMID:19012808

  19. 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.

  20. Achieving patient and family engagement through the implementation and evolution of advisory councils across a large health care system.

    PubMed

    Haycock, Camille; Wahl, Carol

    2013-01-01

    Over the past decade, hospitals and health care systems have responded to the call for increased patient engagement and person-centered care. Organizations across the country have developed models and tools to assist in the effort toward patient and family engagement in health care delivery. In addition, current literature and trends suggest that patient satisfaction and quality outcomes are improved when patients and families become partners in their own health care and the delivery of that care. However, to formalize a patient-centric structure and process across a large health care system that is aimed at patient and family engagement can be a daunting activity. Utilizing well-established tools, Catholic Health Initiatives was successful in implementing the structures to deploy the ideas of patients and families in multiple facilities and care settings across 19 states. Nursing leaderships, in partnership with patients and their families within this health care delivery system, were the key contributors to the implementation of formalized patient and family advisory councils in hospitals across the enterprise. PMID:23744470

  1. Health care worker perspectives inform optimization of patient panel-support tools: a qualitative study.

    PubMed

    Feldstein, Adrianne C; Schneider, Jennifer L; Unitan, Robert; Perrin, Nancy A; Smith, David H; Nichols, Gregory A; Lee, Nancy L

    2013-04-01

    Electronic decision-support systems appear to enhance care, but improving both tools and work practices may optimize outcomes. Using qualitative methods, the authors' aim was to evaluate perspectives about using the Patient Panel-Support Tool (PST) to better understand health care workers' attitudes toward, and adoption and use of, a decision-support tool. In-depth interviews were conducted to elicit participant perspectives about the PST-an electronic tool implemented in 2006 at Kaiser Permanente Northwest. The PST identifies "care gaps" and recommendations in screening, medication use, risk-factor control, and immunizations for primary care panel patients. Primary care physician (PCP) teams were already grouped (based on performance pre- and post-PST introduction) into lower, improving, and higher percent-of-care-needs met. Participants were PCPs (n=21), medical assistants (n=11), and quality and other health care managers (n=20); total n=52. Results revealed that the most commonly cited benefit of the PST was increased in-depth knowledge of patient panels, and empowerment of staff to do quality improvement. Barriers to PST use included insufficient time, competing demands, suboptimal staffing, tool navigation, documentation, and data issues. Facilitators were strong team staff roles, leadership/training for tool implementation, and dedicated time for tool use. Higher performing PCPs and their assistants more often described a detailed team approach to using the PST. In conclusion, PCP teams and managers provided important perspectives that could help optimize use of panel-support tools to improve future outcomes. Improvements are needed in tool function and navigation; training; staff accountability and role clarification; and panel management time.

  2. Breakfast, midday meals and academic achievement in rural primary schools in Uganda: implications for education and school health policy

    PubMed Central

    Acham, Hedwig; Kikafunda, Joyce K.; Malde, Marian K.; Oldewage-Theron, Wilna H.; Egal, AbdulKadir A.

    2012-01-01

    Background Underachievement in schools is a global problem and is especially prevalent in developing countries. Indicators of educational performance show that Uganda has done remarkably well on education access-related targets since the introduction of universal primary education in 1997. However, educational outcomes remain disappointing. The absence of school feeding schemes, one of the leading causes of scholastic underachievement, has not been given attention by the Ugandan authorities. Instead, as a national policy, parents are expected to provide meals even though many, especially in the rural areas, cannot afford to provide even the minimal daily bowl of maize porridge. Objective To assess and demonstrate the effect of breakfast and midday meal consumption on academic achievement of schoolchildren. Design, Materials and Methods We assessed household characteristics, feeding patterns and academic achievement of 645 schoolchildren (aged 9–15 years) in Kumi district, eastern Uganda, in 2006–2007, using a modified cluster sampling design which involved only grade 1 schools (34 in total) and pupils of grade four. Household questionnaires and school records were used to collect information on socio-demographic factors, feeding patterns and school attendance. Academic achievement was assessed using unstandardized techniques, specifically designed for this study. Results Underachievement (the proportion below a score of 120.0 points) was high (68.4%); in addition, significantly higher achievement and better feeding patterns were observed among children from the less poor households (p<0.05). Achievement was significantly associated with consumption of breakfast and a midday meal, particularly for boys (p<0.05), and a greater likelihood of scoring well was observed for better nourished children (all OR values>1.0). Conclusion We observed that underachievement was relatively high; inadequate patterns of meal consumption, particularly for the most poor

  3. 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.

  4. 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. PMID:26120091

  5. Health Aid Is Allocated Efficiently, But Not Optimally: Insights From A Review Of Cost-Effectiveness Studies.

    PubMed

    Bendavid, Eran; Duong, Andrew; Sagan, Charlotte; Raikes, Gillian

    2015-07-01

    Development assistance from high-income countries to the health sectors of low- and middle-income countries (health aid) is an important source of funding for health in low- and middle-income countries. However, the relationship between health aid and the expected health improvements from those expenditures--the cost-effectiveness of targeted interventions--remains unknown. We reviewed the literature for cost-effectiveness of interventions targeting five disease categories: HIV; malaria; tuberculosis; noncommunicable diseases; and maternal, newborn, and child health. We measured the alignment between health aid and cost-effectiveness, and we examined the possibility of better alignment by simulating health aid reallocation. The relationship between health aid and incremental cost-effectiveness ratios is negative and significant: More health aid is going to disease categories with more cost-effective interventions. Changing the allocation of health aid earmarked funding could lead to greater health gains even without expanding overall disbursements. The greatest improvements in the alignment would be achieved by reallocating some aid from HIV or maternal, newborn, and child health to malaria or TB. We conclude that health aid is generally aligned with cost-effectiveness considerations, but in some countries this alignment could be improved.

  6. 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

  7. 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. PMID:24151086

  8. 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.

  9. 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…

  10. 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…

  11. 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…

  12. 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.

  13. 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.

  14. 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

  15. Challenges in achieving optimal glycemic control in type 2 diabetes patients with declining renal function: The Southeast Asia perspective.

    PubMed

    Cc Chow, Francis; Chan, Siew-Pheng; Hwu, Chii-Min; Suwanwalaikorn, Sompongse; Wu, Akira Yt; Gan, Susan Yu; Zacarias, Manuel B

    2012-12-20

    It is well recognised that Asia is at the epicenter of the global type 2 diabetes epidemic. Driven by socioeconomic changes involving industrialization, urbanization and adoption of Western lifestyles, the unprecedented increases in the prevalence of diabetes are particularly evident in Southeast Asia. The impact of diabetes is immense, and despite evidence of the benefit of optimal glucose control in reducing the risk of disease progression and development of macrovascular and microvascular complications, many individuals in this region remain poorly controlled. Chronic kidney disease (CKD) is an increasingly common diabetes-associated complication in Asian patients. Furthermore, Southeast Asia has one of the highest rates of end-stage renal disease (ESRD) in the world. Consequently, CKD in diabetes is associated with considerable morbidity and cardiovascular-related mortality, highlighting the need to screen and assess patients early in the course of the disease. The management of type 2 diabetes patients with declining renal function represents a significant challenge. Many of the older antidiabetic agents, such as metformin and sulfonylureas, are limited in their utility in CKD as a result of contraindications or hypoglycemic episodes. In contrast, dipeptidyl-peptidase IV inhibitors have provided a welcome addition to the therapeutic armamentarium for achieving glycemic control in these special populations. With comparable efficacy to and more favorable pharmacokinetic and side-effect profiles than traditional therapies, agents in this drug class, such as linagliptin, offer a more tailored approach to disease control in type 2 diabetes patients with declining renal function.

  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. 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…

  18. 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

  19. 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 &…

  20. Optimization of health protection of the public following a major nuclear accident: Interaction between radiation protection and social and psychological factors

    SciTech Connect

    Allen, P.T.; Archangelskaya, G.V.; Ramsaev, P.V.

    1996-11-01

    National and international guidance on the optimization of countermeasures to reduce doses in the post-release phase of an accident rightly emphasizes the importance and relevance of psychological, social, and economic factors to this process (e.g., NRPB 1990; ICRP 1991: CEC 1993; IAEA 1994). However, whilst economic factors are, at least partially, taken into account in developing the advice, explicit guidance is not provided on how psychological and social factors should be included in the optimization. Instead it is suggested that this is a matter for those with the appropriate competence and those with responsibility for making the final decisions. This approach implicitly assumes that the optimization of psychological and social factors, and that the results of the two procedures can then be combined to arrive at an optimum course of action. We recognize that formal optimization only forms one input to the process of making decisions on countermeasures and that it is important that psychological and social factors, as well as any other factors, are not {open_quotes}double-counted.{close_quotes} i.e., accounted for within international advice and then again at the time of the decision. It is our view that the optimization of radiation protection and economic factors, and certain psychological and social factors, should not be carried out independently. Research conducted by our respective organization indicates a number of areas in which the optimization of radiation protection and economic factors requires an understanding of key psychological and social processes. These areas fall into three groups; the need to ensure that countermeasures are successfully implemented, the need to achieve a net benefit for overall health, and the need to ensure a smooth transition back to normal living. 10 refs.

  1. Achieving public health goals through Medicaid expansion: opportunities in criminal justice, homelessness, and behavioral health with the Patient Protection and Affordable Care Act.

    PubMed

    DiPietro, Barbara; Klingenmaier, Lisa

    2013-12-01

    States are currently discussing how (or whether) to implement the Medicaid expansion to nondisabled adults earning less than 133% of the federal poverty level, a key aspect of the Patient Protection and Affordable Care Act. Those experiencing homelessness and those involved with the criminal justice system--particularly when they struggle with behavioral health diagnoses--are subpopulations that are currently uninsured at high rates and have significant health care needs but will become Medicaid eligible starting in 2014. We outline the connection between these groups, assert outcomes possible from greater collaboration between multiple systems, provide a summary of Medicaid eligibility and its ramifications for individuals in the criminal justice system, and explore opportunities to improve overall public health through Medicaid outreach, enrollment, and engagement in needed health care.

  2. Achieving Public Health Goals Through Medicaid Expansion: Opportunities in Criminal Justice, Homelessness, and Behavioral Health With the Patient Protection and Affordable Care Act

    PubMed Central

    Klingenmaier, Lisa

    2013-01-01

    States are currently discussing how (or whether) to implement the Medicaid expansion to nondisabled adults earning less than 133% of the federal poverty level, a key aspect of the Patient Protection and Affordable Care Act. Those experiencing homelessness and those involved with the criminal justice system—particularly when they struggle with behavioral health diagnoses—are subpopulations that are currently uninsured at high rates and have significant health care needs but will become Medicaid eligible starting in 2014. We outline the connection between these groups, assert outcomes possible from greater collaboration between multiple systems, provide a summary of Medicaid eligibility and its ramifications for individuals in the criminal justice system, and explore opportunities to improve overall public health through Medicaid outreach, enrollment, and engagement in needed health care. PMID:24148039

  3. Achieving public health goals through Medicaid expansion: opportunities in criminal justice, homelessness, and behavioral health with the Patient Protection and Affordable Care Act.

    PubMed

    DiPietro, Barbara; Klingenmaier, Lisa

    2013-12-01

    States are currently discussing how (or whether) to implement the Medicaid expansion to nondisabled adults earning less than 133% of the federal poverty level, a key aspect of the Patient Protection and Affordable Care Act. Those experiencing homelessness and those involved with the criminal justice system--particularly when they struggle with behavioral health diagnoses--are subpopulations that are currently uninsured at high rates and have significant health care needs but will become Medicaid eligible starting in 2014. We outline the connection between these groups, assert outcomes possible from greater collaboration between multiple systems, provide a summary of Medicaid eligibility and its ramifications for individuals in the criminal justice system, and explore opportunities to improve overall public health through Medicaid outreach, enrollment, and engagement in needed health care. PMID:24148039

  4. 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

  5. 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.

  6. 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.

  7. 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.

  8. Exposure assessment of residential mould, fungi and microbial components in relation to children's health: achievements and challenges.

    PubMed

    Tischer, Christina G; Heinrich, Joachim

    2013-03-01

    Each day we are exposed to a complex mixture of microbial agents and components in indoor environments. A major part of this mixture derives from fungal and bacterial origin. The impact between those microbial agents in the home environment in relation to respiratory health in children is still a major issue in research. There is little known about the causal agents that provoke or arrest the development of allergic respiratory disorders in children. Identification is complicated by the biodiversity and variability of microbial components in indoor air as well as the lack of validated and standardized exposure assessment methods. In this review, we aim to consider all important aspects in terms of research which may encounter an epidemiological study. Apart from the need for standardized exposure assessment methods which consider cost, handling and effort, especially for the participants, we suggest that a combination of different analysis methods such as chemical and molecular methods may have the potential to best describe the microbial milieu in indoor environments at present. Further, the impact of mould and moisture remediation activities on health is still heavily under investigated, especially in larger prospective cohorts of children and should be a topic of future research. Moreover, the exposure to mould and microbial agents might be embedded in a broader spectrum of children's health such as behavior and cognitive development.

  9. 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. PMID:21809387

  10. 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…

  11. 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.

  12. 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. PMID:24328651

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

    ERIC Educational Resources Information Center

    Gallaway, Patrick J.; Hongu, Nobuko

    2016-01-01

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

  14. 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

  15. Optimizing public health strategies for stroke education: need for a controlled trial.

    PubMed

    Kerns, James M; Heidmann, Diane; Petty, Michael; Prabhakaran, Shyam

    2011-01-01

    This brief review examines certain strategies for increasing community awareness and recognition of the warning signs and symptoms of stroke. Attention should be given to the intended audience, especially at-risk groups. To enhance stroke literacy, a complete message should include the following 4 aspects: (1) a stroke is a serious medical problem that involves the blood supply to the brain, (2) all 5 approved warning signs and symptoms, (3) the many risk factors involved in stroke, and (4) the need to promptly call 911 for emergency services and treatment. Such knowledge could lead to improvement in the rapid arrival to an emergency room and promote optimal and timely medical treatment. With several educational paradigms and strategies in existence, we propose that more rigorous study of their comparative performance and utility is needed. In a preliminary survey, our own program, called "KNOW FIVE - STAY ALIVE," provided greater posttest knowledge compared with the "FAST" program and a National Institutes of Health brochure called "Know Stroke. Know the signs, Act in time." PMID:20634684

  16. 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.

  17. 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.

    PubMed

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

    2016-08-01

    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 reduce bias inherent in nonrandomized control studies, was used to select comparison schools. Regression analyses, controlling for proportion of English-language learners, were conducted for each outcome including proportion of students participating in three College Board exams, graduation rates, and meeting university graduation requirements. Findings suggest that SBHC presence is positively associated with college preparation outcomes but not with academic achievement outcomes (graduation rates or meeting state graduation requirements). Future research must examine underlying mechanisms supporting this association, such as school connectedness. Additional research should explore the role that SBHC staff could have in supporting college preparation efforts.

  18. 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

    PubMed Central

    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 reduce bias inherent in non-randomized control studies, was used to select comparison schools. Regression analyses, controlling for proportion of English Language Learners, was conducted for each outcome including: proportion of students participating in three College Board Exams, graduation rates, and meeting University graduation requirements. Findings suggest that SBHC presence is positively associated with college preparation outcomes, but not with academic achievement outcomes (graduation rates or meeting state graduation requirements). Future research must examine underlying mechanisms supporting this association, such as school connectedness. Additional research should explore the role that SBHC staff could have in supporting college preparation efforts. PMID:27009589

  19. 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

  20. 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.

  1. 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. PMID:25665213

  2. Community-Based Participatory Research Integrates Behavioral and Biological Research to Achieve Health Equity for Native Hawaiians.

    PubMed

    Townsend, Claire K M; Dillard, Adrienne; Hosoda, Kelsea K; Maskarinec, Gregory G; Maunakea, Alika K; Yoshimura, Sheryl R; Hughes, Claire; Palakiko, Donna-Marie; Kehauoha, Bridget Puni; Kaholokula, Joseph Keawe'aimoku

    2015-12-22

    Native Hawaiians bear a disproportionate burden of type-2 diabetes and related complications compared to all other groups in Hawai'i (e.g., Whites, Japanese, Korean). Distrust in these communities is a significant barrier to participation in epigenetic research studies seeking to better understand disease processes. The purpose of this paper is to describe the community-based participatory research (CBPR) approach and research process we employed to integrate behavior and biological sciences with community health priorities. A CBPR approach was used to test a 3-month evidence-based, diabetes self-management intervention (N = 65). To investigate the molecular mechanisms linking inflammation with glucose homeostasis, a subset of participants (n = 16) provided peripheral blood mononuclear cells. Community and academic researchers collaborated on research design, assessment protocols, and participant recruitment, prioritizing participants' convenience and education and strictly limiting the use of the data collected. Preliminary results indicate significant changes in DNA methylation at gene regions associated with inflammation and diabetes signaling pathways and significant improvements in hemoglobin A1c, self-care activities, and diabetes distress and understanding. This study integrates community, behavioral, and epigenomic expertise to better understand the outcomes of a diabetes self-management intervention. Key lessons learned suggest the studies requiring biospecimen collection in indigenous populations require community trust of the researchers, mutual benefits for the community and researchers, and for the researchers to prioritize the community's needs. CBPR may be an important tool in providing communities the voice and protections to participate in studies requiring biospecimens.

  3. "You Can Turn off the Light If You'd Like": Pediatric Health Care Visits for Children with Autism Spectrum Disorder as an Interactional Achievement.

    PubMed

    Solomon, Olga; Angell, Amber M; Yin, Larry; Lawlor, Mary C

    2015-12-01

    Substantial scholarship has been generated in medical anthropology and other social science fields on typically developing child-parent-doctor interactions during health care visits. This article contributes an ethnographic, longitudinal, discourse analytic account of a child with autism spectrum disorder (ASD)-parent-doctor interactions that occur during pediatric and neurology visits. The analysis shows that when a child with ASD walks into the doctor's office, the tacit expectations about the visit may have to be renegotiated to facilitate the child's, the parent's, and the doctor's participation in the interaction. A successful visit then becomes a hard-won achievement that requires the interactional and relational work of all three participants. We demonstrate that communicative and sensory limitations imposed by ASD present unique challenges to all the participants and consider how health care disparities may invade the pediatric encounter, making visible the structural and interactional processes that engender them.

  4. "You Can Turn off the Light If You'd Like": Pediatric Health Care Visits for Children with Autism Spectrum Disorder as an Interactional Achievement.

    PubMed

    Solomon, Olga; Angell, Amber M; Yin, Larry; Lawlor, Mary C

    2015-12-01

    Substantial scholarship has been generated in medical anthropology and other social science fields on typically developing child-parent-doctor interactions during health care visits. This article contributes an ethnographic, longitudinal, discourse analytic account of a child with autism spectrum disorder (ASD)-parent-doctor interactions that occur during pediatric and neurology visits. The analysis shows that when a child with ASD walks into the doctor's office, the tacit expectations about the visit may have to be renegotiated to facilitate the child's, the parent's, and the doctor's participation in the interaction. A successful visit then becomes a hard-won achievement that requires the interactional and relational work of all three participants. We demonstrate that communicative and sensory limitations imposed by ASD present unique challenges to all the participants and consider how health care disparities may invade the pediatric encounter, making visible the structural and interactional processes that engender them. PMID:26332032

  5. Community-Based Participatory Research Integrates Behavioral and Biological Research to Achieve Health Equity for Native Hawaiians

    PubMed Central

    Townsend, Claire K. M.; Dillard, Adrienne; Hosoda, Kelsea K.; Maskarinec, Gregory G.; Maunakea, Alika K.; Yoshimura, Sheryl R.; Hughes, Claire; Palakiko, Donna-Marie; Kehauoha, Bridget Puni; Kaholokula, Joseph Keawe‘aimoku

    2015-01-01

    Native Hawaiians bear a disproportionate burden of type-2 diabetes and related complications compared to all other groups in Hawai‘i (e.g., Whites, Japanese, Korean). Distrust in these communities is a significant barrier to participation in epigenetic research studies seeking to better understand disease processes. The purpose of this paper is to describe the community-based participatory research (CBPR) approach and research process we employed to integrate behavior and biological sciences with community health priorities. A CBPR approach was used to test a 3-month evidence-based, diabetes self-management intervention (N = 65). To investigate the molecular mechanisms linking inflammation with glucose homeostasis, a subset of participants (n = 16) provided peripheral blood mononuclear cells. Community and academic researchers collaborated on research design, assessment protocols, and participant recruitment, prioritizing participants’ convenience and education and strictly limiting the use of the data collected. Preliminary results indicate significant changes in DNA methylation at gene regions associated with inflammation and diabetes signaling pathways and significant improvements in hemoglobin A1c, self-care activities, and diabetes distress and understanding. This study integrates community, behavioral, and epigenomic expertise to better understand the outcomes of a diabetes self-management intervention. Key lessons learned suggest the studies requiring biospecimen collection in indigenous populations require community trust of the researchers, mutual benefits for the community and researchers, and for the researchers to prioritize the community’s needs. CBPR may be an important tool in providing communities the voice and protections to participate in studies requiring biospecimens. PMID:26703660

  6. Community-Based Participatory Research Integrates Behavioral and Biological Research to Achieve Health Equity for Native Hawaiians.

    PubMed

    Townsend, Claire K M; Dillard, Adrienne; Hosoda, Kelsea K; Maskarinec, Gregory G; Maunakea, Alika K; Yoshimura, Sheryl R; Hughes, Claire; Palakiko, Donna-Marie; Kehauoha, Bridget Puni; Kaholokula, Joseph Keawe'aimoku

    2016-01-01

    Native Hawaiians bear a disproportionate burden of type-2 diabetes and related complications compared to all other groups in Hawai'i (e.g., Whites, Japanese, Korean). Distrust in these communities is a significant barrier to participation in epigenetic research studies seeking to better understand disease processes. The purpose of this paper is to describe the community-based participatory research (CBPR) approach and research process we employed to integrate behavior and biological sciences with community health priorities. A CBPR approach was used to test a 3-month evidence-based, diabetes self-management intervention (N = 65). To investigate the molecular mechanisms linking inflammation with glucose homeostasis, a subset of participants (n = 16) provided peripheral blood mononuclear cells. Community and academic researchers collaborated on research design, assessment protocols, and participant recruitment, prioritizing participants' convenience and education and strictly limiting the use of the data collected. Preliminary results indicate significant changes in DNA methylation at gene regions associated with inflammation and diabetes signaling pathways and significant improvements in hemoglobin A1c, self-care activities, and diabetes distress and understanding. This study integrates community, behavioral, and epigenomic expertise to better understand the outcomes of a diabetes self-management intervention. Key lessons learned suggest the studies requiring biospecimen collection in indigenous populations require community trust of the researchers, mutual benefits for the community and researchers, and for the researchers to prioritize the community's needs. CBPR may be an important tool in providing communities the voice and protections to participate in studies requiring biospecimens. PMID:26703660

  7. 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

  8. 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. PMID:24841093

  9. Population health management as a strategy for creation of optimal healing environments in worksite and corporate settings.

    PubMed

    Chapman, Larry S; Pelletier, Kenneth R

    2004-01-01

    This paper provides an (OHE) overview of a population health management (PHM) approach to the creation of optimal healing environments (OHEs) in worksite and corporate settings. It presents a framework for consideration as the context for potential research projects to examine the health, well-being, and economic effects of a set of newer "virtual" prevention interventions operating in an integrated manner in worksite settings. The main topics discussed are the fundamentals of PHM with basic terminology and core principles, a description of PHM core technology and implications of a PHM approach to creating OHEs.

  10. 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

  11. 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. PMID:24582489

  12. 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.

  13. Sex differences in the genetic architecture of optimism and health and their interrelation: a study of Australian and Swedish twins.

    PubMed

    Mosing, Miriam A; Pedersen, Nancy L; Martin, Nicholas G; Wright, Margaret J

    2010-08-01

    Optimism has a positive influence on mental and somatic health throughout lifetime and into old age. This association is mainly due to shared genetic influences, with some indication of sex differences in the heritability of these and related traits (e.g., depression and subjective wellbeing). Here we extend our initial study of Australian twins by combining with data available from Swedish twins, in order to increase the power to explore potential sex differences in the genetic architecture of optimism, mental and self-rated health and their covariation. Optimism, mental, and self-rated health were measured in 3053 Australian (501 identical female (MZf), 153 identical male (MZm), 274 non-identical female (DZf), 77 non-identical male (DZm), and 242 non-identical opposite-sex twin pairs, and 561 single twins; mean age 60.97 +/- 8.76), and 812 Swedish (71 MZf, 53 MZm, 93 DZf and 67 DZm twin pairs, and 244 single twins; mean age 60 +/- 14.3) twin individuals using the Life Orientation Test (LOT), the General Health Questionnaire (GHQ) and a single-item self-rating of overall health, respectively. In females all three traits were moderately heritable (.27-.47), whereas in males heritability was substantially lower (.08-.19), but genetic modeling showed that sex differences were not significant. The absence of significant sex differences, despite the consistent trend across the two cohorts, is likely due to a lack of power, raising the importance for future studies, on the same or similar traits, to utilize large samples and to keep the possibility of sex differences in mind when conducting their analyses.

  14. 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.

  15. 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

  16. The Role of eHealth in Optimizing Preventive Care in the Primary Care Setting

    PubMed Central

    Noble, Natasha; Mansfield, Elise; Waller, Amy; Henskens, Frans; Sanson-Fisher, Rob

    2015-01-01

    Modifiable health risk behaviors such as smoking, overweight and obesity, risky alcohol consumption, physical inactivity, and poor nutrition contribute to a substantial proportion of the world’s morbidity and mortality burden. General practitioners (GPs) play a key role in identifying and managing modifiable health risk behaviors. However, these are often underdetected and undermanaged in the primary care setting. We describe the potential of eHealth to help patients and GPs to overcome some of the barriers to managing health risk behaviors. In particular, we discuss (1) the role of eHealth in facilitating routine collection of patient-reported data on lifestyle risk factors, and (2) the role of eHealth in improving clinical management of identified risk factors through provision of tailored feedback, point-of-care reminders, tailored educational materials, and referral to online self-management programs. Strategies to harness the capacity of the eHealth medium, including the use of dynamic features and tailoring to help end users engage with, understand, and apply information need to be considered and maximized. Finally, the potential challenges in implementing eHealth solutions in the primary care setting are discussed. In conclusion, there is significant potential for innovative eHealth solutions to make a contribution to improving preventive care in the primary care setting. However, attention to issues such as data security and designing eHealth interfaces that maximize engagement from end users will be important to moving this field forward. PMID:26001983

  17. 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…

  18. 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.

  19. 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. PMID:25748230

  20. 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.

  1. Optimal Health (Spirit, Mind, and Body): A Feasibility Study Promoting Well-Being for Health Behavior Change.

    PubMed

    Walker, Jenelle; Ainsworth, Barbara; Hooker, Steven; Keller, Colleen; Fleury, Julie; Chisum, Jack; Swan, Pamela

    2015-10-01

    Faith-based programs have shown beneficial effects for health and behaviors. Few have specifically intervened on the spiritual, mental (i.e., stress), and physical dimensions of well-being combined for health and healthy behaviors (i.e., exercise and diet). The purpose of this report is to describe the feasibility of executing a spirituality-based health behavior change, program founded upon the Spiritual Framework of Coping. This study was a quasi-experimental one group pretest-posttest design. Feasibility objectives were assessed, and limited efficacy of pretest and posttest measures was analyzed using paired t test (p < .05). Acceptance of the program was positive, and modest demand was shown with initial interest and an average attendance of 78.7%. The program was successfully implemented as shown by meeting session objectives and 88% homework completion. The program was practical for the intended participants and was successfully integrated within the existing environment. Limited efficacy measures showed no pre-post changes. This study provided preliminary support for the design and further testing of the theoretical components of the Spiritual Framework of Coping that informed the program. PMID:24985320

  2. 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…

  3. 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,…

  4. Use of response surface methodology in a fed-batch process for optimization of tricarboxylic acid cycle intermediates to achieve high levels of canthaxanthin from Dietzia natronolimnaea HS-1.

    PubMed

    Nasri Nasrabadi, Mohammad Reza; Razavi, Seyed Hadi

    2010-04-01

    In this work, we applied statistical experimental design to a fed-batch process for optimization of tricarboxylic acid cycle (TCA) intermediates in order to achieve high-level production of canthaxanthin from Dietzia natronolimnaea HS-1 cultured in beet molasses. A fractional factorial design (screening test) was first conducted on five TCA cycle intermediates. Out of the five TCA cycle intermediates investigated via screening tests, alfaketoglutarate, oxaloacetate and succinate were selected based on their statistically significant (P<0.05) and positive effects on canthaxanthin production. These significant factors were optimized by means of response surface methodology (RSM) in order to achieve high-level production of canthaxanthin. The experimental results of the RSM were fitted with a second-order polynomial equation by means of a multiple regression technique to identify the relationship between canthaxanthin production and the three TCA cycle intermediates. By means of this statistical design under a fed-batch process, the optimum conditions required to achieve the highest level of canthaxanthin (13172 + or - 25 microg l(-1)) were determined as follows: alfaketoglutarate, 9.69 mM; oxaloacetate, 8.68 mM; succinate, 8.51 mM.

  5. 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. PMID:27420165

  6. 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.

  7. Physical Activity in Childhood May Be the Key to Optimizing Lifespan Skeletal Health

    PubMed Central

    Gunter, Katherine B.; Almstedt, Hawley C.; Janz, Kathleen F

    2011-01-01

    Physical activities undertaken in childhood, particularly activities which apply large forces quickly convey optimal benefits to bone mass, size, and structure. Evidence is accumulating that benefits persist well beyond activity cessation. This review examines the potential for early childhood activity to improve bone mineralization and structure and explores childhood activity as prevention for osteoporosis in later life. PMID:21918458

  8. Optimized design of a micromachined G-switch based on contactless configuration for health care applications

    NASA Astrophysics Data System (ADS)

    Ongkodjojo, Andojo; Tay, Francis E. H.

    2006-04-01

    This paper proposes design concept and fundamentals of a novel acceleration microswitch (G-switch), which is an integration of bimorph actuator and field effect transistor (FET). This micro-switch can be used to actuate the alarm system for call for helps - minimizing injuries after the fall among elderly; or trigger the air-inflatable hip protector for the fall prevention. The device can be attached to the developed MEMS-Wear smart shirt. Its structural design and switching FET are optimized using the global optimization method so that the bimorph as a movable gate can collapse on the gate insulating layer, when there is an impact force, which is greater than a threshold value (experimentally found to be 4.8g based on the previously published report). This contactless mechanism optimizes the field effect between the bimorph and the substrate causing an electrical current flow profusely with a sensitivity of 0.1 mA/V2 with a FET's ratio of ~19. The device will consume less power as the gate to source voltage (VGS) can be applied up to 4 V. All design parameters must satisfy the specified design constraints. In future, the optimized design will be fabricated and incorporated into the smart shirt for testing upon the fall events.

  9. 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.

  10. 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.

  11. The content of African diets is adequate to achieve optimal efficacy with fixed-dose artemether-lumefantrine: a review of the evidence.

    PubMed

    Premji, Zulfiqarali G; Abdulla, Salim; Ogutu, Bernhards; Ndong, Alice; Falade, Catherine O; Sagara, Issaka; Mulure, Nathan; Nwaiwu, Obiyo; Kokwaro, Gilbert

    2008-01-01

    A fixed-dose combination of artemether-lumefantrine (AL, Coartem(R)) has shown high efficacy, good tolerability and cost-effectiveness in adults and children with uncomplicated malaria caused by Plasmodium falciparum. Lumefantrine bioavailability is enhanced by food, particularly fat.As the fat content of sub-Saharan African meals is approximately a third that of Western countries, it raises the question of whether fat consumption by African patients is sufficient for good efficacy. Data from healthy volunteers have indicated that drinking 36 mL soya milk (containing only 1.2 g of fat) results in 90% of the lumefantrine absorption obtained with 500 mL milk (16 g fat). African diets are typically based on a carbohydrate staple (starchy root vegetables, fruit [plantain] or cereals) supplemented by soups, relishes and sauces derived from vegetables, pulses, nuts or fish. The most important sources of dietary fat in African countries are oil crops (e.g. peanuts, soya beans) and cooking oils as red palm, peanut, coconut and sesame oils. Total fat intake in the majority of subSaharan countries is estimated to be in the range 30-60 g/person/day across the whole population (average 43 g/person/day). Breast-feeding of infants up to two years of age is standard, with one study estimating a fat intake of 15-30 g fat/day from breast milk up to the age of 18 months. Weaning foods typically contain low levels of fat, and the transition from breast milk to complete weaning is associated with a marked reduction in dietary fat. Nevertheless, fat intake >10 g/day has been reported in young children post-weaning. A randomized trial in Uganda reported no difference in the efficacy of AL between patients receiving supervised meals with a fixed fat content (~23 g fat) or taking AL unsupervised, suggesting that fat intake at home was sufficient for optimal efficacy. Moreover, randomized trials in African children aged 5-59 months have shown similar high cure rates to those observed in

  12. The content of African diets is adequate to achieve optimal efficacy with fixed-dose artemether-lumefantrine: a review of the evidence

    PubMed Central

    Premji, Zulfiqarali G; Abdulla, Salim; Ogutu, Bernhards; Ndong, Alice; Falade, Catherine O; Sagara, Issaka; Mulure, Nathan; Nwaiwu, Obiyo; Kokwaro, Gilbert

    2008-01-01

    A fixed-dose combination of artemether-lumefantrine (AL, Coartem®) has shown high efficacy, good tolerability and cost-effectiveness in adults and children with uncomplicated malaria caused by Plasmodium falciparum. Lumefantrine bioavailability is enhanced by food, particularly fat. As the fat content of sub-Saharan African meals is approximately a third that of Western countries, it raises the question of whether fat consumption by African patients is sufficient for good efficacy. Data from healthy volunteers have indicated that drinking 36 mL soya milk (containing only 1.2 g of fat) results in 90% of the lumefantrine absorption obtained with 500 mL milk (16 g fat). African diets are typically based on a carbohydrate staple (starchy root vegetables, fruit [plantain] or cereals) supplemented by soups, relishes and sauces derived from vegetables, pulses, nuts or fish. The most important sources of dietary fat in African countries are oil crops (e.g. peanuts, soya beans) and cooking oils as red palm, peanut, coconut and sesame oils. Total fat intake in the majority of subSaharan countries is estimated to be in the range 30–60 g/person/day across the whole population (average 43 g/person/day). Breast-feeding of infants up to two years of age is standard, with one study estimating a fat intake of 15–30 g fat/day from breast milk up to the age of 18 months. Weaning foods typically contain low levels of fat, and the transition from breast milk to complete weaning is associated with a marked reduction in dietary fat. Nevertheless, fat intake >10 g/day has been reported in young children post-weaning. A randomized trial in Uganda reported no difference in the efficacy of AL between patients receiving supervised meals with a fixed fat content (~23 g fat) or taking AL unsupervised, suggesting that fat intake at home was sufficient for optimal efficacy. Moreover, randomized trials in African children aged 5–59 months have shown similar high cure rates to those observed

  13. 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

    PubMed Central

    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 achieve the appropriate academic achievement benchmark for their age group and bullied boys (but not girls) were more likely to exhibit depressive symptoms compared to those not bullied. High levels of social support from family were important in promoting good mental health. There was evidence that high levels of support from friends and moderate (but not high) family support was able to protect bullied adolescents from poor academic achievement. Support from friends and family was not sufficient to protect adolescents against mental health difficulties that they might face as a result of being bullied. More active intervention from schools is recommended. PMID:20637501

  14. 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

  15. 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.

  16. 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. PMID:26283358

  17. 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

  18. 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

  19. Cancer risk assessment: Optimizing human health through linear dose-response models.

    PubMed

    Calabrese, Edward J; Shamoun, Dima Yazji; Hanekamp, Jaap C

    2015-07-01

    This paper proposes that generic cancer risk assessments be based on the integration of the Linear Non-Threshold (LNT) and hormetic dose-responses since optimal hormetic beneficial responses are estimated to occur at the dose associated with a 10(-4) risk level based on the use of a LNT model as applied to animal cancer studies. The adoption of the 10(-4) risk estimate provides a theoretical and practical integration of two competing risk assessment models whose predictions cannot be validated in human population studies or with standard chronic animal bioassay data. This model-integration reveals both substantial protection of the population from cancer effects (i.e. functional utility of the LNT model) while offering the possibility of significant reductions in cancer incidence should the hormetic dose-response model predictions be correct. The dose yielding the 10(-4) cancer risk therefore yields the optimized toxicologically based "regulatory sweet spot". PMID:25916915

  20. 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. PMID:26415763

  1. [Limits of optimizing resource allocation by debiting the public health service].

    PubMed

    Schäfer, T

    1997-05-01

    Based on the Dornier consulting opinion on the public health service system of Berlin, the limits of optimising the resource allocation process are discussed with respect to austerity budgets. The discussion focuses firstly on problems of finding a consensus of opinion about public tasks and purposes in the German settings of pluralistic impact on health policy, and secondly on methodical, functional and practical limits. Methodical arguments are supported by a comparison of personal density with regard to the twelve largest cities of Western Germany, and supplemented by a factor analysis of sociodemographic characteristics in order to quantify the need of social work in an urban context. Functional and practical limits are demonstrated with respect to the realisation of the principle of subsidiary and concerning the practice of wholesale cut-downs of public health services budget.

  2. 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. PMID

  3. 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.

  4. 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

  5. Effects on pulmonary health of neighboring residents of concentrated animal feeding operations: exposure assessed using optimized estimation technique.

    PubMed

    Schulze, Anja; Römmelt, Horst; Ehrenstein, Vera; van Strien, Rob; Praml, Georg; Küchenhoff, Helmut; Nowak, Dennis; Radon, Katja

    2011-01-01

    Potential adverse health effects of concentrated animal feeding operations (CAFOs), which were also shown in the authors' Lower Saxony Lung Study, are of public concern. The authors aimed to investigate pulmonary health effect of neighboring residents assessed using optimized estimation technique. Annual ammonia emission was measured to assess the emission from CAFO and from surrounding fields. Location of sampling points was optimized using cluster analysis. Individual exposure of 457 nonfarm subjects was interpolated by weighting method. Mean estimated annual ammonia levels varied between 16 and 24 μg/m³. Higher exposed participants were more likely to be sensitized against ubiquitous allergens as compared to lower exposed subjects (adjusted odds ratio [OR] 4.2; 95% confidence interval [CI] 1.2-13.2). In addition, they showed a significantly lower forced expiratory volume in 1 second (FEV₁) (adjusted mean difference in % of predicted -8%; 95% CI -13% to -3%). The authors' previous findings that CAFOs may contribute to burden of respiratory diseases were confirmed by this study. PMID:21864103

  6. 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

  7. Achieving Finite Element Mesh Quality via Optimization of the Jacobian Matrix Norm and Associated Quantities, Part II - A Framework for Volume Mesh Optimization and the Condition Number of the Jacobian Matrix

    SciTech Connect

    Knupp, P.M.

    1999-03-26

    Three-dimensional unstructured tetrahedral and hexahedral finite element mesh optimization is studied from a theoretical perspective and by computer experiments to determine what objective functions are most effective in attaining valid, high quality meshes. The approach uses matrices and matrix norms to extend the work in Part I to build suitable 3D objective functions. Because certain matrix norm identities which hold for 2 x 2 matrices do not hold for 3 x 3 matrices. significant differences arise between surface and volume mesh optimization objective functions. It is shown, for example, that the equivalence in two-dimensions of the Smoothness and Condition Number of the Jacobian matrix objective functions does not extend to three dimensions and further. that the equivalence of the Oddy and Condition Number of the Metric Tensor objective functions in two-dimensions also fails to extend to three-dimensions. Matrix norm identities are used to systematically construct dimensionally homogeneous groups of objective functions. The concept of an ideal minimizing matrix is introduced for both hexahedral and tetrahedral elements. Non-dimensional objective functions having barriers are emphasized as the most logical choice for mesh optimization. The performance of a number of objective functions in improving mesh quality was assessed on a suite of realistic test problems, focusing particularly on all-hexahedral ''whisker-weaved'' meshes. Performance is investigated on both structured and unstructured meshes and on both hexahedral and tetrahedral meshes. Although several objective functions are competitive, the condition number objective function is particularly attractive. The objective functions are closely related to mesh quality measures. To illustrate, it is shown that the condition number metric can be viewed as a new tetrahedral element quality measure.

  8. 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…

  9. Dispositional optimism.

    PubMed

    Carver, Charles S; Scheier, Michael F

    2014-06-01

    Optimism is a cognitive construct (expectancies regarding future outcomes) that also relates to motivation: optimistic people exert effort, whereas pessimistic people disengage from effort. Study of optimism began largely in health contexts, finding positive associations between optimism and markers of better psychological and physical health. Physical health effects likely occur through differences in both health-promoting behaviors and physiological concomitants of coping. Recently, the scientific study of optimism has extended to the realm of social relations: new evidence indicates that optimists have better social connections, partly because they work harder at them. In this review, we examine the myriad ways this trait can benefit an individual, and our current understanding of the biological basis of optimism.

  10. 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.

  11. 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. PMID:21688870

  12. The optimal negligence standard in health care under supply-side cost sharing.

    PubMed

    Olbrich, Anja

    2008-06-01

    This paper elaborates on the optimal negligence standard in a world where physicians choose their level of care subject to erroneous court judgements and to the degree of supply-side cost sharing. Uncertain liability in malpractice lawsuits leads physicians to provide excessive and insufficient care, which results in a loss of social welfare. The standard that maximizes welfare depends on the cost share: Under traditional, close to full cost reimbursement it is lower than the first-best level of care, while under substantial supply-side cost sharing it increases and may even exceed the first best.

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

    PubMed

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

    2014-01-01

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

  14. 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

  15. 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

  16. Lessons from SARS and H1N1/A: employing a WHO-WTO forum to promote optimal economic-public health pandemic response.

    PubMed

    Mackey, Tim K; Liang, Bryan A

    2012-02-01

    No formal system exists to review trade restrictions imposed during international public health emergencies rapidly. Failure to put one in place creates disincentives for surveillance and reporting, thereby undermining protection efforts. The 2003 SARS outbreak exposed weaknesses in global governance that caused uncoordinated public health and economic responses. New International Health Regulations (IHR), applied first during the 2009 H1N1 influenza outbreak, demonstrated improvement. Yet they failed to allow for management of public health emergencies in a way that balanced threats to health and those to economies and trade. Establishment of a joint WHO-WTO committee to adjudicate these conflicts might better achieve that balance.

  17. Refinement and use of Certificates of Veterinary Inspection (Health Certificates) for optimal assurance of disease freedom in aquatic animals.

    PubMed

    Starling, D E; Palić, D; Scarfe, A D

    2007-01-01

    Certificates of Veterinary Inspection (CVI), generally termed "Health Certificates", are pivotal for ensuring that translocated animals are not diseased or do not harbour significant pathogens. While used very successfully with terrestrial animal movement for decades, CVIs for aquatic animals are not well refined, understood or used, despite the availability of several aquatic animal "certification processes", "permits" and "health certificates", including the OIE model health certificates. Correctly designed CVIs provide the single most economical and effective assurance of disease status (generally freedom from specific diseases or pathogens) for individuals or lots of animals, at any point in time. When issued by a qualified independent third-party (typically a licensed and government accredited veterinarian) they provide the official level of assurance necessary for intrastate, interstate and international trade. Tailored modifications of CVIs are also useful for other purposes requiring the evaluation of animal health (e.g. specific pathogen-free (SPF) assurance for premises, risk-mitigating assurance necessary for insurance policies, breeding soundness assurance of broodstock, etc.). Here we discuss necessary information for aquatic animal CVIs: animal, ownership and location; standardized diagnostic results and their interpretation; and language contained in CVIs. Also addressed is the viability for use with multiple aquatic species and diseases/pathogens of interest, and their use in conjunction with established veterinary inspection procedures. A revised model aquatic CVI, with broad potential use for individual operations, states or countries, is offered for discussion, comment and refinement. In addition an optimally designed model CVI may be of use with electronic systems that are evolving in, for example, Europe, the USA and Australia/New Zealand (e.g. TRACES, e-CVI, e-Certs).

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

    PubMed Central

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

    2014-01-01

    Maintaining bone health is important in all stages of the management of men with prostate cancer. Patients receiving androgen-deprivation therapy (ADT) are at increased risk of treatment-related osteoporosis and patients with bone metastases are at increased risk of skeletal morbidity related to debilitating skeletal-related events (SREs). Osteoclast-targeted agents have a beneficial impact on bone health in patients with prostate cancer. For patients on ADT at high-risk for fracture, bisphosphonates have been shown to increase bone mineral density (BMD), a surrogate for fracture risk, whereas denosumab (Prolia) has been shown to decrease the risk of osteoporotic fractures, in addition to increasing BMD. For patients with castration-resistant prostate cancer (CRPC) with bone metastases, both zoledronic acid (Zometa) and denosumab (Xgeva) have shown benefit in decreasing the rate of SREs. Currently, no agent is approved for the prevention of bone metastases in high-risk patients. Novel systemic agents including radium-223 (Alpharadin), abiraterone (Zytiga), and enzalutamide (Xtandi) have shown a beneficial effect on the rate of SREs in patients with CRPC with bone metastases by directly impacting tumor growth. Integration of these anti-cancer agents with currently approved osteoclast-targeted agents warrants further investigation. PMID:24188262

  19. Folate: a key to optimizing health and reducing disease risk in the elderly.

    PubMed

    Rampersaud, Gail C; Kauwell, Gail P A; Bailey, Lynn B

    2003-02-01

    Inadequate folate status is associated with an increased risk for chronic diseases that may have a negative impact on the health of the aging population. Folate, a water-soluble vitamin, includes naturally occurring food folate and synthetic folic acid in supplements and fortified foods. Inadequate folate status may result in hyperhomocysteinemia, a significant risk factor for atherosclerotic vascular disease, changes in DNA that may result in pro-carcinogenic effects and increased risk for cognitive dysfunction. Folate status may be negatively influenced by inadequate intake, genetic polymorphisms and interactions with various drugs. In the US, folic acid is now added to enriched grain products and continues to be included in the majority of ready-to-eat breakfast cereals. Recent data indicate that the folate status in the US population has improved significantly, presumably due to the effects of fortification. Folic acid (not food folate) intake in excess of the Tolerable Upper Intake Level may mask the diagnosis of a vitamin B(12) deficiency, which is more prevalent in the elderly than younger individuals. When folic acid supplements are recommended, a multivitamin that includes vitamin B(12) should also be advised. To safely and effectively increase folate intake in the elderly, naturally occurring folate-rich food sources should be promoted. Folate-rich foods include orange juice, dark green leafy vegetables, asparagus, strawberries and legumes. These foods are also excellent sources of other health-promoting nutrients associated with chronic disease risk reduction.

  20. [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. PMID:26775496

  1. [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.

  2. Relations among optimism, perceived health vulnerability, and academic, self-regulatory, and social self-efficacy in adolescent survivors of childhood cancer.

    PubMed

    Foster, Rebecca H; Russell, Claire C; Dillon, Robyn; Bitsko, Matthew J; Godder, Kamar; Stern, Marilyn

    2014-01-01

    This study investigated relations among optimism, perceived health vulnerability, treatment intensity, and academic, self-regulatory, and social self-efficacy in adolescent survivors of childhood cancer. Fifty-six adolescent survivors (Mage = 16.19 years, SD = 2.48) completed questionnaires. Compared to a previously published sample of adolescents without a history of cancer, survivors reported similar academic, higher self-regulatory, and lower social self-efficacy. Optimism and health vulnerability were associated with changes in academic, self-regulatory, and social self-efficacy. Cancer-specific variables (e.g., treatment intensity, time since treatment ended) were unrelated to self-efficacy. Interventions aimed at enhancing self-efficacy may benefit from exploring optimism and health vulnerabilities as mechanisms for change.

  3. Health economic analysis of the Swedish neonatal metabolic screening programme. A method of optimizing routines.

    PubMed

    Alm, J; Larsson, A; Rosenqvist, U

    1982-01-01

    A benefit-cost analysis was carried out to optimize the routines for neonatal metabolic screening. The basis of the study was provided by results of the Swedish neonatal screening programme from 1965 to 1979. During this period over one million infants were screened by the Guthrie test for phenylketonuria and galactosaemia, and for limited periods also for tyrosinaemia, homocystinuria and histidinaemia. The benefit-cost ratio was calculated for combinations of different screening tests, recall routines, and varying degrees of coverage. The largest benefit-cost ratio was obtained with combined screening for phenylketonuria and galactosaemia, using a borderline blood phenylalanine level of 0.50 mmol/L in the Guthrie test for phenylketonuria. However, the inaccuracy of this test necessitated the use of a lower blood phenylalanine level of 0.25 mmol/L and the acceptance of a lower benefit-cost ratio. An increase in the present 98% coverage of newborns by the screening programme was found to be an effective means of improving the benefit-cost ratio in the present programme.

  4. Optimizing learning in healthcare: how Island Health is evolving to learn at the speed of change.

    PubMed

    Gottfredson, Conrad; Stroud, Carol; Jackson, Mary; Stevenson, R Lynn; Archer, Jana

    2014-01-01

    Healthcare organizations are challenged with constrained resources and increasing service demands by an aging population with complex care needs. Exponential growth in competency requirements also challenges staff's ability to provide quality patient care. How can a healthcare organization support its staff to learn "at or above the speed of change" while continuing to provide the quality patient care? Island Health is addressing this challenge by transforming its traditional education model into an innovative, evidence-based learning and performance support approach. Implementation of the methodology is yielding several lessons learned, both for the internal Learning and Performance Support team, and for what it takes to bring a new way of doing business into an organization. A key result is that this approach is enabling the organization to be more responsive in helping staff gain and maintain competencies.

  5. Achieving optimal SERS through enhanced experimental design

    PubMed Central

    Fisk, Heidi; Westley, Chloe; Turner, Nicholas J.

    2016-01-01

    One of the current limitations surrounding surface‐enhanced Raman scattering (SERS) is the perceived lack of reproducibility. SERS is indeed challenging, and for analyte detection, it is vital that the analyte interacts with the metal surface. However, as this is analyte dependent, there is not a single set of SERS conditions that are universal. This means that experimental optimisation for optimum SERS response is vital. Most researchers optimise one factor at a time, where a single parameter is altered first before going onto optimise the next. This is a very inefficient way of searching the experimental landscape. In this review, we explore the use of more powerful multivariate approaches to SERS experimental optimisation based on design of experiments and evolutionary computational methods. We particularly focus on colloidal‐based SERS rather than thin film preparations as a result of their popularity. © 2015 The Authors. Journal of Raman Spectroscopy published by John Wiley & Sons, Ltd. PMID:27587905

  6. 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.

  7. 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. PMID:25751207

  8. Optimizing respiratory function assessments to elucidate the impact of obesity on respiratory health.

    PubMed

    Brazzale, Danny J; Pretto, Jeffrey J; Schachter, Linda M

    2015-07-01

    There is an increasing prevalence of obesity worldwide and its impact on respiratory health is of significant concern. Obesity affects the respiratory system by several mechanisms, including by direct mechanical changes due to fat deposition in the chest wall, abdomen and upper airway, as well as via systemic inflammation. The increased mechanical load in obese individuals leads to reduced chest wall and lung compliance and increased work of breathing. While there is generally minimal effect on spirometric values, as body mass index increases, the expiratory reserve volume, and hence functional residual capacity, reduces, often approaching residual volume in more severe obesity. The majority of evidence however suggests that obese individuals free from lung disease have relatively normal gas exchange. The link between asthma and obesity, while initially unclear, is now recognized as being a distinct asthma phenotype. While studies investigating objective markers of asthma have shown that there is no association between obesity and airway hyper-responsiveness, a recent working group identified obesity as a major risk factor for the development of asthma in all demographic groups. Although the temptation may be to attribute obesity as the cause of dyspnoea in symptomatic obese patients, accurate respiratory assessment of these individuals is necessary. Lung function tests can confirm that any altered physiology are the known respiratory consequences of obesity. However, given that obesity causes minimal changes in lung function, significant abnormalities warrant further investigation. An important consideration is the knowledge that many of the respiratory physiology consequences of obesity are reversible by weight loss.

  9. 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

  10. Effects of aging in Masters swimmers: 40-year review and suggestions for optimal health benefits.

    PubMed

    Rubin, Robert T; Rahe, Richard H

    2010-04-07

    The Masters Swimming Program is over 40 years old and has achieved international status, with thousands of participants competing in five-year age categories between 18 and 99. Early studies of Masters swimmers by age groups found an increase in times for most events of about 1% per year, and later studies showed a significant correlation with the age-associated decline in maximal oxygen uptake. As larger sample sizes have become available, the age-related decline in performance among national champion Masters swimmers, both men and women, and for both short and longer swims, has been shown to be linear at about 0.6% per year up to age 70. Beyond age 70, the age-related decline accelerates exponentially for both men and women, with considerably more variability than in younger age groups. Several factors may be related to the accelerated performance decline beyond the of age 70, including accelerated physiological aging, chronic physical disabilities, acute illnesses requiring relatively lengthy recovery, effects of multiple medications, and social issues such as transportation problems, all of which can lead to increasing difficulty in maintaining a regular workout schedule. Masters Swimming is a "user-friendly" aerobic sport, imposing little excess strain, and thus is particularly suitable for the elderly. Masters coaches are gaining increasing experience with the over-70 age groups, tailoring workouts to accommodate their need for longer warm-up periods, longer rest periods between swimming sets, less overall distance, less emphasis on "breath control", and more time between workouts. With these accommodations, the motivation of elderly Masters swimmers to compete remains strong, and their ranks should continue to increase.

  11. 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…

  12. 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

  13. 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…

  14. Practical Management Concerns regarding the Use of Health-Related, Motor and Skill Tests to Achieve Sex-Fair Ability Groupings.

    ERIC Educational Resources Information Center

    Fuller, Janet

    There are many advantages and disadvantages of ability tests for sex-fairness. Several types of assessment criteria for sex-fair ability grouping could be used in fitness-related activities in the curriculum. Health-related physical fitness tests, designed to measure an individual's health fitness and provide for individual improvement, are not…

  15. 'Excuse me, do any of you ladies speak English?' Perspectives of refugee women living in South Australia: barriers to accessing primary health care and achieving the Quality Use of Medicines.

    PubMed

    Clark, Alice; Gilbert, Andrew; Rao, Deepa; Kerr, Lorraine

    2014-01-01

    Reforms to the Australian health system aim to ensure that services are accessible, clinically and culturally appropriate, timely and affordable. During the reform consultation process there were urgent calls from stakeholders to specifically consider the health needs of the thousands of refugees who settle here each year, but little is known about what is needed from the refugee perspective. Access to health services is a basic requirement of achieving the quality use of medicines, as outlined in Australia's National Medicines Policy. This study aimed to identify the barriers to accessing primary health care services and explore medicine-related issues as experienced by refugee women in South Australia. Thirty-six women participated in focus groups with accredited and community interpreters and participants were from Sudan, Burundi, Congo, Burma, Afghanistan and Bhutan who spoke English (as a second language), Chin, Matu, Dari and Nepali. The main barrier to accessing primary health care and understanding GPs and pharmacists was not being able to speak or comprehend English. Interpreter services were used inconsistently or not at all. To implement the health reforms and achieve the quality use of medicines, refugees, support organisations, GPs, pharmacists and their staff require education, training and support.

  16. User preferences and usability of iVitality: optimizing an innovative online research platform for home-based health monitoring

    PubMed Central

    van Osch, Mara; Rövekamp, AJM; Bergman-Agteres, Stephanie N; Wijsman, Liselotte W; Ooms, Sharon J; Mooijaart, Simon P; Vermeulen, Joan

    2015-01-01

    Background The iVitality online research platform has been developed to gain insight into the relationship between early risk factors (ie, poorly controlled hypertension, physical or mental inactivity) and onset and possibly prevention of dementia. iVitality consists of a website, a smartphone application, and sensors that can monitor these indicators at home. Before iVitality can be implemented, it should fit the needs and preferences of users, ie, offspring of patients with dementia. This study aimed to explore users’ motivation to participate in home-based health monitoring research, to formulate requirements based on users’ preferences to optimize iVitality, and to test usability of the smartphone application of iVitality. Methods We recruited 13 participants (aged 42–64 years, 85% female), who were offspring of patients with dementia. A user-centered methodology consisting of four iterative phases was used. Three semistructured interviews provided insight into motivation and acceptance of using iVitality (phase 1). A focus group with six participants elaborated on expectations and preferences regarding iVitality (phase 2). Findings from phase 1 and 2 were triangulated by two semistructured interviews (phase 3). Four participants assessed the usability of the smartphone application (phase 4) using a think aloud procedure and a questionnaire measuring ease and efficiency of use (scale 1–7; higher scores indicated better usability). Results All participants were highly motivated to contribute to dementia research. However, the frequency of home-based health monitoring should not be too high. Participants preferred to receive feedback about their measurements and information regarding the relationship between these measurements and dementia. Despite minor technical errors, iVitality was considered easy and efficient to use (mean score 5.50, standard deviation 1.71). Conclusion Offspring of patients with dementia are motivated to contribute to home

  17. 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

  18. [The optimization of the use of economic resources for vaccination against hepatitis B in professionals in the health area].

    PubMed

    Ferraz, M L; de Oliveira, P M; Figueiredo, V M; Kemp, V L; Castelo Filho, A; Silva, A E

    1995-01-01

    In order to optimize the employment of financial resources to be allocated for hepatitis B vaccination programs involving health care workers, two different aspects were studied: the need of a pre-vaccination screening and the efficacy of low-doses schedules of HBV vaccine by the intradermal (ID) route. The economical analysis (a cost-minimization study) showed that when the prevalence of immune individuals is higher than 11% it is more cost-effective to perform pre-vaccination screening. This situation was observed in the employees group. For students and doctors vaccination without screening was the best approach. Regarding the schedules, 3 doses of HBV vaccine by the intramuscular (IM) route (group A) were compared to first dose by the ID route and second and third doses by the IM route (group B) and to first and second doses by the ID route and the last dose by the IM route (group C). After the third dose, soroconversion rates in groups A and B (92% and 93%, respectively) and geometric mean titers of antiHBs (1278 UI/L and 789.6 UI/L) were similar, and both were different from group A (p < 0.05), showing that alternative vaccination schedules may be cost-effective.

  19. Associations between Health-Related Physical Fitness, Academic Achievement and Selected Academic Behaviors of Elementary and Middle School Students in the State of Mississippi

    ERIC Educational Resources Information Center

    Blom, Lindsey C.; Alvarez, John; Zhang, Lei; Kolbo, Jerome

    2011-01-01

    A wide variety of school-based physical activity contexts have been recently associated with various measures of academic performance. Of these studies, a small number employing objective measures of student fitness have identified a relationship with academic achievements. However, even among these studies, the fitness-academic link has not been…

  20. 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…

  1. Optimism/pessimism and health-related quality of life during pregnancy across three continents: a matched cohort study in China, Ghana, and the United States

    PubMed Central

    Moyer, Cheryl A; Yang, Huixia; Kwawukume, Yao; Gupta, Anu; Zhu, YuChun; Koranteng, Isaac; Elsayed, Yasmin; Wei, YuMei; Greene, Jonathan; Calhoun, Cecilia; Ekpo, Geraldine; Beems, Megan; Ryan, Megan; Adanu, Richard; Anderson, Frank

    2009-01-01

    Background Little is known about how optimism/pessimism and health-related quality of life compare across cultures. Methods Three samples of pregnant women in their final trimester were recruited from China, Ghana, and the United States (U.S.). Participants completed a survey that included the Life Orientation Test - Revised (LOT-R, an optimism/pessimism measure), the Short Form 12 (SF-12, a quality of life measure), and questions addressing health and demographic factors. A three-country set was created for analysis by matching women on age, gestational age at enrollment, and number of previous pregnancies. Anovas with post-hoc pairwise comparisons were used to compare results across the cohorts. Multivariate regression analysis was used to create a model to identify those variables most strongly associated with optimism/pessimism. Results LOT-R scores varied significantly across cultures in these samples, with Ghanaian pregnant women being the most optimistic and least pessimistic and Chinese pregnant women being the least optimistic overall and the least pessimistic in subscale analysis. Four key variables predicted approximately 20% of the variance in overall optimism scores: country of origin (p = .006), working for money (p = .05); level of education (p = .002), and ever being treated for emotional issues with medication (p < .001). Quality of life scores also varied by country in these samples, with the most pronounced difference occurring in the vitality measure. U.S. pregnant women reported far lower vitality scores than both Chinese and Ghanaian pregnant women in our sample. Conclusion This research raises important questions regarding what it is about country of origin that so strongly influences optimism/pessimism among pregnant women. Further research is warranted exploring underlying conceptualization of optimism/pessimism and health related quality of life across countries. PMID:19723332

  2. Two Decades of Serving Children with Autism in the People's Republic of China: Achievements and Challenges of a State-Run Mental Health Center

    ERIC Educational Resources Information Center

    McCabe, Helen

    2008-01-01

    This article presents the results of research conducted at the first place where autism was diagnosed in China, the Nanjing Child Mental Health Research Center. The purpose was to examine the development of service provision for children with autism in this state-run medical institution. Specifically, the specific intervention model for autism,…

  3. 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,…

  4. 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…

  5. Problem-solving for better health.

    PubMed

    Smith, B; Barnett, S; Collado, D; Connor, M; DePasquale, J; Gross, L; McDermott, V; Sykes, A

    1994-01-01

    An outline is given of an approach to the health-for-all goals which involves optimizing resource use, prioritizing people's well-being, achieving excellence and a measurable impact at all levels of care, and solving health problems in a broad developmental context. PMID:8141991

  6. A Tuesday in the life of a flourisher: the role of positive emotional reactivity in optimal mental health.

    PubMed

    Catalino, Lahnna I; Fredrickson, Barbara L

    2011-08-01

    Flourishing--a state of optimal mental health--has been linked to a host of benefits for the individual and society, including fewer workdays lost and the lowest incidence of chronic physical conditions. The aim of this paper was to investigate whether and how routine activities promote flourishing. The authors proposed that flourishers thrive because they capitalize on the processes featured in the broaden-and-build theory of positive emotions, specifically by experiencing greater positive emotional reactivity to pleasant events and building more resources over time. To test these hypotheses, the Day Reconstruction Method (DRM) was administered to a prescreened community sample of adults (n = 208), and they were recontacted two to three months later. Results showed that relative to those who did not flourish or were depressed, people who flourish generally responded with bigger "boosts" in positive emotions in response to everyday, pleasant events (helping, interacting, playing, learning, spiritual activity), and this greater positive emotional reactivity, over time, predicted higher levels of two facets of the cognitive resource of mindfulness. In turn, these higher levels of mindfulness were positively associated with higher levels of flourishing at the end of study, controlling for initial levels of flourishing. These results suggest that the promotion of well-being may be fueled by small, yet consequential differences in individuals' emotional experience of pleasant everyday events. Additionally, these results underscore the utility of the broaden-and-build theory in understanding the processes by which flourishing is promoted and provide support for a positive potentiation perspective. PMID:21859208

  7. 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

  8. Health.

    ERIC Educational Resources Information Center

    Winslow, Kate

    1980-01-01

    Indians have the lowest life expectancy of any group in the US; the general state of Indian health lags 25 years behind the rest of the population. Article discusses problems of health delivery systems, alternative approaches to health care, and some of the most pressing health problems. (DS)

  9. 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

  10. 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

    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.

  11. Potential Causal Relationship Between Depressive Symptoms and Academic Achievement in the Hawaiian High Schools Health Survey Using Contemporary Longitudinal Latent Variable Change Models

    PubMed Central

    Hishinuma, Earl S.; Chang, Janice Y.; McArdle, John J.; Hamagami, Fumiaki

    2012-01-01

    There is a relatively consistent negative relationship between adolescent depressive symptoms and educational achievement (e.g., grade-point average [GPA]). However, we are less certain of the causal direction for this association due to the lack of longitudinal data with both indicators measured across at least two time periods, and due to the lack of application of more sophisticated contemporary statistical techniques. We present multivariate results from a large longitudinal cohort-sequential study of high school students (N = 7,317) with measures of self-reported depressive symptoms and self-reported GPAs across multiple time points (following McArdle, 2009; McArdle et al., 2001) using an ethnically diverse sample from Hawai‘i. Contemporary statistical techniques included: bivariate dynamic structural equation modeling (DSEM); multi-group gender-and-ethnic DSEMs; ordinal scale measurement of key outcomes; and imputation for incomplete longitudinal data. The findings suggest that depressive symptoms affect subsequent academic achievement, and not the other way around, especially for Native Hawaiians as compared to non-Hawaiian females. We further discuss the scientific, applied, and methodological-statistical implications of the results, including the need for further theorizing and research on mediating variables. We also discuss the need for increased prevention, early intervention, screening, identification, and treatment of depressive symptoms and disorders. Finally, we argue for utilization of more contemporary methodological-statistical techniques, especially when violating parametric-test assumptions. PMID:22268606

  12. Self-Beliefs and Student Goal Achievement

    ERIC Educational Resources Information Center

    Wesson, Caroline J.; Derrer-Rendall, Nicola M.

    2011-01-01

    Two preliminary studies are presented investigating the self-beliefs that may affect goal achievement in a student population. In Study 1, goal achievement on an abstract task, where goals are externally set by others, is considered in relation to students' levels of optimism. In Study 2, goal achievement on academic performance, where goals are…

  13. Achieving pregnancy safely: perspectives on timed vaginal insemination among HIV-serodiscordant couples and health-care providers in Kisumu, Kenya.

    PubMed

    Mmeje, Okeoma; van der Poel, Sheryl; Workneh, Meklit; Njoroge, Betty; Bukusi, Elizabeth; Cohen, Craig R

    2015-01-01

    In female-positive HIV-serodiscordant couples desiring children, home timed vaginal insemination (TVI) of semen during the fertile period along with consistent condom use may reduce the risk of HIV transmission when the man is HIV-uninfected. In sub-Saharan Africa, up to 45% of HIV-infected women desire to have more children. HIV viral load assessment is not routinely available in low-resource countries for monitoring adherence and response to antiretroviral therapy. Therefore, in these settings, timed unprotected intercourse without assurance of HIV viral suppression may pose unnecessary risks. TVI, a simple and affordable intervention, can be considered an adjunct method and option of safer conception for HIV prevention with treatment of the HIV-infected partner and/or pre-exposure prophylaxis. We conducted five mixed and single-sex focus group discussions comprised of 33 HIV-serodiscordant couples and health-care providers in the Nyanza region of Kenya to assess the acceptability and feasibility of TVI as a safer method of conception. The transcribed data were analyzed using a grounded theory approach. We found that educating and counseling HIV-serodiscordant couples on TVI could make it an acceptable and feasible safer conception method when associated with frequent communication and home visits by health-care providers. The findings of this study indicate that implementation studies that integrate training and counseling of HIV-serodiscordant couples and health-care providers on TVI combined with consistent condom use are needed. Acknowledging and supporting the reproductive choice and needs of female positive, male negative HIV-serodiscordant couples who desire children should also include the use of assisted reproductive services at the same time as pharmaceutical options that prevent sexual HIV transmission.

  14. Care Groups II: A Summary of the Child Survival Outcomes Achieved Using Volunteer Community Health Workers in Resource-Constrained Settings.

    PubMed

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

    2015-09-01

    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

  15. 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

  16. 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.

  17. 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…

  18. 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. PMID:27653048

  19. Hope, optimism and delusion.

    PubMed

    McGuire-Snieckus, Rebecca

    2014-04-01

    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?

  20. 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